Related Experiment Video
Updated: Jun 12, 2025
Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities
Published on: May 24, 2022
The impact of cone beam CT on outcomes associated with endodontic access cavity preparation: a controlled human
Margarete B McGuigan1, Henry F Duncan1, Gabriel Krastl2
1Division of Oral and Maxillofacial Surgery, Medicine, Pathology and Radiology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Lincoln Place, Dublin, D02 F859, Ireland.
Objectives:
To identify if supplemental preoperative cone beam CT (CBCT) imaging could improve outcomes related to endodontic access cavity preparation, using 3D-printed maxillary first molars (M1Ms) in a rigorously simulated, controlled human analogue study.
Methods:
Eighteen operators with 3 experience-levels took part in 2 simulated clinical sessions, 1 with and 1 without the availability of CBCT imaging, in a randomized order and with an intervening 8-week washout period. Operators attempted the location of all 4 root canals in each of 3 custom-made M1Ms (2 non-complex and 1 complex mesiobuccal [MB] canal anatomy). The primary outcome was tooth volume removed. Secondary outcomes were linear cavity dimensions, canals located, and procedural time. Operator confidence and "helpfulness" of available imaging were recorded. Statistical analysis of data included: paired t-tests, Fisher's exact test, linear mixed-effect modelling, and Mann-Whitney U test, with an alpha level of .05 for all.
Results:
When supplemental preoperative CBCT was available, there were significant reductions in volume of the access cavity and procedural times, with significantly increased MB2 canal location, but only for teeth with non-complex anatomies and for more experienced operators. Linear mixed-effect modelling identified image type and operator experience as significant predictors of tooth volume removed and procedural time. There was significantly lower confidence in canal location and perceived "helpfulness" (all Experience Groups) when conventional imaging only was used compared with when CBCT was available.
Conclusions:
Supplemental preoperative CBCT had several beneficial impacts on access cavity preparation, although this only applied to teeth with non-complex anatomy and for more experienced operators.
