Integrated CBCT and Digital Intraoral Scanning for Precision Endodontic, Prosthetic, and Implant Treatment Planning

Abstract

Background:
Digital integration of cone-beam computed tomography (CBCT) and intraoral scanning (IOS) has the potential to improve the precision and efficiency of multidisciplinary dental treatment planning. However, comparative evidence across endodontic, prosthetic, and implant applications remains limited.
Aim:
To compare treatment-planning efficiency and positional accuracy between a conventional workflow and an integrated CBCT–IOS digital workflow across endodontic, prosthetic, and implant treatment categories.
Materials and Methods:
This comparative study included 90 cases, equally divided between conventional and integrated CBCT–IOS workflows. Each workflow comprised 15 endodontic, 15 prosthetic, and 15 implant cases. Treatment-planning time was recorded for all cases. Endodontic accuracy was assessed using access trajectory and angular deviation, whereas prosthetic accuracy was evaluated using tooth-position, prosthetic margin, and occlusal discrepancies. Implant accuracy was determined from coronal, apical, depth, and angular deviations. Treatment-plan modifications following CBCT–IOS integration were also documented. Continuous variables were compared using independent-samples t-tests, with statistical significance established at probability (p) < 0.05.
Results:
The integrated workflow significantly reduced planning time in endodontic (11.2 ± 2.8 vs. 18.6 ± 4.2 minutes), prosthetic (17.1 ± 3.7 vs. 27.4 ± 5.6 minutes), and implant cases (20.3 ± 4.1 vs. 32.8 ± 6.4 minutes; all p < 0.001). Endodontic access trajectory deviation decreased from 0.82 ± 0.31 to 0.46 ± 0.18 mm and angular deviation from 7.24 ± 2.85° to 3.86 ± 1.62° (both p < 0.001). Prosthetic discrepancies were significantly lower with the integrated workflow for tooth position, margin position, and occlusion (all p < 0.001). Implant coronal, apical, depth, and angular deviations were also reduced, with statistically significant differences. Overall planning time decreased by 10.1 minutes (26.3 ± 7.8 vs. 16.2 ± 5.0 minutes; p < 0.001). Following CBCT–IOS integration, 11 of 90 cases (12.2%) required treatment-plan modification, with the highest proportion occurring in implant cases.
Conclusion:
Integration of CBCT and IOS substantially improved treatment-planning efficiency and spatial accuracy across endodontic, prosthetic, and implant applications. The findings support the use of an integrated digital workflow for more precise and streamlined multidisciplinary dental treatment planning.