This is the published version of a paper published in Dento-Maxillo-Facial Radiology.Citation for the original published paper (version of record):Horner, K., Islam, M., Flygare, L., Tsiklakis, K., Whaites, E. (2009) Basic principles for use of dental cone beam computed tomography: consensus guidelines of the European Academy of Dental and Maxillofacial Radiology.. Dento

The aims of this paper were to critically review the role of radiographic imaging before lower third molar removal and to suggest a strategy for preoperative imaging based on available scientific evidence and clinical experience. Original articles and reviews including the MESH terms "third molar" and "radiography" were selected from the Medline database. Other sources were taken from references of selected papers. It was found that the scientific evidence on the usefulness of different preoperative imaging techniques of wisdom teeth is low. Therefore, information gathered from the literature was combined with the authors' clinical experience to suggest a strategy for preoperative imaging of lower third molars. Currently available radiological techniques used for preoperative imaging of lower third molars are also presented. It is suggested that panoramic and/or intraoral radiographs are sufficient as preoperative imaging in the vast majority of cases where there is no overlap between the mandibular canal and the wisdom tooth. Supplement with a posteroanterior open mouth projection will solve most of the remaining cases. In a restricted number of cases where there is an intimate relationship between the mandibular canal and the wisdom tooth, volume tomography such as cone beam computed tomography or low-dose computed tomography is indicated.

There is still a great need for endodontic treatment in the Swedish population, and no improvement in apical health was found during this 20-year follow up.

PostprintThis is the accepted version of a paper published in Dento-Maxillo-Facial Radiology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination.Citation for the original published paper (version of record):Ohman, A., Kivijärvi, K., Blombäck, U., Flygare, L. (2006) Pre-operative radiographic evaluation of lower third molars with computed tomography.. Objectives: To report radiographic findings of examinations with computed tomography (CT) of impacted lower third molars with an intimate relation to the mandibular canal and to investigate how findings of a dark band across the roots of the lower third molar on panoramic views correspond to the CT findings. Methods: CT images of 90 lower third molars (64 patients, mean age 34.6 years) in which plain radiography was insufficient to allow determination of the precise anatomical relations were reviewed retrospectively. Panoramic views of 88 teeth existed; these images were interpreted independent of the CT examinations with respect to presence of a dark band across the roots. Results: In 31% of the CT images, the course of the mandibular canal was buccal, in 33% lingual, in 26% inferior, and in 10% inter-radicular. The tooth was in contact with the mandibular canal in 94% and with the lingual cortex in 86%. In 23%, grooving of the root by the canal was judged to be present. In 63% of the cases where a dark band across the roots was observed on panoramic radiographs, CT revealed grooving of the root. Conclusions: Pre-operative CT of lower third molars is motivated in selected cases when plain radiography is inconclusive. The finding of a dark band across the roots on panoramic radiographs is an indicator of grooving of the tooth by the canal and justifies a pre-operative CT examination. The absence of dark bands on panoramic views does not exclude grooving of the roots. Dento

Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.