cone beam CE

cone beam1_2012 practice matters _ better communication I Fig. 3_Intraoral powerless scan result of edentulous area. Fig. 4_Design of ideal function and contour proposal. Fig. 5_Two data sets confirmed within E4D Compass. _Software solutions Thesoftwarethattypicallyaccompaniesorissug- gestedforusewiththeactualcone-beamsystem(e.g. Invivo (Anatomage) Cliniview (Instrumentarium), SimPlant (Materialise) is typically feature-rich with levels upon levels of diagnostic fields, measurement capabilities and visual markers. The intent of the E4D Compass software is to combine the accuracy and the simplicity associ- ated with its chairside restorative counterpart (E4D DentaLogic) in a format understood and valuable to the restorative clinician educating (and selling) their patients on the option of implant therapy. But most important is the ability to plan the restorative placement first, as the ideal, providing guidelines for the surgical team — whether it is the practice itself or if the procedure is referred out. There are numerous associated companies and dentallaboratoriesthatprovidesupport,cone-beam readings and associated surgical guides (e.g. 3-D Diagnostics,360imaging)inorderforthefinaltreat- menttobecompleted,butE4DCompassprovidesthe restorative clinician, the capability to preliminarily plan, educate, communicate and then collaborate throughtherestorativecycle—providingaclearcon- ciseandconfidentplanforthesurgicalteam/referral. _The planning process Patients don’t regularly enter a practice with a demand for placement of a dental implant, instead, morecommonly;thecomplaintislostfunctionorthe presenceofafoodtrapinanedentulousarea.Itisup tothedentalprofessionaltogathertherelevantdata andthensuggesttheoptionsfortreatment,basedon a number of clinical parameters that could include one or more of the following: fixed partial bridge, removable partial bridge (partial), implant therapy, orthodontic movement or nothing at all. Only when the restorative clinician has more in- formation via study models (either stone or virtual), 2-D or 3-D data (X-rays or cone-beam scan), clinical observationandfunctionalrequirementscanhe/she properly recommend or treatment plan the func- tional restorative options. Havingadigitalscannerthatcanproceeddirectly to a restorative outcome (i.e., Function First) allows the clinician or clinical team to scan the edentulous (Fig.3) andfunctionalareaandthendesigntheideal restoration, regardless of the manner that will even- tually hold it in place (Fig. 4). Another consideration is if the digital scanner selected uses technology that doesn’t require a con- trast agent (i.e., powders or sprays) scans of the oral environmentcantakeplaceatanystagepre-orpost- surgical without the concern of residual powder or disturbance of the healing process. The E4D Dentist system uses a laser to capture the 3-D environment whethersofttissue,hardtissue,impressionsormod- els and without the use of a contrast agent. By using digital scanning one is able to show the patient immediately the restorative plan, which means the process can continue through to the next stepsmoresmoothly,whichifimplanttherapyisbe- ing considered, could include a work authorization for a cone-beam scan. Once you have a compatible cone-beam scan, (iCAT, Gendex, Instrumentarium, Soredex) you can simply import the cone beam scan and through proprietary visualization within the E4D Compass softwareyoucanalignthetwodatasets(Fig.5). Then the treatment planning and education can begin. After confirming the proper data sets by seeing the intraoral scan data and the cone-beam data, nerve identification can begin if it is a mandibular case. With a click of a mouse, data sets are moved to arch form and visualize the area of interest. Once the mandibular canal in the surgical area is identified, and the areas can be viewed in all planes, thenerveisvisuallydepictedsimilarlytothemethod use to draw the margin on a restoration, clicking the mouse and following the line. Oncethenervehasbeendrawn,itcanbeenlarged toprovideavisualsafetyfactor,andevencarriedout through the mental foramen (Fig. 6). I 39 Fig. 3 Fig. 4 Fig. 5