CBCT

Cone-beam computed tomography, commonly called CBCT, is a three-dimensional imaging technology used in dentistry to visualize teeth, jawbone, nerves and sinuses with high spatial detail. A rotating scanner captures a volumetric dataset in a single pass, and specialized software reconstructs that data into cross-sectional and 3D views clinicians can examine from multiple angles. Because CBCT acquires volumetric information rather than a flat image, it reveals spatial relationships and depth that conventional two-dimensional radiographs cannot.

Clinicians use CBCT datasets to measure bone dimensions, evaluate root anatomy, and assess anatomical variations that influence diagnosis and treatment planning. The images can be reformatted into slices, panoramic views, and 3D renderings to communicate findings and options clearly. Interpretation combines the scan with the clinical exam to ensure imaging findings are correlated with symptoms and treatment goals.

CBCT is recommended when a three-dimensional assessment will materially affect diagnosis or treatment decisions, such as implant planning, evaluation of impacted teeth, assessment of complex root anatomy, or investigation of suspected bony pathology. It is used selectively rather than routinely, applied when the extra information improves safety, predictability, or overall outcomes. Your clinician will weigh the expected diagnostic benefit against the need to limit radiation exposure.

Common indications include preoperative implant evaluation, assessment of failed endodontic therapy, analysis of facial trauma or fractures, and detailed surgical planning for extractions or orthognathic procedures. In orthodontics, CBCT can clarify eruption patterns and skeletal relationships in complex cases. The decision to image is guided by clinical findings, patient history, and the specific questions the team needs answered.

Traditional dental X-rays, such as bitewings and periapical films, produce two-dimensional images that are excellent for routine screening of cavities and periodontal bone levels. CBCT, by contrast, produces a volumetric dataset that preserves depth, allowing clinicians to view structures in three dimensions and to slice through anatomy in any plane. That difference is particularly important when assessing relationships to nerves, sinus cavities, or the true volume of bone for implant placement.

While two-dimensional radiographs remain useful for many everyday diagnostic tasks, CBCT offers complementary information when anatomy is complex or when precise spatial data is required. The technologies are used together: conventional films for routine monitoring and CBCT for targeted diagnostic challenges. Choosing the right imaging modality depends on the clinical question and the level of detail needed.

A CBCT scan is quick and noninvasive. Most modern units complete the image acquisition in less than a minute while the patient sits or stands still and the scanner rotates around the head. The staff will position you carefully, explain the process, and instruct you to remain still for the brief scan to minimize motion artifact.

Preparation is minimal; you may be asked to remove glasses, jewelry or removable dental appliances that could interfere with imaging. After acquisition, the dataset is reviewed and processed by the clinical team, who will explain what the images show and how they will inform the treatment plan. If additional consultation with a specialist is warranted, the team will coordinate next steps.

CBCT uses ionizing radiation, so safety protocols are applied to minimize exposure while obtaining diagnostically useful images. Modern dental CBCT units offer focused fields of view and adjustable imaging protocols so clinicians can limit the scanned area to what is necessary for the clinical task. The principle of ALARA (as low as reasonably achievable) guides imaging decisions to balance diagnostic benefit with radiation stewardship.

Your dental team will select the smallest field of view and lowest acceptable dose that still answers the clinical question, and they will avoid unnecessary repeat scans. For vulnerable populations, such as children or pregnant patients, extra precautions are taken and alternative imaging strategies are considered when appropriate. If you have concerns about radiation, discuss them with your clinician so they can explain the specific benefits and safeguards in your case.

CBCT provides precise measurements of bone height, width and angulation, enabling clinicians to virtually plan implant position, size and orientation before surgery. The ability to visualize the exact relationship of proposed implant sites to nerves, adjacent teeth and sinus cavities reduces intraoperative surprises and helps determine whether bone grafting or staged procedures are necessary. This 3D information supports surgical guides and more predictable implant placement.

By integrating CBCT data with clinical findings and digital impressions, the restorative and surgical teams can coordinate toward an outcome that balances function and esthetics. Virtual planning can also simulate prosthetic space and occlusal relationships, helping to ensure implant position supports the desired final restoration. This collaborative approach often results in fewer complications and a more streamlined treatment sequence.

Yes. Because CBCT visualizes bone and surrounding anatomy in three dimensions, it can reveal cysts, tumors, developmental anomalies, root fractures, and areas of bone destruction that may be obscured or hidden on two-dimensional films. Small lesions or complex anatomical variations can be more readily identified and localized with a volumetric scan. Detecting these issues early can influence treatment decisions and prompt timely referral when appropriate.

CBCT is particularly useful when conventional imaging and the clinical exam do not fully explain symptoms such as unexplained pain, swelling, or persistent infection. Interpretation always considers the entire clinical picture; incidental findings that require monitoring or referral are documented and discussed with the patient. When necessary, the team will collaborate with oral and maxillofacial radiologists or other specialists for a more detailed review.

CBCT scans are reviewed by your treating dentist in the context of your medical and dental history, the clinical examination, and the treatment objectives. When scans show complex or unusual findings, the office may consult with or refer images to an oral and maxillofacial radiologist or a specialist who has advanced training in interpreting three-dimensional imaging. This collaborative approach helps ensure a comprehensive and accurate diagnosis.

After interpretation, the clinician will explain the findings, outline recommended next steps, and describe how the imaging information affects proposed treatments. Results can lead to targeted clinical checks, adjustments in surgical or restorative plans, or referrals to specialists. Clear communication ensures you understand how the scan informs your care and what to expect moving forward.

CBCT is not always required for routine dental care; simple cavities, routine periodontal screenings and basic restorative assessments are typically managed with conventional radiographs and a clinical exam. Imaging is reserved for situations where three-dimensional information will change management or improve safety. Using CBCT indiscriminately is avoided to reduce unnecessary radiation exposure and to keep care focused and efficient.

Certain patient conditions, such as inability to remain still during the scan or contraindications related to pregnancy, may prompt clinicians to defer CBCT or select alternative approaches. When the need for CBCT is uncertain, the team will discuss other diagnostic options and the potential diagnostic yield so patients can make informed decisions about their care.

At the office of Brian Howe DDS, Family Dentistry, CBCT is used selectively to enhance diagnostic clarity and support precise treatment planning across implant dentistry, endodontics, oral surgery and complex restorative cases. The team integrates volumetric imaging with clinical examination and digital workflows to tailor care to each patient’s anatomy and goals. This measured use of technology helps reduce surprises during procedures and contributes to more predictable results.

When CBCT is indicated, clinicians explain the reason for imaging, review the results with the patient, and incorporate findings into a coordinated treatment plan that prioritizes safety and long-term function. For complex interpretations, the practice consults with imaging specialists to ensure comprehensive analysis. Patients are encouraged to ask questions so they understand how CBCT findings influence their personalized care pathway.