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Updated: Sep 10, 2025

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A Grading System for Pulp Canal Calcification Based Upon 3-D Imaging to Aid in Assessment of Case Difficulty in
Paul Cruci1, Allen Gaon1, Mitul Patel1
1Institute of Dentistry, Queen Mary University of London, London, UK.
Introduction:
This article describes a novel grading system for quantifying potential difficulty in locating and instrumenting root canals where there is evidence of calcification.
Methods:
The system is based upon limited field of view cone beam computed tomography which is an essential tool in the diagnosis and treatment of the calcified canal.
Results:
The new grading system considers the vertical level at which the canal becomes radiographically evident (coronal, middle or apical), the length of patent canal, and whether the canal is patent at the terminus.
Conclusions:
At present there is no classification for canal calcification and no means of categorizing a canal in terms of the potential difficulty/feasibility involved in treating it. It is hoped that this novel grading system will be useful in treatment decision making.
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