Diş hekimlerinin periapikal radyografiler ve konik ışınlı bilgisayarlı tomografi (CBCT) görüntülerine göre uygulayacakları endodontik tedavi seçeneklerinin karşılaştırılması
Thesis Type: Dental Specialty
Institution Of The Thesis: Sivas Cumhuriyet University, Diş Hekimliği Fakültesi, Klinik Bilimler Bölümü, Turkey
Approval Date: 2020
Thesis Language: Turkish
Student: BÜŞRA MELDA KENGEL
Supervisor: Demet Altunbaş
Open Archive Collection: AVESIS Open Access Collection
Abstract:Periapical radiographs (PAs) have been used for a long time as a standard for endodontic diagnosis and postoperative evaluation. Imaging with cone-beam computed tomography (CBCT) is a relatively new technology currently used in endodontic treatments. The aim of our study is to investigate the changes of treatment plans that oral and maxillofacial surgery, periodontology, endodontics, and prosthetic dental treatment physicians and dentists will apply in patients requiring endodontic treatment according to PA radiography and CBCT. Descriptive information, anamnesis forms, digital radiographs, and CBCT sections of eight different patients requiring endodontic treatment were obtained from the currently registered patient archive. Case definitions created for each patient were presented to a total of 305 physicians with a printed copy of the radiographic images of the respective tooth. The physicians were asked to choose the treatment options that were determined for 8 cases by examining the PA radiographic images at the first stage and the CBCT sections at the second stage and to select the degree of difficulty at the decision-making stage of the treatment on a scale of 1 to 5. Furthermore, the CBCT interpretation of the survey at the second stage was made at least four weeks after the first stage. The data were analyzed statistically. It was observed that, in cases with acute and chronic apical periodontitis, the majority of the physicians preferred multi-session root canal treatment and restoration at both stages, in the case with facial cellulitis, the majority of the physicians preferred the treatment method of "multi-session root canal treatment should be initiated and NSAIDs and antibiotics should be prescribed," at both stages and in the case with chronic apical abscess, the majority of the physicians preferred multi-session root canal treatment at both stages. In the case with a molar tooth with a large lesion, the majority of the oral and maxillofacial surgeons and dentists preferred extraction at both stages, while endodontists preferred multi-session root canal treatment and restoration. While the majority of the physicians preferred non-surgical root canal retreatment at both stages in the case that became symptomatic due to the lack of treatment of the additional root canal, the percentage of the dentists who chose this treatment option as a result of treatment planning with CBCT increased oral and maxillofacial surgeons, prosthetic dental treatment physicians and dentists. In the case in which the infection could not be eliminated after root canal treatment, it was observed that the majority of the physicians preferred non-surgical root canal retreatment at both stages followed by endodontic surgery, and the majority of the endodontists preferred non-surgical root canal retreatment at both stages. In the asymptomatic case in which root canal treatment was performed but the lesion developed after treatment, the majority of the physicians preferred non-surgical root canal retreatment at the first stage, while they preferred the practice of "there is no need for treatment, and waiting and observation should be performed" at the second stage. The majority of the endodontists preferred non-surgical root canal restoration at both stages. It was observed that endodontists made treatment planning usually more conservative at both stages and their degree of difficulty perception was lower compared to other dentists. Keywords: Radiography, Cone-beam computed tomography, Survey, Periapical diseases.