Interview with Jay Cazes, DDS, FAGD
Edward Shellard, DMD
After using cone-beam computed tomography (CBCT) for any length of time, you get used to discovering the unexpected. As Jay Cazes, DDS, FAGD, said during our discussion, "It almost becomes pedestrian."
When shopping for a CBCT unit, what factors were most important to you?
Our practice is a busy one. In looking for a CBCT unit, I wanted to know the equipment would do what we needed without presenting a lot of challenges. Specifically, I looked for three things. First, I wanted a hybrid machine that could take panoramic, CBCT, and cephalometric images. Second, I wanted a machine that would work seamlessly with our practice management software (CS SoftDent). Third, I wanted a machine that was easy to use. In the end, we chose the CS 9000C 3D system.
What are some of the unexpected benefits you have experienced since implementing CBCT into your practice?
Being able to make diagnoses was an expected benefit. But in regards to your question, there have been important benefits that were unexpected. Here are the ones that deserve particular attention:
1. Enhanced planning-I can use the robust CBCT data to plan a case better. This has been invaluable in a number of situations, but it has been especially useful when predicting how long orthodontic treatment will take when dealing with impacted teeth.
2. More confident diagnosing-The information gathered allows me to make an on-the-spot diagnosis to keep the momentum of the case moving forward.
3. New or different treatment options than originally thought-The data can provide the patient with the option of an implant, for example. For impacted teeth, we're able to see more than 2-D alone, resulting in less invasive procedures for the patient.
4. Endodontic game changer-CBCT is invaluable when managing complex endodontic cases, assessing failures, and searching for missed canals.
5. Wow factor-Our patients are repeatedly amazed when presented with a three-dimensional view of themselves. The treatment acceptance level for these cases has increased dramatically.
6. Changing the way return on investment (ROI) is measured-The interesting thing about CBCT is the fact that you're not getting your return from charging for scans. The largest ROI is actually everything in this list. Viewing the ROI as the number of scans needed to pay off the machine would be a very narrow-minded way of looking at it.
7. Relieving years of pain for a patient-We had a case that was unbelievable when we look back at how it developed. The patient had dealt with unexplained pain on the upper left quadrant of his mouth for years. He had met with his physician and an ENT to determine if it was an infection, had a number of root canals performed (and re-treated), and even had teeth Nos. 12 and 14 extracted.
Because the patient commuted out of state regularly for work, he visited our practice infrequently. He began telling me about how he felt pressure when he put his head down and how uncomfortable it was to fly. I told him, "Look, we have this 3-D technology in our office. Why don't we take a scan and see what's going on to get a definitive diagnosis before deciding on another treatment?"
"His first root canal was in 1999, and it took a 3-D scan in 2015 to finally get to the source of the problem."
Upon taking the scan, we found a thumb-sized lesion in the No. 14 region and large cysts on Nos. 13 and 15. It turned out that when the patient was practicing tae kwon do in the late 1990s (he was a second-degree black belt), he got kicked in the face, which caused the bone under the teeth to basically die. He had all of these issues as a result, and they kept getting diagnosed as other conditions. His first root canal was in 1999, and it took a 3-D scan in 2015 to finally get to the source of the problem.
Edward Shellard, DMD, has more than two decades of clinical and executive experience in the dental industry. Since joining Carestream Dental in 2008, Dr. Shellard has driven global marketing strategy and product development efforts for the latest innovations in dental and practice management technology.
Jay Cazes, DDS, FAGD, is a graduate of the Georgetown University School of Dentistry. He owns a practice with his wife, Janice Cazes, DDS, in Long Valley, New Jersey. Offering a number of services, such as implant dentistry, endodontics, and orthodontics, Dr. Cazes relies on CBCT when diagnosing and treating patients.