The next generation of CBCT system

Many practitioners face the challenge of finding an imaging system with a larger field of view along with the latest technologies to enable a scalable digital workflow. But the Carestream Dental’s CS 9600 CBCT scanner ticked all the boxes and Dr Antoine Diss, founder of Génération Implant from France, shares how his practice has benefitted from utilising it.

INTRODUCTION

Dr Antoine Diss works with dentists at the Génération Implant, a French leading training provider for implantology which he founded in 2006. At his practice, he trains dentists in implantology, periodontology, and implant prosthetics including procedures such as bone fillings, management of extractions, and sinus fillings.

Before implementing cone beam computed tomography (CBCT) in his practice in 2010, Dr Diss would send his implant patients to a radiologist for imaging, which means an additional appointment is required.

Once he added his own system into his workflow, it became indispensable for many reasons, especially in terms of efficiency.

Besides eliminating the extra appointment for imaging, Dr Diss, said, “During a surgery, or after it, we can produce images for verification rapidly. In addition, this imaging has enabled me to be more precise in my diagnoses.”

The ability to save time is something Dr Diss values and seeks to achieve throughout his workflow. In fact, it is the willingness to adopt new technology that plays a key role in his success.

IMAGE QUALITY AND VERSATILITY

The CS 9600 can accommodate Dr Diss imaging needs—as well as those of the doctors he works with—for implant and oral surgery because it features a 14 field-of-view options that range from 4x4cm to 16x17cm.

In addition, Dr Diss upgraded his system from the standard 90 kV model to 120 kV and appreciates the impact the upgrade brings: it enhances the image quality without increasing the dose.

“We now have a system that is truly capable of adapting to the different workflows we have. It has clearly taken CBCT imaging to the next level,” said Dr Diss. “In endodontics, for example, you can take a full arch image [10x10cm volume size] at 75-micron resolution, which is very significant. You can also target a single tooth on the arch. The images are excellent for implantology as well.”

Additionally, metal artifact reduction (MAR) plays a role in improving image quality.

Dr Diss, said, “Without CS MAR [Carestream Dental’s patented software option on the CS 9600], we could not really manage artifacts in our images. We just had to work with them.”

He explained that CS MAR works like a magnifier that enables users to pass through an image and see it— with and without the anti-artifact filter. They can compare the native image to the image with the algorithm applied and easily analyse both.

Multiple fields of view were especially beneficial for a case that was referred to Dr Diss where there was a complete failure of the maxillary. The patient was edentulous with almost no bone present.

Dr Diss was able to treat her with a system called Quad Zygoma. To position four zygomatic implants, he needed precise, localised images as well as larger ones, since the zygoma are situated under the orbits.

Certain anatomical risks made it imperative that he sees the limits with the orbit.

He shared, “I know that with my previous imaging system, which had a smaller field of view, my diagnosis could not have been as precise. My explanation to the patient would not have been as comprehensive, and I would not have had such ideal conditions in which to perform the surgery.”

With the potential of the CS 9600, Dr Diss is looking to expand his orthodontic services. In fact, the CS 9600 is able to accommodate this expansion, thanks to the breadth of imaging capabilities it delivers.

“We may consider offering adult orthodontics with aligners, given that we have an orthodontist who works with us in surgery,” said Dr Diss. “We envision combining analyses of the bone bases with aesthetic analyses from the Face Scan, and being able to propose therapeutic orthodontic solutions for patients.”

Easy, stable patient positioning

Dr Diss’s previous imaging system did not have an integrated seat. So, when he first saw the CS 9600, which has a seat option, he did not immediately envision the potential benefit. Then, it became clear.

“The seat provides stability for the patient and reduces movement during the scan resulting to clearer images. It also eases the process of positioning the patient,” he explained.

The CS 9600 facilitates proper patient positioning by guiding the user via several intelligent features. Now, Dr Diss and his team do nearly all of their examinations with the patient seated.

“The system is designed with a high degree of fool-proofing so that when you follow the protocol, you avoid errors—even for beginner assistants. The CS 9600 also guides you in using the supports specific to each modality,” said Dr Diss.

For instance, with the Face Scan, if the user did not position the correct support on the machine, a red light will alert him that he is using the wrong accessory.

Continue reading here. Published in Dental Asia May June 2021 issue.