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Inside Dentistry
October 2016
Volume 12, Issue 10
Peer-Reviewed

Another question worth asking is if the equipment is self-calibrating. If not, how often does the machine need to be calibrated? What happens if it is not calibrated? What is the cost of these calibrations? There is no way to know the true cost of 3D imaging equipment without asking these questions first. Some companies charge practices an annual operating fee for maintaining equipment.

In addition to expenses, practitioners should also consider that these are complicated machines, which makes the level of customer support another important factor in selecting 3D imaging equipment. Ideally, the company will always be available to quickly accept support requests, log on to the practitioner’s computer, and make any necessary changes.

Voxel Size

One of the terms you will often hear associated with 3D imaging is “voxel size.” A voxel, which is named after a contraction of “vox” for volume and “el” for element, is similar to a pixel. The higher the voxel size of a 3D image, the higher the “noise” and lower the resolution of that 3D image.

In 2012, the Journal of DentoMaxilloFacial Radiology performed an extensive study of the different 3D imaging systems available at that time.5 These researchers came to the conclusion that there was no appreciable difference in quality between 200 µm and 300 µm images.

2D and 3D Technology

There are two kinds of 3D imaging equipment: those that have both a 2D sensor and a 3D sensor, and those that only have a 3D sensor and can reconstruct panoramic 2D images from a 3D scan. It is best to have both 3D and 2D sensors, rather than reconstructing a 2D panoramic image from a 3D scan. A separate 2D sensor is required for high-quality panoramic images.

With a separate 2D sensor, practitioners can take partial mouth x-rays. This is helpful with patients that have trouble with gagging during bitewing x-rays.

The field of view is also very important. Many patients are concerned about radiation, so the equipment purchased has to be versatile in terms of the field of view in order to address these concerns and keep patients feeling safe.

Being able to take a 3D image of a small area when that is all that’s needed produces much less radiation than taking a 3D image of the full arch. But it’s also necessary to have the capability to take a 3D image of a full arch. With a full arch image, a practitioner can manufacture a surgical guide if their machine is able to take a 3D image of the whole upper or lower jaw.

Certain models of 3D imaging equipment provide additional capabilities (eg, having the ability to trace jaw movements and show the patient’s airways). Equipment with additional capabilities is more expensive, but it can provide significant value by enabling practices to offer unique services and stand out from the competition.

Conclusion

3D dental imaging equipment has become both more affordable and more advanced in the last 5 years. Once considered a luxury and used mostly in dental surgery-oriented practices, today it’s becoming an integral part of any multispecialty and many general dentistry practices. It’s a great return on investment, which will quickly pay for itself by increasing the quality of diagnosis and treatment, and allowing practitioners to safely perform many advanced dental procedures. While it’s important to select the right make and model as well as good support options, even less expensive scanners will provide a tremendous improvement over traditional radiography and 2D panoramic equipment.

References

1. Niyas FM. Use of CBCT As A Diagnostic Aid in the Treatment Planning for Implants in Mandibular Premolars Among South Indian Population. J Pharm Sci Res. 2015;7(7):492-496.

2. Orentlicher G, Abboud M. Guided surgery for implant therapy. Oral Maxillofac Surg Clin North Am. 2011;23(2):239-256, v-vi.

3. Kajan ZD, Taromsari M. Value of cone beam CT in detection of dental root fractures. Dentomaxillofac Radiol. 2012;41(1):3-10.

4. Dental Cone Bean Imaging. http://www.dentalcompare.com/Dental-Digital-Imaging-Dental-Imaging/4851-Dental-Cone-Beam-Imaging-Cone-Beam-3D/. Accessed August 20, 2016.

5. Maret D, Telmon N, Peters OA, et al. Effect of voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofac Radiol. 2012; 41(8):649-655.

About the Author

Olga Malkin, DMD
Private Practice
New York, New York

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