CBCT

Cone-beam computed tomography (CBCT) is a specialized radiographic technique that captures a three-dimensional volumetric image of the teeth, jaws, and surrounding structures. Unlike traditional two-dimensional X-rays, which produce flat images, CBCT acquires data by rotating a cone-shaped X-ray beam around the head to generate a volumetric dataset that can be viewed in multiple planes. This 3D perspective reveals spatial relationships, bone dimensions, and anatomical details that are often obscured on panoramic or periapical films.

The added dimensionality enables clinicians to measure distances, assess bone thickness, and examine complex anatomies with greater precision. Because the dataset can be reformatted into slices or rendered as a 3D model, CBCT supports a wider range of diagnostic and treatment-planning tasks. Proper interpretation of volumetric images requires training to correlate radiographic findings with clinical examination and patient history.

CBCT is particularly helpful in implant dentistry, oral surgery, endodontics, orthodontics, and airway assessment. For implants, it shows bone height, width, and proximity to vital anatomy such as the mandibular nerve and maxillary sinuses, which informs site selection and the need for grafting. In oral surgery and endodontics, CBCT identifies impacted teeth, fractures, complex root canal morphologies, and periapical pathology that may not be visible on conventional films.

Orthodontists and airway specialists use CBCT to evaluate jaw relationships, tooth positions, and upper airway dimensions when clinically indicated. The modality also aids in detecting suspected pathology—such as cysts or unusual bony changes—that requires further diagnosis or referral. Clinicians select CBCT when the expected diagnostic benefit outweighs the additional radiation exposure compared with standard imaging.

CBCT provides precise measurements of bone volume and quality, allowing clinicians to determine optimal implant size, angulation, and position before surgery. Virtual planning tools use the volumetric dataset to simulate implant placement and assess proximity to nerves, sinuses, and adjacent teeth, reducing the likelihood of intraoperative surprises. When indicated, the digital plan can be translated into a surgical guide that helps transfer the planned trajectory to the clinical setting with greater accuracy.

By anticipating anatomical challenges, CBCT-supported planning often shortens surgical time and may decrease the need for extensive intraoperative adjustments. It also helps determine whether adjunctive procedures—such as bone grafting or sinus augmentation—are necessary to achieve a stable foundation for implants. Integrating CBCT into the workflow supports a more predictable restorative outcome and clearer communication among the surgical team, restorative dentist, and lab.

A CBCT visit is typically quick and noninvasive. The patient remains seated or standing while the scanner rotates around the head to capture the volume, with the actual exposure often completed in under a minute; positioning and brief preparation are the primary time contributors. Metal objects around the head and neck will be removed or adjusted to reduce artifacts, and the clinician will confirm the exact field of view required for the diagnostic question.

Once the scan is acquired, images are reconstructed and reviewed by the clinician, who will discuss findings and recommended next steps during the same visit whenever possible. Staff will follow radiation-safety protocols and use device settings tailored to the smallest field of view that answers the clinical question. If specialist consultation is needed, the volumetric data can be shared electronically to support coordinated care.

Radiation exposure with modern CBCT is managed through selection of appropriate device settings, careful choice of field of view, and adherence to the ALARA principle—keeping doses as low as reasonably achievable. Clinicians determine whether CBCT is justified based on the specific diagnostic need and opt for limited fields of view whenever possible to reduce dose. Advances in detector sensitivity and software reconstruction have also contributed to dose optimization while preserving diagnostic image quality.

Patient safety is further supported by staff training, quality control protocols, and routine equipment maintenance. For vulnerable populations, such as children or pregnant patients, clinicians weigh risks and benefits and consider alternative imaging modalities or deferment when appropriate. When CBCT is indicated and performed responsibly, it provides important diagnostic information that can improve treatment outcomes while maintaining reasonable exposure levels.

CBCT scans are interpreted by clinicians trained in volumetric imaging who integrate radiographic findings with clinical examination and patient history. In many practices, the treating dentist or a specialist with advanced imaging expertise reviews the dataset, documents relevant observations, and determines whether further imaging or referral is warranted. Interpretation focuses on anatomical landmarks, pathology, and measurements that influence diagnosis and treatment choices.

Findings from CBCT are incorporated into comprehensive treatment plans, informing decisions such as implant placement, endodontic intervention, or surgical approaches. The images can be used to create virtual plans, fabricate surgical guides, and communicate precise information to laboratories or consulting specialists. Clear, documented interpretation helps ensure that imaging contributes meaningfully to safer, more predictable care.

Yes. CBCT is a powerful adjunct in endodontics for detecting complex canal anatomy, missed canals, periapical lesions, vertical root fractures, and resorptive defects that may not be apparent on standard two-dimensional films. The 3D view helps clinicians locate additional canals, assess the extent of pathology, and plan retreatment or surgical endodontic procedures with greater confidence. This detailed visualization can influence decisions about whether to proceed with nonsurgical therapy, refer for specialist care, or recommend surgical intervention.

Because CBCT reveals the spatial relationships of root structures and surrounding bone, it can improve the accuracy of diagnosis and the likelihood of successful treatment. Clinicians use CBCT selectively in endodontics when the results will change clinical management or when persistent symptoms remain unexplained after conventional imaging. Appropriate case selection ensures the benefit of added information while minimizing unnecessary radiation exposure.

CBCT datasets can be combined with intraoral scanner captures or digital impressions to create comprehensive 3D models that represent both hard and soft tissues. Software merges volumetric and surface data to enable virtual restorative planning, design of implant positions, and fabrication of fully guided surgical templates. This digital integration reduces manual steps, improves communication with the dental laboratory, and supports more precise placement of restorations and implants.

At Artistic Family Dental, digital workflows are used when clinically appropriate to translate diagnostic information into predictable restorative outcomes. The combined datasets allow for mock-ups, esthetic simulations, and guide production that reflect both the bone anatomy and the planned prosthetic outcome. When used thoughtfully, this integration streamlines treatment and enhances coordination among the restorative team.

CBCT is not always the first-line imaging choice and has limitations that influence its utility. Small fields of view provide high-resolution images of a localized area but may miss pathology outside that region, while larger volumes increase radiation exposure and are only justified when the diagnostic question requires them. Additionally, metal restorations and patient motion can introduce artifacts that degrade image quality and complicate interpretation.

CBCT may be unnecessary when conventional radiographs adequately answer the clinical question, or when alternative diagnostic methods can provide the needed information with lower exposure. Patient-specific factors, clinical urgency, and the likelihood that imaging will change management are all considered before recommending a scan. When imaging is indicated, clinicians select protocols to maximize diagnostic yield and minimize limitations.

CBCT images are typically exported in standard formats that can be securely shared with specialists, labs, or referring providers to support coordinated care. After acquisition and initial interpretation, the treating clinician discusses findings and proposed treatment options with the patient and determines whether multidisciplinary input is needed. Electronic sharing speeds collaboration, ensures consistent visualization of anatomy, and reduces the need for repeat imaging when referrals are required.

Subsequent steps depend on the clinical findings and the agreed-upon plan: this may include scheduling guided surgery, ordering further diagnostic tests, initiating endodontic therapy, or arranging specialist consultation. Documentation of the scan, its interpretation, and the planned actions helps maintain clarity in the treatment pathway and supports informed consent for the patient.