Non-Cochrane · DTA;prognostic · PM41973313
Role of cone-beam computed tomography in predicting root canal treatment success: A systematic review and meta-analysis.
Alqahtani Saeed · The Saudi dental journal · 2026 · PubMed · doi:10.1007/s44445-026-00133-3
Findings
16 findings
| Population | ||||
|---|---|---|---|---|
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for periapical lesions | Reference standard (varied across studies) | Specificity for Periapical lesions Overall | Specificity 0.84 [0.78, 0.89] GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for periapical lesions | Reference standard (varied across studies) | Sensitivity for Periapical lesions Overall | Sensitivity 0.88 [0.82, 0.92] GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for periapical lesions | Reference standard (varied across studies) | Area under the curve for Periapical lesions Overall | AUC 0.92 GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for vertical root fractures | Reference standard (varied across studies) | Specificity for Vertical root fractures Overall | Specificity 0.86 [0.78, 0.92] GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for vertical root fractures | Reference standard (varied across studies) | Sensitivity for Vertical root fractures Overall | Sensitivity 0.81 [0.72, 0.88] GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for vertical root fractures | Reference standard (varied across studies) | Area under the curve for Vertical root fractures Overall | AUC 0.90 GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for root canal morphology | Reference standard (varied across studies) | Sensitivity for Complex root canal morphology Overall | Sensitivity 0.91 [0.86, 0.94] GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for root canal morphology | Reference standard (varied across studies) | Specificity for Complex root canal morphology Overall | Specificity 0.88 [0.82, 0.92] GRADE not reported Studies not reported |
| Patients with teeth requiring or having had non-surgical root canal treatment | Pre-operative CBCT (index test) for root canal morphology | Reference standard (varied across studies) | Area under the curve for Complex root canal morphology Overall | AUC 0.94 GRADE not reported Studies not reported |
| Patients undergoing non-surgical root canal treatment with pre-operative CBCT | Periapical lesion detected on CBCT | Finding absent on CBCT | Root canal treatment failure (post-treatment failure) Overall | OR 2.63 [1.78, 3.58] GRADE not reported Studies not reported |
| Patients undergoing non-surgical root canal treatment with pre-operative CBCT | Root fracture detected on CBCT | Finding absent on CBCT | Root canal treatment failure (post-treatment failure) Overall | OR 3.48 [2.05, 5.12] GRADE not reported Studies not reported |
| Patients undergoing non-surgical root canal treatment with pre-operative CBCT | Complex canal anatomy/morphology detected on CBCT | Finding absent on CBCT | Root canal treatment failure (post-treatment failure) Overall | OR 1.94 [1.20, 2.82] GRADE not reported Studies not reported |
| Patients undergoing non-surgical root canal treatment with pre-operative CBCT | CBCT-detected findings predicting treatment outcome (all predictors combined, as reported) | Finding absent on CBCT | Root canal treatment failure (post-treatment failure) Follow-up 12 months or longer | OR 2.20 GRADE not reported Studies not reported |
| Patients undergoing non-surgical root canal treatment with pre-operative CBCT | CBCT-detected findings predicting treatment outcome (all predictors combined, as reported) | Finding absent on CBCT | Root canal treatment failure (post-treatment failure) Follow-up shorter than 12 months | OR 1.40 GRADE not reported Studies not reported |
| Patients undergoing non-surgical root canal treatment (primary or retreatment) with pre-operative CBCT and follow-up of at least 6 months | Any CBCT-detected finding (periapical lesion, root fracture, complex canal anatomy) | Absence of the finding | Root canal treatment failure by baseline lesion size Lesion size >= 3 mm versus < 3 mm Unresolved: the two extractors disagree on this row. | Stronger prediction of failure for lesion size >= 3 mm versus < 3 mm (no numeric estimate reported) GRADE not reported Studies not reported |
| Patients with teeth undergoing or having undergone non-surgical root canal treatment (primary or retreatment) | CBCT with voxel size < 0.2 mm | CBCT with voxel size >= 0.2 mm | Diagnostic accuracy Voxel size < 0.2 mm versus >= 0.2 mm Unresolved: the two extractors disagree on this row. | Higher diagnostic accuracy with voxel size < 0.2 mm (p = 0.03); no numeric estimate reported GRADE not reported Studies not reported |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al Yahya 2023 Root Canal Configuration and Its Relationship with Endodontic Technical Errors and Periapical Status in Premolar Teeth of a Saudi… PMID:36673896 | 2023 | this review only | not stated | not extracted yet |
| Aristizabal-Elejalde 2020 Assessment of fractures in endodontically treated teeth restored with and without root canal posts using high-resolution cone beam… PMID:32665813 | 2020 | this review only | not stated | not extracted yet |
| Dabrowski 2022 Guided Endodontics as a Personalized Tool for Complicated Clinical Cases. PMID:36011600 | 2022 | this review only | not stated | not extracted yet |
| Dogan 2018 The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study. PMID:29670714 | 2018 | this review only | not stated | not extracted yet |
| Gambarini 2018 Cone-beam computed tomography in the assessment of periapical lesions in endodontically treated teeth. PMID:29657539 | 2018 | this review only | not stated | not extracted yet |
| Kadkhodayan 2023 Uncovering the Hidden: A Study on Incidental Findings on CBCT Scans Leading to External Referrals. PMID:38142160 | 2024 | this review only | not stated | not extracted yet |
| Kalogeropoulos 2022 The Effect of Cone-Beam Computed Tomography (CBCT) Evaluation on Treatment Planning after Endodontic Instrument Fracture. PMID:35409771 | 2022 | this review only | not stated | not extracted yet |
| Karobari 2023 Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT… PMID:37189077 | 2023 | this review only | not stated | not extracted yet |
| Kazimierczak 2024 Endodontic Treatment Outcomes in Cone Beam Computed Tomography Images-Assessment of the Diagnostic Accuracy of AI. PMID:39064157 | 2024 | this review only | not stated | not extracted yet |
| Madfa 2023 Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi… PMID:37681163 | 2023 | this review only | not stated | not extracted yet |
| Shah 2021 A cone beam computed tomographic evaluation of root canal treatment quality using periapical and endodontic status scale DOI:10.4103/srmjrds.srmjrds_31_21 | 2021 | this review only | not stated | not extracted yet |
| Yilmaz 2016 Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis. PMID:27551342 | 2016 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with teeth undergoing non-surgical root canal treatment (primary or retreatment); pre-operative CBCT | Teeth treated with root canal therapy; 12 studies (sample sizes 150 to 350); mandibular and maxillary premolars, molars, endodontically treated teeth |
| Intervention | Pre-operative CBCT as index test or prognostic predictor (periapical lesions, vertical root fractures, canal complexity) | Pre-operative CBCT; voxel size 0.12-0.30 mm |
| Comparison | Reference standard (diagnostic studies); absence of the CBCT-detected finding (prognostic studies) | Reference standards varied (clinical findings, 2D radiographs, anatomical validation); absence of CBCT finding |
| Outcomes | Diagnostic accuracy (sensitivity, specificity); root canal treatment success or failure (clinical or radiographic criteria) | Pooled sensitivity/specificity for periapical lesions, vertical root fractures, canal morphology (6 diagnostic studies); pooled ORs for failure (6 prognostic studies) |
| Study designs | Diagnostic accuracy: cross-sectional or cohort studies; prognostic: cohort or cross-sectional with follow-up; English, 2013-2024 | 6 diagnostic accuracy studies and 6 prognostic studies (cross-sectional, cohort, observational) |
| Timing | Prognostic studies: minimum follow-up of 6 months | Follow-up 6 months to 5 years; success rates 70 to 95% |