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Best Dental CBCT & X-Ray Systems: A Contractor’s Installation Guide
Your CBCT or panoramic X-ray machine needs a dedicated room with specific construction requirements that most general contractors don’t know about. Radiation shielding, electrical capacity, ventilation, structural support, and room dimensions all need to be planned before your first wall goes up. Here’s what I’ve learned from installing imaging rooms across the NYC metro area — and what you need to know about the four major imaging brands before construction starts.
Why Imaging Equipment Choices Affect Construction
Unlike dental chairs where the construction impact is mainly plumbing and electrical at the operatory level, imaging equipment affects the actual structure of your building. You’re dealing with lead-lined walls for radiation shielding, reinforced flooring for heavy CBCT units, dedicated high-amperage electrical circuits, specific room dimensions that vary by machine model, and ventilation requirements for equipment heat dissipation.
The imaging system you choose determines your room specifications. A panoramic-only unit needs a smaller room and lighter shielding than a full CBCT. A large field-of-view CBCT requires more shielding than a small FOV unit. Choosing your imaging equipment after the room is built is a recipe for expensive rework.
The Four Major Imaging Brands
| Factor | Planmeca | DEXIS / i-CAT | Carestream | Vatech |
|---|---|---|---|---|
| Headquarters | Helsinki, Finland | Charlotte, NC (Envista) | Rochester, NY | Hwaseong, South Korea |
| Key CBCT Models | ProMax 3D (various configs) | i-CAT FLX V-Series, OP 3D LX | CS 9600, CS 8200 3D | Green X, PaX-i3D |
| FOV Range | Small to Large (up to 26×26 cm) | Small to Large (up to 23×17 cm) | Small to Large (up to 17×13.5 cm) | Small to Large (up to 18×15 cm) |
| 2D Pan Included? | Yes — dedicated panoramic | Yes — dedicated or extracted from 3D | Yes — dedicated panoramic | Yes — dedicated panoramic |
| Ceph Option? | Yes (configurable) | Yes (configurable) | Yes (configurable) | Yes (configurable) |
| Price Range (new) | $80K – $180K+ | $70K – $160K+ | $60K – $140K+ | $50K – $120K+ |
| Room Size Required | Min. 5′ × 5′ (pan only) to 8′ × 8′ (full CBCT + ceph) | Min. 5′ × 5′ to 8′ × 10′ (with ceph arm) | Min. 5′ × 5′ to 8′ × 8′ | Min. 5′ × 5′ to 7′ × 8′ |
| Unit Weight | 200 – 450 lbs depending on config | 350 – 550 lbs | 250 – 450 lbs | 200 – 400 lbs |
| Electrical Requirements | Dedicated 20A/120V circuit | Dedicated 20A/120V circuit | Dedicated 20A/120V circuit | Dedicated 20A/120V or 15A depending on model |
| Software Ecosystem | Planmeca Romexis (closed) | DEXIS / DTX Studio (Envista) | CS Imaging (open source) | Ez3D-i (open source) |
| Best For | Fully integrated Planmeca operatories | Orthodontics, oral surgery, large FOV | General dentistry, multi-brand practices | Budget-conscious, high image quality |
Planmeca — ProMax 3D Series
Planmeca is the technology leader in dental imaging. Their ProMax platform is modular — you can start with panoramic and add CBCT and cephalometric capabilities later. The imaging quality is excellent, and their Romexis software integrates deeply with Planmeca chairs and other equipment for a fully connected digital operatory.
Room Requirements: Planmeca units are generally compact and well-designed for space efficiency. The ProMax 3D configurations require a minimum room size of approximately 5′ × 5′ for pan-only, expanding to 8′ × 8′ or larger with CBCT and ceph attachments. Lead shielding requirements follow standard radiation safety calculations based on the unit’s output and your practice’s workload. One advantage: many Planmeca configurations are designed to be upgradeable, meaning you can build the room for the full configuration now and add CBCT capability later without modifying the room.
Construction consideration: If you’re building a Planmeca-based practice with their chairs, imaging, and software all integrated, plan the entire infrastructure as a unified system. The data cabling between your Planmeca imaging room and Planmeca-equipped operatories needs to be planned together.
DEXIS / i-CAT — FLX V-Series & OP 3D
DEXIS is the umbrella for some of the most recognized names in dental imaging. The i-CAT FLX is one of the most popular CBCT systems in the U.S., known for its seated patient position, large field of view, and 3-in-1 capability (panoramic, CBCT, and cephalometric from a single scan). The newer OP 3D LX extends the platform with an even larger FOV option.
Room Requirements: The i-CAT systems use a unique seated patient position, which affects room layout differently than standing units. The i-CAT FLX requires a larger room footprint than some competitors — plan for approximately 7′ × 8′ minimum, and up to 8′ × 10′ with a ceph arm. These are heavier units (350-550 lbs), so verify your floor can handle the point load, especially in older NYC buildings. Electrical needs are standard — a dedicated 20A/120V circuit. The i-CAT’s large FOV (up to 23 × 17 cm) means higher radiation output, so shielding calculations should be done by a qualified radiation physicist based on the specific model and your projected workload.
Construction consideration: The seated design means you need to plan for patient flow differently — the chair needs clear approach from the front. If your imaging room is tight, the standing units from other manufacturers may fit better.
Carestream — CS 9600 & CS 8200
Carestream is well-respected for high image quality, ease of use, and — critically for multi-brand practices — open-source software compatibility. Their CS Imaging software integrates with most practice management systems, so you’re not locked into one manufacturer’s ecosystem. The CS 9600 is their premium CBCT with up to 14 different FOV options.
Room Requirements: Carestream units are moderately sized with reasonable room requirements. The CS 9600 uses a standing patient position and needs approximately 6′ × 7′ minimum for the base unit, more with ceph. Electrical is standard 20A/120V. Carestream’s open-source approach to software means less proprietary cabling requirements — the data integration is typically simpler than more closed ecosystems. This can reduce construction complexity and cost.
Construction consideration: If you’re building a practice with mixed equipment brands — say, A-dec chairs and Carestream imaging — the open-source software approach means fewer compatibility headaches during setup. Your IT infrastructure is simpler.
Vatech — Green X & PaX-i3D
Vatech is the value leader in dental CBCT. Their imaging quality consistently rivals more expensive competitors, and their pricing makes CBCT accessible to practices that might otherwise stick with 2D. The Green X offers a full range of FOV sizes from 4×4 cm to 18×15 cm, giving you flexibility for everything from single-tooth endodontic imaging to full maxillofacial scans.
Room Requirements: Vatech units tend to be lighter and more compact than some competitors, which is an advantage in tight NYC spaces. The Green X requires approximately 5′ × 6′ minimum, expanding for ceph options. The unit weight is relatively modest (200-400 lbs), so floor reinforcement is rarely needed. Electrical is standard — some models run on a 15A circuit, which is a minor advantage in older buildings where 20A circuits may require electrical panel work. Their Ez3D-i software is open-source, making integration straightforward.
Construction consideration: If you’re adding CBCT to an existing practice where room size is limited, Vatech’s compact footprint and lighter weight make it the easiest retrofit. Also the most budget-friendly option if you’re trying to stretch your buildout dollars.
Imaging Room Construction Requirements
What Every Dental Imaging Room Needs
Radiation Shielding: Any room where X-ray equipment operates requires lead shielding in the walls, and sometimes floor and ceiling, to protect adjacent occupied spaces. Standard dental X-ray shielding is typically 1/16-inch lead equivalency, but the exact requirement depends on your unit’s output, workload, and what’s on the other side of each wall. A qualified radiation physicist should perform the shielding calculation — your imaging vendor can usually recommend one, or we can connect you with one in the NYC area.
Budget for shielding: $8,000 – $20,000 depending on room size and number of walls requiring lead lining.
Dedicated Electrical Circuit: Every imaging unit needs its own dedicated circuit — typically 20A/120V. This circuit should not be shared with any other equipment. Plan for an additional circuit if you have a ceph attachment or if the manufacturer specifies separate circuits for the unit and the computer workstation.
Data/Network: At minimum, one hardwired Ethernet connection for the imaging workstation. Some units require two — one for the machine and one for the computer. Plan for Cat6 cabling from the imaging room to your server closet or network switch.
Climate Control: CBCT machines generate heat during operation. The imaging room needs adequate HVAC to maintain the equipment within its specified temperature range — typically 60-80°F. In a small room, a CBCT running multiple scans can raise the temperature significantly. Make sure your HVAC can handle the additional heat load.
Flooring: Level, hard surface flooring. No carpet. If the unit weighs over 400 lbs, verify your floor’s load capacity, especially in older buildings or on upper floors.
Operator Position: You need a shielded position for the operator outside the room, or behind a lead barrier inside the room, with a clear line of sight to the patient. This requires either a lead-glass window, a lead-lined wall niche, or the control positioned in the hallway with a window. Plan this into your floor plan.
NYS Department of Health Registration: New York State requires registration of all dental X-ray equipment with the Department of Health’s Bureau of Environmental Radiation Protection. This registration process can take 4-8 weeks and should be started as early as possible. You cannot operate imaging equipment without it. The registration is separate from your building permits and your dental license — don’t assume one covers the other.
Contractor’s Tip: Build the imaging room for the largest configuration you might ever want, even if you’re starting with pan-only. Adding lead shielding later means tearing open finished walls. Running extra electrical circuits costs almost nothing during construction vs. hundreds of dollars after. If there’s any chance you’ll add CBCT in the future, build the room for it now. The incremental cost is $3,000-$5,000 during initial construction vs. $15,000-$25,000 to retrofit later.
The Contractor’s Summary
All four brands produce excellent imaging systems. Your choice should depend on:
Planmeca if you’re building a fully integrated Planmeca practice (chairs + imaging + software) and want the deepest technology integration.
DEXIS / i-CAT if you need large FOV imaging for orthodontics or oral surgery and prefer the seated patient position.
Carestream if you’re building a multi-brand practice and want open-source software that plays well with everyone else’s equipment.
Vatech if you want excellent imaging quality at the most competitive price, especially in tight spaces or budget-conscious buildouts.
The most important thing from a construction standpoint: choose your imaging system before the imaging room walls go up. The room size, shielding requirements, electrical needs, and operator position all depend on which machine you’re installing.
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