The decision to add a CBCT system to your practice is a big one, largely because of the capital required. It isn’t like integrating a new laptop or tablet into your workflow. This kind of investment calls for careful consideration—particularly in five areas.
1. Image resolution. The most important aspect of all: high image quality. Increasing your diagnostic capabilities is the number one reason to integrate CBCT technology into your practice in the first place. You need to be able to see your area of interest with unprecedented detail. But you also need to be able to adjust image quality with dose—so options for field of view are important.
2. Versatility. What if you invest in CBCT imaging today and—six months down the road—you decide you want the ability to do cephalometric scanning? It would be nice to have a system that could expand with your capabilities, instead of having to purchase a whole new system. You should be able to take advantage of updates to your system when they become available, like for airway analysis, integration with CAD/CAM or low dose imaging. Continue reading
While most of the scans you read will fall into the “normal anatomy” category, the logical next step in the journey of learning how to interpret data sets from cone beam computed tomography (CBCT) imaging is developing proficiency at deciphering anatomical variations. These variations can often be seen in intraoral and extraoral radiography, and it is sometimes helpful to use 3D radiography to fully understand certain variations; which otherwise could result in failure to diagnose.
One of the most common anatomical variations of a critical structure is the anterior extension/loop of the inferior alveolar nerve. Visualizing this structure is imperative when planning surgical procedures in the anatomical areas around mental foramen and the immediate area anterior to it.
Anterior extension of Inferior Alveolar canal: the red circle shows anterior extension and the yellow circle shows mental foramen
In addition to mental foramen, accessory foramen(s) can also be noted as a variation of normal anatomy in the mandible.
The temperomandibular joint (TMJ) area can exhibit wide variations in normal anatomy, which has to be correlated with clinical findings and additional imaging if necessary to establish the absence of any pathology. One of the most common variations can be the inter-articular space of the joint. This space may vary widely between contralateral joints of the same patient and between patients as well. The complexity of this anatomical region warrants a thorough review of all information available. Continue reading
When it comes to cone beam computed tomography (CBCT) imaging systems, there’s a number of bells and whistles to choose from. In this video, Jordan Reiss, Carestream Dental’s North American Sales Director for 3D Imaging, provides his advice on how to choose the right unit to meet your practices needs.
Whether you’re currently in the market for a 3D unit, or you already have one, what do you consider to be the most important criteria for choosing a system?
When choosing technology for your practice you want to ensure you’re not only getting the best price, but the best fit for your practice workflow. A cone beam computed tomography (CBCT) system can be a big investment so you’ll want to consider many factors when shopping for a new unit.
Let’s start with the obvious: Does your practice have the space for a CBCT system? Even if you think you don’t, technology has come a long way. CBCT systems released in the past few years can now literally fit inside closets. I’ve seen “before and after” pictures of cluttered bookshelves tucked in a corner one day and a compact 3D imaging system the next. Look for small footprints if you’re buying a new system, or ask if your existing pan system has the ability to upgrade to 3D. Continue reading
Very few people like to visit the dentist. Now, imagine how much less they like visiting an oral surgeon. In the patient’s mind, surgery involves scalpels, anesthesia and recovery time—it’s far more involved than the biannual dental prophy. However, I’ve found when it comes to a “scary” treatment, such as an autogenous bone graft, using cone beam computed tomography (CBCT) helps me calm the fears and address the concerns of my patients. Not only that, CBCT improves patient understanding of their treatment and can increase case acceptance.
Borrowing Bone “in the Neighborhood”
Let’s say that a patient is interested in implants. However, a CBCT scan, which lets me view the oral cavity in 3D from any angle, reveals there isn’t enough bone present. To proceed with treatment, an autogenous bone graft is necessary. When discussing bone grafts with patients, their response is typically: “Gosh, that sounds terrible; taking bone from one part of my body to another?!” However, as I’ve discussed previously, the accuracy of CBCT reveals possible donor sites within the same maxillofacial region. It’s almost like moving a puzzle piece from one area of the puzzle and snapping it in to another area to make it fit. I reassure the patient by explaining: “Actually, we’re going to borrow a little bit of your own bone while I’m ‘in the neighborhood’.” That sounds far better to a patient than informing them we’re going to go to their hip or leg to take bone. Continue reading
When placing implants, I try to answers the questions of “how many,” “where” and “what size.” When asking “where,” bone volume plays a huge role. If I find bone deficiencies or inadequacies at the implant site, the treatment plan can go from very basic to very involved, as an autogenous bone graft may be necessary. Fortunately, cone beam computed tomography (CBCT) lets me view multiple planes in 3D. It not only reveals if there is a need to regenerate or augment bone, but also helps me identify possible donor sites for a bone graft.
The “Gold Standard”
Of course, there are is a cache of treatment options—autogenous, bone substitutes, ridge splitting, guided bone regeneration, block grafting, tissue engineering, mesh, etc—but for an oral surgeon the gold standard is the autogenous bone graft. A bone graft can stabilize the jaw, correct deformities and preserve the jaw in preparation for the next step of treatment, i.e., the implant. Continue reading
By Dr. Nestor Cohenca
I have been using cone beam computed tomography (CBCT) since 2003; in fact, I believe I am one of the first endodontists to incorporate this technology into my practice. In the time since, the evolution of CBCT systems has been impressive.
At its core, I find the following benefits to be instrumental when it comes to utilizing 3D imaging in my endodontic and traumatology cases: Continue reading
By Dr. Nestor Cohenca
At this point, cone beam computed tomography (CBCT) is recognized as an important diagnostic technology by general practitioners and specialists. While sending patients to an imaging center is one option for obtaining desired scans, I cannot stress enough the importance of having a 3D imaging unit available onsite. An in-house CBCT system not only benefits your patients, but your practice as well.
Common Objections to In-Office CBCT Imaging
Ask any specialist why they would send a patient to a third party for imaging, and inevitably, the answers involve cost and space. As technology evolves, however, these reasons are becoming less of a problem. Continue reading
By Dr. Alan Slootsky
Cone beam computed tomography (CBCT) imaging has played a valuable role in the way I practice, improving both my diagnoses and treatment planning. But, when I decided to invest in CBCT for my practice, there were a number of considerations I had to make from a business standpoint.
Like every dentist or specialist, I had my own obstacles to overcome. My particular obstacles were:
- My wife was nervous about spending so much money on a new piece of technology.
- Keeping the office open for an extra day to drive return on investment created some staff problems and required adding at least one more person to the team.
Any fears regarding the expense of the CBCT unit have been allayed, as I have found that a minimum of 20 new patients per month allows for a return on investment in one year. Patients have been really excited about the new technology and are more comfortable staying on site rather than going to a specialist. Having CBCT readily available within the practice has also allowed us to expand our diagnostic capabilities and services; which has a positive impact on revenue. Continue reading