1. Export the scan from the scanner
Every CBCT scanner has an export dialog. Pick DICOM as the format — not PDF, not JPG. If offered, choose uncompressed or JPEG 2000 lossless for the best image quality. The result is usually a folder with hundreds of .dcm files or a single ZIP archive.
If your scanner uses a proprietary format (for example Planmeca .pln, NewTom .proj), look for an option called "Export DICOM" or "Send to disk". A conversion may be needed but most scanners include this.
2. Open the study in a viewer
Browser-based viewers: drag the folder or ZIP into the viewer. Processing is local and takes a few seconds. No install, no workstation.
Desktop viewers: install the viewer, open the folder from the File menu. Works but is tied to one operating system and one machine.
Verify the viewer reads DICOM tags (not just file names) to ensure the slices are ordered correctly and measurements are in millimetres, not voxels.
3. Navigate the volume
A CBCT is a 3D stack. Modern viewers show three orthogonal planes at once (axial, coronal, sagittal) plus a 3D rendering. Scroll each plane with the mouse wheel or trackpad. Window and level (brightness/contrast) sliders adjust for bone vs soft-tissue evaluation.
Use MPR (multi-planar reformat) to tilt the slices along a curved canal or a nerve. Panoramic reconstruction flattens the arch into a single curved slice, handy for quick orientation.
4. Measure and annotate
Place linear measurements for implant length, bone height, canal distance. Any good viewer gives sub-millimetre precision because the voxel size is preserved.
Annotate with arrows and text for the referral letter. Export screenshots or a PDF report if the viewer supports it. Some viewers let you export a single DICOM slice with the measurement burned in, useful for the patient record.
5. Share with patient or specialist
Email attachments are a bad idea — a CBCT is often 200 MB to 1.5 GB. Use a viewer that generates a share link. The recipient clicks the link and opens the scan in their own browser.
Check that the link is private and revocable. Browser-based viewers that process locally do not upload the raw DICOM to a server unless you explicitly enable sharing. Before sending the link, make sure the patient has given consent.