When is cone-beam computed tomography most justified in endodontics?

• A. When complex anatomy, extreme root curvature, resorption, or occult pathology are suspected and 2D imaging is inconclusive
• B. Routine checks with straightforward cases
• C. Only for radiographic documentation after treatment
• D. In all patients regardless of findings

Answer: (C)

Cone-beam computed tomography should be used when the information from standard 2D radiographs is not enough to reliably diagnose or plan treatment, such as when complex canal anatomy, extreme root curvature, resorption, or occult pathology is suspected. The 3D view provided by CBCT helps reveal variations and lesions that 2D images can miss, guiding more accurate access design, prognosis assessment, and management decisions.

Using CBCT for routine checks in straightforward cases isn’t justified because it adds radiation exposure and cost without improving outcome. Limiting its use to radiographic documentation after treatment is too narrow; CBCT is most valuable when its detailed 3D information will influence how you diagnose or treat, not merely to document healing after the fact.