The Future of Dental Imaging Is Here
Jan 24, 2019 07:18PM
● By Ingo Mahn
Image 1: Sirona 3D scanner.
Dental X-rays have come a long way. With the advent of three-dimensional (3D) imaging technology, that progress just took a huge leap (see Image 1).
The diagnostic value of X-rays has always been limited by the fact that we are compressing information about a 3D object into a two-dimensional (2D) image. As a result, it is not only possible to completely miss certain problems but, in some cases, see things that “aren’t there.” For this reason, dentists have had to be extremely cautious about making a definitive diagnosis from a single X-ray.
Fortunately, over the last few years, a new technology has emerged that solves many of the problems associated with traditional 2D imaging. Known as a cone beam or cone beam compute tomography (CBCT), it has been a game changer.
CT scans have long been employed in the medical industry, and the CBCT, a similar imaging process (mentioned above), is now available in dentistry. At a fraction of the cost and approximately 1/100th of the radiation exposure, dentists are now able to see structures of the head and neck area in ways they could never have imagined.
A CBCT scan can easily be taken in less than 15 seconds and allows a dentist to literally look at a cross section of any part of the mouth. This is particularly valuable when looking at the sinuses, the jaw joints, or for oral infections.
Image 2 shows the panoramic X-ray (left) of a patient who presented with a painful tooth (circled in red). The previous X-rays had shown only that the patient had a very deep crown. But look at the detail revealed by a 3D scan of the same tooth (right). Not only are we able to see extensive decay (that black void at the end of the red arrow) but also the presence of an infection. This gave us the ability to immediately pursue the proper course of treatment.
Being able to image in 3D has also given us the ability to do other things never before possible. One is the precise planning for the placement of dental implants. When placing a dental implant, it is critical to know where the bone as well as vital structures (such as the sinuses and nerves) are located. Some manufacturers of modern CBCT units include software that even gives dentists the ability to virtually place the implant right in the scan. This information is then relayed to the dental laboratory, and a surgical guide is fabricated that allows for the very accurate placement of the implant in the optimal position.
This has made the process of placing implants easier and much more predictable. In the past, the placing of implants was usually done by a specialist. Thanks to this technology, there are now many general practitioners performing these procedures in their offices.
The other new application of 3D scanning is in the screening for airway obstructions (see Image 3). Recently, correlations have been made between poor breathing and a multitude of health issues. It is for this reason that treatment of sleep apnea and airway prosthodontics is perhaps the fastest growing area in dentistry today. By visually depicting the airway in 3D, the CBCT plays an important part in not only diagnosis but also provides an educational aid in addressing these vital issues.
In all facets of health care, proper diagnosis is critical. By implementing the use of 3D CBCT technology, dentists now have a tool to serve their patients better than ever before.
Ingo Mahn, DDS, is a 1985 graduate of Marquette University School of Dentistry. He is an accredited member of the IAOMT (International Academy of Oral Medicine and Toxicology) and earned a doctorate in Integrative Medicine from Capital University, in Georgetown. He is the founder of Natural Dental Partners (602-775-5120), a high-tech, health-centered practice in North Phoenix. For more information and a listing of upcoming events, visit MyNaturalDentist.com.