By Mari Koivunen
Oral and maxillofacial surgeon Dr Chan Siew Luen has been working in his private practice at Mount Elizabeth Medical Centre in Singapore since 1994 with a focus on aesthetic and reconstructive jaw surgery.
In his clinic, Dr Chan works together with a team consisting of a second maxillofacial surgeon, an orthodontist, an endodontist and a prosthodontist to offer patients all dental services they need. The high standards for dentistry in Singapore are one of the main reasons why many international patients choose to fly in for dental treatments, Dr Chan believes.
“We have patients coming in asking for the latest technology, even though it is not always needed for their case. The awareness of technical advancements has certainly grown among patients in the past years.”
Choosing Planmeca CBCT unit for large FOV and small patient doses
In the past, it is inconceivable for dentists to use protective gloves when treating patients, and using an orthopantomogram (OPG) machine in private practice is considered advanced. Today, having a cone-beam computed tomography (CBCT) machine is mainstream in Singapore.
“Digitalisation has transformed many practices into modern dental practices. Our practice, for example, is completely paperless. We can provide our patients with the information they need at any time, even from home, safely through cloud services,” said Dr Chan.
“When I got my first CBCT unit about 15 years ago, we used it sparingly because of the radiation exposure. It also took a lot of work to get the patient acceptance for using the technology. Today, patients are already aware that CBCT offers better imaging modalities than traditional 2D X-ray films, and the demand for CBCT has grown significantly.”
When it was time to replace his previous CBCT unit, Dr Chan turned to Planmeca for a new unit. He is the first dentist in Singapore to purchase Planmeca Viso G7, the “most advanced CBCT imaging unit” that Planmeca offers, according to the company.
“As I was comparing different units, I was particularly impressed with the endodontic imaging mode and the clarity of a small field of view (FOV) image of a single tooth, in which I was able to see the crack lines clearly. But since I am not an endodontist, the most attracting thing for me was the large FOV of Planmeca Viso G7 – and especially the ability to take a large FOVs with comparatively low patient doses thanks to Planmeca Ultra Low Dose imaging protocol. That was an important advantage over other brands,” Dr Chan explained.
“The resolution of the CBCT images is second to none. The 3D image is the best that I have seen in CBCT machines. A senior radiologist from a major teaching hospital also said it is even comparable to a conventional spiral computed tomography (CT), which, however, exposes patients to much higher doses.”
Convenience for users and patients alike
Dr Chan has been using Planmeca Viso G7 and Planmeca Romexis imaging software since July 2021. Ever since, the unit has been in daily use both in treatment planning and in patient communication.
According to Dr Chan, patient positioning is simpler using the video monitor of the Planmeca Viso G7. With the flexible height adjustments of the unit, the positioning is more convenient for the patients as well, especially for children and exceptionally tall patients. It also allows patients to sit or stand during the imaging procedure.
“Furthermore, I use the Planmeca CALM movement correction algorithm for all cases. It helps improve the image quality greatly,” added Dr Chan.
Dr Chan uses the device for various indications, such as to assess wisdom teeth proximity to inferior alveolar nerves, bone quantity for implant placement, temporomandibular joint disorders, bony pathology in the jaws, traumatic injuries to the face, and dentofacial deformities.
He commented that the software is easy to learn. Features such as segmentation of jaws and teeth also make the visualisation of the case simpler for patients. The airway measurement tool also provides an immediate and non-invasive appraisal of the dimensions of the airways, useful for the obstructive management of sleep apnea.
Modular platform allows adding new features later on
His CBCT unit is equipped with Planmeca ProFace, which allows capturing 3D photos of the patient with the X-ray unit. According to him, the option to incorporate 3D photography in the CBCT unit itself instead of equipping a dedicated room for 3D photos is attractive in cities where additional floor space can be expensive, such as Singapore.
In September 2021, Dr Chan also added the feature for tracking jaw movements to his Planmeca Viso G7, since he treats many temporomandibular (TMJ) patients and wanted to use jaw motion tracking in the examinations. The feature is available as an additional software module Planmeca 4D Jaw Motion, which was added to the Romexis software platform with a simple software update.
He concluded: “The possibility to add features to the imaging unit and software later is again something unique I did not have before. The Romexis 4D Jaw Motion gives a good record and visualisation of the movement of the condyles in function. I can achieve similar diagnostic values as with using a live continuous image intensifier, but at a fraction of the radiation dose.”
Photo credit: Aesthetic Reconstructive Jaw Surgery dental clinic