Clinical utility of Cone Beam Computed Tomography to define treatment in cases of medium and high endodontic complexity.

  • Germán Buchheister Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile.
  • Patricio Meléndez Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile.
  • Alejandro Herrera Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile.
  • Kevin Lever Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile.


 The aim of this study was to evaluate the clinical utility of Cone Beam Computed Tomography (CBCT) in cases of medium and high endodontic complexity. The relevance of CBCT to define treatment was evaluated through the Wittenberg questionnaire and the variation in treatment plans after CBCT exam analysis. The sample (n=40) was chosen for convenience over a period of 4 months. It considered the current recommendations to request CBCT exams before performing root canal treatments. Data collection was carried out through a survey applied to the treating clinicians, after examining the information obtained by the CBCT system. Data were analyzed with the Stata version 13 software, and the Chi-square test was used for inferential analysis. A 95% confidence interval was considered. The most frequent dental groups corresponded to upper posterior and upper anterior teeth (47.5% and 30.0%); the cases were equally distributed according to complexity (50% and 50%). The main reason for requesting CBCT exams corresponded to complex anatomy and/or atypical canal system (37.5%). The use of CBCT increased confidence in the initial treatment chosen by clinicians in 50% of cases according to the Wittenberg questionnaire, and a 45% variation in treatment plans was observed. There was no statistical relationship between complexity and the variables studied. CBCT contributed greatly to the therapeutic management of cases regardless of their complexity.


1. Kiarudi A, Eghbal M, Safi Y, Aghdasi M, Fazlyab M. The Applications of Cone-Beam Computed Tomography in Endodontics: A Review of Literature. Iran Endod J. 2015;10(1):16–25.
2. Abella F, Morales K, Garrido I, Pascual J, Duran-Sindreu F, Roig M. Endodontic applications of cone beam computed tomography: Case series and literature review. G Ital Endod. 2015;29(2):38-50.
3. Balasundaram A, Shah P, Hoen M, Wheater M, Bringas J, Gartner A, Geist J. Comparison of Cone-Beam Computed Tomography and Periapical Radiography in Predicting Treatment Decision for Periapical Lesions: A Clinical Study. Int J Dent. 2012:920815.
4. Funda Y, Kivan K, Naz Y, Meltem D. Cone beam computed tomography aided diagnosis treatment of endodontic cases: Critical analysis. World J Radiol. 2016;8(7):716–25.
5. SEDENTEXCT Guideline Development Panel. Radiation protection No 172. Cone Beam CT for Dental and Maxillofacial Radiology. Evidence based guidelines. Luxembourg: European Commission Directorate-General for Energy. 2012;61-71.
6. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2015;120(4):508-12.
7. Mota de Almeida F, Knutsson K, Flygare L. The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics. Dentomaxillofac Radiol. 2014;43(4):20130137.
8. Wittenberg J, Fineberg H, Black E, Kirkpatrick R, Schaffer D, Ikeda M, Ferrucci J. Clinical efficacy of computed body tomography. AJR Am J Roentgenol. 1978;131(1):5–14.
9. Herder G, Van Tinteren H, Comans E, Hoekstra O, Teule G, Postmus P, Joshi U, Smit E. Prospective use of serial questionnai-res to evaluate the therapeutic efficacy of 18F-fluorodeoxyglu-cose (FDG) positron emission tomography (PET) in suspected lung cancer. Thorax. 2003;58(1):47–51.
10. De Carlo B, Tibúrcio-Machado C, Dotto C, Branco F, Heitor C, Medianeira C. Diagnostic Efficacy of Four Methods for Locating the Second Mesiobuccal Canal in Maxillary Molars. Iran Endod J. 2018;13(2):204–08.
11. Zhang D, Chen J, Lan G, Li M, An J, Wen X, Liu L, Deng M. The root canal morphology in mandibular first premolars: a comparative evaluation of cone-beam computed tomography and micro computed tomography. Clin Oral Investig. 2017;21(4):1007-12.
12. Nascimento E, Gaeta A, Andrade M, Freitas D. Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig. 2018;22(7):2495-2503.
13. Rodríguez G, Abella F, Durán-Sindreu F, Patel S, Roig M. Influence of Cone-beam Computed Tomography in Clinical Decision Making among Specialists. J Endod. 2017;43(2):194-99.
14. Krug R, Connert T, Beinicke A, Soliman S, Schubert A, Kiefner P, Sonntag D, Weiger R, Krastl G. When and how do endodontic specialist use cone-beam computed tomography?. Aust Endod J. 2019.
15. Setzer F, Hinckley N, Kohli M, Karabucack B. A Survey of Cone-beam Computed Tomography Use among Endodontic Practitioners in the United States. J Endod. 2017;43(5):699–04.
16. Jaju P, Jaju S. Cone-beam computed tomography: Time to move from ALARA to ALADA. Imaging Sci Dent. 2015;45(4):263–65.
17. Sousa T, Haiter-Neto F, Nascimento E, Peroni L, Freitas D, Hassan B. Diagnostic Accuracy of Periapical Radiography and Cone-beam Computed Tomography in Identifying Root Canal Configuration of Human Premolars. J Endod. 2017;43(7):1176-79.
18. Venskutonis T, Plotino G, Juodzbalys G, Mickevičienė L. The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature. J Endod. 2014;40(12):1895–901.
19. Karabucak B, Bunes A, Chehoud C, Kohli M, Setzer F. Prevalence of Apical Periodontitis in Endodontically Treated Premolars and Molars with Untreated Canal: A Cone-beam Computed Tomography Study. J Endod. 2016;42(4):538-41.
How to Cite
BUCHHEISTER, Germán et al. Clinical utility of Cone Beam Computed Tomography to define treatment in cases of medium and high endodontic complexity.. Journal of Oral Research, [S.l.], v. 8, n. 6, p. 455-462, jan. 2020. ISSN 0719-2479. Available at: <>. Date accessed: 28 feb. 2020. doi: