To investigate the usefulness of cone-beam CT images and three-dimensional reconstruction techniques for assisting extraction of ambiguous teeth and orthodontic windowing. METHODS: Fifty-three ambulant teeth that were difficult to locate on conventional surface tomography were clinically selected for cone beam CT scanning, and the CT images of five complex ambulant teeth were reconstructed in three dimensions. 45 ambulant teeth were extracted by selecting the shortest surgical access route based on the CT images, and eight ambulant teeth were extracted by open jaw traction. RESULTS: The cone-beam CT scan was a good guide for selecting the correct surgical access for extraction of the buried teeth, and the CT three-dimensional reconstructed images accurately guided the surgical windowing path and shortened the time for traction of the buried teeth to the normal dentition. CONCLUSION: Cone-beam CT imaging and three-dimensional reconstruction techniques are significantly better than traditional curved tomography and apical slices in showing the position and morphology of the buried tooth.