Optical coherence tomography (OCT) is a noninvasive imaging technology that provides high-resolution, cross-sectional views of biological tissues using near-infrared light. Since its introduction in the early 1990s, OCT has expanded from ophthalmology into dentistry. With micrometer-level resolution and no ionizing radiation, dental OCT offers significant advantages over conventional x-ray–based imaging modalities such as intraoral radiography and cone beam computed tomography, particularly for detecting early or subtle changes in hard and soft tissues. In this article, we review the evolution of OCT in periodontology and share 3 novel applications: assessment of postorthodontic fenestrations, preoperative planning for periapical lesions, and gingival revascularization after gingivectomy. These advances go beyond the reach of standard imaging tools and support the adoption of OCT for improving diagnosis, guiding treatment, and monitoring treatment response. As imaging protocols become increasingly sophisticated and targeted, OCT promises great advances in periodontal diagnostics and patient care.
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