2022/2023 Orthodontic Equipment Catalog - 10

ORTHODONTICS
CUSTOMIZED PRACTICE SOLUTIONS
continued from page 9
There are also many benefits for CBCT in orthodontics.
With 3D, doctors can determine if a tooth can be moved
buccal or lingual based on the cortical bone and alveolar
housing. This relationship is not available in a 2D pan. In 2D,
doctors can see tooth relationships mesial and distal, but
absolutely no information is available about the torque of
the tooth as it relates to the alveolar boundaries of the patient.
There are small, medium and large field-of-view cone beam
systems on the market, each designed to address particular
needs. Today, however, dentists are gravitating to medium
and large volume systems that allow them to do more
dentistry. For example, an ideal system for a GP might be
the Planmeca ProMax®
3D Plus. It offers a field-of-view
that is similar to what a practitioner would see in a 2D pan,
providing a level of familiarity. However, if a practice wants
to do orthodontic work, this system can be upgraded to
offer a 20 by 17 cm volume.
Case studies in using cone beam computer tomography
There are many examples of clinicians using CBCT in the
field that illustrate how it may augment a practice's toolkit:
*
A 39-year-old patient had persistent pain on the upper
left, where she previously had root canal treatment.
The dentist took a 3D scan, and, in addition to seeing
a short fill on the canal and radiolucent lesion already
visible on a periapical X-ray, the doctor was able to
detect some asymptomatic abscesses that couldn't be
seen in 2D.
*
A patient, in their 30s, had pain on the upper left,
which the dentist localized to tooth number 14. With
the medium field of view, the dentist was able to see
a short fill on the palatal root. The cone beam detected
an apical lesion on tooth number 19 and a bit of PDL
widening on tooth number 18 - the tooth behind
it. CBCT technology identified a few more teeth that
needed to be addressed for this patient.
*
An older patient sought help for jaw pain on both sides
and halitosis (bad breath). The dentist took a CBCT
scan and discovered a lesion associated with tooth
number 14 and another associated with number 18.
With the larger field-of-view cone beam, the dentist
discovered calcifications on either side of the airway
- tonsil stones that are a cause of halitosis. There
was some flattening of the condylar head, signaling
degenerative changes in the TMJ, indicating that the
patient might benefit from an occlusal guard or night guard.
How physicians can incorporate 3D imaging into
their practice
The American Dental Association suggests that CBCT be
considered an adjunct or supplement to traditional duty
equipment present in your offices on a day-to-day basis.
Fortunately, it is possible to incorporate this technology
without subjecting patients to high doses of radiation.
The Ludlow Study from the University of North Carolina
found that there is no reduction of image quality when
using Planmeca Ultra Low Dose™ radiation, a technology
only found on Planmeca systems. This technology yields
diagnostically valuable images at extremely low does,
without sacrificing image quality.
Some dentists fear they are obligated to send every
CBCT scan to a radiologist, concerned they are liable for
everything in the image. While this is true, it's also true for
2D panoramic images. A good rule of thumb is to treat a
CBCT scan like a pan. For instance, you might start on one
condyle and work your way through the image to the other
condyle. While doing that, you evaluate the apices of all
the teeth, looking for asymptomatic abscesses and other
pathology. If you see something you don't recognize, you
are not obliged to make a diagnosis. But rather, those are
the scans best sent to a radiologist for a review.
Conclusion
The best way for dentists to determine if 3D imaging is
right for their practice is to schedule a demonstration. A
3D specialist can show you what is visible in a CBCT scan
and how to navigate within the software. Even better, visit
a showroom, get some preliminary training and try using
CBCT to see if you are comfortable operating the machine
and if it offers the features you need.
Like any technology, CBCT requires some education.
Manufacturers are well aware of this and offer education
programs regularly. Once you are armed with the
knowledge of how best to use CBCT, it can be a valuable
adjunct that helps you arrive at the most accurate diagnosis
so you can deliver the best treatment options to your patients.
Scan the QR Code
to Learn More about CBCT!
* Based on volume size, image resolution and using Planmeca Ultra Low Dose setting.
10
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2022/2023 Orthodontic Equipment Catalog

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