CHICAGO – In response to new developments and research indicating the effectiveness of 3-D imaging for endodontic diagnosis and treatment, the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology have issued a revised position statement on the use of cone beam-computed tomography in endodontics. The joint statement is an update to a 2010 position on CBCT use in endodontics.
An AAE-AAOMR committee reviewed the scientific literature from the past five years, and updated the position statement to include specific recommendations for the appropriate use of CBCT. The statement emphasizes that CBCT should not be used routinely for endodontic diagnosis or screening purposes in the absence of clinical signs and symptoms, and provides 11 specific recommendations and supporting evidence for when CBCT should be considered the imaging modality of choice. The statement is consistent with principles of ALARA—keeping patient radiation doses "as low as reasonably achievable," and notes that the patient's history and clinical examination must justify the use of CBCT by demonstrating that the benefits to the patient outweigh the potential risks.
"Endodontists continue to have excellent results with two-dimensional radiography," said AAE President Dr. Terryl A. Propper. "However, limited field of view CBCT does have a place in endodontics when dealing with more complex cases, which are reflected in the position statement. Our goal is to help AAE members and general dentists determine where it fits for them."
"Dental imaging is interlaced with endodontics not only for accurate diagnosis but for periodic evaluation of certain treatment outcomes," said AAOMR President Dr. Christos Angelopoulos. "Complex cases may require the use of advanced imaging modalities such as CBCT for proper diagnoses, although advanced imaging may not be necessary as a routine diagnostic tool. The collaboration of AAOMR and the AAE aims to provide guidance to general dentists and endodontists based on the available evidence. The main goal of the two organizations is simply to guide practitioners toward 'best practice'."
The current position statement was drafted by a special joint committee of leading experts in the area of CBCT in endodontics. Each organization appointed four representatives. Dr. Mohamed I. Fayad of the University of Illinois at Chicago, appointed by the AAE, and Dr. Madhu K. Nair of the University of Florida, appointed by the AAOMR, served as co-chairs of the committee. AAE Members Drs. Craig S. Hirschberg, Martin D. Levin and Richard A. Rubinstein also served on the committee, along with Drs. Sevin Barghan, Erika Benavides and Axel Ruprecht from the AAOMR. The position statement is available at www.aae.org/guidelines.
