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CBCT influences endodontic therapeutic decision-making in immature traumatized teeth with suspected pulp necrosis: a before-after study
Umeå universitet, Medicinska fakulteten, Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM). Tandvårdens Kompetenscentrum, Norrbotten Public Dental Service, Luleå, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.ORCID-id: 0000-0002-8747-3307
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2021 (Engelska)Ingår i: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 50, nr 8, artikel-id 20200594Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To evaluate the impact of cone-beam computed tomography (CBCT) in endodontic therapeutic decision-making of immature traumatized teeth with suspected pulp necrosis.

Methods: Over two years, consecutive patients with a dental trauma in their front teeth (apex >0.5 mm) and with suspected pulp necrosis based on clinical and radiographic findings were referred to a specialist clinic in Sweden. Fifteen patients aged 6-13 (18 teeth) were included and clinically examined by an endodontist. Intraoral radiographs and CBCT examinations were obtained. Five practitioners, three endodontists and two residents in endodontics, used these examinations to determine the most appropriate treatment for the 18 cases (all central incisors) on two occasions scheduled 19 weeks apart. On the first occasion, the practitioners had access to clinical information and the intraoral radiographs ('before' CBCT); on the second occasion, the practitioners had also access to a radiologist report and the CBCT images ('after' CBCT). Their treatment plans - no treatment, watchful waiting, endodontic orthograde treatment, or extraction - were made anonymously and independently. Results were analysed using descriptive statistics and Wilcoxon signed-rank test.

Results: 'After' CBCT, practitioners changed treatment plans in 30% of the 90 assessments, 74% of which were more aggressive (p = 0.028). In 49% of the assessments, practitioners who chose the watchful and waiting treatment plan 'before' CBCT changed to a more aggressive therapy such as endodontic orthograde treatment and extraction 'after' CBCT (p = 0.005).

Conclusion: This study provides evidence that CBCT influences endodontic therapeutic decision-making regarding immature traumatised teeth with suspected pulp necrosis, chiefly when expectant management (i.e., watchful and waiting) was selected before access to CBCT.

Ort, förlag, år, upplaga, sidor
British Institute of Radiology (BIR) , 2021. Vol. 50, nr 8, artikel-id 20200594
Nyckelord [en]
Clinical Decision-Making, Cone-beam computed tomography, Dental Pulp Necrosis, Tooth Apex, Tooth Injuries
Nationell ämneskategori
Odontologi
Identifikatorer
URN: urn:nbn:se:umu:diva-190122DOI: 10.1259/dmfr.20200594ISI: 000730396600003PubMedID: 34086502Scopus ID: 2-s2.0-85120059455OAI: oai:DiVA.org:umu-190122DiVA, id: diva2:1617260
Forskningsfinansiär
Knut och Alice Wallenbergs StiftelseRegion VästerbottenSveriges TandläkarförbundTillgänglig från: 2021-12-06 Skapad: 2021-12-06 Senast uppdaterad: 2023-11-22Bibliografiskt granskad

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Brundin, MalinRomani Vestman, Nelly

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Brundin, MalinRomani Vestman, Nelly
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Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)Institutionen för odontologi
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Dento-Maxillo-Facial Radiology
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