Th The Cone Beam 01

The Cone Beam Dimension

Sept. 1, 2008
Diagnostics provide 360-degree scan of the entire head.
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Diagnostics provide 360-degree scan of the entire head.

by Jackie Raulerson, RDH, and Mali Schantz-Feld, MA

Technology that improves patient care is evolving more quickly than ever before. As more sophisticated treatments become a reality, diagnostics are needed to provide the most precise view of the teeth and surrounding structures. Cone beam 3-D technology provides a 360-degree scan of the entire head (called full field of view), or the jaws (medium field of view), depending on the unit. The 3-D images created by these systems allow dental practitioners to view the bone, nerves, and tissues, and a chance to detect problems that may be missed by 2-D imaging options.

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The cone beam scan is similar to the hospital CT scan — with some very important differences. As clinicians, we should always follow ALARA (as low as reasonably achievable) protocol concerning radiation levels. This is where cone beam 3-D technology is more beneficial since it exposes the patient with up to 10 times less radiation than traditional medical CT scans of the same areas. The adjustable beam collimnation on some cone beam 3-D machines reduces the radiation even more as the scan area decreases. For instance, if a scan of the TMJ area is not needed, yet scans of both arches are, the machine can be adjusted to capture just the mandible and maxilla, resulting in less radiation for the patient and more flexibility for the practitioner.

Waiting time is another important difference. Hospital scans emit fan-shaped beams that gather data in multiple slices and then reassemble them. This type of exposure is time consuming, as is the hospital “paperwork” process. In-office cone beam scans capture in a cone-shaped pattern and can be completed in as little as 8.9 seconds, and reconstructed in less than 20 seconds. Images are ready to be viewed nearly immediately, without waiting for the data to be delivered by the hospital. Plus, patients remain in your office, which saves them time and aggravation.

Once the scan is complete, the 3-D imaging software takes over. These 3-D images precisely replicate the positions, shapes, and measurements of every scanned facial structure, including the maxilla, mandible, TMJ, sinuses, nasal cavity, and area back to the cervical spine. Within the software, these views can be sliced and rotated for diagnostics and treatment planning. It’s like picking up a cup and looking at it from all sides instead of looking at a picture of it, and then slicing the cup any way you want to see and measure its internal structure.

Specialized procedures are particularly aided by 3-D technology. Defining the position of vital structures can help avoid complications during implant planning and placement, as well as third molar removal. For those dentists placing implants, the “nerve marking estimation tool” locates previously undetected nerve canals. The precise slices of the mandible and maxilla assist in determining implant type, size, and location.

Orthodontists can accurately pinpoint root positions, impacted teeth, supernumerary teeth, and other conditions that affect tooth movement. Clinicians who treat TMJ disorders benefit from viewing the TMJ areas from all angles. The list goes on.

The cone beam 3-D does not take up a lot of space, and it fits into the same space as a traditional pan unit. It can double as a traditional 2-D panoramic unit, making it very cost effective and convenient, especially if the unit does not require a sensor change out. The patient can sit in a comfortable seated position while the clinician can easily operate the unit with the push of a button. This seated position keeps the patient not only comfortable, but stable for less chance of movement during the scan.

Imaging software allows for 3- navagation.
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Besides helping the professional staff achieve a realistic view, a 3-D scan gives patients a very clear understanding of diagnosis and proposed treatment so they can make more informed decisions. Patients are more likely to accept treatment and follow-up with compliance at home when they can view conditions not normally seen or reached through conventional imaging methods. Cone beam 3-D imaging adds depth to the patient’s office experience, and knowledge to the office staff.

About the Author

Jackie Raulerson, RDH, practiced hygiene for more than 20 years in Atlanta, New York, and Detroit before moving to the corporate side of dental. She is currently a media manager for DEXIS and Gendex. Mali Schantz-Feld, MA, a member of the American Medical Writers Association, has two decades of experience in medical and dental writing. Believing that knowledge is power, they both share a thirst for new information that leads to better patient care.