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Oral and maxillofacial radiologist Dr. Chris Matessi answers the cone beam CT questions general dentists ask most. From TMJ imaging and crown-root fractures to airway screening and legal liability, this episode clarifies what CBCT can reliably tell you, where it falls short, and how to choose the right scan for the right question.
In this episode, you'll learn:
- Open-mouth versus closed-mouth CBCT scans for TMJ assessment, and why a chin cup beats a bite stick for joint position
- Scan positioning for implant planning and full arch cases
- The limits of CBCT for the TMJ and when to order an MRI for soft tissue, disc position, and inflammation
- The narrow, U-shaped bone loss pattern that points to a crown-root fracture when you can't see the fracture line
- Why a brand-new fracture can look completely normal on a CBCT
- What affects image quality: manufacturer, resolution, field of view, metal and motion artifacts
- The CBCT units he likes for endodontics and general practice, and why
- Airway screening with minimum cross-sectional area, and why CBCT cannot diagnose obstructive sleep apnea
- Your legal responsibility for everything in the scan volume, and the value of a radiology report
- Choosing the smallest appropriate field of view for better resolution and lower radiation dose
Questions answered in this episode:
Can a CBCT diagnose sleep apnea? No. OSA must be diagnosed by a physician with a sleep study. CBCT is a screening and risk stratification tool.
Am I responsible for incidental findings on a full field scan? Yes. You are responsible for everything in the volume, so review it thoroughly or have it read by a radiologist.
When should I order a TMJ MRI instead of relying on CBCT? When conservative TMD therapy hasn't worked and you need to evaluate the disc, joint spaces, or inflammation.
About the guest: Dr. Chris Matessi is an oral and maxillofacial radiologist who practiced clinical dentistry for seven years before specializing in radiology. He reads CBCT scans for dentists and specialists and taught a CBCT course for Elevated GP.
Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.
