Cone Beam Computed Tomography
Diagnostic information directly influences clinical decisions. Accurate data facilitate better treatment-planning decisions and more predictable outcomes. CBCT is an emerging tech- nology with the potential to revolutionize the diagnosis and management of endodontic problems. An increasing number of specific applications of CBCT in endodontics are being identified as use of the technology becomes more wide- spread.
The benefits of a CBCT investigation must outweigh any potential risks; therefore, cases of endodontic disease should be judged on an individual basis. Until further evidence is available, CBCT should only be considered in situations where conventional imaging systems do not yield sufficient informa- tion to allow the appropriate management of the endodontic problem. The ALARA principle must be adhered to in all cases.
CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses and better resolution become available. However, the currently available literature in this field is mainly limited to technical details and diagnostic accuracy (levels 1 and 2 in a hierarch- ical model) and, even in these areas, the information avail- able is limited and incomplete.75 Further clinical trials are needed to provide insight on the increased efficacy possible with endodontic applications of CBCT, especially regarding patient outcome.
Furthermore, practitioners of CBCT must be adequately trained in CBCT radiology as well as in the interpretation of the images obtained, because the modality is completely different from conventional radiography. In summary, a cautious and rational approach is advised when considering the use of CBCT imaging in endodontics.