الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cone beam computed Tomographic imaging offers a more precise, three-dimensional image that could aid in proper diagnosis and treatment planning in endodontic and endo-perio cases. CBCT is considered crucial for detection and proper diagnosis of Endo-Periodontal lesions. For all endodontic cases with missed canals, calcified canals and inflammatory resorptive defects, CBCT is deemed necessary.
For a total of 131 patients, who visited private radiology centers in Alexandria seeking for CBCT scan from July 2021to June 2022, all scans were inspected for assessing referral’s 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 endo-perio related problem. The number of teeth found with endo-perio 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 cases referred with endo-Perio lesions that were not previously root canal treated and those endodontic related cases that received earlier endodontic treatment (p=0.004*). Most of the cases inspected with endodontic related problems showed no post CBCT changes in diagnosis relative to the original endodontist’s diagnosis (n=111/123, 90.2%); but teeth referred with EPLs exhibited a changed diagnosis following inspection of the CBCT images (n=10, 71.4%) (p<0.001). Therefore, CBCT had a positive effect on changing endodontists’ diagnosis and treatment plan, especially in endodontic-periodontal cases. Practitioners should put into consideration that CBCT uses ionizing radiation so it should be handled with awareness, not as a standard procedure, being restricted to conventional radiography and following the current guidelines recommended by ESE, AAE/AAOOMR Joint Position Statement.
As we categorized findings according to the American Association of Endodontist (AAE) recommendations and American Association of oral and maxillofacial radiology (AAOMR) Joint Position Statement; CBCT scan in this study showed the fact that approximately 19.2% of cases were not falling under any category of the Joint Statement,i.e., missed canals of already root filled teeth, short obturation and pre-operative tracing of canals. Therefore, recommendation 3 should be extended to consider missed canals in already root filled teeth, which are being evaluated for re-treatment. It is suggested that AAE/AAOMR (2015) recommendation should be amended to reflect the finding of this study, or if this is not applicable, an entirely new recommendation addressing the hiatus should be considered.
In a recent research, there was a defect in the link between endodontist and radiologist, as CBCT request must contain all information that will guide the radiologist in scanning, and give more details about the main reason of referral.