Do CBCT and Clinical Experience Impact Decision-Making in Endodontic Diagnosis and Treatment Planning? A Before-After Study

This before-after study evaluated the impact of cone beam computed tomography (CBCT) and clinical experience on diagnosis and treatment planning for endodontic cases, compared to periapical radiography (PR). 28 CBCT cases with corresponding PR images were assessed by five endodontic specialists and five final-year dental students in two stages, 30 days apart: first using PR images and then CBCT scans. McNemar and Wilcoxon signed-rank tests were applied, along with binary and ordinal logistic regressions, to assess changes in diagnosis and therapeutic decisions between imaging modality, evaluator experience, and perceived difficulty. Most evaluators changed their diagnostic and treatment decisions from PR to CBCT, particularly among students. Evaluator experience significantly influenced the difficulty of diagnosis and treatment planning, especially with CBCT. The interpretation of CBCT images increased decision-making difficulty for students while facilitating it for professionals. CBCT significantly influenced clinical decisions and perceived difficulty, with effects varying based on evaluator experience.