Why dental CT is needed, and what the dentist sees on it

Computed tomography, or 3D dental CT, is needed when a regular flat image isn't enough to see the true three-dimensional picture of the jaw: the shape and number of root canals, bone volume and density, the exact position of the mandibular nerve or maxillary sinus, and hidden inflammatory lesions near the root. Unlike a periapical or panoramic image, which show the shadow of the teeth in a single plane, CT builds a 3D model of the jaw with slices in any plane — and it's this model the dentist uses to plan complex endodontic treatment, implantation, wisdom tooth removal, or root movement during orthodontic treatment.

Why dental CT is needed

3D CT is most often prescribed before implantation, when a cyst or granuloma is suspected, when a tooth hurts and a regular image doesn't show all the canals, before removing complex impacted wisdom teeth, or when an orthodontist needs to see the actual position of the roots. The scan itself is taken at a separate diagnostic centre — more on that below. The search query "dental CT Dnipro" is most often entered right before one of these treatment steps, when the dentist has already recommended a 3D scan and the patient wants to understand what it's for and what to expect from the procedure.

How 3D CT differs from a regular scan

A periapical intraoral X-ray shows one or two teeth in a single projection — enough to check a root canal filling or shallow decay. A panoramic image (orthopantomogram) covers both jaws at once, but it's also a flat image, on which roots, bone, and neighbouring structures overlap one another. 3D CT is a series of thin slices from which the software builds a 3D model: the dentist can rotate the jaw on screen and view a cross-section at any point, rather than just a shadow, as on a flat image.

It's precisely because of the overlapping shadows on a panoramic image that it's easy to miss a second canal in a tooth, a vertical root fracture, or a small cyst — they hide behind neighbouring roots or bone. For example, a suspicious area of bone on a panoramic image often looks like nothing more than a faint shadow, whereas on CT the same area can be examined in three planes to work out whether it's inflammation or a separate canal that wasn't treated during previous treatment. A 3D image removes this overlap, so in ambiguous cases the dentist asks for a CT scan specifically, not another flat image. An orthodontist, for example, needs to see not just the crown of the tooth but the exact position of the root in the bone — on a panoramic image the root can look straight, when in reality it's tilted towards the neighbouring tooth or the cortical plate.

What exactly the dentist sees on a 3D scan

On a 3D scan, the dentist sees far more detail than on a flat image:

• additional and curved root canals that are not visible on a periapical X-ray;
• vertical root fractures;
• cysts and granulomas near the root apex, their exact size and boundaries;
• the volume and density of bone tissue at the future implant site;
• the exact position of the mandibular nerve relative to the roots and the future implant;
• the condition and dimensions of the maxillary sinus;
• the position of impacted (unerupted) wisdom teeth relative to the nerve and neighbouring roots;
• the actual position of the roots for planning orthodontic treatment.

This information directly affects the dentist's decision: whether all canals can be located and filled, or whether endodontics under the microscope, whether there's enough bone for an implant without additional procedures, and how to safely remove a wisdom tooth without touching the nerve. The dentist reviews the scan in special software right on the computer screen: it's possible to zoom in on a single root, take a cross-section at the required angle, and measure the distance in millimetres, rather than estimating it by eye.

When CT is genuinely needed, and when a regular scan is enough

CT doesn't replace the periapical X-ray in everyday practice. For ordinary decay, checking the quality of a root canal filling, or assessing bone level in periodontitis, a flat image is entirely sufficient — the radiation dose and cost are lower. For example, a routine filling replacement or a check after decay treatment doesn't require a 3D scan — a periapical X-ray of a single tooth is enough. A 3D image is justified when the dentist's decision depends specifically on spatial details that aren't visible on a flat image.

In practice, CT is ordered in the following situations:

• planning implantation — bone volume and density need to be assessed;
• suspected cyst, granuloma, or a hidden focus of inflammation;
• complex retreatment of root canals, when previous treatment hasn't succeeded;
• removal of impacted wisdom teeth close to the mandibular nerve;
• suspected root fracture;
• planning complex orthodontic treatment.

In other cases, the dentist usually manages with a periapical or panoramic image. If a tooth simply reacts to cold or there's a small enamel chip with no pain on biting, the dentist usually manages with an examination and, if needed, a periapical X-ray — a 3D scan wouldn't add any useful information in that case.

CT before implantation

Before implantation CT is needed almost always, and it's not a formality. On the 3D scan, the dentist sees the actual bone volume and density at the future implant site, and the exact position of the mandibular nerve and the maxillary sinus floor — it's these parameters that determine what size of implant can be placed and whether additional intervention is needed, such as a sinus floor lift. If there isn't enough bone in the side of the upper jaw because of the sinus's proximity, this is visible already at the diagnostic stage, and the treatment plan accounts for it in advance, rather than it becoming a surprise during surgery.

Based on the CT scan, the Houston clinic prepares a navigation surgical guide — it transfers the plan drawn up on screen directly into the mouth, so the implant is placed at the exact location and angle calculated in advance. Without CT, the dentist plans implantation essentially blind, relying only on a panoramic image, which doesn't show bone density or the actual distance to the nerve. The cost of implantation itself — from UAH 18,000, and this is a separate stage of treatment after diagnosis. The same applies to cases where a tooth was extracted previously and the bone has partly resorbed: CT shows exactly how much bone actually remains, rather than a rough estimate made during an examination in the chair.

Radiation dose: how safe is it

Radiation dose is a question that concerns almost every patient, and the honest answer is this: the Planmeca ProMax 3D uses Ultra Low Dose technology, and a CT scan of both jaws gives approximately 10-15 µSv depending on the scan volume. For comparison, published readings for various modes of ProMax series machines range from 4-22 µSv.

Every year a person receives approximately 2400-4000 µSv from natural background radiation (cosmic rays, soil, air), depending on the region they live in. Put simply, a single scan adds less than one percent to the annual dose — which is why dentists don't consider CT a cause for concern, provided there's a clinical need for it. The device also automatically reduces the dose for children. A dentist orders a CT scan only when the information obtained genuinely affects the treatment plan, not as a formality, so the additional radiation is justified by the clinical benefit it brings.

Dental CT for a child

A dental CT scan for a child is done for medical indications, not for prevention: for example, if the position of an unerupted tooth needs assessing, a complex orthodontic treatment plan needs to be drawn up, or the effects of an injury need investigating. This kind of scan is usually recommended from age 5-7, once the child can sit still for a few seconds, which is needed for a good-quality scan. If a child only needs a check on decay or the state of tooth eruption without suspicion of a complex problem, the dentist manages with a panoramic or periapical image, just as for an adult patient.

The device automatically reduces the radiation dose for children depending on jaw size, so there's no need to manually reduce the scan area further. The decision on whether a child needs a CT scan is made individually by the dentist, based on the specific clinical situation.

CT and pregnancy

X-ray examinations, including CT, are only done during pregnancy for clear medical indications and using a protective apron covering the abdomen. The decision on whether a scan is advisable during this period is made by the dentist together with the patient, taking into account how urgent the problem is and whether the scan can be postponed to a later date. If it's possible to wait until after delivery, that's usually what's done; if urgent care is needed, the dentist weighs up the benefit-to-risk ratio in the specific situation. Dental problems that aren't a health risk and can wait are usually postponed until after delivery, while routine consultations without scans can be attended throughout the pregnancy.

How the examination goes

Scans are taken at Houston 3D, a separate diagnostic centre at 3B Mykhaila Hrushevskoho Street in Dnipro, using a Planmeca ProMax 3D machine with a resolution of up to 75 µm. No doctor's referral is needed: you can come on your own initiative or on the recommendation of a dentist from any clinic. The centre is open Monday to Saturday from 8:00 to 19:00, and on Sundays from 10:00 to 18:00. The centre is located separately from the clinic's treatment rooms, so you can visit even if you haven't yet decided which dentist you'll be treated by.

The scan itself takes less than 5 minutes, and the result is given out immediately afterwards — no additional waiting required. This is handy if you need the scan on the same day, for example before a consultation on implantation or root canal treatment. More details on the centre and booking can be found on the houston.dp.ua website.

Dental CT price and discounts

Scan prices at Houston 3D:

• panoramic image — UAH 390;
• CT of a jaw segment or the temporomandibular joint (TMJ) — UAH 790;
• CT scan of both jaws — UAH 1,290, without a flash drive — UAH 990 (UAH 300 cheaper).

A CT scan of both jaws comes with a free USB Type-C flash drive containing the scan. Combat veterans and military personnel receive a 50% discount, and internally displaced persons a 10% discount. The cost of the scan doesn't depend on which clinic you go on to be treated at — you can come in on your own and pass the result on to your dentist. Prices are the same regardless of the day of the week or appointment time, and the discounts for military personnel, combat veterans, and internally displaced persons apply to any of the scans listed.

There's currently a promotion: with a 3D CT scan of both jaws including a flash drive, a consultation with the head dentist (worth UAH 1,500) is free.

What you get after the scan

After the scan, you receive the images on a flash drive along with a link to the result in electronic form — you can pass it on to any dentist of your choice, including a specialist at the Houston clinic (consultation — UAH 690) or the head dentist (UAH 1,500). Scans have been stored since 2022, and the link to the result works indefinitely, so there's no need to come back for a copy, even if you see a dentist years later. It's handy to bring the flash drive with the scan even to a consultation at another clinic — the format the study is stored in can be read by standard CT viewer software.

If a cyst or granuloma is visible on the scan, the dentist will discuss treatment options, including a cyst or granuloma at the tooth root, and if repeat endodontic treatment is needed — root canal treatment for pulpitis is performed under the microscope.

Frequently asked questions

Dmytro Kobozev

Head doctor

13+ years of practice. Root canal treatment, implantation, prosthetics, complex clinical cases.

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