The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning

Sami Chogle; Maan Zuaitar; Ramzi Sarkis; Manal Saadoun; Anthony Mecham; Yihong Zhao

doi:https://doi.org/10.1016/j.joen.2019.10.034

The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning

Sami Chogle, Maan Zuaitar, Ramzi Sarkis, Manal Saadoun, Anthony Mecham, Yihong Zhao

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Introduction: Although intraoral radiographs are foundational for diagnosis and planning treatment in dentistry, the resulting 2-dimensional image varies in interpretation requiring judgment. Cone-beam computed tomographic imaging provides a more detailed 3-dimensional image that may affect treatment recommendations. This study aimed to determine the basis for CBCT recommendations and the effect on diagnosis and treatment planning. Methods: The study involved a sample of 45 cases that presented for endodontic treatment, 30 with a CBCT scan on record and 15 without. For phase 1, all 45 cases were reviewed by 3 examiners without access to the CBCT scans. For phase 2, 4 months later, the 3 examiners reanalyzed the 30 cases, this time with the associated CBCT scan. Intra- and interexaminer agreements were recorded and analyzed. Also, the recommendations for CBCT were compared with the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology joint statement. Results: Interexaminer agreement in phases 1 and 2 was 65% and 72%, respectively. For endodontic diagnoses, there was a 19% change in the pulpal diagnosis category when CBCT imaging was added, whereas there was a 30% change in the apical category. The selections changed in 55% of the cases when determining etiology and in 49% of the cases when making recommendations. CBCT imaging was recommended 78.8% of the time when the case had a CBCT on record versus 33% of the time in cases without. Conclusions: CBCT imaging has a significant effect in determining the etiology of endodontic pathoses and in recommending treatment. Furthermore, CBCT imaging is not overprescribed in the endodontic department, and the faculty members adhere to the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology recommendations.

Original language	English (US)
Pages (from-to)	162-168
Number of pages	7
Journal	Journal of Endodontics
Volume	46
Issue number	2
DOIs	https://doi.org/10.1016/j.joen.2019.10.034
State	Published - Feb 2020
Externally published	Yes

ASJC Scopus subject areas

Dentistry(all)

Keywords

Agreement
cone-beam computed tomography
diagnosis
recommendation

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https://doi.org/10.1016/j.joen.2019.10.034

Cite this

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title = "The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning",

abstract = "Introduction: Although intraoral radiographs are foundational for diagnosis and planning treatment in dentistry, the resulting 2-dimensional image varies in interpretation requiring judgment. Cone-beam computed tomographic imaging provides a more detailed 3-dimensional image that may affect treatment recommendations. This study aimed to determine the basis for CBCT recommendations and the effect on diagnosis and treatment planning. Methods: The study involved a sample of 45 cases that presented for endodontic treatment, 30 with a CBCT scan on record and 15 without. For phase 1, all 45 cases were reviewed by 3 examiners without access to the CBCT scans. For phase 2, 4 months later, the 3 examiners reanalyzed the 30 cases, this time with the associated CBCT scan. Intra- and interexaminer agreements were recorded and analyzed. Also, the recommendations for CBCT were compared with the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology joint statement. Results: Interexaminer agreement in phases 1 and 2 was 65% and 72%, respectively. For endodontic diagnoses, there was a 19% change in the pulpal diagnosis category when CBCT imaging was added, whereas there was a 30% change in the apical category. The selections changed in 55% of the cases when determining etiology and in 49% of the cases when making recommendations. CBCT imaging was recommended 78.8% of the time when the case had a CBCT on record versus 33% of the time in cases without. Conclusions: CBCT imaging has a significant effect in determining the etiology of endodontic pathoses and in recommending treatment. Furthermore, CBCT imaging is not overprescribed in the endodontic department, and the faculty members adhere to the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology recommendations.",

keywords = "Agreement, cone-beam computed tomography, diagnosis, recommendation",

author = "Sami Chogle and Maan Zuaitar and Ramzi Sarkis and Manal Saadoun and Anthony Mecham and Yihong Zhao",

note = "Funding Information: The authors thank Dr Hongsheng Liu for his great contribution to this study and Ms Sharon Rich for her outstanding analysis of the data. Supported in part by a research grant from the American Association of Endodontists Foundation . The authors deny any conflicts of interest related to this study. Publisher Copyright: {\textcopyright} 2019 American Association of Endodontists",

year = "2020",

month = feb,

doi = "https://doi.org/10.1016/j.joen.2019.10.034",

language = "English (US)",

volume = "46",

pages = "162--168",

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T1 - The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning

AU - Chogle, Sami

AU - Zuaitar, Maan

AU - Sarkis, Ramzi

AU - Saadoun, Manal

AU - Mecham, Anthony

AU - Zhao, Yihong

N1 - Funding Information: The authors thank Dr Hongsheng Liu for his great contribution to this study and Ms Sharon Rich for her outstanding analysis of the data. Supported in part by a research grant from the American Association of Endodontists Foundation . The authors deny any conflicts of interest related to this study. Publisher Copyright: © 2019 American Association of Endodontists

PY - 2020/2

Y1 - 2020/2

N2 - Introduction: Although intraoral radiographs are foundational for diagnosis and planning treatment in dentistry, the resulting 2-dimensional image varies in interpretation requiring judgment. Cone-beam computed tomographic imaging provides a more detailed 3-dimensional image that may affect treatment recommendations. This study aimed to determine the basis for CBCT recommendations and the effect on diagnosis and treatment planning. Methods: The study involved a sample of 45 cases that presented for endodontic treatment, 30 with a CBCT scan on record and 15 without. For phase 1, all 45 cases were reviewed by 3 examiners without access to the CBCT scans. For phase 2, 4 months later, the 3 examiners reanalyzed the 30 cases, this time with the associated CBCT scan. Intra- and interexaminer agreements were recorded and analyzed. Also, the recommendations for CBCT were compared with the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology joint statement. Results: Interexaminer agreement in phases 1 and 2 was 65% and 72%, respectively. For endodontic diagnoses, there was a 19% change in the pulpal diagnosis category when CBCT imaging was added, whereas there was a 30% change in the apical category. The selections changed in 55% of the cases when determining etiology and in 49% of the cases when making recommendations. CBCT imaging was recommended 78.8% of the time when the case had a CBCT on record versus 33% of the time in cases without. Conclusions: CBCT imaging has a significant effect in determining the etiology of endodontic pathoses and in recommending treatment. Furthermore, CBCT imaging is not overprescribed in the endodontic department, and the faculty members adhere to the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology recommendations.

AB - Introduction: Although intraoral radiographs are foundational for diagnosis and planning treatment in dentistry, the resulting 2-dimensional image varies in interpretation requiring judgment. Cone-beam computed tomographic imaging provides a more detailed 3-dimensional image that may affect treatment recommendations. This study aimed to determine the basis for CBCT recommendations and the effect on diagnosis and treatment planning. Methods: The study involved a sample of 45 cases that presented for endodontic treatment, 30 with a CBCT scan on record and 15 without. For phase 1, all 45 cases were reviewed by 3 examiners without access to the CBCT scans. For phase 2, 4 months later, the 3 examiners reanalyzed the 30 cases, this time with the associated CBCT scan. Intra- and interexaminer agreements were recorded and analyzed. Also, the recommendations for CBCT were compared with the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology joint statement. Results: Interexaminer agreement in phases 1 and 2 was 65% and 72%, respectively. For endodontic diagnoses, there was a 19% change in the pulpal diagnosis category when CBCT imaging was added, whereas there was a 30% change in the apical category. The selections changed in 55% of the cases when determining etiology and in 49% of the cases when making recommendations. CBCT imaging was recommended 78.8% of the time when the case had a CBCT on record versus 33% of the time in cases without. Conclusions: CBCT imaging has a significant effect in determining the etiology of endodontic pathoses and in recommending treatment. Furthermore, CBCT imaging is not overprescribed in the endodontic department, and the faculty members adhere to the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology recommendations.

KW - Agreement

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KW - diagnosis

KW - recommendation

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The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning

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Keywords

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