Dental CBCT should be prescribed only when three-dimensional information is expected to answer a specific diagnostic question and change patient management. Use the smallest suitable field of view, an optimised exposure protocol and prior-image review; CBCT is not a routine screening examination.
Contents
When is dental CBCT justified?
CBCT is justified when history, examination and lower-dose imaging do not provide information required for a clinical decision, and expected benefit outweighs radiation risk. Prescriptions must be patient-specific. Review available imaging before ordering another examination.
When may CBCT add value?
- Presurgical implant-site assessment requiring three-dimensional anatomy.
- Complex endodontic anatomy, resorption, perforation or complications not resolved by planar imaging.
- Impacted teeth, pathology or surgical relationships requiring localisation.
- Selected trauma, developmental, orthodontic and osseous TMJ questions.
Radiation optimisation
- Select the smallest field of view covering the region of interest.
- Match resolution and exposure to the diagnostic task and patient size.
- Avoid fixed-interval imaging without clinical indication.
- Interpret and document the entire acquired volume.
- Refer for radiology reporting when findings exceed the clinician’s competence.
Imaging decision table
| Question | Initial approach | When CBCT may be considered |
|---|---|---|
| Caries | Examination and indicated bitewings | Not routinely indicated |
| Periapical disease | Intraoral radiography | Persistent uncertainty or complex anatomy |
| Third molar | Panoramic imaging when indicated | When 3D relationships may change surgery |
| Implant planning | Clinical and panoramic assessment | Presurgical 3D site evaluation |
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Frequently asked questions
Should CBCT be taken before every implant?
No universal rule replaces clinical judgement. Use CBCT when 3D information is required for safe presurgical planning.
Is CBCT suitable for routine orthodontic records?
No. Do not use CBCT routinely when lower-dose methods answer the question.
Who interprets the CBCT volume?
The complete acquired volume requires systematic interpretation by an appropriately trained clinician or radiology service.