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Exploring Cone Beam 3–D Dental Imaging

Issue: Winter 2007
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2-D imaging (standard film and digital X-rays) has long been the standard for dental scans-despite the somewhat costly price and high radiation dosages. Now 3-D imaging technology is set to address these issues. Cone Beam technology obtains crucial information at much higher resolution using lower radiation, and is cost-effective for practitioners and patients. Indeed, such important benefits will certainly give traditional 2-D X-ray imaging a run for its money.

THE INTRODUCTION OF CONE BEAM TECHNOLOGY

Here’s where 3-D imaging is invaluable. It lets dentists see patients’ anatomies in all dimensions by creating a 360° analysis. These images give dental professionals a complete makeup of the human jaw, face, and associated structures-something unattainable in 2-D imaging.

In fact, Cone Beam technology is specifically designed to capture human oral and maxillofacial features. It provides a linear path to treatment by taking a complete 3-D scan of the face and displaying the images on an accompanying computer screen within minutes. This gives operators the ability to reconstruct the data in a very short period of time, and analyze the complete surface.

The scanner uses a cone shaped X-ray beam rather than a conventional linear fan beam to obtain images of the bony structures of the skull. Cone Beam systems use a square 2-D array of detectors to capture the cone shaped beam providing a volume of data for dental specialists.

The 3-D scan also exposes issues previously undetectable with traditional methods, giving dental professionals better insight into the relationship between patients’ underlying dental structures and soft tissue. Such detailed information greatly increases the accuracy, precision, and efficiency of their patient diagnosis and treatment.

As a result, dentists discover the unexpected well in advance of a procedure, shorten treatment planning time, and increase diagnostic accuracy and surgical predictability.

DIAGNOSES IN THREE DIMENSIONS

From the maxillofacial surgical viewpoint, Cone Beam technology impacts all areas of dentistry, from implants and sleep apnea, to TMJ and dentoalveolar surgery, and more.

Time and again, 3-D’s precision imaging reveals what 2-D X-rays never could: The true interrelationships between positions, shapes, and measurements of every facial feature. It’s a dynamic connection simply impossible to pinpoint with 2-D X-rays.

Moreover, combining the power of a 3-D radiographic image with a highly precise color 3-D surface image creates anatomicallyaccurate 3-D replications of patients’ faces for diagnosis.

This makes treatment more predictable, improves diagnoses, clarifies surgical approaches, and helps determine appropriate referrals for the following conditions:


First on any list is cost, which is also affected by equipment’s physical size. Many newer Cone Beam units are large enough to easily replace a standard Panorex unit in many dental offices today. Therefore, it’s crucial to determine early on what size device delivers the capabilities a practice needs-and then make certain it will actually fit in the available space and can be easily installed.

Likewise, consider designs that will be most comfortable for patients, and are minimally intrusive or intimidating. Look for a system that allows the patient to sit comfortably and upright during the scan, and holds patients in place with a chin rest or a head strap, such as the Imaging Sciences i-CAT®. These features ensure that dentists achieve the most anatomically accurate images at optimal comfort for the patient.

Dentists must also choose a machine with features that can impact their treatment planning and surgical success, such as total scan time and scanning reconstruction time. Dentists should look for a machine that will produce results quickly and accurately, which increases workflow and productivity, while shortening patient appointment time.

It’s also important to consider the Field of View produced by a Cone Beam system. Large and extended Field of Views are critical for dentists to capture all necessary anatomy and pathologies prior to treatment planning and surgical procedures. Some systems, like the i-CAT®, feature an adjustable beam collimation that allows for both full height and targeted field of view scans, providing the ability to further minimize patient radiation.

The equipment’s ease of use for staff members is also a very important feature to ensure smooth and efficient workflow. Look for a system that can be successfully integrated into a practice. This will benefit the entire staff by allowing them to view and reference scans from any networked operating system or consultation room.

As far as brands go, seek manufacturers who back up their systems with reliable customer service, product training and equipment support. Such service components include software education, compatibility with existing office systems, fast repair schedules, product guarantees, and support availability, whether by phone or in-office. In addition, consider whether or not the manufacturer includes software upgrades with the system as they become available. Some manufacturers do not include this, leaving practices stuck with outdated versions, or forcing them to spend more money on an upgrade.

At the same time, it’s also necessary to investigate software capabilities. Some imaging manufacturers offer proprietary software within the unit that lets dentists quickly diagnose, identify, and measure data directly from the machine. This data can also be downloaded and imported into a number of other software programs sold by other vendors for a variety of other applications.

The final step: Once the research is complete, and the system is acquired, integrate the practice’s 3-D images at the outset into a single image management system. This streamlines workflow processes, consolidates patient data, and ensures the best patient outcomes, making the transition from 2-D to 3-D smooth and seamless.

CONE BEAM COMES FULL CIRCLE

Having a Cone Beam CT system in-office directly influences a practice’s overall quality of care. Creating a “virtual patient” gives practitioners the most complete information on the anatomy of a patient’s mouth, face, and jaw areas, and leads to the most accurate treatment and predictable outcomes for patients’ surgical procedures.

Moreover, the preoperative scans help dental professionals perform safer, less invasive procedures by increasing precision, and reducing risk for the practice and patients. Patients also experience far less discomfort afterwards, and benefit from shorter appointments, faster procedures, more accurate placement, faster recoveries, and cost savings.

With application and usages ever expanding, cone beam technology will take forward-thinking practices to the next level, and soon become the standard of care for dentists everywhere.

CONE BEAM BENEFITS: AN OVERVIEW
Integrating Cone Beam technology into a practice produces immediate and dramatic results. Here are some important benefits:

  • Fast and Complete Work-Ups. One short scan-under a minute formost systems-provides a complete orthodontic work-up. This includes information on cephalometics, SMV, supernumeraries, airways, TM joints, impactions, and spinal studies. Such fast results mean dentists don’t require multiple scans, can keep patients in-house, and can evaluate and plan treatment faster and better-without multiple appointments.
  • Improved Patient Education. Showing patients their conditions in full 3-D color and imagery on the screen dramatically increases their comprehension. It demonstrates the problems in a highly visual and straightforward manner, not only reinforcing patient education, but also involving them in their own treatment. This, in turn, builds their trust and comfort.
  • Increased Revenue. Cone Beam systems can help practices contain operational costs, as well as lower treatment costs for the patient or their insurers, in three ways. Firstly, their immediate accuracy reduces surgery time and shortens treatment schedules. Secondly, its low perscan cost also helps dental professionals minimize the costs to the patient. And lastly, the low costs of scans help patients save money on more expensive hospital CT scans, which increases case acceptances and treatment follow-through.
  • Effective Use of Office Space. Certain workstations-such as that of the i-CAT, which includes machine, computer station, and access space-require less than 60 square feet of office space.
  • Pathology Scanning. 3-D imaging is critical for long-term health and preventative care. Cone Beam technology catches problems previously undetected by other dentists, simply because their imaging systems were not sophisticated enough. It’s also easier to quickly sort through the volume of data to find developing problems, such as jaw joint deterioration, in its early stages. This helps dentists start treatment quickly, and avert more serious problems down the line.
  • Location and Growth Tracking. Dentist can better evaluate airways for problems such as nasal polyps, restricted airways, and infected sinuses, among others. It also helps them track patients for skeletal asymmetries, excessive growth of the mandible or maxilla, or root resorption. The in-depth data enables location of impacted canines and supernumeraries.
  • Precise Measurements. More accurate information results in less invasive surgery, and produces better surgical guides. The greater accuracy also lets dentists see the interrelationships between anatomies, and helps develop the correct measurements for implant sizes, nerve canal height, and buccal/lingual width.
  • Efficient Data-Gathering. 3-D imaging removes much of the operator error inherent in 2-D imaging techniques. Now, with one scan, dentists can gather exponentially more data than with traditional methods. This requires less time and labor for technicians, and makes the scan shorter and simpler for patients.

CONE BEAM 3-D IMAGING: NINE PERKS FOR PATIENTS

  • Patients are exposed to over 10 times less radiation compared to a medical CT, depending on the Cone Beam system.
  • A quick and easy produces the most anatomically accurate 3-D images of the mouth, face, and jaw.
  • The fast, comfortable, and safe open environment scan increases the patient’s comfort level.
  • The entire scan procedure has a lower patient cost than a medical CT.
  • Cone Beam technology offers the highest level of surgical predictability, which results in successful surgical outcomes for patients, and reduced surgery time.
  • The in-office location helps patients avoid multiple hospital visits and appointments.
  • Depending on the Cone Beam system, typically within minutes of the scan patients receive an immediate virtual diagnosis and treatment plan from their dentist-all in one visit.
  • Data-sharing software-which some systems, such as the i-CAT, provide for free-lets dentists easily swap 3-D info with the patient’s general practitioner.
  • The 3-D images helps patients see and better understand the relationship between their dental structure and their soft tissue or facial appearance.