Interpreting the Cone Beam Data Volume for Occult Pathology

Although digital x-ray adoption has been slow over the 20 years since its introduction, cone beam volumetric imaging (CBVI) or cone beam volumetric tomography (CBVT) has been employed very rapidly. Dentists will not replace all panoramic or intraoral procedures with CBVT, but the images and image data produced by this modality will help dentists perform many dental tasks more efficiently and confidently, tasks such as implant site assessment, visualizing temporomandibular joint structures and impaction problems among others. In short, dentistry, like medicine, will select the appropriate imaging modality for a specific diagnostic task—instead of trying to make one modality fit all tasks. Images and data sets will be moved between clinicians and laboratories rapidly and efficiently for diagnosis, second opinion, and even model and surgical guide construction as well as orthodontic models. Orthodontic analyses will eventually be performed with more accuracy in three-dimensional (3D) and 4D formats. This article attempts to predict in a limited way some of the imaging “standards of care” that will arise from the latest advancements in imaging and inform the reader of some issues yet to be resolved.