Cone-beam computed tomography (CBCT) has transformed oral and maxillofacial imaging by enabling true three-dimensional, voxel-based visualization of osseous structures and pathological processes. However, despite its volumetric nature, CBCT interpretation is frequently approached using slice-based or density-oriented paradigms derived from two-dimensional radiography and multidetector CT, leading to conceptual inconsistency and diagnostic ambiguity. This chapter presents a unified voxel-based visual volumetric interpretative framework for jaw lesions, grounded in CBCT physics and imageology. The voxel is adopted as the fundamental analytical unit, and lesion characterization is systematically organized into volumetric morphology and lesion–bone interface domains. Key descriptors including voxel intensity, voxel count, voxel composition, voxel distribution, aggregation pattern, cortical involvement, marginal translation, zone of transition, border characteristics, and patterns of bone loss are defined and integrated across multiplanar reformations, maximum intensity projection, and three-dimensional volume-rendered CBCT images. By correlating two-dimensional slice-based findings with three-dimensional volumetric expression, the framework enables differentiation between pressure-driven, reactive, neoplastic, and infiltrative lesion behavior, thereby providing biologically meaningful radiological interpretation. Importantly, the structured and standardized nature of this voxel-based approach facilitates reproducibility, enhances diagnostic clarity, and establishes CBCT volumetric analysis as a radiobiomarker-driven platform suitable for radiomics and advanced artificial intelligence integration.