Cone-beam computed tomography (CBCT) has emerged as a transformative imaging modality in oral and maxillofacial surgery(OMS), particularly in dental implant therapy in the United States. By providing accurate three-dimensional visualization of osseous anatomy and critical adjacent structures, CBCT has enhanced diagnostic precision, surgical planning, and outcome predictability. This article examines the impact of CBCT on implant site assessment, prosthetically driven implant placement, achievement of primary stability, facilitation of osseointegration, and long-term implant success rates. The application of CBCT in medically and periodontally compromised patients, including individuals with diabetes mellitus and chronic periodontal disease, is discussed in detail. Limitations of CBCT and its role in emerging digital and guided surgical innovations are also explored. As guardians of technological advancement in OMS, oral and maxillofacial surgeons must apply CBCT judiciously and ethically to optimize patient outcomes and maintain evidence-based standards of care.