Influence of Cone-beam Computed Tomography in Clinical Decision-making among Different Specialists in External Cervical Resorption Lesions: A Before-After Study

J Endod. 2022 Sep;48(9):1121-1128. doi: 10.1016/j.joen.2022.05.010. Epub 2022 Jun 8.

Abstract

Introduction: Inadequate management of external cervical resorption (ECR) lesions may impact the treatment outcome. This study aimed to ascertain the influence of cone-beam computed tomography (CBCT) in clinical decision-making choices in cases of ECR among dentistry specialists (endodontics, prosthodontics, oral surgery, periodontics orthodontics, and general dentistry). A secondary objective was to evaluate the self-reported level of difficulty in choosing a treatment plan before and after viewing the CBCT images.

Methods: Sixty examiners from different specialties were chosen to evaluate 12 cases of ECR lesions. Each case included clinical photographs, digital periapical radiographs, and a small-volume CBCT scan. In the first assessment, the examiners were given all the relevant information of each case, except the CBCT scan. Each examiner was asked to select 1 of the proposed treatment options and assess the difficulty of decision-making. Four weeks later, the examiners randomly reviewed the same 12 cases with additional information from the CBCT data.

Results: After the CBCT evaluation, the clinicians changed their treatment plan in 72.2% of the cases (P < .05). The self-reported level of difficulty in choosing a treatment changed in all groups after evaluating the CBCT scans (P < .05). After viewing the CBCT scan, the extraction option increased significantly in all groups (P < .05).

Conclusions: CBCT scan had a significant impact on clinical decision-making in cases of ECR evaluated by different specialists.

Keywords: CBCT scan; clinical decision-making; dentistry specialists; external cervical resorption; treatment planning.

MeSH terms

  • Clinical Decision-Making
  • Cone-Beam Computed Tomography* / methods
  • Controlled Before-After Studies
  • Endodontics*
  • General Practice, Dental
  • Humans