Conhecimento e percepção dos endodontistas sobre tomografia computadorizada de feixe cônico e impacto do exame em casos endodônticos

Abstract

The objective of this work was to evaluate the knowledge of Brazilian endodontists about cone beam computed tomography (CBCT or CBCT), as well as its clinical use. Furthermore, an analysis was carried out on the impact of the exam on diagnosis, clinical decision-making and level of confidence in endodontic clinical cases. This study was developed in two parts: I, a cross-sectional observational study and II, a systematic literature review. Data collection occurred through a 24-question electronic questionnaire, covering demographic information, CBCT learning, clinical use of CBCT, and the perceived impact of CBCT. Data analysis was performed using descriptive statistics and logistic regression; results were presented as Odds Ratios (OR) with 95% confidence intervals (CI) and p-values. Results: The sample consisted of 300 endodontists, of whom 79.3% reported having received some type of education in CBCT. There was a significant association between the use of the CBCT exam and learning (p<0.001). Logistic regression analysis revealed that endodontists who reported relying only on the radiologist's report of the CBCT exam were less likely to perceive the impact of the exam on diagnosis (OR 0.17; CI 0.44-0.73) and on the level of trust (OR 0.18; CI 0.04). -0.84). Endodontists with less postgraduate experience also had a lower chance of perceiving the impact of the exam on their level of confidence (OR 0.18; CI 0.03-0.95). Brazilian endodontists who reported more learning about CBCT are more likely to use the exam. In study II, a systematic search was carried out in the PubMed/MEDLINE, Cochrane-CENTRAL, EMBASE, Scopus, LILACS and Web of Science databases, as well as in the gray literature (PROSPERO, Google Scholar and DANS EASY Archive). 30 publications were read in full and 24 met the inclusion criteria. Information on changes in diagnosis, treatment planning and level of confidence after CBCT was assessed. The methodological quality of the included studies was assessed by QUADAS-2. 24 studies were included, with a total of 1,144 teeth evaluated. Nine studies were classified as low risk of bias. Most studies focused on changes in treatment planning (n=10) or diagnosis (n=5). CBCT led to diagnostic changes in most cases of primary endodontic treatment (n=6); Studies that evaluated dental trauma showed the most significant improvement. CBCT impacts diagnosis, treatment planning and professional confidence in cases of complex endodontic treatments, often leading to more invasive treatments.