Shanon Patel, Jackie Brown, Federico Foschi, Nassr Al-Nuaimi, James Fitton
International Endodontic JournalEarly View
First published: 18 February 2025 https://onlinelibrary.wiley.com/doi/10.1111/iej.14203
I thought … this should be interesting. It wasn’t. (But I still think Jackie Brown is wonderful)
A somewhat tedious compendium of behavioural observations from 200 or so endodontic specialists in the UK based on an online survey.
Such has been the effect of CBCT on the practice of endodontics. The only surprise was that not everyone calling themselves endodontic specialists were using it routinely.
The major gripe in the conclusion was that CBCT wasn’t being used according to guidelines. This does not surprise me. I despair of the number of times I see full maxillary and mandible scans taken for a single tooth. Not only is it a radiation hazard, but the resolution required for accurate endodontic diagnosis is simply not available in such scans.
This will no doubt be grist to the mill for those lovely folk who gather together in committees to discuss and then legislate for what we should and should not be doing. Good luck to them. What is needed is common sense, and if 66% (WTF!) of primarily young graduate specialists are happy to scan during pregnancy and do not routinely adjust the voltage, current, definition and rotation on a case-by-case basis, then we have lost already.
One statistic that bothers me is that 21% of endodontists do not review their treatment using CBCT. No doubt these endodontists are the ones who claim 95% success rates. If you cannot make out the pathology on routine radiography to start with, how can you tell whether it is healing? How do you know if your treatment protocols really work? Or perhaps they would prefer not to know.
From my observation, there is a major skills gap. The ability not only to manipulate and read scans but to also extract every piece of knowledge necessary from a well-taken and ALARA scan just does not seem to be present in many of endodontists I come across. The ability to translate all observations into rationale clinical decision-making is indeed a highly skilled practice, but don’t worry, AI is coming, and we can trust machine learners to do it for us.
The future is bleak.
