PAGD Keystone Explorer Winter 2020

6 www.pagd.org Q dentistry issues T o scan, or not to scan, that is the question. Is there a straightforward case? These are some of the common questions that endodontists face in their daily practices. In endodontics, clinical examination and diagnostic imaging are both essential components of the preoperative diagnosis. Cone Beam Computed Tomography is a diagnostic imaging modality that provides high-quality, accurate 3-D representations of the osseous elements of the maxillofacial skeleton. CBCT has great potential to become a valuable tool in modern endodontic practice. The addition of subjective and objective clinical findings to CBCT should allow for an even more accurate clinical diagnosis and appropriate treatment plan. Accurate diagnosis leads to confident treatment planning, which is an integral part of the endodontic decision- making process. Conventional 2-D radiographs continue to be the most popular method of imaging today. However, the diagnostic potential of periapical radiographs is limited. The different applications of CBCT in diagnosis, treatment planning and long-term outcome evaluation are well documented in the endodontic literature. 1–8 In 2015, a revised joint AAE/AAOMR position statement on the use of limited field of view CBCT in endodontics was published. 9 The impact of CBCT in nonsurgical and surgical treatment planning was evaluated in several recent studies. 10–12 A recently published prospective observational study evaluated the outcome of CBCT examinations performed in a clinical setting and the impact on diagnosis before CBCT examination (Stage 1) and after CBCT examination (Stage 2). 10 The results of the study demonstrated a change in diagnosis in 22 patients (42 percent) between Stage 1 and Stage 2. Treatment planning decisions using CBCT versus intraoral radiographs were compared to the gold standard diagnosis. 11 An accurate diagnosis was reached in 36.6 percent TO SCAN OR NOT TO SCAN, T H A T I S T H E Q U E S T I O N By Dr. Mohamed Fayad Accurate diagnosis leads to confident treatment planning, which is an integral part of the endodontic decision- making process. Conventional 2-D radiographs continue to be the most popular method of imaging today. However, the diagnostic potential of periapical radiographs is limited.