The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics.
OBJECTIVE
The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems.


METHODS
The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis.


RESULTS
4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%).


CONCLUSIONS
CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.
Department of Endodontics, Tandvårdens Kompetenscentrum, Luleå, Sweden;
F J
FJ
Mota de Almeida
K
K
Knutsson
L
L
Flygare
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003657:Decision Making; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004708:Endodontics; D005060:Europe; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D012390:Root Canal Therapy / Q000379:methods*; D019227:Tooth Apex / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000000981:diagnostic imaging; D055815:Young Adult
cone beam computed tomography; decision-making; endodontics; therapeutics