Cone-beam computed tomography (CBCT) was introduced into the U.S. market in 2001. Today, there are more than 3,000 installed units in the United States. There are numerous CBCT manufacturers and types of units. To produce the best imaging results, clinicians need to be knowledgeable about the CBCT unit, the clinical issue being investigated and how to optimize the unit's operational parameters. The author identifies the variables that should be considered for each imaging session and addresses the building blocks required to design the appropriate imaging strategy. The remaining articles in this supplement address imaging for orthodontics, the investigation and localization of impacted teeth and implant planning, and customized imaging protocols designed to solve the clinical issues being presented.The author addresses CBCT from an operational point of view. An ideal imaging examination answers the clinical question while maintaining an acceptable radiation dose and cost. The quality and value of each imaging study is proportional to the protocol being used. The author also addresses imaging protocol variables (raw data frames, scan time, voxel size, field of view and milliampere settings) and their effects on the final image quality and radiation dose, as well as CBCT accuracy and the radiation dose.CBCT can provide image volumes of the maxillofacial region and can be useful in clinical dentistry.CBCT has been shown to be a precise imaging modality and is a valuable tool for use in dental applications.CBCT can be used for diagnosis and treatment planning for all of the dental specialties.