CBCT viewer comparison 2026: 8 options tested side by side

The CBCT viewer market in 2026 has quietly split into two camps: heavyweight desktop suites that came from the scanner era, and lightweight browser tools that emerged with WebAssembly and modern GPU rendering. This is a practical comparison of eight options you will actually run into, based on what each one does well and what it costs in time and money.

The eight viewers

We're looking at: Planmeca Romexis, Carestream CS 3D Imaging, Invivo, OsiriX MD / Lite, Horos, RadiAnt, OnDemand3D, and CBCTHub.

Installation and platform

Romexis, CS 3D Imaging, Invivo and OnDemand3D are Windows-only. Each is a 1–3 GB install with a license key tied to the scanner. Sharing them with a referring dentist means asking that dentist to install and license the same software.

OsiriX and Horos are Mac-only. Both are native desktop apps of similar size (~1 GB). OsiriX has a commercial tier that is FDA cleared; the free Lite version has a watermark.

RadiAnt is Windows-only with a 30-day trial. Paid license runs a few hundred dollars per seat.

CBCTHub is browser-based. It runs on macOS, Windows, Linux, iPadOS, Android and ChromeOS. No install on any platform. See Mac, Windows and iPad workflows.

Speed to first view

From "I just received a DICOM" to "I can see the study":

• Romexis / CS 3D / Invivo: 20–40 minutes first time (install + license). 1–2 minutes subsequent.
• Horos: 15 minutes first time. 30 seconds subsequent.
• RadiAnt: 5 minutes first time. 20 seconds subsequent.
• CBCTHub: 30 seconds first time. 10 seconds subsequent.

DICOM compatibility

All eight handle standard DICOM. The difference is handling of edge cases: multiframe vs per-slice, compressed pixel data, manufacturer-specific private tags, scout images mixed with the volume, missing DICOMDIR.

Scanner-native viewers (Romexis, CS 3D, Invivo, OnDemand3D) are 100 % compatible with their own scanners and 70–90 % compatible with others. RadiAnt, Horos and CBCTHub aim for universal compatibility and typically handle 95 %+ of exports from any brand.

Feature depth

For daily dental reading — MPR, panoramic curve, oblique, measurements, basic 3D render — all eight are adequate.

For advanced surgical planning, Romexis, CS 3D, Invivo and OnDemand3D pull ahead with proprietary guide design integration and CAD/CAM hooks. OsiriX MD and Horos have rich plugin ecosystems for research.

For everyday general practice and referral reading, the desktop suites are overkill. The lightweight viewers deliver the 80 % of features that 95 % of users actually need.

Sharing and distribution

This is where the split becomes obvious.

Desktop viewers don't share anything by themselves. To send a scan to a referring dentist, you export a CD/USB with the viewer installer, or email a massive ZIP and hope the recipient has a matching install.

CBCTHub was built as a distribution platform first, viewer second. Sharing is a single link that opens on any device with no install. A referring dentist with an iPad Pro gets the same view as a radiologist on a Windows workstation.

This matters more than feature depth for most practices. See our sharing workflow.

Cost over three years

Rough all-in cost for a 5-user clinic, over 36 months:

• Romexis Full: $6,000–$15,000 depending on modules.
• CS 3D Imaging Suite: $5,000–$12,000.
• Invivo Dental: $4,000–$9,000.
• RadiAnt: $1,000 total (5 seats × lifetime license).
• OsiriX MD: $2,200–$5,500.
• Horos: $0.
• CBCTHub: $720 (1 × Pro) or $3,600 (5 × Pro) over three years.

Which should you pick

If you own the scanner and need the proprietary surgical planning tools: stick with Romexis, CS 3D or OnDemand3D at the scanner workstation. You need the full suite for acquisition anyway.

If you're a referring general dentist opening one CBCT a week: use a browser viewer. RadiAnt if you need it offline and you're on Windows; CBCTHub if you want it to work on any device.

If you're a radiologist reporting for multiple centers: pick the lightest tool. Desktop PACS plus a browser viewer for ad-hoc access. Skip anything that asks for a per-seat license at referring offices.

If you're a dental student or researcher: Horos on a Mac, RadiAnt on Windows, or the free tier of CBCTHub.

The trend

Desktop viewers won the 2010s. Browser viewers are winning the 2020s — not because the desktop suites are bad, but because distribution is the actual workflow bottleneck and only browser tools solve it without licensing every dentist.

Expect the scanner-native viewers to keep ruling acquisition and guide design, and expect distribution and referral workflows to move entirely into the browser over the next few years.