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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