Describe one clinical question. Include the tooth or area, current findings, existing imaging, and how the answer could affect care. Omit patient identifiers.

Starting point for this review

Begin with the patient’s history and examination, using appropriate 2D X-rays as the initial imaging when needed. This tool assumes the history and exam are complete, relevant 2D X-rays have been taken and reviewed, and no CBCT has been taken for this question.

Use suitable existing images; this does not call for new 2D exposures in every case. If any assumption is incorrect, say so in your description. Describe what is still unclear or what information is needed for planning.

Try an example:

Your description and follow-up answers are processed in this browser. They are not sent or saved. Decision method and limitations

Guidance for your case

Add a case to begin

The result will show guidance, details used, and anything still needed.

How to use the result

The tool identifies a covered question, checks the reported circumstances, and links to the relevant recommendation. Each result shows the information used and any details still needed.

“Outside current coverage” means the tool cannot assess that topic. It does not mean CBCT is inappropriate. A supported result is guidance for consideration, not a patient-specific prescription.

Topics currently covered

Selected endodontic questions: unclear tooth symptoms, persistent disease, suspected fractures, root resorption, canal anatomy, retreatment, root-end surgery and possible endodontic sinusitis. Also presurgical implant planning, localized dental trauma, impacted-tooth localization and third-molar anatomical risk.

Routine screening and sleep-apnea diagnostic requests receive purpose-specific notices. General TMJ, jaw pathology, orthodontic, periodontal and implant follow-up or complication pathways are not yet included.

Scan guides

Find help with your scan.

Choose the part of the workflow you want to review.

Scan size & detail

Review field-of-view and resolution considerations for the question being investigated.

Review scan settings →

Image review

Find practical steps for working through common clinical questions in CS 3D Imaging.

Open image-review guide →

Artifact examples

Compare image patterns and review checks for motion, metal, and other artifacts.

View artifact examples →

Estimate scan volume

Estimate your monthly CBCT scans.

Start with your monthly cases. See your scan total, how study findings relate to those cases, and optional revenue from scans alone.

1. Enter your monthly cases

Include only cases you have assessed as appropriate for CBCT. We assume each entered case proceeds to one scan. Count a scan once under its main reason, even if several categories apply. Leave other fields at zero or blank.

“Which cases count?” gives examples within each category; the symptoms alone do not establish a need for CBCT.

Unclear or hard-to-localize pain

Which cases count?

Pain that is difficult to locate, conflicting clinical findings, or symptoms involving more than one tooth, when the examination and 2D images do not answer the endodontic question.

Nonhealing after endodontic treatment

Which cases count?

Persistent symptoms, a sinus tract or a nonhealing lesion after root canal treatment, when further information is needed to decide on care. Excludes routine follow-up of a tooth that is healing as expected.

Suspected vertical root fracture

Which cases count?

A suspected root fracture with findings such as isolated deep probing, persistent biting pain or a suspicious bone-loss pattern, when the examination and 2D images are inconclusive. CBCT cannot reliably rule out every fracture.

Resorption concern

Which cases count?

Internal, external or cervical resorption requiring assessment of location, extent or treatment options beyond what the examination and 2D images provide.

Retreatment or missed anatomy

Which cases count?

A suspected missed canal, complex anatomy, separated instrument, perforation or other complication where 3D information is needed for retreatment planning. If already counted under nonhealing, do not count the same scan again.

Endodontic surgery planning

Which cases count?

Planning apical or root-end surgery, including root position, lesion extent and relationships to the sinus, nerve canal, cortical bone or nearby roots.

Implant site assessment

Which cases count?

Presurgical implant planning: ridge width and height, nearby nerves and sinus, and assessment of grafting needs. Count a scan once even if it covers more than one proposed implant site.

Possible tooth-sinus relationship

Which cases count?

A suspected dental source of sinus disease or an upper tooth infection whose relationship to the sinus needs clarification after initial assessment. Incidental sinus thickening alone is not an automatic indication.

Impacted or ectopic tooth assessment

Which cases count?

An impacted or ectopic tooth with an unresolved question about 3D position, adjacent roots, resorption or surgical risk that could affect management. Excludes routine scanning of every impacted tooth.

Other clinically indicated scans

Which cases count?

Cases outside these categories for which you have already established a specific CBCT indication. They contribute to scan volume and revenue only; no decision-change percentage is assigned.

2. Your monthly estimate

Total CBCT scans per month0

One scan per entered case, with each scan counted once.

Treatment plans clarified or changedNo estimateStudy illustration per month

The decision figure illustrates findings from selected cases in an endodontic specialty clinic. It is not a validated forecast for your practice or a measure of improved patient outcomes.

How is the decision figure calculated?

We multiply each matching case count by its published treatment-planning percentage, add the results, and round the total once. The study counted teeth; this illustration assumes one primary tooth or endodontic question per entered scan.

Percentages used from Chugal and colleagues, JADA 2024, Figure 4
Case category	Your cases	Study rate

“Clarified or changed” includes establishing a plan that was previously uncertain and correcting a provisional plan. Other categories remain in the scan total but are not assigned a rate. Diagnosis-change and fracture-detection percentages are not added to this figure.

Read the study · Review sources

3. Optional revenue from scans alone

Assumes your practice performs and charges for every scan in the total.

What would you charge per CBCT scan? ($)

Gross scan revenue per month—

Enter your fee to calculate monthly scan revenue.

Scan fees only. Excludes treatment revenue, expenses, discounts and uncollected charges. Gross revenue is not profit.

← All scan guides

Scan selection

Field of view & image detail

Choose the scan size and resolution that match the diagnostic question, patient context, and level of detail needed.

Main principle

Match the scan to the question

Select the scan coverage and image detail needed to answer the clinical question, considering the individual patient and ALADA/ALADAIP principles. Avoid unnecessary exposure; the smallest scan or highest resolution is not always the appropriate choice.

Localized questionSmaller fields of view are often appropriate when the clinical question is localized.

Broader anatomyBroader coverage may be appropriate when the anatomy of interest extends beyond one focused region.

Fine detailHigher resolution may be useful when subtle endodontic, root-surface, or cortical detail is clinically relevant.

Larger structuresStandard or lower-dose protocols may fit broader anatomy when fine-detail visualization is not the primary objective.

Scan coverage

Compare the area each field of view covers. Expand a card to review examples.

Focus field

Useful when the clinical question is highly localized and fine detail is important.

Review examples

May fit questions such as

Localized endodontic concern
Suspected vertical root fracture
Localized resorption evaluation
Focused periapical assessment
High-detail review of a limited anatomical region
Localized pre-surgical endodontic assessment

Single jaw

A single-jaw scan may be the practical minimum when implant planning, intraoral scan integration, or guide design needs continuous anatomy across one arch.

Review examples

Worth considering when

Multiple teeth within one arch are being evaluated
Implant planning requires regional anatomical context
Intraoral scan overlay or surgical guide design is anticipated
The anatomy of interest extends beyond a focus field
Sinus or mandibular canal relationship must be evaluated within one arch

Dual jaw

Dual-jaw imaging may help preserve anatomical relationship between arches while avoiding unnecessary expansion into a broader cranial scan.

Review examples

May be useful when

Both arches require evaluation together
Occlusal or opposing-tooth relationships are clinically relevant
Symptoms are difficult to localize between arches
Upper and lower anatomy together may improve interpretation
Broader restorative or functional relationships must be visualized

5x8 regional scan

A 5x8 FOV refers to approximately 5 cm width by 8 cm height, allowing upper and lower arch anatomy to be captured within a focused regional scan.

A 5x8 regional scan may be useful when the clinician needs focused anatomical detail while still capturing vertically related upper and lower anatomy within one localized region.

Review examples

Examples

Pain that radiates between upper and lower arches
Symptoms that are difficult to localize clinically
Evaluation involving opposing posterior teeth
Localized regional pathology involving both arches
A traditional focus field may be too restrictive vertically
Regional implant or surgical evaluation involving opposing anatomy

A 5x8 scan may help keep the view focused while still showing upper and lower anatomy in the same region.

Cranial scan

Cranial scans are generally reserved for situations where the clinical question cannot reasonably be answered using a more limited field of view.

Review examples

May be considered when

Airway or broader craniofacial anatomy is relevant
Orthodontic evaluation requires broad relationships
Broader surgical planning is being evaluated
Trauma or larger pathology assessment requires larger coverage
Bilateral or multi-regional anatomy must be reviewed together
Full craniofacial relationships are clinically relevant

Image detail

High resolution

May be useful when fine detail may affect interpretation.

Review examples

Fine endodontic detail
Suspected vertical root fracture
Resorption detail
Subtle periapical findings
Root morphology or canal anatomy
Pre-surgical endodontic planning

Standard resolution

May be appropriate when the diagnostic question is not dependent on the smallest visible detail.

Review examples

Broader anatomy review
Implant planning that does not require ultra-fine endodontic detail
Sinus, airway, impaction, orthodontic, or larger structural questions

Lower-dose / lower-resolution protocols

Often fit questions involving larger structures rather than subtle fine-detail interpretation.

Review examples

Larger anatomical structures
Broader anatomical orientation
Airway, sinus, orthodontic, craniofacial, or structural evaluation
Patient-specific dose considerations

System & lab notes

These notes refer to CSD systems and laboratory workflows. Confirm requirements for your equipment and lab.

High-resolution coverage on CSD systems

Some CBCT systems restrict high-resolution imaging to very small focus fields. CSD CBCT systems can capture high-resolution datasets across field sizes larger than a traditional localized focus field. This may allow clinicians to see fine detail while still including enough surrounding anatomy to answer the clinical question.

Preparing scans for laboratory workflows

High-resolution datasets from CSD CBCT systems may contain more detail and larger files than some labs prefer for routine guide fabrication or digital workflows.

Many labs prioritize manageable file size, enough anatomical coverage, efficient workflow, and easier segmentation rather than maximum possible resolution.

A scan optimized for fine clinical review may not always be the ideal dataset for every laboratory workflow. Confirm preferred scan settings, export requirements, file formats, and workflow limits before sending datasets.

This guidance is educational and intended to help align scan selection with the clinical question and ALADA/ALADAIP radiation-safety principles. It does not diagnose, recommend treatment, replace clinician judgment, or determine the correct scan protocol for an individual patient.

← All scan guides

Image review

Review images in CS 3D Imaging.

Start with the basic review steps, then choose the area you want to examine. Review the full scan as well as the area of concern.

Before reviewing a specific area

Use the slice views (MPR) first, not the 3D rendering, for image review and measurements.
Orient the area of interest so the tooth or ridge is straight in at least two planes.
Scroll slowly through adjacent slices before deciding whether a finding is real.
Save screenshots that show the finding in more than one plane.

Tooth and sinus relationship

Follow the root apices, sinus floor, and adjacent mucosa in sagittal and coronal views.
Look for a dental source plus a matching sinus response, not mucosal thickening alone.
Ask whether the cortical sinus floor is intact, thinned, or interrupted.
When the relationship is uncertain, describe the uncertainty rather than calling it dental in origin too quickly.

Back to review topics ↑

Resorption

Center the tooth and scroll from crown to apex in axial slices.
Decide whether the defect starts inside the canal space or on the external root surface.
Describe location, depth, pulpal proximity, and bone communication.
Use the scan as an anatomic map, then confirm significance with clinical findings.

Back to review topics ↑

Cracks and fractures

Do not require a visible crack line; it may be hidden by voxel size or artifact.
Look for supporting bone patterns: isolated narrow defects, halo loss, or buccal/lingual breakout.
Be cautious near posts, crowns, and root filling material.
Interpret CBCT together with probing, bite testing, symptoms, and 2D images before any clinical decision.

Back to review topics ↑

Root canals and endodontic anatomy

Start at the chamber floor and follow canal paths apically in axial slices.
Use the synchronized crosshair to confirm the same structure in all three views.
Map missed anatomy, curvature, calcification, perforation risk, and apical anatomy.
Keep the scan question specific and document what clinical uncertainty the image is helping clarify.

Back to review topics ↑

Implant site and surgical anatomy

Trace the arch and evaluate cross-sectional slices at the proposed site.
Measure ridge width, height, concavities, sinus or nasal floor, and nerve position in cross-section.
Keep the restorative goal, anatomy, and patient-specific risk factors in the same view.
Record the slice and plane used for key measurements.

Back to review topics ↑

Periodontal and bone defects

Evaluate buccal, lingual, mesial, and distal surfaces separately.
Differentiate periodontal defects from endodontic lesions by tracking their origin and extent.
Thin bone may disappear because of artifact or resolution limits, so be cautious before calling dehiscence.
Use CBCT as an anatomic map, then confirm with probing and clinical attachment findings.

Back to review topics ↑

Review the full scan

Review beyond the immediate tooth: sinuses, nasal cavity, canals, cortices, condyles, and airway space.
Separate dental findings from incidental or nonodontogenic findings in the chart.
Refer when a finding is outside the clinical question or your interpretive comfort.
Document what was reviewed and why the scan was taken.

← All scan guides

Artifact examples

Compare artifact patterns

Compare common artifact patterns and review checks that can help with interpretation.

Check for patient movement first. Motion can duplicate borders, blur fine anatomy, and change the apparent size of small defects. Review the whole scan for motion before interpreting subtle findings.

Hover over an image to enlarge it. Click to open the image viewer.Tap an image to open the image viewer.

ImagePatternTypical appearanceHow to check it

Patient movementHow common? Most commonTypical appearanceSame CBCT machine, different patients: motion produces global blur, softer canal borders, and less interpretable trabecular/cortical detail.How to check itCompare edges across the whole scan. Motion affects many structures at once, while disease usually follows anatomy.

Beam hardeningHow common? Very commonTypical appearanceA black line or band adjacent to dense material. In a canal, it can look like obturation stops short or leaves an unfilled void.How to check itAsk whether the dark line follows the curve or contour of the radiopaque material blocking the x-rays. If it tracks the material instead of anatomy, treat it cautiously.

Scatter from metalHow common? Very commonTypical appearanceBroad dark bands, bright streaks, or starburst effects radiating from crowns, posts, restorations, or implants.How to check itLower confidence inside the scatter path. Correlate with clinical tests and 2D images before diagnosing cracks or bone loss next to metal.

Noise and limited fine detailHow common? CommonTypical appearanceGrainy texture or soft boundaries make subtle root-surface, canal, or cortical findings less certain.How to check itAdjust brightness/contrast and decide only from findings that persist across adjacent slices and planes.

Blending artifactaliasing / partial volumeHow common? OccasionalTypical appearanceThin structures may appear softened, merged together, interrupted, or less sharply separated than expected.How to check itReview nearby slices and multiple planes before deciding a structure is truly missing, fractured, or perforated.

Ring / detector artifactHow common? RareTypical appearanceCircular or band-like pattern unrelated to anatomy.How to check itLook for the same pattern crossing air, soft tissue, teeth, and bone. Anatomy respects anatomy; detector artifact does not.

Reference

CDT code reference

Common CBCT-related CDT codes for educational reference. Codes do not determine medical necessity, guarantee reimbursement, or replace current CDT guidance, payer policy, documentation requirements, or the procedure actually performed.

Reference only. Confirm code selection using current CDT guidance, payer policy, documentation requirements, and the procedure actually performed. Clinical indication, image content, and insurance coverage are separate considerations.

CodeReference description

D0364CBCT capture and interpretation with limited field of view, less than one whole jaw.

D0365CBCT capture and interpretation with field of view of one full dental arch, mandible.

D0366CBCT capture and interpretation with field of view of one full dental arch, maxilla, with or without cranium.

D0367CBCT capture and interpretation with field of view of both jaws, with or without cranium.

D0368CBCT capture and interpretation for TMJ series including two or more exposures.

D0381CBCT image capture and interpretation with field of view of one full dental arch, mandible.

D0382CBCT image capture and interpretation with field of view of one full dental arch, maxilla, with or without cranium.

D0383CBCT image capture with field of view of both jaws, with or without cranium.

D0384CBCT image capture for TMJ series including two or more exposures.

Evidence

About & references

How the case tool works

The case tool recognizes selected clinical questions, checks the reported circumstances and shows guidance with source links. It distinguishes missing information, conflicting details, existing imaging, unsupported purposes and topics outside its coverage.

Descriptions and follow-up answers are processed in your browser; they are not sent or saved. Omit patient identifiers. Recognition can be incomplete, and the software has not been independently validated as a clinical decision instrument.

Each result explains which information was used. It is not a diagnosis, a probability of disease or a prescription for a scan. Read the decision rules, source map and limitations.

The scan estimator uses your entered case counts and optional fee. These values and study outcome percentages do not influence clinical guidance.

Selected study findings

These results come from the study populations described in each source and may not apply to your case mix.

Guidance & patient selection

ADA/AAOMR 2026 clinical recommendations. The clinical case rules link directly to the applicable box or table in the full consensus recommendations. Full recommendations (PDF) · Journal DOI · Case-tool source map

AASM adult OSA diagnostic guideline (2017). Recommendations 1–2 support the case tool’s sleep-apnea diagnostic boundary. Full guideline (PDF)

AAE/AAOMR 2025 update. AAE newsroom announcement, January 14, 2026: the update replaces the 2015 statement, condenses recommendations to 12, emphasizes training, ALADAIP, selective use, and patient-specific protocols. Source

ADA/AAOMR patient selection and ADA safety guidance. ADA Oral Health Topic on X-rays/Radiographs, updated March 26, 2026: imaging should follow clinical need, patient selection criteria, ALARA/ALADA principles, and CBCT should be used when lower-exposure imaging will not provide the needed diagnostic information. Source

Research studies

Study results describe the populations and methods in each source. Review the source before applying a finding to your practice.

Applying AAE/AAOMR guidelines in endodontics. JADA 2024 study: CBCT was prescribed for 12% of patients, changed periapical diagnosis in 21% of evaluated teeth, and changed, established, or corrected treatment plans in 69% of evaluated cases overall. Reported rates describe the selected endodontic study population. They are not general-practice forecasts. Study DOI

Impact on endodontic diagnosis. The study "The impact of cone beam computed tomography (CBCT) on the choice of endodontic diagnosis" reports diagnosis changes for at least one tooth in 41% of patients and 35% of evaluated teeth. Study DOI

Referral impact in endodontics. The study "CBCT assessment of referral reasons and impact on modifying treatment plan in endodontics" reports diagnosis changes in 34.45% in the abstract and major treatment-plan changes in 62.02% of referred endodontic cases. These results describe referred endodontic cases. Study DOI

Vertical root fracture diagnostic accuracy. Hassan and colleagues report overall diagnostic accuracy of 0.86 for CBCT and 0.66 for periapical radiographs in a laboratory study of vertical root fracture detection in endodontically treated teeth. Study DOI

Impacted canines. The 2025 Applied Sciences study reports that 51.5% of extraction decisions made with 2D data changed to orthodontic traction after CBCT review. This is specialty-specific impacted-canine context. Study DOI

What would you like to do?

Review a clinical case

Use the scan guides

Estimate scan volume

Quick access

Artifact examples

Field of view & resolution

CDT code reference

Review a clinical case.

Add a case to begin

How do you think the additional information could impact the outcome?

What to clarify

How to use the result

Find help with your scan.

Scan size & detail

Image review

Artifact examples

Estimate your monthly CBCT scans.

1. Enter your monthly cases

2. Your monthly estimate

Field of view & image detail

Match the scan to the question

Scan coverage

Focus field

Single jaw

Dual jaw

5x8 regional scan

Cranial scan

Image detail

High resolution

Standard resolution

Lower-dose / lower-resolution protocols

System & lab notes

Review images in CS 3D Imaging.

Before reviewing a specific area

Review the full scan

Compare artifact patterns

CDT code reference

About & references

How the case tool works

Guidance & patient selection

Research studies