Using the i-CAT FLX to improve treatment acceptance

June 26, 2017

How one dentist uses this CBCT system as a tool to educate his patients.Christopher Hoffpauir, DDS, is a relatively new dentist. Perhaps that explains his zeal for what he does. He calls himself an oral physician and likens his diagnostics with his early technology to Christopher Columbus’s poorly understood route to the New World.

Christopher Hoffpauir, DDS, is a relatively new dentist. Perhaps that explains his zeal for what he does. He calls himself an oral physician and likens his diagnostics with his early technology to Christopher Columbus’s poorly understood route to the New World.

“Before I had the CBCT, it’s like the earth was flat,” he explains.

That’s because his panoramic X-ray just wasn’t doing the job his cone beam CT does now - but he had no idea.
“There’s an old saying, ‘You don’t know what you’ve been missing until you find it,’” he says.

Dr. Hoffpauir uses the i-CATTM FLX as a screening device and also as a tool to help with treatment planning and case acceptance. He’s even caught a few cases that turned out to be cancer by identifying anomalies and sending patients to get biopsies.

Related article: i-CAT FLX V-Series provides an upgradeable solution

“We use it for airway assessment and as a tool to help the patient understand,” he says. “A lot of the airway has to do with the intraoral and extraoral signs that you see on examination, but you can’t give the patient an idea of the severity of the problem until they’re shown the airway. When they can see that the airway is constricted, they understand better that they may really have a problem.”

Implants

Dr. Hoffpauir also uses the i-CAT FLX for implant dentistry in his practice, from assessing the site to placing the implant through guided or freehand surgery.

“It saves me a lot of time,” he says. “Whenever I’m planning an implant case, I’ll pull up a 3D skull and tell the patient, ‘This is you and this is the tooth you’re missing.’ I’ll tell them that if someone’s not using this technology to place their implant, they could damage their nerves here. I’ll show them how to highlight their nerves in the skull, and I’ll measure 2 mm from it and say, ‘This is the safe distance, so we want to make sure your implant sits in this space with as much bone around it as possible and in a position where we can put a tooth on it.’ And then I’ll drop an implant in and we’ll go through a couple of different sizes and I’ll say, ‘I think this is the right implant for you. I think this one’s going to work really well.’”

He’ll then show the patient a 3D printout of his or her jaw and do a virtual surgery on it, paired with a 3D-printed guide to show him or her that the appropriate degrees of angulation and the correct depth are marked.

“Saying, ‘We’re going to be able to keep you really safe and we’ll make sure that everything’s going to work before we place the implant,’ is really powerful in selling implants to people and convincing them to do the treatment because it really gives you a lot of authority,” he says. “You’re sitting here and showing them this skull and how you’re going to place the implant and you’re showing them all the things that go into the consideration.”

The i-CAT FLX also helps Dr. Hoffpauir with simpler cases.

“With Tx STUDIO, you can actually go in and place a crown on that implant, then turn it around and say, ‘This is what your tooth is going to look like,’” he says. “Not only does it truly keep your patients safe, but it’s an amazing tool for education and for getting patients to move to ‘yes’ when it comes to treatment.

“Sales is a dirty word in dentistry, but the truth is that no matter what your skills are or how many CE courses you’ve done or how many implants you’ve placed, if you’re not able to get your patient to move to ‘yes,’ then you’re no good to them,” he adds. “You can’t help them solve their problems.”

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Time savings

The i-CAT FLX saves Dr. Hoffpauir a lot of time in his practice without sacrificing the level of care he wants to uphold.

“When I first started placing implants, I used a panoramic to measure the bone,” he says. “I would get a model and shave it down to see where the bone was, then I would try to make a guide based on that to show where the restoration needed to go within the emergence profile, and I’d spend money on wax-ups from the lab to make sure I was doing everything I possibly could do.

Read more: i-CAT helps a whole family breathe easier

“My i-CAT FLX really brings home all that data in an easy-to-read and easy-to-use way. It really elevates what you can do as a practitioner.”

The CBCT also ensures a more accurate image. Dr. Hoffpauir says that using a panoramic X-ray to place implants led to a lot of uncertainty. “Panoramics are notorious for being inaccurate, particularly in the anterior segments,” he says.

That uncertainty led him to refer a lot of implant cases. “I just didn’t have the data that I needed,” he says.

Sleep apnea

A CBCT also offers certain data patients need- the images that help them fully understand their health.

“We’d already been screening patients for a while and trying to send them out to sleep studies, and only about half the patients would go,” Dr. Hoffpauir says. “I just thought, ‘Man, if only I had a better tool to do this.’”

One day, he was talking to his Henry Schein rep, who told him that an i-CAT would be the solution.

“Imagine being able to show the patient what’s wrong,” his rep told him. “Imagine being certain when you’re placing implants, knowing that what you’re doing is what’s right and what’s best for the patient.”

Dr. Hoffpauir was intrigued, so he started doing research on CBCTs.

“I had gotten to the point where I decided I needed one, so I started reading online about what different people say about their CBCTs and what the companies said about them,” he says. “When it came down to it, the i-CAT has the best image you could possibly get. It has an image that I can use for airway. It has multiple low-dose radiation options, including QuickScan+.  It really startled me to find out that a basic scan on the i-CAT FLX was going to be delivering less radiation to my patients than my panoramic was. That floored me. I think that was the straw that broke the camel’s back that made me move to i-CAT.”

For Dr. Hoffpauir and his patients, using the i-CAT has been a game changer.

“There’s a lot of denial in disease diagnosis, but whenever a patient can see on the screen what it looks like and how constricted their airway is, they start really listening to the other things that you’re talking about and starts that conversation,” he says. “It’s just a great tool for educating them."