🦷 DenCT — Dental CBCT & DICOM Viewer with Implant Planning for React

DenCT is an open-source, embeddable dental CBCT / CT DICOM viewer and guided implant planner for React + TypeScript. It reconstructs a panoramic (OPG) view along the dental arch, renders the jaw in true 3D, plans implants with nerve / sinus / neighbour safety clearances, and exports a 3D-printable surgical drill guide (STL) — entirely in the browser, with no upload.

▶ Try the live demo (loads an anonymized sample CBCT) · 📖 API reference · 🧪 Next.js example · 🌐 Docs: 🇬🇧 English · 🇩🇪 Deutsch · 🇪🇸 Español · 🇭🇺 Magyar

Panoramic view — OPG, cross-section and 3D with a planned implant

3D view — true-3D volume rendering with linked axial / sagittal / coronal MPR

✨ Features

Viewing

• 🩻 MPR (axial / sagittal / coronal) with linked crosshairs and window/level synced across every view
• 🧊 True-3D volume rendering — render presets incl. a translucent X-ray mode, colormaps, one-click Low / Medium / High quality, intersecting slice planes, crop box, mouse-wheel zoom
• 🦷 Panoramic (OPG) reconstruction along a draggable dental-arch curve — or let Auto arch estimate the arch from the scan — plus tiltable, perpendicular cross-sections
• 🔀 Panoramic layout with swappable panes: blow the cross-section or the 3D view up to the big slot and back; the 3D pane marks where the cross-section cuts
• 🗂️ Multi-study — DICOM folders, .dcm files, GALILEOS and OneVolume / Morita exports in a series tree; each study keeps its own plan

Implant planning

• 🎯 Guided implant planning — true 3D implant bodies with drill sleeve and osteotomy axis, shown consistently in every view
• ⚠️ Safety clearances to the marked mandibular nerve, the maxillary sinus and neighbouring implants
• 🦴 Bone quality at the implant site (Misch D1–D5, indicative — from uncalibrated CBCT gray values)
• 👑 Prosthetically-driven (backward) planning — Plan from crown derives an implant from a wax-up / tooth-setup mesh, detects upper vs lower jaw from bone density, and shows the screw-access channel on the cross-section
• 📏 Measurements — length, angle, ROI mean ± SD HU, HU probe, and an HU profile along a line; values appear in the layers list and the PDF

Surgical guide & export

• 🖨️ 3D-printable drill guide (STL) built with constructive solid geometry (manifold-3d), with an optional metal-sleeve seat and shoulder drill stop
• ✅ Pre-export guide checks — thin walls, narrow drill channels, fragile webs between bores, and a drill path that reaches the nerve or sinus past the implant apex
• 🧩 Surface-scan (STL / OBJ / PLY) import with 3-point landmark registration to the CBCT
• 🖼️ Image export (PNG / JPG) and a configurable PDF report; plan save / load as JSON

Integration & privacy

• 🔒 100% local — parsing, rendering and exports run in the browser; nothing is uploaded
• ⚛️ React 18 / 19 component with an imperative ref API, controlled props and callbacks, and a React-free /core of the geometry / safety math
• 🌐 4 UI languages (EN / DE / ES / HU) · 🌓 self-scoped dark mode that never restyles the host page

The exported guide is for verification on a printed model — tissue fit needs a registered surface scan, and the sleeve seat must be checked against your own sleeve kit before any use.

💡 Use cases

• Embedding a CBCT viewer in dental practice-management, treatment-planning or quoting software
• Teaching and research on implant planning, panoramic reconstruction and guided surgery
• Prototyping surgical-guide workflows without a desktop planning suite
• A lightweight, private way to review a dental cone-beam CT scan in the browser

📦 Installation

npm install dental-cbct-viewer react react-dom

Requirements: React 18 or 19 (peer dependency); a bundler that supports the exports field, ESM, Web Workers and WASM (Vite, webpack 5, Next.js, Rollup). The heavy imaging libraries (Cornerstone3D, vtk.js, jsPDF, dicom-parser) are regular dependencies and are installed for you.

⚠️ Cross-origin isolation. The DICOM decode workers use SharedArrayBuffer, so the host page must be served with:

Cross-Origin-Opener-Policy: same-origin
Cross-Origin-Embedder-Policy: require-corp

Without these headers, image decoding will not run.

🚀 Quick start

Render DicomViewer and import the stylesheet once:

import { DicomViewer } from "dental-cbct-viewer";
import "dental-cbct-viewer/style.css";

export function Planner() {
  return (
    <div style={{ height: "100vh" }}>
      <DicomViewer lang="en" />
    </div>
  );
}

The viewer fills its parent, so give it a sized container. Dark mode is the default and is scoped to the viewer's own root — it never touches the host page's theme.

🎛️ Imperative API (ref)

import { useRef } from "react";
import { DicomViewer, type DicomViewerHandle } from "dental-cbct-viewer";
import "dental-cbct-viewer/style.css";

function App() {
  const ref = useRef<DicomViewerHandle>(null);

  return (
    <>
      <button onClick={() => ref.current?.loadSample()}>Load sample</button>
      <button onClick={() => ref.current?.exportPdf()}>Export PDF</button>
      <DicomViewer
        ref={ref}
        initialLayout="1+3"
        onImplantsChange={(implants) => console.log(implants.length, "implants")}
        onPlanChange={(plan) => localStorage.setItem("plan", JSON.stringify(plan))}
      />
    </>
  );
}

Handle methods: getImplants, addImplant, updateImplant, removeImplant, getPlan, loadPlan, loadStudy(files), loadSample, setLayout, setActiveView, exportPdf, exportGuideStl.

Props: patientId, patientName, initialPlan, initialLayout, lang, onPlanChange, onImplantsChange, className, embedded.

🧩 Framework-free core (/core)

Pure, React-free building blocks run in Node, tests or your own logic — the implant data model + system catalog and all the geometry/analysis math:

import {
  IMPLANT_SYSTEMS, getImplantSystem,   // implant catalog
  implantWorldAxis, evaluateImplant,   // geometry + nerve/sinus/neighbour safety
  classifyBone, sampleImplantBoneHU,   // Misch D1–D5 bone quality
} from "dental-cbct-viewer/core";

The heavy CSG kernel (drill-guide Boolean via manifold-3d) is loaded lazily, so importing /core for the geometry/safety helpers stays light.

⚙️ Notes for host bundlers

• Vite: works out of the box (set the COOP/COEP headers in server.headers / preview.headers).
• Next.js / webpack 5: render the viewer in a client component ("use client") — it reads the DOM on mount. Ensure the COOP/COEP headers above are set (e.g. via next.config.js headers). Worker/WASM assets are pre-bundled into the package. A complete example lives in examples/nextjs/.

🔒 Security & privacy

• No network egress. The viewer never uploads scans or patient data — all parsing, rendering and exports happen in the browser. It contacts no analytics or third-party host; the only fetch is for its own bundled sample asset. Exported PDF/PNG/STL/plan files are user-initiated downloads.
• Untrusted input is bounded. Decompression enforces an output budget (gzip-bomb safe), the native-volume decoders validate geometry against hard caps before allocating, and plan JSON is parsed with a strict field allowlist (no prototype pollution).
• Content-Security-Policy. The hosted demo ships a strict CSP (connect-src 'self', object-src 'none', no unsafe-eval for scripts). When you embed the component, set an appropriate CSP on your host page — the library needs script-src 'wasm-unsafe-eval' and worker-src blob: for the WASM decode workers, plus the COOP/COEP headers from Installation.

🤝 Contributing

Issues and pull requests are welcome — see CONTRIBUTING.md. npm test runs the unit tests (Vitest) and npm run test:e2e the browser smoke tests (Playwright). If DenCT is useful to you, a ⭐ on GitHub helps others find it.

📄 License & disclaimer

MIT © Zoltán Dul. Bundled Roboto font under Apache-2.0 (see LICENSE).

Medical disclaimer: research/demonstration software only — not a certified medical device and not for clinical diagnosis, treatment planning, precise measurement or implant workflows.