When to Get a CBCT Scan for Dental Treatment

At Valley Hills Dentistry, we know that dental procedures can sometimes feel overwhelming. One technology that patients often have questions about is the Cone Beam Computed Tomography (CBCT) scan. This advanced imaging technique has transformed how dental professionals diagnose and treat various conditions.

What Is a CBCT Scan Dental Examination?

A CBCT dental scan creates detailed 3D images of teeth, soft tissues, nerve pathways, and bone structures in a single scan. Unlike traditional X-rays that produce flat, two-dimensional images, the dental CBCT scan offers a complete volumetric view of the oral and maxillofacial region.

According to data published by the National Center for Biotechnology Information (NCBI), Cone Beam Computed Tomography (CBCT) delivers up to 98% diagnostic accuracy in detecting complex root canal anatomy, missed canals, and periapical lesions, far surpassing the capabilities of traditional 2D X-rays. 

Additionally, CBCT exposes patients to a radiation dose nearly 10 times lower than conventional CT scans, while offering superior 3D imaging. This makes it an essential tool in modern dentistry for procedures like dental implant planning, TMJ evaluation, and orthodontic diagnostics.

Common Situations When a CBCT Scan Is Recommended

Dental Implant Planning

Implant dentistry requires precise assessment of:

• Bone density: This measurement determines if the jawbone can support an implant without additional procedures. Insufficient density might require bone grafting before implant placement.

• Bone volume: The three-dimensional quantity of available bone directly impacts implant size selection. Adequate volume ensures proper integration and long-term stability of the dental implant.

• Location of anatomical structures: Identifying nerves, sinuses, and adjacent tooth roots prevents surgical complications. Precise mapping allows for safe implant placement without damaging critical structures.

• Available space for implant placement: Proper spacing ensures functional and aesthetic outcomes for the final restoration. Insufficient space may require orthodontic preparation or alternative treatment plans.

The three-dimensional imaging helps determine if bone grafting might be necessary before implant surgery.

Impacted Teeth Evaluation

For patients with:

• Wisdom teeth complications: The scan reveals exact positioning relative to nerves and adjacent teeth. This information helps prevent nerve damage and unnecessary trauma during extraction procedures.

• Canines that haven't erupted: CBCT shows the precise location and orientation of impacted canines for treatment planning. This visibility allows orthodontists to create targeted strategies for bringing these teeth into proper alignment.

• Other impacted teeth: The relationship between impacted teeth and surrounding structures becomes clearly visible. This knowledge helps determine whether surgical extraction or orthodontic guidance is the better approach.

The 3D visualization shows the exact position of these teeth and their relationship to other structures, making extraction or orthodontic treatment planning more accurate.

Root Canal Treatment

For complex endodontic cases, especially when:

• Previous root canal treatment has failed: CBCT reveals missed canals or anatomical variations causing persistent infection. This visibility allows for targeted retreatment addressing the specific areas of concern.

• Patients have unusual root anatomy: Extra canals, curved roots, or fused roots become visible in three dimensions. This detailed view helps endodontists navigate complex root systems successfully.

• There are signs of root fractures: Hairline fractures, often invisible on traditional X-rays, can be detected with CBCT imaging. Early identification prevents unnecessary treatments when a tooth might require extraction instead.

• Dental pulp infection has spread: The extent of infection beyond the tooth apex can be accurately assessed. This information guides treatment decisions and helps determine the prognosis for saving the tooth.

TMJ Disorders

The temporomandibular joint (TMJ) can be thoroughly examined using CBCT, helping diagnose:

• Joint degeneration: Early signs of cartilage wear and bone changes become visible before symptoms worsen. This early detection allows for intervention before permanent damage occurs.

• Structural abnormalities: Congenital or acquired defects in the joint structure can be identified with precision. Understanding these abnormalities helps create targeted treatment plans addressing the root causes.

• Bone changes: Erosions, cysts, or abnormal bone growth patterns are visualized in three dimensions. These findings often explain persistent pain or dysfunction that traditional imaging has missed.

• Joint dysfunction causes: The relationship between the condyle, disc, and fossa can be evaluated in detail. This comprehensive view helps determine whether splint therapy, surgery, or other interventions would be most effective.

Orthodontic Planning

For comprehensive orthodontic assessment:

• Tooth positioning: The exact location of each tooth relative to ideal placement becomes clear through 3D imaging. This precision allows for more accurate treatment planning and prediction of tooth movements.

• Jaw relationships: The alignment between upper and lower jaws can be evaluated from multiple angles. This assessment helps determine if orthognathic surgery might be needed alongside orthodontic treatment.

• Dental arch development: Any abnormalities in arch form or growth patterns become evident through volumetric analysis. These insights guide expansion decisions and help prevent future complications from crowding or spacing issues.

• Airway analysis: The volume and shape of the airway can be assessed for potential breathing issues. This evaluation helps identify patients who might benefit from additional treatments addressing sleep-disordered breathing.

Oral Surgery Preparation

Before surgical procedures such as:

• Complicated extractions: The relationship between tooth roots and vital structures becomes visible. This visualization helps surgeons plan the safest approach to remove difficult teeth without complications.

• Jaw surgery: The exact dimensions and relationships of facial bones can be measured precisely. This accuracy allows for virtual surgical planning and creation of custom surgical guides.

• Trauma repair: The extent of fractures and displacement of bone fragments can be fully assessed. This comprehensive view helps surgeons restore proper anatomical relationships during reconstruction.

• Pathology removal: The borders and extent of cysts, tumors, or other abnormal tissues can be clearly defined. This precision allows for complete removal while preserving adjacent healthy structures.

Making the Decision

The decision to get a CBCT scan dental examination should always be a collaborative one between the patient and the dentist. Our professionals at Valley Hills Dentistry evaluate each case individually, weighing:

• Diagnostic needs: The complexity of the case and information required determine imaging recommendations. More challenging cases often benefit from the additional data provided by three-dimensional imaging.

• Treatment complexity: Multi-stage or intricate procedures generally warrant more comprehensive imaging. CBCT provides critical information that can simplify complex treatments and improve outcomes.

• Patient-specific factors: Medical history, previous treatments, and individual risk assessments inform decisions. These personal considerations help tailor recommendations to each patient's unique situation.

• Alternative imaging options: The potential information gain must justify any additional radiation exposure. In some cases, combining several traditional radiographs might provide sufficient information without CBCT.

When to Request a CBCT Scan

Consider asking about this advanced imaging option if:

• Your treatment involves surgical procedures: Complex surgeries benefit from detailed anatomical mapping before the first incision. This preparation helps ensure safe and efficient surgical approaches with minimal complications.

• You have persistent pain of unknown origin: Subtle pathologies often invisible on conventional X-rays may be identified with CBCT. The additional dimension of information can reveal the source of mysterious dental or facial pain.

• Previous treatments haven't resolved your issues: Recurring problems may indicate complexities that only become apparent on 3D imaging. CBCT can reveal hidden factors contributing to treatment failure that need addressing.

• You're planning dental rehabilitation with implants: Comprehensive implant planning requires a detailed assessment of available bone and anatomy. Three-dimensional information significantly improves implant positioning and restoration design.

• Your case involves multiple or complex procedures: Coordinated treatment planning benefits from complete visualization of all structures. The comprehensive view allows for efficient sequencing of various procedures for optimal results.

Final Thoughts

The CBCT dental scan represents an important advancement in dental diagnostics. While not necessary for every dental situation, when indicated, it provides invaluable information that can make treatments more predictable, safe, and successful.

If you have questions about whether this type of imaging might benefit your specific dental situation, we encourage you to discuss your concerns with your dental provider, who can offer personalized guidance based on your oral health needs.