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Future of Dental CBCT Is Bright as Technology Evolves


Diagnostic technologies in dentistry continue to evolve rapidly. That evolution has been readily apparent in the last 15 years or so with the introduction and adoption of cone-beam computed tomography (CBCT) systems.

To contextualize the rapid growth, FDA notes that dental CBCT systems have been sold in the U.S. since the early 2000s and are increasingly used by radiologists and dental professionals for various clinical applications, including dental implant planning, visualization of abnormal teeth, evaluation of the jaws and face, cleft palate assessment, endodontic diagnosis and diagnosis of dental trauma. 

Market research valued the CBCT market at U.S. $407.5 million in 2014, and it’s anticipated to reach nearly $1 billion by the end of 2023. In other words, the CBCT market is expected to more than double in less than a decade.

Planmeca has been at the forefront of introducing CBCT in the U.S. market and around the world. In 2005, the company introduced a CBCT system for 3D dental imaging and developed the Planmeca Romexis software platform for processing X-ray images. Planmeca continued to develop the technology and in 2011, became the first company to combine three different 3D datasets into a complete 3D model with one x-ray unit. The Planmeca ProMax 3D family brings together a CBCT image, 3D face photo, and 3D model scan into a three-dimensional virtual patient.

This was also about the time that Mark Malterud, DDS, MAGD, incorporated Planmeca CBCT into his practice. Over the past 7 years, he has become a strong advocate for use of this technology in providing the best care for his patients.

“As my continuing education and consequently my practice develops, I found that I needed a larger field of view to not only uncover more areas of potential pathology, but I needed to look more into airway issues that my patients are having,” said Dr. Malterud. “So, of course I chose the unit from the company that had given me virtually 7 years of glitch-free use of a very powerful technology.”

Dr. Malterud’s selection was Planmeca ProMax 3D Plus, which offers users a wide selection of 3D volume sizes in addition to traditional 2D panoramic, extraoral bitewing, and cephalometric imaging. The volume sizes range from Ø40 x 50 mm to Ø200 x 100 mm, with the wide selection optimizing the imaging area according to a specific diagnostic task. The unit’s voxel sizes range from 75 μm to 600 μm, while the Planmeca Romexis software offers versatile tools for visualizing airways, sinuses, soft tissues, and the smallest bone structures in ears. These are the helpful tools that Dr. Malterud is relying upon as he visualizes his patients’ anatomy.

Efficient Airways Analysis

With just a few simple clicks in Planmeca Romexis, airways are segmented. The software automatically calculates the volume and minimal area and visualizes the patient’s airways with vibrant colors.  

Say, hypothetically, that Dr. Malterud wanted to export the airway data for fabrication of a sleep appliance. Planmeca Romexis allows any type of 3D data in a standard file format to be imported to or exported from the platform. The software allows volumetric DICOM data to be converted to a surface model and exported as an STL file. STL models can be exported either as one file or individually, and the 3D module integrates with third-party software as well as lab ports and services.

Dr. Malterud can also address patient concerns about radiation. Planmeca ProMax 3D Plus, like all Planmeca 3D imaging units, offers the proprietary Planmeca Ultra Low Dose imaging protocol, which enables 3D imaging with an even lower patient radiation dose than standard 2D panoramic imaging. This protocol is an optimal choice for examining airways, as it lowers the patient dose significantly without a statistical reduction in diagnostic image quality. In this example, Dr. Malterud can capture a 20x10 cm 3D image for about the same radiation dose as a single intraoral bitewing. Users can also have greater confidence in capturing an optimal image on the first try with the Planmeca CALM (Correction Algorithm for Latent Movement) algorithm, which eliminates patient movement from a CBCT scan, eliminating the risk of retakes. 

Of course, the 3D imaging capabilities of Planmeca ProMax 3D Plus extend beyond airway analysis. The system supports 3D endodontic imaging, 3D orthodontics, 3D implantology, and 4D jaw motion, which can be a supporting tool for temporomandibular (TMD) examinations. Additionally, 2D imaging and CAD/CAM solutions are supported.

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