Meeting Recap

How to Read a CBCT: Five Lessons from Dr. Vinicius Dutra

November 5, 2026 · ITI Study Club · Glacial Sands Education Facility, Chesterton

On November 5, 25 dental professionals gathered at the Glacial Sands Education Facility in Chesterton for an ITI Study Club evening with Dr. Vinicius Dutra, DDS, MBA, PhD, Clinical Associate Professor in the Department of Oral Pathology, Medicine and Radiology at Indiana University School of Dentistry.

Hosted by Dr. Bennett, the session focused on a deceptively simple question: once the scan is on the screen, how do you make sure you actually see what matters?

1. Read the whole volume, not just the chief complaint

Dr. Dutra's first rule was to resist anchoring on the tooth or implant site that prompted the scan. Read global to local: assess symmetry first, orient the head position on the hard palate, then move through the axial, coronal, and sagittal planes. The teeth come last.

A structured description helps: size, shape, borders, locularity, cortication, effect on nearby teeth, location, and density. The system matters because the finding that changes treatment is not always the finding the scan was ordered to confirm.

2. Before guided surgery, check the registration

For guided implant surgery, Dr. Dutra identified STL-to-CBCT registration as the number-one checkpoint. If the digital impression and the scan are not aligned correctly, the plan can look precise while carrying that error into the guide.

His broader point was that virtual planning is not just a software step. Planning against the intended implant position helps remove slice-angle error and forces the clinician to test the plan before surgery begins.

3. Know what your voxel size is telling you

Measurement error tracks voxel size. Dr. Dutra used a 0.2 mm voxel, and roughly 0.2 mm of measurement error, as the working example. His preferred balance was a 150-micron voxel, with a 2 mm safety margin drawn from the literature.

The practical lesson is not to memorize one setting. It is to know the limits of the image in front of you before making a measurement-dependent decision.

4. If it is in the volume, it is your responsibility to recognize it

Incidental findings were a major theme of the evening. Most are low significance, but they still have to be seen, described, and, when indicated, referred.

That discipline extends beyond the implant site: the sinuses, TMJ, cervical spine, and surrounding anatomy are all part of the acquired volume. For sinus grafting, Dr. Dutra emphasized imaging the entire drainage pathway rather than relying on a small field of view. Unilateral sinus opacification, he noted, is often dental in origin, so the teeth should be assessed before assuming the cause lies elsewhere.

"If it's in the volume, it's our responsibility."

Recognize and refer; the dentist does not have to treat every finding personally.

5. AI can assist the read. It cannot replace it

Dr. Dutra drew a clear line around current dental AI. It can help with image reconstruction, segmentation, workflow, and turning findings into report language. It cannot find what the clinician did not see.

That makes the systematic read more important, not less. The clinician still owns the interpretation, the referral decision, and the treatment plan.

Thank you

Thank you to Dr. Dutra for a practical, case-driven evening, and to the dentists who joined us in Chesterton.

The ITI Study Club returns Wednesday, February 10, 2027, when Dr. Wei-Shao Lin presents on prosthetic and mechanical complications associated with dental implant restorations. The club's next hygiene C.E. session, on white spot lesions, is scheduled for Thursday, January 14, 2027.

See upcoming event details and join the club email list for future announcements.