ASSESSMENT OF CONE BEAM COMPUTED TOMOGRAPHY SCANS REFERRAL REASONS AND ITS IMPACT ON MODIFYING TREATMENT PLAN IN ENDODONTICS

Abstract

BACKGROUND: Radiographs taken intra-orally are essential for planning a diagnosis; however the resulting two-dimensional images require thorough interpretation. Cone beam computed Tomographic (CBCT) imaging offers a more precise, three-dimensional image that could aid in proper diagnosis and treatment planning in endodontic and endo-periodontal cases. OBJECTIVES: Assessment of CBCT referral reasons to private radiology centers, and its impact on modifying treatment plan in endodontic and endo-periodontal related cases. MATERIALS AND METHODS: This cross-sectional study comprised a total of 131 patients, who visited private radiology centers in Alexandria, seeking CBCT scans, from July 2021to June 2022: All scans were inspected for assessing referral reasons; referring dentists were asked about their reason for CBCT acquisition, and its effect on their diagnosis and treatment plan. Assessed cases were categorized into either a group of teeth with solitary endodontic-related problem or teeth with an endodontic-periodontal - related problem. RESULTS: The number of teeth found with endo-periodontal radiographic problems in the CBCT scans was significantly lower than solitary endodontic cases (n=14, 8.4%,n=152, 91.5% respectively). Also, a significant difference was detected between those referred cases with endodontic-Periodontal lesions that were not previously root canal treated and those endodontic related cases that received earlier endodontic treatment (p=0.004*) , CBCT had a positive effect on changing the endodontists’ diagnosis and treatment plan, especially in endodontic-periodontal cases (p<0.01 ٭ ). CONCLUSION: CBCT is considered crucial for detection and proper diagnosis of endo-perio lesions. For all endodontic cases with missed canals, calcified canals and inflammatory resorptive defects