Four things an endo CBCT must do well
Most CBCT marketing is about big fields of view for implants. For endo, the opposite matters: a small, sharp volume of one or two teeth.
Small field of view
A limited volume of about 4×4 to 5×5 cm covers one or two teeth. It keeps the dose low and puts all the detail where you need it.
Look for: 4×4 or 5×5 cmSmall voxel size
Canals, isthmuses and early lesions are tiny. A voxel size of around 75 µm shows detail that a standard 150–200 µm implant scan blurs.
Look for: ~75 µm or smallerMetal artefact reduction
Posts, crowns and root fillings cause streaks that hide the very thing you're looking for. A metal artefact reduction (MAR) setting cleans much of this up.
Look for: a MAR option2D and 3D in one
Most practices don't need a dedicated endo scanner. A combined panoramic and CBCT unit gives you endo detail and replaces your OPG.
Look for: pan + CBCT unitWhen a CBCT is justified in endodontics
CBCT is not for every root canal. The European Society of Endodontology and the AAE/AAOMR joint position statement both recommend a limited field of view scan when periapical radiographs are inconclusive and 3D information will change your treatment. Typical cases:
- Complex anatomy, such as a suspected extra canal
- Calcified or obliterated canals
- Retreatment of a failed root canal
- Internal or external resorption
- Planning surgical endodontics
- Dental trauma
- Pain with no clear cause on 2D images
- Developmental anomalies, such as dens invaginatus
Under IR(ME)R, every scan needs a justification, and someone must report the whole volume, not just the tooth you scanned for. Our Level 1 online course covers justification. The Level 2 reporting day teaches you to report the full volume.
Which CBCT scanners suit endo?
We supply and install both Carestream and Acteon, so this is an honest comparison. Any of these will do excellent endo work. The right one depends on what else you want the machine to do.
| Scanner | Endo scan | Largest field of view | Also does | Best for |
|---|---|---|---|---|
| Carestream CS 8200 3D AccessFloor-standingGreat all-rounder | 5×5 cm at 75 µm | 8×9 cm, with a 10×10 cm option | Panoramic | General practice with a strong endo and single-implant focus |
| Carestream CS 8200 3D AdvanceFloor-standing | 5×5 cm at 75 µm | 12×10 cm, with a 16×10 cm option | Panoramic, optional ceph | Practices doing endo plus full-arch implants or oral surgery |
| Acteon X-Mind OptimaWall-mountedTight surgeries | 4×4 cm micro field at 70 µm | 12×10 cm | Panoramic, ceph option | Endo in a small room, since it takes no floor space |
| Carestream CS 9600Floor-standing | Small FOV at 75 µm | Up to 16×17 cm | Panoramic, ceph option, face scan | Referral centres and multi-disciplinary practices |
Weighing up the two most popular choices? Read our CS 8200 vs Optima comparison. For the full cost, including installation and training, see what a CBCT really costs in the UK.
Why voxel size and field of view matter so much
*In endodontically treated teeth, CBCT detected periapical lesions in 178 teeth, compared with 146 on periapical radiographs (Patel et al., International Endodontic Journal, 2012). Lesions that don't show on a PA can still be there.
A large, standard scan
A full-arch implant scan uses a larger voxel. Fine canals and small lesions blur, and metal streaks spread across the image. It's the right scan for implants, but the wrong one for endo.
A small, high-resolution scan
A 4×4 or 5×5 cm scan at 70–75 µm focuses on one or two teeth. You see canal anatomy, calcification and early periapical change clearly, at a lower dose to the patient.
Not ready to buy a CBCT? We run our own scan centre. You can refer a patient for a scan through MyCBCT and see the difference 3D makes to your endo cases first.
Endo CBCT FAQs
What voxel size do I need for endodontic CBCT?
Aim for around 75 µm or smaller. The Carestream CS 8200 3D and CS 9600 scan at 75 µm, and the Acteon X-Mind Optima reaches 70 µm in its 4×4 cm micro field. Standard implant scans use larger voxels, which blur fine canal detail.
What field of view is best for endo?
A limited field of view of about 4×4 to 5×5 cm, covering one or two teeth. It gives the sharpest image at the lowest dose, and it is what endodontic guidelines recommend.
Is CBCT better than a periapical radiograph for endo?
For the right cases, yes. CBCT shows the tooth in three dimensions, so it can reveal extra canals, calcification, resorption and lesions that a PA hides. PAs are still the first-line image. CBCT is justified when the PA is inconclusive and 3D information will change your treatment.
Do I need a CBCT for every root canal treatment?
No. Every scan must be justified under IR(ME)R. Most routine root canals only need periapical radiographs. CBCT helps with complex anatomy, calcified canals, retreatment, resorption, trauma, surgical planning and unexplained pain.
Can CBCT detect a vertical root fracture?
Sometimes. A small, high-resolution scan can show a fracture line or the bone loss pattern it causes. Metal posts and root fillings create artefacts that can hide or mimic a fracture, so metal artefact reduction and careful reporting matter.
Which is better for endo: the Carestream CS 8200 or the Acteon Optima?
Both are excellent. The CS 8200 3D scans 5×5 cm at 75 µm and is floor-standing. The Optima has a 4×4 cm micro field at 70 µm and is wall-mounted, so it suits a small surgery. Our side-by-side comparison covers the other differences.