Diagnostic Accuracy of <scp>CBCT</scp> Versus <scp>2D</scp> Radiography for Various Dental Pathologies: A Systematic Review and Meta‐Analysis

ABSTRACT Accurate diagnosis of dental pathologies is essential for effective treatment. Cone‐beam computed tomography (CBCT) provides 3D imaging that may surpass 2D radiography, despite higher radiation and cost. This systematic review and meta‐analysis compared CBCT and 2D radiography for diagnosing periapical lesions, root fractures, endodontic complications, root resorption, third molar issues and root perforations. Following PRISMA 2020, we searched PubMed, Scopus, Web of Science, Embase, Cochrane and Google Scholar until September 2025. Studies with sensitivity and specificity versus histopathology or clinical references were included. Pooled sensitivity (SRR) and specificity risk ratios (SpRR) were computed using R, assessing heterogeneity ( I 2 ) and publication bias. From 3214 records, 48 studies (5604 patients) showed CBCT's superior accuracy (SRR: 1.53, 95% CI: 1.34–1.75; SpRR: 1.08, 95% CI: 1.01–1.14), particularly for root fractures (SRR: 1.89, 95% CI: 1.49–2.39). CBCT thus improves diagnostic precision, recommended for complex cases. Trial Registration: PROSPERO: CRD420251142505