CBCT, or cone-beam computed tomography, is an imaging technology that has gained widespread recognition, especially in dentistry, orthodontics, otolaryngology, and maxillofacial surgery. The main advantage of CBCT is its ability to image small and precise structures such as teeth, jaws, facial bones, temporomandibular joints, paranasal sinuses, and nerve canals. Compared to traditional computed tomography (CT), cone-beam tomography uses lower doses of radiation, making it a safer method for patients.

These technologies differ in their applications, image quality, and the radiation dose received by the patient. What other differences between CBCT and CT are significant from the patient’s perspective? When should you choose cone-beam tomography, and when computed tomography?

CBCT vs. Traditional Computed Tomography (CT) – Fundamental Differences

1. Principle of Operation

Cone-beam tomography (CBCT) uses a cone-shaped X-ray beam that performs a full rotation around the patient’s head, capturing images from multiple angles simultaneously. The collected data is processed into a high-resolution three-dimensional image. In contrast, computed tomography (CT) operates by emitting X-rays that pass through the patient’s body and are then recorded by detectors on the opposite side of the scanner. The system rotates around the patient, creating multiple cross-sectional images of the body, which are computer-processed into a three-dimensional image.

2. Radiation Dose

One of the key aspects that differentiates CBCT from traditional computed tomography is the radiation dose.

• CBCT is characterized by a significantly lower radiation dose. Thanks to the cone-shaped X-ray beam, CBCT allows for obtaining a three-dimensional image with less radiation exposure for the patient. This means that cone-beam tomography is always a safer choice in terms of the radiation dose received by the patient. This is particularly important when multiple examinations are necessary in a relatively short time and for patients who need regular check-ups.
• CT generates a higher radiation dose due to the way image data is collected. Traditional computed tomographs can emit from 50 to even 500 times greater radiation dose than CBCT, depending on the type of examination and exposure parameters.

3. Image Quality and Detail

Over several decades of cone-beam tomography technology development, it has become possible not only to obtain images as sharp as traditional tomography but even surpassing it. Currently, advanced CBCT scanners offer better image quality than most traditional tomographs available on the market. They produce images of very high resolution, as demonstrated by the modern devices used at Skanai.

It’s worth choosing CBCT when imaging facial structures is necessary—teeth, bones, joints, or paranasal sinuses. Among the advantages of CBCT is the ability to quickly assess the image during the examination. This allows for immediate correction or even repeating the scan if necessary.

The advantage of CT, on the other hand, is the ability to accurately image soft tissues. However, currently, CBCT undoubtedly surpasses traditional tomography in quality when imaging small and precise structures such as teeth, jaws, facial bones, temporomandibular joints, paranasal sinuses, and nerve canals. Computed tomography also allows obtaining images of different slice thicknesses, enabling detailed assessment of pathological changes.

• Cone-beam tomography has significantly improved its image quality, especially in the area of facial structures. Modern CBCT devices, such as those used at Skanai, offer very high resolution, making them particularly effective in imaging teeth, bones, joints, and paranasal sinuses. A key advantage of CBCT is the ability to quickly assess the image during the examination, which allows for immediate correction or repeating the scan if needed. This makes CBCT the preferred choice in diagnostics of facial structures, where precision and speed are crucial.

The photo shows an example of a cone-beam tomograph at Skanai.

• On the other hand, computed tomography (CT) offers high image quality, especially for soft tissues. CT is ideal for diagnosing more complex structures such as internal organs, the brain, or the vascular system. It also enables obtaining images of different slice thicknesses, allowing for accurate assessment of pathological changes.

The photo shows an example of a traditional computed tomograph.

4. Examination Time and Patient Comfort

One of the fundamental differences between cone-beam tomography and traditional tomography is the time required to perform the examination. In the case of a traditional tomograph, the patient must lie still inside the scanner for some time, which can be difficult for many people — especially the elderly, those with disabilities, or those with claustrophobia. In contrast, performing a scan using CBCT takes only a few seconds. Moreover, the patient does not have to lie down, as the examination takes place in a standing or sitting position. The short exposure makes the examination less stressful for the patient. The risk of motion artifacts is also reduced, which positively affects image quality.

When to Choose CBCT, and When Computed Tomography?

The differences between CBCT and CT mean that they have somewhat different applications in diagnostics. CT is primarily used when we need to obtain images of soft tissues and internal organs. Therefore, it is worth choosing computed tomography for assessing neoplastic changes, multi-organ injuries, or neurological problems.

On the other hand, CBCT has found application mainly in dental, otolaryngological diagnostics, and facial surgery. When to choose CBCT? Primarily for:

• Diagnostics and planning of dental treatment, e.g., in root canal treatment, implantation, or jaw surgery.
• Assessment of all sinuses.
• Diagnostics of temporomandibular joints, e.g., when it is necessary to assess their structure, detect degenerative changes, or anatomical anomalies.
• Assessment of airways, e.g., in the evaluation of sleep apnea.

Cone-Beam Tomography vs. Traditional Tomography – What to Choose?

When to choose CT, and when CBCT? The decision to choose between cone-beam tomography and traditional tomography should be based on several key aspects:

• Type of Examination: CBCT is the best choice if detailed assessment of bone structures is necessary. However, computed tomography may be better suited for examining soft tissues and internal organs.
• Radiation Dose: One of the main differences between CBCT and CT is the radiation dose received by the patient. Therefore, CBCT will be a safer choice when multiple examinations are necessary or for patients particularly sensitive to radiation (e.g., children and pregnant women).
• Patient Comfort: Many patients have difficulty lying still for a long time. In those situations, CBCT offers greater comfort by shortening the examination time and eliminating the need to lie down.

Read also: What You Should Know About Radiation in Imaging Diagnostics.

Both cone-beam tomography and traditional computed tomography are advanced diagnostic technologies without which it is hard to imagine modern medicine. Thanks to significant development, CBCT has become a highly valued tool, especially in facial diagnostics. On the other hand, CT remains indispensable in the assessment of soft tissues. Therefore, the decision on the choice of examination type should be made by the physician based on the individual needs of the patient and the type of diagnosed conditions.

If you need a professional CBCT examination, we invite you to our diagnostic laboratory Skanai.