Cone-beam CT (CBCT) is a relatively novel digital imaging technology to provide undistorted, three-dimensional information of teeth and surrounding tissues for aiding the diagnosis procedure and improving clinical decision-making. The use of CBCT in endodontics is widely and rapidly increasing. The aim of this review article is to introduce not only the current endodontic applications but also the limitations of CBCT such as artefacts and concerns on radiation dose. Furthermore, the evidenced-based guidelines on the reasonable application of CBCT in endodontics is also presented and re-considered. Clinicians should be more conscious neither to take CBCT as a substitute for two-dimensional radiography nor as a routine examination. With the continuous improvement of equipment and technology, it is urgent to establish and update guidelines in clinical practice. Endodontists should strengthen training, update knowledge, familiarize with CBCT technology and cooperate with radiologists to fulfill their diagnostic responsibilities.
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