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Imaging Integration with Dr. Curtis Jansen

In this video, Dr. Curtis Jansen talks about the impact of digital workflow optimization, the impact of 3D technology, the considerations in the selection process, and more.


Video Transcript 

InterviewerHow does digital workflow optimization impact profitability and quality of care within a practice?

Dr. Curtis Jansen:  Many times I’m asked how digital workflows can increase optimization profitability within my practice. I think it’s a real good question and a lot of condition that one can answer to. And what I think clinicians need to understand is there’s many different levels and many different workflows one can be engaged with. For instance, from an iOS standpoint I can just merely utilize an iOS in the digital platform in my office. From this simple iOS I can take another workflow and send it to a mill and potentially mill a restoration or I can interface with lab partners or other partners in my business and send it out to them for procurement of restorations.

With CBCT it’s incredible depending on the volume and the size. There are many things to think about, profitability and the digital workflow and optimization with CBCT but I think it’s the ultimate diagnostic tool for doing diagnosis or simply implant planning. So the workflows can be tailored to your needs. Be it endodontics, orthodontics or restorative dentistry. And the profitability cannot be understated. It’s very interesting what doctors can do. And they need to be educated and certainly get more information on it, so that they don’t make a bad decision. But increasing profitability with less chair time is a big point about digital workflow.

Interviewer: How critical is it to have an open platform with practice management software?

Dr. Curtis Jansen:  I think a very good question that doctors ask and they’re not really sure about is architecture. What is opened architecture? What’s closed architecture? Doctors need to realize there’s a couple of different things to consider. Closed architecture which is really one manufacturer, one system. Then they’re selectively open where manufacturer may engaged some other manufacturers or some other software programs but still selectively opened. They’re still telling you what you can do. I think the most important is you have something that’s opened architecture, to be able to utilize all the different software manufacturers, all the different 3D systems, intra-oral systems and certainly opened architecture’s important for the future. Because we don’t know what’s going to happen but we would like to believe that these can all get along and communicate with one another. So for any practice I think they really need to understand the difference between closed and opened architecture and embrace opened architecture.

Interviewer: How does 3D technology impact a practice?

Dr. Curtis Jansen:  3D technology for a lot of clinician seems to be a little out there. Why would I need to have 3D? What they need to realize is 3D is not just about cone beam computerized tomography and placing implants. They need to really think about it some of the software programs today like extra-oral images. Everyone’s doing hygiene. When Mrs. Sticklovicz needs to get bitewings every 18 months to 2 years, what doctors don’t appreciate is they can have a CBCT made and do extra-oral bitewings. No sensor, they can do that maybe every hour. So a doctor on a routine may be able to utilize their CBCT system for extra-oral use with extra-oral images like bitewings. It’s hugely important that they understand that. Other things that they can do is implant planning software, they can look at periodontal defects not only as dental imaging but as skeletal rendering which is very powerful tool in looking at things in the 3D image. So 3D is extremely important for doctors to realize it’s not just for surgeons, it’s just something that they can utilize endodontics, orthodontics, airway, extra-oral bitewings. Very important for them to realize that.

Interviewer: What should a doctor consider during the selection process for a 3D imaging unit?

Dr. Curtis Jansen:  Doctors need to take a couple of things into consideration when they’re going to purchase 3D. Important things to be able to think about are volume size for instance. What are they can be utilizing their system for? Are they going to be utilizing it as a center in the community? Or do they need a large volume? Or an orthodontist may want to send over a patient. If they don’t want to do that, if they’re strictly thinking about their practice, why are they using it, endodontists for instance? They may want to do a smaller volume. They also need to consider the team and the infrastructure in their practice. Is their dental assistant going to be able to be trained on this? They may want to think about – again, opened architecture – are they going to be utilizing the CBCT information? Do they want to scan models? They can scan impressions. They no longer need iOS, they can make an impression and then scan that and get into a partner and fabricate restorations. So I think that for every individual practice, it’s a little bit different and important things to think about again are the architecture, what it’s going to be utilize for, and how they best want to be trained for that.

Interviewer:  What is restorative driven implant therapy?

Dr. Curtis Jansen: So one of the things I’m most happy about with the integration of CBCT and iOS intra-oral scanning is I can truly do top down treatment planning. In other words if clinicians don’t understand that, typically a surgeon or restorative doctor will get a CBCT, they’ll look at the available bone and they’ll put the implant in according to the available bone. Well, a lot of times this doesn’t work out best because the implant might be coming through the nostril or the ear and then I have to kind of bail the surgeon out and figure how to restore this.

What’s beautiful about intra-oral scanning and then taking an intra-oral scan, pinning it to a CBCT. Prior to pinning it I can do an intra-oral scan of the edentulous area, be it a single tooth, multiple tooth, whatever the clinical situation is. At that time I can design restorations that fit from a functional standpoint and an aesthetic standpoint. Once those are designed, I import that data into my CBCT or pin it. Then I integrate the restoration or restorations. From there, I can place ideally placed implants according to the restoration, not the available bone. At this times alarms can be sounded if I don’t have adequate bone. If there’s not enough height, width and I can inform the patient of potentially increased time and cost.

So top down treatment planning or restorative driven treatment planning is huge and going to be very beneficial because when we make these arrangements and we look at this top down treatment planning, it then can go to the cloud and we can inform our different partners in this of what may need to be done to put in the best possible restoration for Mrs. Sticklovitz from an aesthetic and functional standpoint, not just where the bone is.

Interviewer: What imaging technologies are used to assist in the integration of 2D and 3D and CAD/CAM?

Dr. Curtis Jansen: What kind of imaging technologies can we use to integrate or interface with 2D and 3D, as a restorative doctor, a prosthodontist, I’m in the 2D world a lot. I appreciate the 3D world and I realize when I need to utilize that but at times I’m going to probably utilize 2D a lot more, for instance in extra-oral images or extra-oral bitewings which is a phenomenal potential with these different systems. I’d like those to be in 2D. I can use 3D and just reformat it into a 2D image.

So this is important for doctors to understand, do they need 2D? Once they have 2D, can they upgrade to 3D? Can they use 3D and get a reformatted 2D image? So it’s very important if you’re looking at the manufacturer to specifically find out what 2D looks like on a 3D system or to start slow with 2D and slowly be able to upgrade into 3D. And then to make sure your management software can handle both of those different potentials and utilize those in your practice on one platform.

Speaker: Curtis E. Jansen, DDS