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cone beam international magazine of cone beam dentistry

42 I I industry news _ Planmeca turning their head to see if the children in the back seat are okay. You should not look back, but protect yourself ”, says Villanen. Villanen and Mikkonen state that the upper neck is a relatively new area of interest in imaging and medicine. “The upper neck has been somewhat of a no-man’s land, even though it is one of the most mobile joint systems in the body. A neuroradiolo- gist examines the brain, while a radiologist usually examinestheareabelowtheC3vertebra.Treatment of a neck injury patient is a challenging multidisci- plinaryeffortthatrequiresaclinician,aphysiother- apist and a radiologist. If a brain or spinal injury is also suspected, the team needs a neurologist and a neuropsychologist as well.” A CBCT scan is an economical imaging method for which many insurance companies have agreed to cover the costs, describes Villanen. _A new standard of resolution CBCT images are also useful in examining osteo- porosis and degenerative changes, since thin slices provide an accurate insight into bone structure. “Compared to the resolution of CT images, CBCT images are on a whole new level”, states Villanen. The Planmeca Romexis software suite is an effective working tool for the radiologists: “The software is fast, visual and easy to use, and various measurements and scrollings work well. It is also a very visual tool in the training of physicians and physiotherapists.” Pantomo too is very happy about this coopera- tion that has been going on for a few years now. What started as a pilot experiment now provides genuine benefits. “It is great to discover new ap- plications for this imaging method, since we can nowobtainadditionalinformationandexaminethe cause of a patient’s problems”, says Mattila. _Patient case (Figs. 4a–d) A 58-year-old woman, generally healthy. During thepasttwoyears,herneckhasbecomesosoreand stiff that she can no longer turn her head. Dizziness spells. A lot of soreness on the right side, at the ver- tebrallevelC1/C2.Noinflammatoryarthritisfound. CBCTimagingindicationsfortheneckarea: _Determining the bony anatomy of the upper neck on levels C0–C4 (not indicated for imaging ligaments); _Fractures of the upper neck; _Avulsion injuries of the upper neck; _Differential diagnostics of arthrosis/rheumatoid arthritis of the upper neck; _Subluxation and abnormal rotation positions of the upper neck._ Case presentation Fig. 4a_Marked loss of height at the right atlanto-axial joint (C1–C2). Calcification and small bone cysts present in the bone under the articular surface. The structure of the bone is clearly visible. Fig. 4b_Marked loss of height and osteophyte formation at the right atlanto-axial joint. A cyst under the articular surface on the side of the C2 vertebra. Fig. 4c_The dens has moved to the left in relation to the C1 vertebra. Osteophytes in the atlanto-axial joint. Fig 4d_A large anterior osteophyte in the atlanto-axial joint. cone beam3_2014 Planmeca Oy Asentajankatu 6 00880 Helsinki Finland www.planmeca.com cone beam_contact Fig. 4dFig. 4c Fig. 4bFig. 4a CBE0314_40-42_Planmeca 30.09.14 14:18 Seite 3

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