In what scenarios is cone-beam computed tomography (CBCT) preferred over conventional radiographs in endodontics?

• A. When complex anatomy, root curvature, resorption, or occult periapical pathology is suspected and 2D imaging is inconclusive
• B. Routine checks for straightforward cases
• C. No suspicion of pathology
• D. Only for implants

Answer: (A)

The key idea is that 3D imaging is used when the information from standard 2D radiographs isn't enough to understand the tooth and surrounding structures. Cone-beam CT gives a true three-dimensional view, so it can reveal complex root canal anatomy, curved or narrow canals, accessory roots, resorption patterns, and occult periapical pathology that may be hidden or overlapped in 2D images. This added detail can change how you access the tooth, negotiate canals, or decide on surgical or other interventions. In routine cases with clear anatomy and no signs of disease, conventional radiographs usually provide sufficient information with a lower radiation dose. So CBCT is preferred specifically when 2D imaging is inconclusive or when there’s a suspicion of complex anatomy or hidden pathology. It’s not limited to implants, and its use should be justified by the potential to impact treatment.