What’s new in CBCTHub

The homepage button used to lead to a screen asking you to drag in your own DICOM files. Someone arriving to decide whether the product is worth it has no CBCT to hand — and if they do, they will not upload it to a site they do not know yet: the button was asking for the one thing a visitor cannot give. It now opens a real, already prepared exam, with the panoramic curve drawn and the nerve marked, and everything works: slices, oblique, TMJ, measurements, implants, cephalometrics, the report. No account, nothing to install. Nothing done there leaves the browser. It is not that it fails to save to your account: it is never sent, and it disappears when you close the tab. The exam cannot be downloaded or shared either — both buttons explain why when you press them — because it is the study of a patient who agreed to have it shown, not handed around. And it opens in whatever language you are browsing in.

Privacy and data now has an Applicable law button with a sheet for your country. All twenty Latin American countries are there, the European Union and the European Economic Area as a single sheet — the regulation is the same across the twenty-nine, but the clinical record retention period is not, which is why it goes in a country-by-country table — plus the United Kingdom, the United States, Canada, Australia, New Zealand, South Africa, the United Arab Emirates and Qatar: fifty-seven countries in all. Each sheet states which law applies today — and which is coming, since Chile switches regime on 1 December 2026 and Mexico already did in March 2025 —, what role we play within that law, what it requires for health data to live on servers in another country, how quickly a breach must be reported and to whom, what a patient can ask for and within what deadline, and how many years health regulations require the image to be kept: five in Mexico, ten in Argentina, El Salvador, Nicaragua and Ontario, fifteen in Chile, Peru, Colombia, the Dominican Republic and several Spanish regions, sixteen in British Columbia, twenty in Brazil, thirty in Belgium, twenty from the patient’s death in Panama and twenty-five in the UAE. That last figure is the one that surprises most and the one most worth checking before deleting anything, because it outweighs an erasure request. Each sheet ends with what we do NOT cover in that country, stated plainly and with its reason, and with links to the official sources so it can be checked. And there is nothing to choose: the country comes from the account details, the same ones that already pick the currency on the receipt and the language of the emails. And if we do not know it, or it is a country we have no sheet for, the box simply does not appear: showing you the neighbouring country’s would be worse, because two legal sheets look alike enough that nobody notices the swap until an inspection arrives.

The five earlier templates had a flaw you cannot see: boxes are stored as a fraction of the sheet, and the area a plate is drawn in is not square, so a “square” box printed taller than it was wide. Cross-sections — the most used box of all — came out squashed, and the two condyles on the TMJ sheet came out different shapes, which on that sheet is not a detail: if the two sides are not the same size, joint space cannot be compared, and that is exactly what the scan was ordered for. There are nine now, and every box has the proportion of what goes in it: the panoramic is a band, the orthogonal planes are square, and cross-sections are tall and narrow like the 25 to 30 millimetres of bone they show. They are also organised by what you are doing, not by what you are cropping. Exam overview opens a report with the panoramic and the three planes. Implants splits into single site and full arch, and every page carries its own reference axial: a cross-section without the image saying where it came from cannot be interpreted, and the old sheet had eleven of those. Endodontics becomes one block per tooth — sagittal, coronal and both axials aligned to the long axis — instead of twelve loose slices. Third molars gives each one its axial, three cross-sections and a coronal, which is what it takes to say whether the canal runs buccal or lingual; before there was a single image per tooth. And three did not exist at all: impacted canine, airway, and TMJ with the mouth open and closed. Consecutive slices now fill themselves in: drag one and the ten in the series complete with the next ones along. That only happened in one of the five before; on the implant sheet it was twenty-two separate drags. The old templates do not disappear. They stop being offered for new plates, but reports already using them open and print exactly as they always did.

Marking to a millimetre was, until now, impossible with a mouse. The gesture only counted as a drag past four screen pixels, and below that it was read as a click: with the outline turned on there is always some landmark still to place, so a nudge of nasion planted glabella on top of nasion. And a millimetre at nasion is a degree of SNA. Now, if the pointer is over a landmark, the click is on that landmark and nothing else; and with a landmark selected, the arrow keys move it one image pixel — five with Shift — which is an exact step that does not depend on a steady hand. The loupe follows suit: it focused the cursor while the landmark sat up to twelve pixels away, so fine adjustment meant watching one place and moving another; it now focuses the landmark and draws the tracing inside — the landmark itself and the lines it defines — instead of a background and a crosshair. And dragging no longer redraws the whole viewer sixty times a second: the position lives in the panel for the duration of the gesture and is saved on release, so the landmark stops stuttering on modest machines. Moving with the arrows counts as reviewing, just like dragging.

Ricketts organised his analysis into six "problems" — dental, skeletal, dentoskeletal, aesthetic, determinant and internal structure — and the sheet now follows that order, which is part of the method because it says in what order a case is read. Eight measurements that did not exist were added: maxillary depth and height, cranial deflection, cranial length, porion location, ramus position, the mandibular arc and the mandibular corpus length, plus lower facial height measured the way Ricketts measures it, which is not the ANS-Me distance it gets confused with. The last of these needed three landmarks that are now placed — Xi, the centre of the ramus; Dc, the condyle neck; and Pm, on the symphysis — and two that are never placed by hand because they build themselves: the cranial centre and the facial centre. With the mandibular arc available, the VERT appears: Ricketts’ growth coefficient, a single figure printed beside the case headline that says whether the face grows forward — brachyfacial, deep bite — or downward — dolichofacial, open bite tendency. It is the average of five measurements and is printed only when all five are there: with four it does not give a number, it says which one is missing.

The cephalometric report now ends with a plate: the patient’s lines on white, with no radiograph underneath. It carries the bone outlines, the soft tissue profile, the reference planes, every landmark with its abbreviation, and a dozen values written where they are measured — the facial axis at the cranial centre, the mandibular plane where it crosses Frankfort, the interincisal angle between the two incisors. It is the sheet that gets shown and filed, and it does three things the radiograph with the tracing on top cannot: it photocopies without turning into a grey smudge, it overlays on the tracing from the first visit to see how much the patient grew, and it can be shown to someone without showing them a radiograph. The numbers are a selection rather than the whole table: twenty-two of them spread over a face collide with each other and cover exactly what you came to look at. And none is invented: a measurement that could not be computed is not written. With fewer than eight landmarks the plate is not produced, because a figure that does not look like a face, signed as "the patient’s tracing", is worse than not offering it.

The cephalometric report sheet was a single page, and whatever did not fit was not printed: with the full Ricketts analysis, the last measurements were drawn on top of the legal notice and the source list — where each norm comes from — was cut in half without warning. A sheet that asserts twenty-two numbers and cites eleven sources is worse than one citing none, because it looks complete. The report now takes as many pages as it needs: the table breaks between rows, each new page repeats the column names and a header with the patient and the analysis so a loose page can be identified, the legal notice appears on all of them, and each carries its number. Short analyses still come out on a single page. This applies both to the downloaded PDF and to the image that goes into the report.

The soft tissue profile now draws itself, from the radiograph. It used to be built by joining the ten soft tissue landmarks placed by hand — glabella, soft nasion, nose tip, columella, subnasale, lips, stomion, mentolabial sulcus and soft pogonion — so in practice it was almost never seen: automatic tracing places four of those ten, and since a missing point cuts the curve rather than bridging it, what was left was a five-millimetre line between subnasale and the upper lip. The app now finds the skin-against-air edge, the highest-contrast boundary on the whole plate, and draws the entire profile: forehead, nasal dorsum and tip, lips, chin and neck. It is drawn solid rather than dashed, because it is not an interpolation between points: it is the edge, pixel by pixel. It is computed in your own browser, in a tenth of a second, and the radiograph goes nowhere. It draws, it does not measure: the E line and the nasolabial angle still come from the landmarks you place, because a measurement has to be something you can point at. If the plate is cropped in front of the nose, or the profile cannot be made out, it draws nothing rather than inventing a curve, and the "Auto profile" button turns it off.

Until now the numbers lived in a table off to the side: the table says "SNA 82.4°" but not which line of the drawing it belongs to, and after moving a landmark you had to hunt for the row to see what changed. Every measurement of the chosen analysis is now written over the tracing, beside the structure it measures — SNA at nasion, the gonial angle at gonion, the interincisal angle between the two incisors — and it updates while the landmark is being dragged. The "Degrees" button turns them off when the film is crowded and they get in the way. The positions are the ones the report plate already uses, taken from a single table, so the PDF and the screen for the same patient never say different things. Two numbers moved: FMA and SN-GoGn were written where their two lines cross, and those lines only converge behind the head — far off the paper — so the number ended up outside the drawing; they now sit on the mandibular plane, at gonion. And the tool rail, which vanished entirely when cephalometry opened, is back with what is useful here: brightness and contrast, invert, and reset. Porion and basion on a dark teleradiograph are precisely the ones that ask for more brightness before they can be placed, and until now cephalometry had to be closed to touch it. While brightness is active, dragging adjusts the image and does not mark or move landmarks, the same way the scale step works: one gesture cannot mean two things.

You place the landmarks on the very lateral ceph you are looking at, with the analysis panel alongside: pick Steiner, Ricketts, Downs or any of the nine, the panel asks for the next point in turn, and the measurement table updates as you go. A loupe follows the cursor so Nasion can be placed to the millimetre. When you are done, "Save to Analysis" keeps the tracing with the study: the radiograph with the lines drawn on it, and the results sheet with the table and the chart. The first one reopens with your points exactly where you left them, so you can pick a case up weeks later or compare today’s tracing with the one from the first visit. And it no longer opens in a separate window: you work inside the viewer, on the plate, without going anywhere.

The radiograph viewer now has measure, arrow and note, with the same gestures as the CBCT viewer: two clicks for a line or an arrow, one for a note; drag them by an end or by the body, delete with the X that appears on hover, change an arrow’s colour with a double click. Everything is saved with the study, image by image: what you marked on the first plate does not show up on the second. Nothing is invented about scale: a radiograph that arrived as a file lost how much each pixel measures, so when you pick the ruler the viewer asks whether you want to calibrate. Measure something of known size — on a lateral ceph, the cephalostat’s own ruler, which is magnified exactly as the patient is — type what it really measures, and every measurement on that image switches to millimetres at once. If you would rather not calibrate, it measures in pixels and the label says so.

A radiograph now opens with the same header and the same tools as a CBCT: the rail on the left with the pointer, brightness and contrast, zoom and pan; up top, the study, the patient aligned to the right, and the Analysis, Report and Cephalometrics buttons. The Analysis is the same card bank: you save the image you are looking at — with the brightness and contrast you set — reorder by dragging, name each card and export the lot as a PDF. And brightness and contrast are adjusted by dragging, as in any DICOM viewer, instead of three sliders taking up a permanent row to say 100 %.

The landmarks you place are no longer loose dots: they join into the outline of the soft tissue profile, the mandible, the maxilla and the cranial base, each structure in its own colour. It earns its place three times over. It shows a landmark that sits wrong, which is the hard thing to catch: twenty-nine dots on a radiograph have no shape, and a Gonion three centimetres too high looks exactly as good as one in the right place — joined to the rest it throws a bulge into the lower border of the mandible that you cannot miss. It explains the case to the patient: forty numbers in a table do not show why the chin is set back; the drawn profile does. And the drawing goes into the plate saved to Analysis and into the sheet you download. So that the profile has the shape of a profile, three further landmarks can be placed — soft tissue nasion, stomion and the mentolabial sulcus — in a list of their own and entirely optional: no analysis asks for them and they do not count towards the tally. The outline is dashed on purpose, because it is the curve through the landmarks and not the edge of the bone; and where a landmark is missing the line stops there rather than skipping it, which would draw a mandible with no angle. Toggle it with "Outline", next to "Lines".

Two measurements every case is judged on were missing from the summary and are now in it: overjet and overbite, with their 1–3 mm norm. Wits asks for two new landmarks — the upper and lower premolar cusps — because it is taken on the functional occlusal plane, not the bisected one Downs uses; the tracing carries both planes and each analysis takes the one that belongs to it. Incisor and molar abbreviations read U1, L1, U6 and L6: the bars used before sat on the wrong side, so "upper" appeared where the landmark was the lower one. The McNamara and Ricketts norms, along with the gonial angle, were checked against the published tables and corrected where they did not match. And a deviation is no longer flagged all the same way: the sheet tells mild from marked by how far the value sits from the norm, and when the patient’s sex is missing it says so, instead of colouring green a comparison that never happened.

Until now the file was a screenshot wrapped in a PDF: fine on a monitor, poor on paper, with type that blurred the moment you zoomed and nothing you could select or search. The PDF now carries text as text and lines as lines, so it prints crisply at A4 or any other size, a figure can be copied out of the table, and a measurement can be found with Ctrl+F. The radiograph is still an image, because that is what it is, but the tracing over it, the measurement table and the bar chart are properly drawn. It is also a good deal smaller, which helps when the sheet goes out attached to an email.

The viewer could measure one thing: the inferior alveolar canal. And since the canal is mandibular, an implant in the maxilla got nothing measured at all — the row read "—" and that was that, even with the sinus floor a millimetre from the apex. You can now trace the sinus floor, the nasal floor and an adjacent tooth root with the same gesture used for the canal, and say which is which in the annotations panel. Each has its own colour, its own threshold — 1 mm under the sinus and the nasal floor, 1.5 mm to the adjacent root, the usual 2 to the canal — and its clearance shows up in the list, the details, the report and the plan PDF. Entering the sinus is worded for what it is, "enters the sinus", not as a mistake: after a lift that is exactly the intent. And the spacing between neighbouring implants is measured too, the other figure that decides a plan: the rule quoted is 3 mm, and it is measured along the whole body rather than only between platforms, because two implants can leave three millimetres at the top and touch at the bottom.

The same tooth has a different name depending on where you work: 11 in FDI, 1.1 as it is written in Chile, and 8 in the Universal notation used in the United States. You now choose which one you see, right in the chart where you assign the tooth, and it applies across the whole viewer at once: the list, the details, the label on the slice and the plan PDF. The chart itself does not rearrange — a tooth is in the same place in the mouth either way — only the number written in each box changes. And the FDI number is still what gets stored: it is what decides the quadrant and finds the crown shape, so a case opened in one notation and in another is still the same case.

Settings has a new section, Data protection, with the full data processing agreement: what CBCTHub may and may not do with your patients’ data, who else is involved and for what, how a breach is notified and what happens when the service ends. You read it right there — no PDF to download in order to find out what it says. Accepting it records the date, the version and the document fingerprint, and that record can be printed or saved. It matters because your practice is the controller under the law and CBCTHub only the processor: this agreement is exactly what the regulation requires you to hold with any provider. And if the provider list ever changes, the document moves to a new version and you are told here — nothing you already accepted is edited quietly.

When there are implants, an Implants button appears on the panoramic, and with it the table of them all: tooth, model, size, distance to the canal and density, one under the other. From there you jump to any of them — even one in another part of the arch — change its tooth or its size, and switch it off on screen to see the bone underneath without deleting it. And it exports to PDF: the panoramic with the table on the first sheet, and each implant’s detail with its slice after it.

The crown that appears over an implant once you assign it a tooth now uses the piece from the library: a molar’s cusps, a premolar’s profile, each tooth’s real shape. The library had been there all along, but its files never actually loaded and the viewer always showed the fallback — the formula-generated shape. Because that fallback works well, nobody could tell the library was never being used. And the crown no longer lives only in 3D: it is drawn on the cross-section too, which is where you decide whether there is buccal bone left and whether the implant axis comes out where it should. It is drawn where the slice CUTS THROUGH it, not as its shadow: if the crown is three millimetres away, that slice shows nothing. And it now rises from the implant platform instead of floating above it: library teeth are laboratory teeth and their neck is a natural tooth’s — a lower first molar opens eleven millimetres over a four-and-a-half millimetre platform — so the emergence profile between the two is generated using the diameter of the implant actually placed. The neck is no longer a straight cut either: it rises toward mesial and distal, like a tooth’s cervical line.

A whole body was missing: the crown rose straight out of the implant platform. The abutment is now drawn — the gingival portion, the shoulder and the tapered post that runs up inside the crown — in 3D and on the cross-section too, which is where you see whether the margin sits above or below the bone crest. The abutment’s height decides where the crown seats, and its angulation is what lets a tilted implant carry an upright crown: both are judged against the bone. From the implant list you open the abutment panel and set four of them: gingival height, margin diameter, post height and angulation. The other five follow from these and from the implant diameter. The abutment appears as soon as the implant is placed — no tooth needs to be assigned, because an abutment screws into the implant, not into a tooth. The crown does need one, and it seats on the post: at 0° — a straight abutment, a Ti-base — the crown comes out with whatever tilt the implant has, and you raise the angle until it sits where it should. That number is the angled abutment to order. Double-clicking the implant opens its details — implant, abutment and crown on one screen — and there you pick the abutment family: Ti-base, straight, angled 15° or 25°, and multi-unit straight, 17° or 30° for full-arch. Each one fills in its measurements and you fine-tune from there. These are each family’s typical measurements, not any manufacturer’s catalogue.

While an exam downloads, a card at the bottom shows how much has come down, how much is left, and it stays on screen even if you close the exam card or open the viewer. You can cancel from there. If you try to leave the page mid-download, the browser warns you before you lose it. And if a file did not make it, it now says so: before, the exam came out anyway, with the right names and a file or two missing, which is the worst way to fail because it looks complete. The warning also travels inside the ZIP, for whoever opens it the following week.

An intraoral scan or a radiograph now downloads as the file it is, with nothing around it: whoever receives it opens it straight in their planner. A CBCT still comes as a package, because it is not one file but a package: it carries the DICOMDIR and the folder tree from the CD, and that is how the person opening it expects to find it. The difference shows most on a phone, which is where the link a patient receives usually gets opened.

Mark the landmarks on the lateral cephalogram and get the nine standard analyses — Steiner, Ricketts, McNamara, Tweed, Downs, Jarabak and others — with every value compared against its norm and explained in plain language. It ends in an A4 sheet ready to print or attach, without leaving for another program.

What one window saves shows up in the other, so no single machine holds editing rights any more. The centre also decides whether whoever receives the shared link can save what they mark; if not, they are told their marks stay on their own screen.

Cross sections are spaced by real millimetres and form a block you drag along the arch by hand, with the wheel or with the slider. Stretch it from the edges to cover more area without losing detail.

Four, nine or sixteen contiguous slices at whatever millimetre spacing you choose, each with its ruler, its slider and the reference lines of the other planes. The whole grid drags into the report or the plate as a series, one frame per slice.

Save the viewer’s full position under a name — “Tooth 1.2” — and return to it with one click, without losing the work in progress. The Analysis panel becomes a grid you order by hand, with a link so a colleague opens exactly that view.

Record the spoken explanation together with everything done on screen. Whoever receives it plays it, pauses it and carries on from wherever they like. It comes transcribed and with per-tooth markers to jump to a finding, exports to video, and is sent by email with a link that expires.

Build plates by picking the grid in a visual selector, with quick fill or free composition, undo, drag to reorder, alignment magnets and a reading zoom over the sheet. Captures include the measurements, arrows and notes made on the slice.

Dictate it by voice and the text appears live, with the option to arrange it into clinical prose. Drag slices from the study into the body of the text and adjust each image’s size, brightness, contrast and crop. The PDF comes out with the layout, the images and the study details.

With a single scan covering both joints they appear side by side, the reference axial in the middle and its slices below, instead of switching between right and left. The radiologist declares which side each acquisition is, and that travels to the report and the plates.

The centre’s computer is linked with a six-character code — no passwords, no configuration — and from then on it uploads studies automatically. Settings shows which machines are connected, when each last uploaded, and lets you cut their access.

Place the implant on the panoramic and the viewer reports the distance to the mandibular canal measured from the implant’s edge, the corresponding tooth, and the density of the area. Implant and canal also appear in the 3D view, to check how much bone is left and whether it breaks through the cortical plate.

Measure the airway by volume and minimum cross-sectional area, with the height profile showing where it narrows, then export the image or take it to the report. The patient’s intraoral scan can also be uploaded and comes out aligned over the CBCT, next to the slices.

The viewer a centre publishes on its own site shows its logo and its domain in a single top bar, alongside the exam’s tabs. Patient and dentist see the centre’s brand, not ours.

In exams with more than one acquisition, the panoramic curve, the annotations and the framing are stored separately for each and no longer overwrite one another. In TMJ, the both-sides view loads the volume belonging to each side.

Drag images onto the sheet from any view without giving up measuring, annotating or scrolling through slices. Frames move, grow, are added and removed within each exam, without touching the template of every other report. The preview shows the sheet exactly as the PDF will come out.

Next to the search box, filter by date — today, 7 days, 30 days, this year — by study type and by referring professional. Only the filters that make sense for the exams on file are shown.

Without going back to the exam list, the study’s owner generates the link, sends it by email or copies the embed code, all from the viewer’s own menu. It honours anonymised mode.