Clinical Benefits and Limitations of Cone-Beam Computed Tomography in Endodontic Practice: A Contemporary Evidence-Based Review

Cone-beam computed tomography (CBCT) has transformed endodontic practice by enabling more precise diagnosis and treatment of pulpal and apical pathologies. The aim of this review was to summarize the current clinical applications, benefits and limitations of CBCT in endodontic practice. A search of electronic databases identified relevant literature on CBCT applications, innovations, and limitations. Emphasis was placed on identifying contemporary studies published in the last 5 years. In general, CBCT demonstrates better diagnostic efficacy across multiple applications, including identifying complex anatomy, detection of apical periodontitis, pre-surgical planning and the diagnosis and management of longitudinal root fractures, traumatic dental injuries and root resorptions. However, clinicians should balance the benefits of CBCT against its shortcomings, such as increased radiation exposure, presence of artifacts and higher costs. Proper use requires adherence to guidelines, optimized machine settings, and interpretation by trained individuals. Recent research explores the integration of CBCT with emerging technologies like artificial intelligence and guided systems. In summary, CBCT remains an essential tool for clinical decision-making in endodontics when used judiciously, with ongoing research continuing to expand its potential applications.