The Optimum Choice for Implantologist
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- Karin Matthews
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1 The Optimum Choice for Implantologist
2 What is essential for your practice? What s the best way to choose a 3D X-ray machine for implant treatment planning? 02
3 Doctor says.. There are diagnostic limitations with my current dental X-ray equipment. I need something that provides 3D Images for accurate implant treatment planning? 03
4 The best way; 1. Familiarize with a new 3D software in a minimal time. 2. Improve the accuracy of implant treatment planning. 3. Achieve the goals set for investing in a 3D X-ray machine. 04
5 Are you trained well enough to use 3D? Have you already purchased a CBCT? It may be installed properly and you and your staff learned how to use it. But what about the 3D software? Have you ever felt like your software is too much? What if your 3D software is like a dashboard of an airplane? Complicated UI / UX VS Simple UI / UX Stressful software to deal with everyday The value of CBCT is not just in the hardware, but is mainly in 3D software. The important thing is how well you can use it. But as mentioned above, if the 3D software has too many functions like instrument panel of airplane, you are likely to use only 10% of all function it provides. This means you are only using 10% of the software's value and not making the most out of your investment. 05
6 Are you trained well enough to use 3D? There are some advanced features that you must do that are barriers to using CBCT properly. Orienting all axes; Axial, Sagittal, Coronal Drawing panoramic curve for every case Dealing with too many buttons and functions To make the most of your investment, you need to be familiar with 3D and use it freely to expand your practice. However, the above steps you from reaching success. Since you never had the chance to learn 3D software before even though you purchased a CBCT, this will result in a low return on your investment. 06
7 Are you trained well enough to use 3D? There are some advanced features that you must do that are barriers to using CBCT properly. Orienting all axes; Axial, Sagittal, Coronal Drawing panoramic curve for every case Dealing with too many buttons and functions One-Click Sectioning What can One-Click sectioning do for you? (Stress free) Easy to access 5-second sectioning is possible because Ez3D-i provides volume panoramic image. Without getting stressed out, you can access and utilize 3D in any case. Time Saving Advanced required steps for making diagnostic plans can be done within a few seconds. It dramatically saves you time to see more patients, and makes it easy for your staff to learn as well. 07
8 5 seconds is enough, to get sectional images of your region of interest. 3D software is even more difficult because it is based on 2D viewer s operating system. You got a 3D viewer, but you are still required to operate complicated Axial, Sagittal, Coronal images whenever you need to get to the R.O.I. With One-Click sectioning of Ez3D-i you can work in streamlined workflow and save time dramatically. More than 60 seconds VS Less than 5 seconds Step 1. Step 2. Step 3. Step 4. Adjusting Axes Finding R.O.I Drawing panoramic curve Sectional images One Click Sectioning! 08
9 5 seconds is enough, to get sectional images of your region of interest. What if you no longer need to do these challengeable works? VS 09
10 Spend less time for a treatment plan. What about the implant simulation process? Find R.O.I in Axial/Panoramic image with scrolling Position Navigation Window Click Panoramic curve button Draw Panoramic curve Measure Length To make right angle, rotate the Sagittal image Go to the [Implant] module Scroll down the bar to find R.O.I Insert Implant Measure the length Open the implant library Select implant Place implant Reposition implant 10
11 Who are your potential patients? Rapid-growth Implant Market Globally, the rising aging population is increases the demand for dental implants in the market. As a result, the market is expected to grow at a CAGR of about 8.3% from Dental Implants Market, Global, Market Value (US$M) $8,000 $6,000 $4,000 $2,000 $ Year As baby boomers enter their 50s, 60s, and 70s, many will need treatment to replace missing teeth. Implants represent the best treatment choice for many of these patients and others <30 30~40 40~50 50~60 60< Age (Years) Reference 1. Medical Equipment Market Size & Growth - Dental Devices[Dental Implants] Market, Global , USD Constant Millions, Global Data 2. A Retrospective study of the type of patients, the distribution of implant and the survival rate of [TEX]Xive (R) Xive(R) [/TEX] implant 11
12 What is the best solution for implant surgery of ages 40-50? Beginning in patients' early to mid 40s, prosthodontic treatment becomes a common procedure. About 80 percent of patients over the age 40 have various types of metal in their mouths such as prosthesis, implants or dental fillings. Normally they have between 3 and 5 teeth with metal. VATECH s ART-V TM1) is optimized solution to image this oral condition Patients Undergoing Complex Prosthodontic Rehabilitation * The Association Between Oral Health, Overall Systemic Health and Age Using DMFT Scores ( More metal, more distortion Leave bands or streaks on images Interrupt diagnosis Difficult to merge 3D and STL data 1) ART-V TM : Artifact Reduction Technology from VATECH 12
13 Benefits of ART-V TM Improve the accuracy with ART-V TM P Clear images give you less stress and more confidence P Leads to accurate diagnosis for implant planning P No extra discomfort to create surgical guide Efficient Workflow P ART-V TM Solution automatically activates the function according to patients dental conditions Same word, but a different meaning Metal artifacts hinder visualization and naturally reduce diagnostic confidence This picture is for illustration purposes only. 13
14 Benefits of ART-V TM ART-V TM finds the location of metals when radiation is exposed. And it deletes the metal in projection data artificially and fills that part with the similar values to surrounding area. At the same time, it remembers the original location and status of metals and then it inpaints the area with a new values that have no streaks. Compare images ART-V TM Off vs. ART-V TM On ART-V TM Off VS ART-V TM On 14
15 Achieve the goals set for investing in a 3D X-ray machine Proper FOV for Better Treatment Planning The CBCT FOV determines how much of the patient's anatomy you will be able to visualize. It is very important to find the most right FOV for your diagnostic tasks. In order to diagnose a variety of diseases and planning implants accurately, you may need to see the entire arch. With FOV 8x8, it s not possible to capture the entire arch, which limit the scope of diagnosis. However, as you can see on the table below, PaX-i3D Smart provides the image which shows the entire arch with FOV 10x8.5 [Anatomical FOV 12x9] so you can perfectly diagnose and plan the treatments. FOV comparison 5 x 5 8 x 8 10 x 8.5 [Anatomical 12x9] 15
16 Achieve the goals set for investing in a 3D X-ray machine Visualize the hidden area with anatomical FOV 12x9 Normally, an FOV 8x8 image does not show the 3rd molars. With this limitation, it is not possible to accurately gauge the anatomical relationship between the tooth and the mandibular nerve. However, PaX-i3D Smart captures an arch-shaped volume with FOV 10x8.5. Therefore, it is possible to acquire a 3D image for the entire arch and we call it, Anatomical FOV 12x9. PaX-i3D Smart FOV 10x8.5 (Anatomical 12x9) Conventional FOV 8x8 16
17 Achieve the goals set for investing in a 3D X-ray machine Anatomical FOV 12x9 improves treatment outcomes Thanks to the technology that captures arch-shaped volumes, the PaX-i3D Smart can cover the full arch, which will expand the scope of diagnosis. For example, you may need to extract 3rd molar lying on its side before inserting an implant for the 2nd molar. Therefore, proper selection of FOV can absolutely improves treatment outcomes in the oral surgery practice. There is no doubt that using full arch FOV prepares you better before a surgical procedure, and your results will reflect the change. Step 1 3rd molar extraction Step 2 Insert Implant for 2nd molar 17
18 Quality images are essential for your investment What makes a good quality images? There are many factors you need to consider before purchasing a 3D imaging device. But the most important factor is, after all, image quality. If the image quality is good, you will be satisfied with the 3D X-ray machine. The X-ray performance in regards to image quality will be different by the type of sensor. As you can see in the following comparison chart of the X-ray performance by detectors, the fabrication cost of TFT X-ray sensor is 1/3 the cost of CMOS X-ray sensors. For X-ray sensors, such a small pixel requires consistent, precise manufacturing, even a single defect at a microscopic level can render the entire imaging array defective. For most manufacturers this has proven to be cost prohibitive and continues to be; unless the precision in manufacturing will advance to make this a reality. Detector CMOS TFT Fabrication Cost High Low Sensor Size Small Large (Suitable for large area static 2D image) Image Quality High Low Pixel Size 49.5μm * 127μm Noise Low (Low dose scans are possible) Prone to noise * Native (non-binning mode) pixel size 18
19 Quality images are essential for your investment PaX-i3D Smart utilizes CMOS X-ray sensor CMOS sensors are easy to readout at high speed which minimizes ghosting on the images. TFT sensors on the other hand perform poorly with high speed readouts, so it is more suitable for one-shot images. CMOS sensors read data 10 times faster than TFT sensors so the sensor has minimal motion artifacts. However, TFT sensors have a poor data refresh rate so they are prone to motion artifacts such as ghosting and image lag. CMOS Without Image Lag TFT With Image Lag Minimal Motion Artifact Prone to Motion Artifacts Higher readout speed & Minimized ghosting on the images Faster CT scanning Higher electrical charge mobility & Lower noise 19
20 Quality images are essential for your investment Iterative Reconstruction for high quality image When baking, bakers always sift flour to make the texture more delicate in the finished product. If a baker repeats sifting flour, the bread can have an exceptionally fine texture, and will reduce any clumps of flour in the batter. Likewise, VATECH developed the advanced dental image reconstruction algorithm to provide better quality dental images. VATECH replaced the conventional dental reconstruction algorithm with the medical reconstruction algorithm. It repeats the reconstruction process 10 times and it produces a high quality image as the result. Under the same exposure condition, the image reconstructed using this method has significantly better image quality with reduced noise and better contrast resolution. One-Time Reconstruction Ten-Time Reconstruction 20
21 2D VS. 3D, The reasons why you need 3D 3D diagnosis, it is time to start! As we learned in math class, 2D only provides width and height information while 3D covers depth as well. In other words, 2D is a plane while 3D is a space. In the same manner, 3D gives more abundant information than a 2D image because it is possible to see the 3D image from different angles. This 3D technology is also adapted in dental X-ray imaging systems. With its cubic effect background, it allows doctors to view dental anatomy at different angles so they can understand the anatomy clearly by gaining a better view of the bone structures. 2D VS 3D Images of multiple planes are taken to make up the composite panoramic image The anatomical structures are clearly examined with each sectional view 21
22 2D VS. 3D, The reasons why you need 3D Overcome the limitations of 2D diagnosis with 3D imaging 2D imaging is like a plane image overlapped by several transparent images. Therefore, the anatomical structures are superimposed and distorted. However, 3D allows viewing dental anatomy at different angles. 3D has a cubic effect so the anatomical structures can be clearly examined and each sectional view shows the accurate distance between apical foramen and the mandibular nerve. As you can see below, it looks like the impacted tooth is touching the mandibular nerve in the 2D panoramic view when actually the tooth does not touch the nerve. We can only identify it with a 3D image with a viewer. 2D 3D 22
23 Cutting-edge Design and Functionality User-Friendly Design Accessory Box Use the built-in accessory box to organize all kinds of accessories. Stable Temple Support The temple support is designed to accuractely keep the patients head stable. Wheelchair Accommodation The base is designed for wheelchair users. Wheelchair Accommodation Patients remove all the metal objects (glasses, earrings, hair pins, etc.) on the cradle. 23
24 The Optimum Choice for Implantologist Dimensions [Unit: mm] FRONT VIEW TOP VIEW SIDE VIEW Specifications [PaX-i3D Smart : PHT-30LFO] Function CT(with Auto Pano) + Pano + Ceph Focal Spot Size 0.5 mm CT FOV Size Adult 10x8.5 cm / 5x5 cm (Optional) Child 10x7 cm Voxel Size 0.08 mm / 0.2 mm / 0.3 mm Scan Time (sec) CT 18.2 sec Pano 13.6 sec / 7 sec (Optional with Magic PAN) Ceph Scan : 12.9 sec / One-Shot : 0.7 sec Gray Scale 14 Bit Tube Voltage / Current 50~99 kvp / 4~16 ma The specifications are subject to change without prior notice. 24
25 The Optimum Choice for Implantologist
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