ROLE OF CONE BEAM COMPUTED TOMOGRAPHY IN ENDODONTICS: A SYSTEMATIC REVIEW

Abstract

The objective of this study was to assess the role of Cone Beam Computed tomography in the field of endodontics. In the last 30 years, digital imaging, as opposed to analogue imaging, has been developed and introduced. This has facilitated the development of advanced x ray imaging methods, notably computed tomography (CT). Recently, cone beam computed tomography (CBCT) has been developed that brings three dimensional imaging into the dental surgery and there have been several reports in the literature of using CBCT for endodontic imaging. CBCT does, however, have some drawbacks. First among these is the radiation dose which is higher than periapical radiographs. Its cost is high and availability is limited. In rational use of imaging, it is fundamental that benefits must outweigh risks. There is, therefore a need to develop evidence based guidelines for when CBCT should be considered in endodontic imaging. At present intra oral radiograph is the technique of choice for diagnosing, managing and assessing endodontic disease but it is well established that intra oral radiography is of limited use for detecting some critical endodontic problems. The lack of three dimensional information and masking of areas of interest by overlying anatomy is of particular relevance in endodontics. Cone beam computed tomography scans provides high quality accurate three dimensional
images of Dentomaxillofacial region and have replaced conventional computed tomography because of its reduced radiation dose. A systematic review was conducted in the University of Manchester. The literature related to the importance of Cone Beam Computed Tomography in endodontics was searched in several bibliographic databases such as Medline, Embase and Cocharane database of systematic reviews from 2000 to May 2008. This study showed an increasing trend of seeking Cone beam computed tomography in endodontic treatment however to recommend routine CBCT for periapical diagnosis is inappropriate with such limited evidence and an almost certain lack of costeffectiveness.