AIM To compare conventional radiographic and cone beam computed tomography (CBCT) findings with reference to the American-Association-of-Endodontics and American-Academy-of-Oral-and-Maxillofacial-Radiology (AAE/AAOMR) joint position statement and to determine the effect of the CBCT on the initial diagnoses and treatment plans in a single centre Postgraduate Endodontic Programme. METHODOLOGY The clinical CBCT scans of patients, treated at the Endodontic Department of the University of the British Columbia, were reviewed for CBCT referrals by comparing it with corresponding radiographs. The features considered were periapical lesions, missed/extra canals, root fractures, complex anatomy, calcified canals and root resorption of tooth /teeth in question. Reasons for the CBCT prescriptions were assigned to 3 groups: to formulate the primary diagnosis, to confirm the diagnosis achieved by clinical examination and conventional radiographs, and to assist in treatment planning. Variables were compared statistically using Chi-square and McNemar tests. RESULTS A total of 128 CBCT examinations were performed on 110 patients. No CBCT examination was performed more than once on the same tooth. Overall, 76% of CBCT examinations were performed on previously root filled teeth. CBCT mages revealed a significantly higher incidence of periapical lesions (P = 0.002), missed canals (P < 0.001) and vertical root fractures (P = 0.004) than periapical radiographs. CBCT was prescribed most frequently to assist surgical treatment planning (62%) rather than for generating a diagnosis (9%) or confirming diagnoses (29%). Both the diagnosis (P = 0.001) and the treatment plan (P = 0.005) initially made by examining periapical radiographs were altered significantly by the subsequent CBCT examination by revealing information such as new periapical lesions, missed canals or involvement of buccal or lingual cortical bone. CONCLUSION The CBCT examinations were prescribed mainly to assist treatment-planning rather than for diagnosis. The majority of CBCT examinations were performed on previously root filled teeth. The additional information obtained from CBCT scans resulted in the alteration of the initial diagnoses as well as subsequent treatment plans in 59 out of 128 cases.

中文翻译：

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在牙髓病例中，临床决策和AAOMR / AAE位置声明对CBCT检查的重要性。

目的比较常规放射影像学和锥形束计算机断层扫描（CBCT）的发现，并参考美国牙髓学会和美国口腔颌面放射学学会（AAE / AAOMR）的关节位置说明，并确定CBCT对单个中心研究生牙髓治疗计划中初始诊断和治疗计划的影响。方法学将不列颠哥伦比亚大学牙髓系接受治疗的患者的临床CBCT扫描与相应的X射线照片进行比较，以检查CBCT的转诊情况。所考虑的特征是根尖周病变，根管缺失/根管，根部骨折，复杂的解剖结构，钙化的根管以及所讨论的牙齿/牙齿的根吸收。CBCT处方的原因分为3组：制定初步诊断，以确定通过临床检查和常规X射线照片所获得的诊断，并协助制定治疗计划。使用卡方检验和McNemar检验对变量进行统计比较。结果共对110例患者进行了128次CBCT检查。对同一颗牙齿进行的CBCT检查不止一次。总体而言，76％的CBCT检查是在先前已根充牙齿上进行的。CBCT法师发现根尖周X线片显着高于根尖周片（P = 0.002），遗漏根管（P <0.001）和垂直根部骨折（P = 0.004）。处方CBCT最常用于辅助手术治疗计划（62％），而不是产生诊断（9％）或确诊（29％）。诊断（P = 0.001）和治疗计划（P = 0。005）最初通过检查根尖周X光片制作而成，随后的CBCT检查通过显露信息，例如新的根尖周皮病变，漏道或颊侧或舌侧皮质骨受累，而发生了显着改变。结论CBCT检查主要是为了帮助治疗计划而不是诊断。大部分CBCT检查都是在先前已根充牙齿上进行的。从CBCT扫描中获得的其他信息导致128例病例中的59例的最初诊断和后续治疗方案发生了变化。结论CBCT检查主要是为了帮助治疗计划而不是诊断。大部分CBCT检查都是在先前已根充牙齿上进行的。从CBCT扫描中获得的其他信息导致128例病例中的59例的最初诊断和后续治疗方案发生了变化。结论CBCT检查主要是为了帮助治疗计划而不是诊断。大部分CBCT检查都是在先前已根充牙齿上进行的。从CBCT扫描中获得的其他信息导致128例病例中的59例的最初诊断和后续治疗方案发生了变化。