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Treatment Planning Using 3D Technology

Hear what Dr. Khalid Choudhary has to say about treatment planning using 3D imaging, referral rate, and the impact of 3D technology on his practice, patients, and staff.


Video Transcript

Interviewer: What impact has 3D imaging had on your practice, your patients, and your staff?

Dr. Khalid Choudhary: 3D imaging has been an integral part of our practice. It gives us two machines into one, it gives us the traditional 2 dimensional radiographic panorex and the ability of the 3 dimensional scan which allows us to visualize not only the bone volume but also anatomical structures such as nerve canals, [inaudible 00:29] and any pathology that might be present in the area. We do a lot of surgical and implant procedure in our practice such as teeth in a day, immediate loading, sinus grafting and zygomatic implants for advanced bone loss patients. And 3 dimensional scan is an integral part of not only diagnosis treatment planning but also patient presentation.

With the current generation of the machines which we find very very useful in our practice is that allows us various fields of view, from a small field of view where we can just look at a couple of teeth in a quadrant to diagnose if there’s a fracture or the amount of advanced bone loss to a lower arch or an upper arch or both arches as well as a full head scan including a TMG evaluation as well as an airway evaluation. All that data combined with the latest software advances in terms of treatment planning has made this an integral part of our surgical treatment planning and diagnosis in our practice.

Interviewer: Has treatment plan acceptance gone up as a result of 3D imaging?

Dr. Khalid Choudhary: Treatment plan acceptance is definitely gone up and is much better and well-received by the patients using a cone beam technology because of the fact that this scan is very very quick and from when the time the scan is done when the model is rendered on the computer is within mere seconds. You can go and do the consultation with the patients using their own 3 dimensional model. It’s not a generic model or a cartoon or an animation they’re looking at, it’s their own anatomy and bone they’re looking at which makes it a lot easier to discuss treatments for patients, especially when it’s concerning implants or fracture or pathology in the area. If we’re going to go ahead and graft the area to regenerate the bone to place the implant. You can virtually treatment place the implant, you can change the size, position, angulation and let the patient know that this is the area we might have to graft and the patient is integrally involved in their own care and their own treatment plan which makes the acceptance and the understanding of the overall treatment plan a lot more – for example if we’re going to graft into the sinus we can show the patient the length and the size of the implants we’re planning on placing. And then we can show them the amount of implants that’s exposed whether we’ll be doing an osteotome or a vertical sinus lift versus a lateral window or a horizontal sinus lift. So all those things combined allow the patient to take a very very active role in not only understanding but accepting their treatment plan.

Interviewer: What has your experience been like with the imaging / treatment planning software?

Dr. Khalid Choudhary: Well, the imaging and software packages that are included with the current generation of cone beam machines are very very powerful. They not only allow us to measure precisely the length, the width but also the angels of the anatomy in question, the bone in question. Also, the greatest benefits that are added into the newest software, like the ability of having an implant library. Our referrals prefer various different kinds of implants, so it’s great for us to be able to use the implant library and pick and choose the implant not only from different manufacturers but also various implant types from that manufacturer in terms of the model, the diameter, the length. It makes our workflow a lot easier.

And then the additional benefit has been the ability to send very very quickly the data if you find a pathology that you would like to have further evaluated by an oral radiologist, the ability to just click a button and send the data to be evaluated and get a radiology report within a day or so. So it’s a very very powerful and convenient tool.

The second option is that if we’re doing a big implant case or if somebody is just starting off with implants and they want the margin of safety by using a radiographic or a surgical guide, those can be manufactured very very easily within the imaging planning software. You can either plan the implant yourself by changing the size, diameter position, angle and then send that data to a processing center that will go ahead and make a surgical guide for you or you can just send the raw data to the processing center and they will treatment plan the case for you and make the surgical guide and have it delivered to your office within a few days.

Interviewer: Are you seeing more referrals from GPs because of the 3D Machine?

Dr. Khalid Choudhary:  Our referring doctors prefer the fact that we have a cone beam machine in our office just due to the diagnostic and treatment planning abilities that are offered with the machine. Referrals also take value in the fact that the safety margin that’s involved with treatment planning using a 3D scan is much higher than using a traditional 2D scan. We do a lot of advanced cases in our office such as teeth in a day, all-on-four, full arch implants as well as advanced zygometic implants. So our referring doctors definitely take comfort in the fact that we are able to go ahead and do the scan, do a precise measurement, make the surgical guides if needed and have a very very wide margin of safety in terms of providing the best treatment and care for their patients.

Speaker: Khalid M. Choudhary, DDS, MS