IMAGE DIAGNOSIS TRAINING IN ENDODONTICS

C. González Losada1, A. Saralegui Calvo1, P. Saralegui González2

1University Complutense of Madrid (SPAIN)
2Autonoma University of Madrid (SPAIN)
Introduction:
3D image techniques, specially CBCT ( Cone Beam Computer Tomography ) are an useful tool for teaching how to make a proper diagnosis in Endodontics.
This technique´s main advantages are the maximum amount of tridimensional information which is provided to the clinician, with interrelationated images in three orthogonal planes. It can be considered an ideal method to instruct students in matters of orientation and spatial visualization. Therefore, the students acquires the possibility to visualize images from different perspectives and reinforces his knowledge; with satisfactory educational results.

Objectives:
1. Bibliographic review of CBCT’s application efectiveness in Endodontics.
2. Clinical cases review on which conventional radiography does not provide enough clinical information to establish a proper diagnosis.
3. Conclude CBCT’s utility in Endodontics, specially for training students.

Material and Methods:
We have studied clinical situations in which CBCT has been necessary in order to take an appropriate diagnosis decission. Clinical criteria which makes us indicate a CBCT is periapical pathology suspicion when no significant signs are observed on a conventional radiography and an objective, concludent and evidence-based diagnostic decision is needed.

Discussion:
CBCT is a 3- D technnology device, derived whose main advantages are its reduced economic cost and radiation exposure. This diagnosis 3-D method is specially indicated for complex clinical situations when conventional radiography methods do not allow clinicians to establish a concludent diagnosis.
This technique offers the possibilty to analyze multiple section of the tooth in three planes so it helps to interpret and understand images. As a result of this studies we realized of advantages applied to the instruction of Endodontics.

Results:
- The efectiveness of tridimensional radiographic techniques in Odontologic specialities, has been confirmed by different authors due to its efficiency and reliability
- According to our experience and other authors’ publications, CBCT should be used in clinical situations when the amount and quality of information provided by conventional techniques is not enough to take an accurate diagnosis decision.
- This technology´s educational advantages are the possibility to select the appropiate section in every clinical case which helps us to confirm a suspected diagnosis. These images have been determinant specially when complex therapeutic decisions are to be taken. In addition, tridimensional images help students to stablish the previous treatment’s cause of failure, so a better prognosis can be ensured.
- CBCT improves communication with patients; specially when the tridimensional simulation is employed. This software device in 3D is also useful to explain novel students how to interpret radiological images and apply his knowledge to real clinical cases.

Conclusions:
1. Bibliography review conclusions are that most authors consider CBCT as an effective diagnosis method in Endodontics.
2. Clinical cases reviewed make us confirm Tridimensional Radiology in Endodontics’ utility.
3. CBCT provides us with aditional information, specially when non-specific images are associated with periapical clinical symptoms. These data apport a valuable education implement, which can be used with students as well as with patients.