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cone beam international magazine of cone beam dentistry

20 I I opinion _ use of CBCT CBCT device will travel to your office or the patient’s home. Although this is much more convenient for the patient, reliability of these services is sometimes questionable and there may be concerns again about calibration due to relatively imperfect road surfaces, which may cause the machine to bounce around in the van. In addition, there may be issues with trans- ferring the data, depending on the software applications that are to be used. All of the points in contention were resolved when I decided to purchase a CBCT device for my office. After investigating all of the machines, I decided on an i-CAT Classic (Imaging Sciences) HavingCBCTtechnologyintheofficehaspro- vided me with the control that I desired and has made a dramatic change in our daily workflow, with instant access to the technology. Literally within seconds, patient anatomy can be viewed in three different orthogonal views (axial, coro- nal and sagittal), as well as a 3-D reconstructed solid model view—all with total interactivity af- forded to me through the software applications. The complete visualisation of the anatomy can be viewed and information assessed almost immediately. Treatment planning is expedited, since the patient does not have to schedule an appointment at a separate location. In addition to passively viewing the images on the LCD screen,thedatacanbeimportedintothird-party software that allows for virtual 3-D implant placement, providing me with the tools that I need to remove all of the guesswork associated with 2-D imaging. The treatment plan can be shown on a large screen in my office or on my laptop to each pa- tient, greatly enhancing treatment acceptance. Onceacceptedbythepatient,thetreatmentplan can then be accurately carried out via a surgical guided derived from the 3-D planning software. Other advantages of CBCT imaging in the office that I have found highly rewarding are airway analysis for sleep apnoea patients; inter- pretation of hard-tissue pathology (Figs. 3a & b, 4a & b); identification of vital structures during oral surgery procedures (Figs. 1a & b), such as third-molar extractions; periodontic/endodontic evaluations; and identification of radiopacities suggestive of carotid artery calcification, requir- ing further evaluation by a radiologist (Fig. 2). Having CBCT in the office has allowed me to have a greater understanding and appreciation of the anatomy and related structures of each patient. This knowledge is then applied during the treatment planning process to determine which tissues are deficient and with careful attention to vital structures so that implants can be placed in the most optimal receptor sites. Honestly, I do not know how I could practice without a CBCT device in my office today._ Fig. 4a_A digital panoramic radiograph (from CBCT) showing a large odontogenic cyst in the mandibular right side. Fig. 4b_A cross-sectional slice of the mandibular right molar area showing large-area destruction by the cyst. cone beam1_2014 Dr Barry Kaplan, Prosthodontist,Bloomfield, N.J.,USA.Past President of the NJ Section of theAmerican College of Prosthodontists, FellowoftheInternationalCongress of Oral Implantologists (ICOI). www.kaplandentistrynj.com cone beam_about the author Fig. 4bFig. 4a CBE0114_18-20_Kaplan 31.01.14 15:50 Seite 3