Fonseca Tamyres Veleda, Braz Gabriel Lima, Vieira Henrique Timm, de Souza Ferreira Nadia, Damian Melissa Feres
Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Aust Endod J. 2025 Aug;51(2):474-482. doi: 10.1111/aej.12966. Epub 2025 Jun 19.
This before-after study evaluated the impact of cone beam computed tomography (CBCT) and clinical experience on diagnosis and treatment planning for endodontic cases, compared to periapical radiography (PR). 28 CBCT cases with corresponding PR images were assessed by five endodontic specialists and five final-year dental students in two stages, 30 days apart: first using PR images and then CBCT scans. McNemar and Wilcoxon signed-rank tests were applied, along with binary and ordinal logistic regressions, to assess changes in diagnosis and therapeutic decisions between imaging modality, evaluator experience, and perceived difficulty. Most evaluators changed their diagnostic and treatment decisions from PR to CBCT, particularly among students. Evaluator experience significantly influenced the difficulty of diagnosis and treatment planning, especially with CBCT. The interpretation of CBCT images increased decision-making difficulty for students while facilitating it for professionals. CBCT significantly influenced clinical decisions and perceived difficulty, with effects varying based on evaluator experience.
这项前后对照研究评估了锥束计算机断层扫描（CBCT）和临床经验对牙髓病病例诊断和治疗计划的影响，并与根尖片（PR）进行了比较。5名牙髓病专家和5名牙科专业最后一年的学生对28例有相应PR图像的CBCT病例分两个阶段进行评估，间隔30天：首先使用PR图像，然后使用CBCT扫描。应用McNemar检验和Wilcoxon符号秩检验，以及二元和有序逻辑回归，以评估成像方式、评估者经验和感知难度之间诊断和治疗决策的变化。大多数评估者将他们的诊断和治疗决策从PR改为CBCT，尤其是在学生中。评估者经验显著影响诊断和治疗计划的难度，尤其是在使用CBCT时。CBCT图像的解读增加了学生决策的难度，同时却为专业人员提供了便利。CBCT显著影响临床决策和感知难度，其影响因评估者经验而异。
