Cone beam — awareness in three dimensions

A cone-beam scan captures an image using up to 10 times less radiation than medical CT scans. My medium field-of view scanner (Gendex GXCB-500) takes 8.9 seconds to capture and 20 seconds to reconstruct.

That means less time wasted at a hospital or imaging center for my patients and no waiting for the results for me.

My in-office system bypasses the delay in implementing a viable treatment plan for my patients.

Cone-beam imaging has pushed my practice into an exciting new era of opportunity. A 3-D scan takes the guesswork out of implants, presenting a view of nerve canals and bone structure, plus it has the ability to slice the scan, rotate, zoom in and check the area from any angle.

It gives me the chance to educate my patients through visualization, as well.

During the past 15 years, I have collaborated with many other specialists on implants without this technology. Before 3-D brought more dimension to my practice, I was constantly searching for ways to make unacceptable surgical cases (for surgery I sent out) into acceptable restorative cases.

Without a 3-D scan, chances for error abound — implant placement that is non-parallel, too lingual, too buccal, too close together or implants placed in sinuses or in inadequate bone — even when I referred cases to well-known and respected surgeons.

Three dimensions increases predictability, and implant-planning software makes the process even more exact. I use a scan for the fabrication of a stent to guide me to implant success. Being able to place implants exactly, precisely where I want them, eliminates the fear that treatment will do more harm than good.

Cone beam bestows complete confidence that the implants are exactly where I planned them and that translates to greater treatment acceptance and trust from my patients.

Besides showing me what I can do, the scans also show me what I can’t do. As a general dentist, a 3-D scan gives me a clear picture of my limitations. I can predict what I feel comfortable tackling in the office and what I need to send to a specialist. When I refer my patients, I copy the scan and the imaging software onto a CD to share the benefits with my colleagues.

Besides implants, my repertoire now includes sleep apnea conditions, TMD and neuromuscular full-mouth reconstruction.

With scans, the educational opportunities are immense. I can take a pre-op scan to check the oral pharynx. Then, when I place the appliance in the mouth, I can show the patients their airway opening.

This impresses the patients and builds my reputation as a technology-savvy practitioner.

Implants and restorations are two of the hottest procedures now and are within the grasp of the general dentist.

To do a good job, we must have the full picture. Don’t be afraid of failure — the old saying that “you don’t know what you don’t know” is very true.

Cone-beam imaging gives me more control over what I know, what I can aspire to and what I can accomplish. It has improved my awareness, and it has brought depth and dimension to my practice.

Abut the author

Dr Derek Fine graduated from the University of Medicine and Dentistry of New Jersey in 1987 and has been in private practice for 18 years with Alan Steiner, DMD, in Denville, NJ, USA. He is a fellow of the Academy of General Dentistry and a member of the Academy of Laser Dentistry, the Academy of Comprehensive Esthetics, the American Dental Association and the Tri-County Dental Society. He has completed advanced training in neuromuscular dentistry and occlusion at the Las Vegas Institute for Advanced Dental Studies. Contact him at dfine8@mac.com.