This question is put forth in an article in the JAAOMS in 2020. (J Oral Maxillofac Surg 78: 1071-1077, 2020). The process is actually the other way around, at least in our practice. We first diagnose the third molar condition using a panoramic scan which is a lower radiation dose and less costly than a cone beam scan. If appropriate, such as when we discover anatomy as risks that suggest it – we recommend the cone beam scan.

In my practice, the most common need in third molar cases is when the third molars are well formed and have roots that are overlapping or otherwise close to the sensory nerve in the lower jaw (inferior, alveolar nerve) and putting it at risk. The cone beam scan is a wonderful, relatively new, technology. I am able to trace out the nerve bundle and “see” the surgical site virtually before I ever make an incision. This allows me to better avoid problems and lower the surgical risks.