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November 2008 | Dental Products Report
Clinican's Comments | Cone beam technology

	Fig. 1 The patient is positioned in the GXCB-500. Because the patient is seated, there’s less chance for movement.       Fig. 2  In about 20 seconds, the scan is reconstructed and appears on the screen.       Fig. 3 The EasyGuide software makes it possible to select exact dimensions of the implants.     Click here, for more information on the GXCB-500 from Gendex Dental Systems

Imaging technology keeps getting better, and the best part is my practice improves right along with it. For my office, the GXCB-500™ provides all of the functions and details I need for implant planning and placement.

For those who are unfamiliar with this technology, the cone beam scan provides an accurate 3D image of the mouth, similar to a traditional CT scan. Similar, yes; but the differences are important. While traditional CT scans emit a fan-shaped beam producing single sliced images that are overlapped and reconstructed, the GXCB-500’s cone-shaped beam produces a complete volume image in a single rotation. Because the image is captured in a single motion, radiation exposure is reduced. Research shows that this technology exposes patients to up to 10 times less radiation than traditional scans. Because my CBCT unit provides a partial field of view, radiation is reduced even more.

Tighter treatment plans

With my 3D scan, I can see nerve canals and available bone structure with no distortions for more exact treatment planning. After capturing the image, I can scroll through different views, turning the image in any direction and taking precise measurements. The scan is completed in 8.9 seconds and reconstructed in less than 20 seconds. I then integrate the scan into my Keystone treatment planning software, EasyGuide™, for applications such as virtual teeth placement visualization, bone density assessment, alveolar nerve identification and implant proximity detection.

Time well spent, communication well received

In addition to the realistic 3D image that facilitates my treatment planning process, there are other major benefits to cone beam technology. Twice in one morning I was reminded of one of the top reasons: Two separate patients drove a long way—1 to 1½ hours—to visit my office.

Both walked in without any idea of their condition or treatment plan. Because I had a cone beam imaging machine in my office, they each walked out with a scheduled surgery appointment. Without this technology, if they had needed a 3D scan, they would have been forced to travel to a hospital or imaging center, bring me back a CD with their images and return to my office for a pre-surgery appointment. The surgery itself would have to wait until the third appointment.

Cone beam technology provides a streamlined flow of appointments and faster treatment completion, a win-win for us and our patients. When additional appointments for imaging and consultation are eliminated, patients don’t feel shuffled around. My colleagues are more confident in their referrals to me, and these dentists and their patients are more confident in their treatment plans. My patients are impressed with the technology and visualization of their own anatomy. With the image up on my screen, both the patient and I can look at the implant site in 3D. Believe me, treatment acceptance is not far behind. The next time we see the patient—their second appointment—we are ready for surgery and we’re placing implants.

Communication with various colleagues is yet another plus. Those two patients who traveled to my practice came from referring doctors. To maintain communication, I take a screenshot to show the referring doctor what I already presented to the patient. I can print the image and mail it—or better yet, e-mail it. Their reaction is: “This guy has got it together. Look what he’s teaching my patients.” This gives me an advantage above others who don’t have this technology.

Imaging made easy

As practitioners, we only fully experience these benefits I’ve outlined when we have a clear, working protocol in place that allows us to use technology such as this to its fullest. Here’s my process for using the GXCB-500.

All cases start with the scan itself. It takes a few seconds to enter the patient information; this information will be embedded into the scan data. The patient is placed into the unit and positioned—probably a 30-second procedure. Because the patient is seated, there is less chance of movement (even though I typically take a scan in less than 9 seconds) and the jaws remain in a natural relation (Fig. 1).

We have the ability to shoot a quick preview to verify the patient’s position. We then perform the scan. Within 20 seconds, the scan is reconstructed and appears on the screen, ready for me to begin diagnosis and treatment planning (Fig. 2).

I typically view the scanned area in i-CATVision™ software first, then move the scan to my implant planning software, EasyGuide, where I, among other processes, select exact dimensions of the implants I will use for the patient’s procedure (Fig. 3).

After the treatment plan is complete, I e-mail the case to the referring dentist.

Without my CBCT system, a visit to my office could easily become what patients perceive as the “hassle” of visiting the dentist—taking off from work, driving long distances multiple times and not understanding my reasons behind the treatment plan. Cone beam imaging makes the journey through the procedure clearer to me, the referring doctor, and most of all, the patient. When I can clearly and quickly map out that journey (in 3D!), it is so much easier for all of us to reach the destination.