CBCT
Reserve CBCT for a justified question where 3D information changes management; choose the smallest suitable field of view and assess the full volume.
Understand
CBCT offers high-resolution bony 3D detail at a higher dose than many conventional dental images; it has limitations for soft tissues. Field size should fit the question.
Assess
Justify whether 3D anatomy would change a decision, such as a complex root or nerve relationship. Ensure the entire acquired volume is reviewed by a competent reporter.
Apply
Use appropriate local protocols and referral for interpretation beyond competence. An incidental abnormality outside the target tooth still needs consideration.
Key distinctions
CBCT may clarify root-canal proximity, complex anatomy, trauma or lesion extent, but image quality can suffer from movement or metal artefact. Field of view and voxel size should suit the diagnostic question. The full volume includes structures outside the intended tooth, so competent reporting or referral for reporting is required. Soft-tissue disease often needs a different modality.
Think through a case
A CBCT is requested solely to “be safe” before a straightforward extraction. If it will not change the decision, the additional exposure is hard to justify.
The distinction to remember
Do not leave the rest of the CBCT volume unread because the referral mentioned only one tooth.
Test your recall
Does a CBCT automatically replace conventional images?
Show answer
No; the added information must justify the higher exposure.