Clinical Significance
Preoperative CBVT images offer more information that is
Hands OnCone-beam volumetric tomography
Section snippets
Background
Conventional two-dimensional (2D) radiography is the most popular method of imaging today and provides a cost-effective, high-resolution image, but it offers limited diagnostic potential. Cone-beam volumetric tomographic (CBVT) imaging, or cone-beam computed tomographic imaging, provides a three-dimensional (3D) image with a low radiation dose and the special resolution required for endodontic diagnosis and treatment planning. CBVT scanning offers some advantages over periapical radiographs but
Methods
Thirty endodontic cases were randomly selected for study. Each had a preoperative digital periapical radiograph and a CBVT scan. The 30 preoperative periapical radiographs were reviewed by three board-certified endodontists, then 2 weeks later the CBVT scans were reviewed in random order by the same evaluators. Evaluators selected a preliminary diagnosis and treatment plan based solely on their interpretation of the periapical and the CBVT images. The diagnosis and treatment plans were compared
Results
The diagnosis based on periapical radiographs matched the gold standard in 36.6% to 40% of the cases. The diagnosis based on CBVT diagnosis matched the gold standard in 76.6% to 83.3% of cases. A comparison of the treatment plans between the periapical and CBVT images found that 56.6% to 66.7% of them (62.2% overall) were altered after viewing the CBVT images (Fig 4).
Discussion
A high level of misdiagnosis in endodontic cases is potentially clinically relevant, especially when there is invasive cervical root resorption and vertical root fracture. In these cases, delayed detection can contribute to treatment failure and tooth loss. CBVT imaging provided more diagnostic information than the preoperative periapical radiographs and led to a change in treatment plans for a high number of cases.
References (0)
Cited by (0)
Ee J, Fayad MI, Johnson BR: Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography. J Endod 40:910-916, 2014
Reprints available from BR Johnson, Dept of Endodontics (MC 642), Univ of Illinois at Chicago, 801 S Paulina St, Chicago, IL 60612; e-mail: [email protected]
Copyright © 2014 Elsevier Inc. All rights reserved.