Which imaging modality is most appropriate for evaluating impacted teeth or complex craniofacial anatomy with minimal dose, and what caveat applies?

• A. MRI; uses no radiation.
• B. CBCT; it provides detailed 3D information but delivers higher radiation than 2D imaging; use only when justified.
• C. Panoramic; always lower dose than 3D.
• D. Intraoral periapical; provides 3D information.

Answer: (B)

Evaluating impacted teeth or complex craniofacial anatomy benefits from true three-dimensional visualization to accurately judge spatial relationships, root morphology, and proximity to critical structures. Cone-beam computed tomography provides detailed 3D information in a single scan, enabling precise localization and planning that 2D views cannot offer. At the same time, it carries more radiation than standard 2D imaging, so its use should be justified by the information gained—only proceed when the 3D data will meaningfully influence treatment decisions. To minimize dose, use the smallest field of view that covers the area of interest and apply dose-optimized settings in line with ALARA principles. While MRI avoids ionizing radiation, it is not ideal for hard-tissue detail around teeth, and panoramic or intraoral periapical radiographs do not capture the 3D relationships needed for complex cases.