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While many linear measurements between cephalometric landmarks on 3D volumetric surface renderings obtained using Dolphin 3D software generated from CBCT datasets may be statistically significantly different from anatomic dimensions, most can be considered to be sufficiently clinically accurate for craniofacial analyses.

Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics.

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Maxillofacial cone beam computed tomography (CBCT) is one of the most significant advances in dental imaging since rotational panoramic radiography. While the acquisition of CBCT data is technically simple, numerous parameters should be considered so that CBCT imaging is performed appropriately and 'task specific'. This involves an understanding of not only exposure (e.g. geometric and software parameters to minimize patient dose, while sustaining diagnostic image quality) but also image formatting options to maximize image display. CBCT images contain far more detailed information of the maxillofacial region than do panoramic or other 2-D images and necessitate a thorough knowledge of the 3-D anatomy of the region and considerations of variability in the range of the anatomically normal. These principles, procedures and protocols, together with the interpretation of CBCT images form the basis of best practices in maxillofacial CBCT imaging. This communication aims to provide: (1) an overview of the fundamental principles of operation of maxillofacial CBCT technology; (2) an understanding of 'task specific' equipment, image selection and image display modes; and (3) a systematic methodology for sequencing interpretation of CBCT images.Keywords: 3-D X-ray, computed tomography, X-ray, cone beam, dental radiography, diagnostic image processing.Abbreviations and acronyms: ALARA = As Low As Reasonably Achievable; CAT = computed axial tomography; CBCT = cone beam computed tomography; CMOS = complementary metal oxide semiconductor technology; CT = computed tomography; DVR = direct volume rendering; FDK = Feldkamp; FH = Frankfort horizontal; FOV = field of view; FPD = flat panel detectors; HU = Hounsfield units; II ⁄ CCD = image intensifiers and charge-coupled device; IVR = indirect volume rendering; kV = kilovolt; mA = milliampere; MIP = maximum intensity projection; MPR = multiplanar reformations; MSCT = multiple slice detector acquisition; ROI = region of interest; RPR = rotational panoramic radiography; TACT = tuned aperture computed tomography.

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