3D CBCT Imaging

A cone beam CT scanner takes a three dimensional picture of your jaws in under a minute. A flat x-ray flattens everything into one plane, so roots overlap and bone width disappears. The cone beam scan separates them. At Pearl32 Dentistry and Wellness in Laguna Hills, we use it when it changes the plan: implants, wisdom teeth, failed root canals and jaw joint questions. The scanner sits in our own office in Suite 450.

What does a cone beam scan show that a flat x-ray cannot?

It shows depth. A regular x-ray gives height and width. A cone beam scan adds the third dimension, so we can measure bone thickness from cheek to tongue, which decides whether an implant fits.

Four other things become visible. The path of the lower nerve canal, which must be avoided. The floor of the sinus, which sits above the upper back teeth. Extra or missed canals inside a root. And small areas of bone loss at root tips that a flat image hides behind the root itself. See our digital dentistry page for the rest of the equipment.

When is a scan used?

Four situations account for most scans. Planning dental implants, where bone height, width and nerve position decide everything. Assessing wisdom teeth whose roots may sit against the nerve canal. Investigating a root canal that has failed, to find a missed canal or a root fracture.

The fourth is jaw joint and airway assessment, including night guard and sleep appliance planning. We also scan before some extractions in the front of the mouth, and when a tooth hurts and everything else looks normal. If a flat x-ray answers the question, we use the flat x-ray.

How much radiation is involved?

The dose is low compared with a medical CT of the same region, and higher than a single dental x-ray. A small field scan of one area sits in the range of a few days to a couple of weeks of ordinary background radiation. A medical CT of the head is far higher than either.

We control dose in three ways. We choose the smallest field that answers the question. We use the lowest resolution that shows what we need. And we scan only when the result will change the treatment plan. Tell us if you are or may be pregnant.

What is the scan like?

You stand or sit still while the arm rotates once around your head. It takes under a minute, and it does not enclose you. Nothing touches your teeth. There is no dye and no injection.

The images appear on the screen in the operatory within a few minutes. We go through them with you, slice by slice, and show you the measurement that matters: the millimeters of bone above the nerve, or the dark area at a root tip. Most people find the picture easier to follow than a flat x-ray. The scan is part of your record and we can share a copy.

What a scan will not do

A scan will not show soft tissue detail. It images hard structures well and is poor at muscles, discs and nerves themselves. For a jaw joint disc problem, an MRI is the right test, and we refer for one when the question calls for it.

It also will not reliably show a crack. Cracks are often narrower than the resolution of the scan, so we rely on a bite test, dye, light through the tooth and direct inspection, using the scan mainly to read the bone pattern beside the root. And a scan does not replace an examination. It informs one.

What does a cone beam scan cost?

A cone beam scan is quoted in writing, itemized, after an examination, and it is listed as its own line so you can see it. It is often included within an implant or surgical plan rather than charged separately, and we tell you which applies to your case.

We are in network with most major PPO plans and Delta Dental HMO. Coverage for three dimensional imaging varies widely between plans, so we check yours before scanning. Third party financing is available and the practice is not the creditor, through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). See financing.

Questions people ask about 3D CBCT Imaging

Is a cone beam scan safe?

The dose is low compared with a medical CT of the same area, though higher than a single dental x-ray. We reduce it by scanning the smallest field that answers the question. We also scan only when the images will change the plan, which is the part that matters most. Tell us if you are or may be pregnant so we can postpone or reconsider.

Will I be enclosed in a tube?

No. You stand or sit upright while an arm rotates once around your head. Nothing encloses you and nothing touches your teeth. The rotation takes under a minute, and holding still is the only thing asked of you. People who find MRI machines difficult usually have no trouble here. If you are unsteady on your feet, the scan can be taken seated.

Can I bring a scan from another office?

Yes, and please do. Bring the raw data file, usually on a disc or a download link, rather than printed images, because the raw file lets us view any slice we need. If it was taken within the last twelve months and covers the right area, we can often avoid a new scan. Older scans are reviewed case by case.

Do I need a scan for every implant?

For nearly every one, yes. Implant planning needs bone width and the distance to the nerve canal or the sinus floor, and neither is measurable on a flat x-ray. The scan also lets us position the implant for the crown rather than only for the bone. For a simple filling or a routine cleaning, no scan is needed.

How long does the appointment take?

The scan itself takes under a minute. Allow about twenty minutes for the visit, which includes positioning, processing and reviewing the images with you on the screen. It is usually combined with a consultation rather than booked alone. We are at 24022 Calle De La Plata, Suite 450, reached by elevator, Monday to Friday, 8 AM to 5 PM.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.