We recently installed a J.Morita CBCT unit and i-Dixel software for Dr. Esteban Velez. He made a short video using his new J.Morita 3D R100 CBCT unit and i-Dixel viewing software. He pairs the software with Blue Sky plan for all of his implant planning and 3D printing of his surgical guides. Both software blends seamlessly together to keep the entire process in his office. If you're thinking about investing in CBCT make sure you watch his video to see live clips of the imaging software, how it works and how he uses it for implant planning and surgical guides.
The annual CDA meeting in Anaheim, California is a nationally recognized conference touting some big names in dental technology. Attendees get close and personal with new products and services, earn C.E. credits, grab inspiration from renowned speakers and innovators or network with other industry professionals.
If you have a dental practice, you have likely heard people talk about CBCT technology. You may have even been approached about adopting the technology for your practice. Before moving forward, though, you need to have a better understanding of what this technology is and how it can help your practice. Then, you will know if CBCT technology is the right option for your dental practice.
When looking towards a CBCT investment start with the end in mind. Why are you thinking about CBCT and what will you be using it to accomplish? For many general dentists the answer is predictably placing implants. If this is your motivation, then it is safe to say that guided implant surgery may also be something that you are pursuing to achieve the highest degree of a predictable outcome.
You have a new CBCT machine in your office and you are excited. You want to get the most out of it, which means you need to know how to position your patients. If you properly position your patients, your machine will take clear images that will help you with everything from diagnosis and treatment to undergoing complex procedures. Fortunately, there are a few tips you can follow that will make this process extremely simple. Once you follow these tips, you will be well on your way to getting the most out of your CBCT machine.
One of the most frustrating aspects to digital x-ray technology is having a sensor fail outside of warranty. Most manufacturers will state that the average life of a sensor is three to five years with normal wear and tear. This is true regardless if you use the SuniRay2, UniRay 1.5, QuickRay, EI, XDR, Schick CDR or 33, Dexis Platinum, etc. However, many dental offices have experienced failures before the average life expectancy. The following are tips to help your office get the most life from your sensor.
Interest in CBCT technology in dental has grown substantially as more general dentists place implants and recognize the value of virtually planning the procedure for the best treatment results. There is no substitution for being able to accurately measure bone level and thickness prior to placing an implant.
Most CBCT software allows for the virtual placement of the implant so that the exact best placement can be determined prior to the actual procedure. The peace of mind that this kind of precision offers helps dentists placing implants avoid sleepless nights wondering about the success of difficult procedures. Buccal perforations and angulation errors become a thing of the past with a properly used CBCT scan.
There are a lot of claims about digital x-ray quality with some companies claiming that they have the best image quality. In this particular study soon to be graduates from the University of St. Louis'
Endodontic Program compared 6 sensors to see how much difference there really is among sensors. A pig jaw was used and a #6 file was inserted in a canal to be x-rayed. Each sensor was exposed using the same position and an exposure level that was deemed ideal for that sensor. The results are in the image below. The first group is "native" or unenhanced while the second group has been sharpened. The sensors evaluated were: Dexis Platinum, Poloroid Sensor, Quickray, SuniRay2, XDR.
I was speaking with a dental imaging expert who I highly respect for his depth of knowledge and expertise regarding dental imaging. He is a dentist, radiologist, and programmer and widely recognized as one of the foremost experts in dental imaging technology.
I wanted to pick his brain about "modulation transfer function" and how it is measured. In layman's terms MTF is the measurement of the difference between reality and the image. So in the case of a CBCT volume, how accurate of a reproduction is the 3D volume. My friend the expert told me that MTF is the true measurement of quality in all imaging from photography to CBCT. He said that MTF can actually be measured at the pixel or voxel level electronically which started to get over my head. He then said that he believes that this measurement should be required from every CBCT system manufactured. This would provide a true ranking of image quality among competitive CBCT machines. In this way the dentist could rely on science rather than anecdotal evidence to determine how image quality compares when shopping. If I want to buy a fast car, I rely on tested and published 0-60 times, 1/4 mile times, and 0-100 time as well as top speed. I do not take the sales person's word that his model is the fastest. I also do not look at one factor such as horsepower to make my decision because I know that power to weight ratio is more important than either of those variables alone.
Unfortunately, in dental imaging there are not resources to compare this measurement. Instead many units are sold by the sales person's comments about their system's superiority. For example " our unit goes down to a 75 micron voxel and therefore it gives the finest image quality." If the rotation time is 30 seconds for that micron size, the resulting MTF will be greater than a larger micron voxel with a faster scan time. Additionally, as pixels and voxels are reduced in size more noise is introduced into the image and more radiation is required to take the image. Thus, just like a car's performance, a CBCT's ultimate image quality will be determined by a combination of factors (time of rotation to take the image, voxel size, harmonic vibration, sensor quality, scintillator quality, and processing algorithms to name a few) It can all get very confusing! That is why there needs to be a standard meaningful measurement of MTF.
To my knowledge, J.Morita is the only manufacturer that has measured MTF and resulting LPPMM for the CBCT systems that they produce. The measurement is in the brochure for the Morita R100. I think it's great that the J.Morita is trying to bring truth to digital imaging but it is all meaningless if other manufacturers do not provide this measurement for comparative purposes. The December 2011 issue of The Journal of Oral Science Volume 53, #4 rated two of Morita's products as having the top image quality among 8 different units evaluated. However, this was a subjective study done by 5 dentist observers so opinions varied. Morita was rated #1 in virtually every assessment. It would be interesting to have true MTF figures and see if the measurements matched the subjective ratings. The images in this study represented a HUGE difference in subjective image quality.
It is not surprising that J. Morita, who is internationally recognized as a leader in CBCT image quality, is leading the way by providing MTF measurements for all of their units. If other manufacturers would agree to use the same universally recognized measure of image quality, it would be much easier for dentists to know how their chosen unit stacks up against other options.
CBCT is a big investment for your practice and there's a lot to know before you make a purchase decision. So if you're thinking about investing in CBCT make sure you ask the right questions and download my free purchase guide below!