Opening an Endodontic Practice or a Second Location: The Technology Build-Out Plan, Room by Room

The general contractor walks you through the shell two weeks before drywall. The dealer has marked the chairs and cabinets; the low-voltage bid says "2 data per op". Nobody has drawn where the microscope monitor hangs, where the CBCT acquisition computer sits, or which room holds a server that must be wired, mirrored and on battery backup.

This plan sits under our endodontic office technology guide. For openings, see our dental startup IT services; for ongoing care, our dental IT support page.

It is the endodontic layer on top of our dental startup IT guide, from lease to opening, and covers only what changes for an endo office and for a second endo location. Building your first office? Read the sections in order. Adding a site? Start with the second-location decision tree.

What changes when the office is an endodontic office?

An endodontic office adds a microscope with a camera and monitor in most operatories, a CBCT unit with its own acquisition computer, and practice software with strict network rules. If you run TDO Software, its requirements say workstations must be wired and the server needs a static IP and mirrored data drives, with a UPS strongly recommended. Everything else follows the general startup plan.

The table below lists only the differences. The right-hand column points to the page that already covers the generic version, so you are not reading the same advice twice. For the IT side of an endodontic practice as a whole, see our dental IT support for endodontic practices page.

If your practice runs PBS Endo (Henry Schein One), DentalEMR or another endo system, the rows change in detail but not in shape: ask the vendor for its current requirements document and fill the same columns.

What should be decided before the drawings are final?

Seven decisions change where cable, power and backing go, so they belong at schematic design, while walls can still move. Log each one with the date, who decided it and which vendor document was checked. Choose the practice software first: the room plan, the closet and the internet order all depend on it.

A cloud endo system removes the practice-database server, not the imaging. DentalEMR's own comparison page says moving to its software "does not remove every server in your office. CT and imaging software have their own on site requirements." The server-or-cloud decision itself is covered in our comparison of endodontic software on a server or in the cloud; this page takes the result as an input.

Next step: copy the table into your project file and fill in the date and the vendor document for each row before the next drawing review.

What does each room need? The endodontic room-by-room drop and device table

There is no fixed number of network drops per endodontic room. List every device in the room that needs a wire, add at least one spare, and give that total to the low-voltage contractor. Sensors and intraoral cameras usually connect by USB to the workstation, so they need ports on the computer, not wall drops.

Use the table as your drop schedule. The "Drops" column is yours to fill: count devices, then add spares.

The CBCT room, network part only

For the Carestream CS 8100 3D family, Carestream's CS 8100 3D installation guide (SM843 Ed10, print date 2022-03) says the X-ray room needs an Ethernet outlet of at least Class 5E for the unit and a separate LAN outlet. It also says the unit "MUST be connected to the computer using a point-to-point ethernet link and not using a LAN." In practice the acquisition computer needs a 1 Gb Ethernet board for the unit link, which the guide says is not supplied, plus its normal network connection. The imaging software must be allowed through the Windows firewall. Carestream's CS 8100 3D safety and technical specifications (SM844 Ed10, 2017) list the acquisition computer's minimums, including two Ethernet interfaces (1 Gbit for the unit plus an optional LAN board), 8 GB of RAM and a 2 GB Nvidia graphics card. That edition lists Windows versions that are now out of support, so ask the dealer for the current edition before buying the computer. For the CS 9600, Carestream's specifications (SMA17 Ed05, 2020) say the acquisition computer is delivered with the unit.

PreXion publishes a pre-installation survey for the PreXion3D Explorer (form CF 0506 Rev. A, 2020). It says PreXion supplies a dedicated server, which needs a hardwired network connection, plus an Ethernet port so the other computers in the office can view the scans, and internet access for remote support. The scanner-to-server cable is 49 feet, and conduit of at least 3/4 inch must be in place before install. For J. Morita or any other unit, ask the dealer for the pre-install sheet in writing; we have not read one, so we do not quote it here. Room footprint, ceiling height, electrical circuits and shielding belong to the dealer and physicist, and X-ray registration runs through your state's radiation-control program (in Texas, the DSHS Radiation Control Program). This page covers only the network and computer side of the room.

Two decisions are IT decisions and have to be made before install day. The first is where reconstructed scans are saved. TDO's Carestream CBCT integration article (KB 854) says that for Carestream units the save location "in many offices" is a second internal drive on the acquisition computer, and in some offices it is the server. The second is the computer's name: TDO says duplicate computer names are not supported, "even for replicated offices." Decide the save location, add it to the backup plan, and see our guide to microscope capture and CBCT imaging in endo operatories for storage and backup. Legend supports the IT environment for Carestream imaging (CS Imaging); our Carestream imaging IT support page describes that work.

Cabling: what the AAE recommended, and what has changed

The AAE's 2016 Communiqué article on integrating technology into endodontic office design recommends Category 6 Ethernet between workstations and the server, keeping data cable away from high-voltage wiring and fluorescent lighting, and running it in clean, room-temperature space above the ceiling or below the floor rather than an attic. It also suggests underfloor conduit to the chair for chair-mounted technology. That advice still holds. What it predates is zoned Wi-Fi, cloud software that depends on the internet circuit, and TDO's wired-only and Hybrid rules. For cable categories, labelling and certification, follow our guide to dental office network cabling, closet and Wi-Fi setup.

Worked example: counting drops without guessing

Use letters, not our numbers. Say the office has O operatories, one CBCT room, one consult room and D front-desk seats.

1. 1. In one operatory, count the wired devices: workstation (w), networked microscope capture device if the vendor says it needs one (m), phone (p), any networked screen (s). Operatory drops = w + m + p + s + spares.
2. 1. Multiply by O.
3. 1. Add the CBCT room's drops from the dealer's sheet (two in the Carestream example).
4. 1. Add the consult room, each front-desk seat (D × the per-seat count) and the doctor's office.
5. 1. Add one drop for each access point in the Wi-Fi coverage plan.
6. 1. That total, room by room, goes on the low-voltage bid.

What does the network closet need for an endo practice-software server?

If your endo software runs on a server, the closet is built to the vendor's published spec. For TDO Software, TDO's minimum requirements (KB 39), updated October 2025, list Windows Server 2016 to 2022, a private static IP, data drives mirrored in RAID 1 or RAID 10 rather than RAID 5, 1 Gb networking and a UPS, which TDO says is "strongly recommended" for the server.

Hand this sheet to whoever builds the closet. It is the build subset only; the full server and workstation spec and the server-or-cloud decision live in our endodontic software server vs cloud comparison.

Closet size, heat load and keeping it away from the compressor are generic; our technology plan for every room covers them.

If you run PBS Endo instead, Henry Schein One's PBS Endo Enterprise hardware document (2022) describes an on-premise server-client system (Windows Server 2016/2019, SQL Server 2014 or later); pbsendo.com still links that document and states no hosted option (checked in a browser 26 Oct 2026). The same document lists remote access to the server through RDP or TeamViewer, and says Terminal Server is not supported and IPv6 addresses are not supported for multi-location or remote access. Ask Henry Schein One for the current edition before you buy hardware.

How much internet does a new endo office order, and when?

Order the internet circuit at the permit stage, because the carrier's install date is outside your control. Size it from your software vendor's published figures. TDO publishes three: remote support access, Cloud Services or Replica, and TDO Hybrid. Hybrid has the highest bar, at 50/25 Mbps minimum and 100/50 recommended.

Hybrid has a higher bar than Cloud/Replica: they are two deployment models with two published numbers. These are the software's needs only; phones, guest Wi-Fi, cameras and CBCT exports to referring offices share the same line, so size above them. A second circuit for failover is a choice, not a vendor requirement. For carrier steps and failover, see our dental office network cabling, closet and Wi-Fi setup guide; for the fax and alarm lines, plan for the copper phone lines going away before you sign the carrier order.

Adding a second endodontic location: one database, two, Hybrid or the cloud?

On server-based TDO Software, the second office's workstations cannot run over a VPN to the first office's server: TDO's best-practice guide (KB 107) says, "We do not support VPN remote access to TDO." The documented options are a replicated server at each site, TDO Hybrid with a site-to-site VPN to a cloud-hosted primary server, TDO's cloud software, or separate databases.

The decision tree

1. 1. Is your endo software cloud-hosted (TDOS, DentalEMR)?

• • Yes: the new site needs internet, wired workstations, its own imaging and CBCT equipment, and a backup of anything saved locally. TDO's why-cloud page says of TDOS (TDO's browser-based cloud software): "Adding a location doesn't mean adding a server - it means adding a login." Go to step 4.
• • No: go to step 2.

1. 1. Which server-based system do you run?

• • TDO Software: go to step 3.
• • PBS Endo (Henry Schein One): Henry Schein One's PBS Endo product page says PBS Endo offers "true multi-location capabilities, using one database to support multiple locations." Ask Henry Schein One for the documented connection method for site 2 and its bandwidth, in writing. Go to step 4.
• • Another system you may run (EndoVision, XLDent and others): ask the vendor for its multi-site document. Go to step 4.

1. 1. TDO Software on a server: choose one option.

• • (a) A replicated server at site 2. TDO KB 39 says multiple locations sharing one database should use TDO Data Replication, which "requires the purchase of Microsoft SQL Server Standard." Replica bandwidth is 10/10 Mbps minimum, 50/25 recommended. Every computer at both sites needs a unique name. More than three locations on one database: contact TDO Support.
• • (b) TDO Hybrid. TDO's Hybrid article (KB 803) describes a cloud-hosted primary server ("Publisher") and an on-site server at each location. You "must configure and maintain a site-to-site VPN connection" between each office and the VM gateway, with 50/25 Mbps minimum and 100/50 recommended, wired on-site workstations with 1080p displays, and an active TDO Support contract. KB 803 also says the primary server is a single point of failure: if it goes down, all satellite locations must stop entering data.
• • (c) Move to TDOS. The trade-offs are in the server-or-cloud comparison linked in the closet section above.
• • (d) Separate databases. Each site runs its own server and charts. This means separate patient records and separate referral reporting; it is a trade-off, not a recommendation.

1. 1. Will site 2 have a CBCT? If yes, it needs its own acquisition computer and save location, and both go in the backup. TDO KB 727 says TDO "does not synchronize CBCT scans between locations"; viewing them across sites needs a third-party sync that IT sets up and maintains.

The options side by side

Elite Endodontic Specialists in Missouri City is one of the second locations we have worked on: our project page covers the final stages of the tech build-out for Dr. Russell's second location. For a group heading past three sites, our page on IT for dental groups with several locations covers standardisation. Regional detail is in our guides to a second dental office or relocation in Dallas–Fort Worth and planning IT for a second dental office in Houston.

What is the build timeline, milestone by milestone?

Endodontic technology work starts at the lease and runs through handover. The tasks below follow the same order as the eleven milestones in our startup guide. Each row names who owns the task, so nothing waits for someone who did not know it was theirs.

This work happens during construction, not after it. At Transcend Endodontics in Midlothian, our team was on site building out the technology backbone while the practice was under construction; at Texas Roots Endodontics in Fort Worth, Legend has provided IT infrastructure, technology installation and daily oversight since day one (see the project cards below).

What should be tested before the first endo patient?

Test every path a patient record or image takes, from the operatory to the backup, before the first patient is booked. Twelve checks cover an endodontic office: the server by name, wired workstations, charting, sensor, microscope and CBCT images, the backup and a restore, tablets, referral letters, phones and a controlled power cut.

1. 1. Every workstation reaches the server by name, not IP (if you run a server).
2. 1. No practice-software workstation is on Wi-Fi.
3. 1. A test patient is charted end to end.
4. 1. A sensor image lands in the test patient's chart.
5. 1. A microscope still and a short clip land in the chart.
6. 1. A CBCT test volume saves to the agreed path and opens on the consult-room computer.
7. 1. That save location appears in the backup job.
8. 1. A restore is tested. On TDO Software, that means a practice run of TDO's own Fire Drill: TDO's responsibilities article (KB 125) lists "Perform a monthly Fire Drill" among the IT professional's duties, and the Fire Drill article (KB 675) says "The doctor is responsible for the TDO backup!"
9. 1. A tablet registration form is signed and appears in the chart.
10. 1. A referral letter prints and sends by the office's fax method.
11. 1. Inbound and outbound calls work, including a 911 test call made the way the phone provider instructs.
12. 1. Unplug the server's UPS from the wall and confirm a controlled shutdown.

For the wider backup plan, use our dental backup and disaster recovery checklist.

Which endodontic offices has Legend helped open or expand?

Legend has worked on endodontic openings, a second location and an expansion in Texas. Each card below links to the project page and says only what that page says. Project pages describe the build stage shown in each post; they do not list the systems installed. How we support endo offices day to day is on our IT services for endodontists page.

The facts below are Legend Networking's own:

• • Practices: Served over 3,500 practices since 2004
• • Experience: 22+ years in dental IT (since 2004)
• • Engineering team: In-house engineers; no outsourced first-level triage
• • Onsite: Onsite dispatch by appointment across served dental markets; remote-first nationwide

Opening in a specific market? See our specialty practice guides for Dallas–Fort Worth, San Antonio, Tampa Bay and the DC area. For openings in general, our dental startup IT services page explains how we approach them.

What to ask your IT provider about an endodontic build-out

Send these questions before you sign anything, and ask for written answers. They are grouped by who should answer, because the IT provider should be able to tell you which party owns each one. For the general questions every practice should ask, use our 20 questions to ask before signing with a dental IT company.

Next step: paste the groups into separate emails, one per party, and set a reply date before your next drawing review.

The endodontic build-out checklist

Print this and tick it off by phase. Items covered by the general startup plan are marked as such and are not repeated here.