VIEW REPORT

The American Association of Endodontists (AAE) and the American Academy of Oral and Maxillofacial Radiology (AAOMR) have released an updated joint position statement titled “Use of Cone-Beam Computed Tomography in Endodontics 2025 Update.” This important revision reflects the latest research, best practices, and technological advancements in CBCT imaging, reaffirming the specialty’s commitment to safe, effective, and evidence-based patient care.

This revision replaces the widely cited 2015 statement and introduces 12 condensed clinical recommendations—streamlined from the previous 14—for greater clarity and implementation in clinical practice.

“The 2025 update delivers a more accessible and modern framework for how and when CBCT should be used in endodontic diagnosis and treatment,” said Dr. Steven J. Katz, President of the American Association of Endodontists. “We’re offering clinicians both guidance and flexibility rooted in the latest evidence and real-world use.”

“With increasing advancements in dental imaging—including artificial intelligence tools and expanded CBCT use in complex cases—it’s critical that dental professionals stay current on protocols that optimize patient outcomes while minimizing unnecessary exposure,” Dr. Katz added.

Key Highlights of the 2025 Position Statement:

• Condensed Recommendations: The document features 12 clear, practical recommendations tailored for clinical decision-making across diagnosis, treatment, and outcome assessment.
• Greater Emphasis on Training: The statement calls for enhanced training in CBCT use and interpretation for dentists and auxiliary staff, and collaboration across educational institutions and specialties.
• Focus on Safety and Individualized Protocols: Updated guidance supports the ALADAIP principle—ensuring radiation exposure is As Low As Diagnostically Acceptable, being Indication- and Patient-specific.
• Emerging Technologies Addressed: The statement introduces how AI may support image interpretation, helping clinicians improve diagnostic confidence and consistency.

The joint position statement reiterates that CBCT should not be used routinely but rather selectively—guided by clinical indications, existing imaging, and the patient’s specific needs. The new guidance also aligns with recent ADA and AAOMR findings that lead aprons and thyroid collars are no longer recommended for CBCT, while acknowledging state-specific requirements.

Implications for Multiple Audiences:

• For Endodontists and General Dentists: A reaffirmed emphasis on clinical judgment, imaging precision, and training in CBCT interpretation.
• For Patients: Assurance that imaging protocols are increasingly tailored, safer, and grounded in the most current research.
• For Educators, DSOs, and Third-Party Payers: A revised standard that can inform curriculum development, clinical policy, and benefit plan design.

The position statement was developed by a special committee representing both the AAE and AAOMR, consisting of leading experts in endodontics and oral radiology.

They are:

▪Saulo L. Sousa Melo, D.D.S., M.S.D., Ph.D., M.S., AAOMR Co-Chair

Oregon Health and Science University School of Dentistry

▪ Scott Makins, D.D.S., M.S., AAE Co-Chair

University of Texas School of Dentistry at Houston

▪ Anita Gohel, B.D.S., Ph.D., AAOMR Representative

University of Florida College of Dentistry

▪ Mohamed Fayad, D.D.S., M.S., Ph.D., AAE Representative

University of Illinois Chicago, College of Dentistry

▪ Sajitha Kalathingal, B.D.S., D.D.S., M.S., AAOMR Representative

Augusta University, Dental College of Georgia

▪ Frank Setzer, D.D.S., D.M.D., M.S., Ph.D., AAE Representative

University of Pennsylvania, School of Dental Medicine

▪ Mina Mahdian, D.D.S., M.D.Sc., AAOMR Representative

Stony Brook University, School of Dental Medicine

▪ Bradford R. Johnson, D.D.S., M.H.P.E., AAE Representative

University of Illinois Chicago, College of Dentistry

▪ Madhu Nair, B.D.S., D.M.D., M.S., Ph.D., AAOMR Representative

Texas A&M School of Dentistry

“This joint position statement represents a critical advancement in dental imaging standards,” said Dr. Aruna Ramesh, President, of the AAOMR. “It reinforces our shared commitment to evidence-based imaging practices that prioritize diagnostic accuracy, patient safety, and the responsible integration of emerging technologies like AI into clinical care.”

The full document is available here and on the AAE and AAOMR websites.