Three-dimensional (3D) imaging has emerged as a transformative tool in the diagnosis and treatment planning of periodontal diseases. Traditional two-dimensional (2D) imaging modalities, though widely used, are limited by anatomical superimposition, distortion, and lack of spatial resolution. In contrast, 3D imaging technologies steps in as a game-changer, such as cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI), ultrasound, and optical coherence tomography (OCT) offer enhanced visualization of both hard and soft tissues, enabling more accurate assessment of periodontal structures.
This review outlines the evolution of imaging in periodontology and critically examines the clinical applications of various 3D modalities. Focus is given to CBCT due to its growing role in evaluating bone defects, furcation involvement, anatomical variations, and in guiding regenerative and implant-related procedures. Non-ionizing techniques such as ultrasound and OCT are also discussed for their potential in soft tissue imaging and early inflammatory detection.
The real power comes when we combine these 3D images with digital workflows, including intraoral scanning and facial scanning, this makes planning treatments across specialties smoother and helps patients see and understand their condition better.
Of course, it’s not all perfect yet. We discuss the hurdles: radiation concerns (especially with CBCT), costs, the learning curve for dentists, and how some methods still struggle with soft tissue detail.
Looking ahead, we’re excited about where this is going. AI for smarter analysis, ultra-low-dose scans, combining different imaging types, and 3D printing are all poised to make periodontal care even more precise and personalized. This review shows why 3D imaging isn’t just a fancy tool – it’s fundamentally reshaping precision periodontology.

Objectives: 1. To explore the evolution of periodontal imaging from traditional two-dimensional methods to advanced three-dimensional technologies, highlighting key milestones and innovations.
2. To critically evaluate the clinical applications of various 3D imaging modalities—such as CBCT, MRI, ultrasound, and OCT—in periodontal diagnosis, treatment planning, and outcome monitoring.
3. To discuss the integration of 3D imaging into digital workflows, including intraoral and facial scanning, and how this enhances interdisciplinary collaboration and patient communication.
4. To identify current limitations and highlight future directions in 3D periodontal imaging, including advancements in artificial intelligence, low-dose imaging protocols, and 3D printing for personalized care.