Cone-beam computed tomography (CBCT), as a core three-dimensional imaging technique in oral and maxillofacial medicine, plays a pivotal role throughout the entire process of aesthetic restoration—including preoperative assessment, intraoperative guidance, and postoperative follow-up—thanks to its advantages of low radiation exposure and high-resolution imaging. With the integration of digital technologies and artificial intelligence, continuous advancements in CBCT image denoising, artifact reduction, and 3D reconstruction have overcome the limitations of traditional two-dimensional imaging and conventional qualitative CBCT diagnosis. Radiomics enables deep extraction of hidden quantitative features from CBCT images, facilitating precise evaluation of both soft and hard tissues in the oral cavity, thereby providing data support for personalized treatment planning, outcome prediction, and risk management. This article systematically reviews the current status of CBCT technological innovations and radiomics applications across various aesthetic dental restorations, analyzes existing technical challenges, and outlines future development trends, offering theoretical insights for the standardized clinical implementation of precise and personalized aesthetic dental care.