3-D imaging — Making digital even better

This is the way technology works — a year ago, I finally bought a digital pan after 20 years of depending on a film-based pano.

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This is the way technology works — a year ago, I finally bought a digital pan after 20 years of depending on a film-based pano. I was able to get rid of my darkroom when I added it to my intraoral digital imaging system. I am still happy with my choices, but I'm always searching for other innovations that can increase my diagnostic capabilities. That's how I discovered a distinctive cone beam 3-D imaging system. With features including and beyond the 2-D pano, this 3-D machine makes everything else seem obsolete.

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Taking the guesswork out of precise measurements
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Here are some facts about my GXCB-500™ to sink your teeth into: It offers a molar-to-molar view from the nose to the bottom of the jaw. You may have heard about the already developed technology that provides a "full skull" view, but the full skull can be considered too much for many dental practices. This machine gets the job done with a smaller field of view and a smaller price tag. Another great feature is that the system can change modes to a 2-D digital panoramic, without switching out the sensor. This saves time, and you won't have to worry about your assistant dropping the sensors!

While 2-D imaging may be enough for a general dentistry practice, especially since 3-D cannot be used for caries detection (yet), 3-D cone beam imaging is important for any dentist who does implants, surgery, or orthodontics. 3-D images are more precise than 2-D, especially in accurate size comparison. With a 2-D, you may not be able to accurately estimate the distance between two artifacts; they may appear as if they are on top of each other even though they aren't.

Delivery of specialty services is much simpler with 3-D. For implants, your 3-D view homes in on the proposed area's location, size, width, and length. Cone beam technology also helps in diagnosis of TMD because you can view its size, form, quality, and the spatial relationship of the osseous joint components. You can actually visualize the teeth and evaluate the whole maxillomandibular relationship and occlusion. In my own practice as a restorative dentist, just about everything I do is related in some way to the TMJ. With this new technology, I can assess the temporomandibular joint before, during, and after treatment.

For further surgical considerations, 3-D helps localize an impacted tooth and identifies any pathology, and 3-D images assist in planning surgical access to the impacted tooth and in designing the mechanics for removing any impacted teeth in the dental arch form.

The imaging possibilities are extremely important for orthodontic practices. When moving teeth, it can show you the amount of bone on the buccal or lingual plate, as well as how much you can tilt or turn the teeth without extruding them beyond the bone.

In addition to the detailed image quality, this cone beam machine has the fastest scan and reconstruction rates in the industry (8.9 seconds and 20 seconds, respectively). This means that you see the images almost immediately — no waiting around or sending the patient out to another facility. You can diagnose and accurately plan at the same visit. And don't forget that in this digital age, dentists can easily share these images quickly with other clinicians.

Even though I just upgraded to a digital 2-D pano system, 3-D is now some of the technology that I'm seriously looking at, especially now that I'm adding a periodontist who will place implants for my expanded practice. When you learn about cone beam technology, you think, "Wow, when we look at other types of images for certain procedures, we are really guessing."

Dr. Lorin Berland is an internationally acclaimed cosmetic dentist and one of the most published authorities in the professional dental and general media. Dr. Berland, a Fellow of the American Academy of Cosmetic Dentistry, is the co-creator of the Lorin Library Smile Style Guide, www.denturewearers.com, and is the founder of Arts District Dentistry, a multidoctor specialty practice in Dallas that pioneered the concept of spa dentistry. Dr. Berland was honored by the AACD with the 2008 Outstanding Contribution to the Art and Science of Cosmetic Dentistry Award.

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