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In dentistry, image is everything

Blog post   •   Aug 14, 2019 11:16 UTC

Your X-ray unit is arguably the most important tool in your dental practice. But how do you achieve a great diagnostic image? If you ask Planmeca’s Product Development Manager Mikko Lilja, it’s a combination of three Cs: contrast, crispness, and correcting artefacts.

You can’t treat what you can’t diagnose. You can’t diagnose what you can’t see. That’s why the most important diagnostic tool in your office is, arguably, your dental X-ray unit.

Both imaging technology and software are making daily strides to reduce doses on the one hand and improve image quality on the other. However, despite the incredible progress made in the last decade, some challenges remain. So how do you achieve a great image? Our Product Development Manager Mikko Lilja says it’s a combination of three Cs: contrast, crispness and correcting artefacts.

Contrast, resolution and sharpness

In order to take a quality image, you first need a quality imaging unit. Planmeca offers plenty to choose from, from tried-and-true X-ray units to the most advanced 3D imaging devices. Consequently, it is important to look at what kind of device suits your clinical needs – whether it’s a solid workhorse unit or a full-featured, fully-capable CBCT device.

In choosing the right imaging unit, Lilja mentions looking at devices that “have the baseline image quality – nice contrast, resolution and sharpness.” With the additional dimension provided by CBCT, a crisp 3D image can provide an in-depth look at any area of interest, from single implant cases to the entire maxillofacial region.

Zap those pesky artefacts

Although panoramic X-rays have been the norm in dental imaging for a long time, there is only so much you can see from a 2D image of a 3D structure. To achieve a great image, then, a CBCT imaging unit that consistently performs to a high standard is one half of the equation. The other half, however, has to do with what – up until now – has been the Achilles’ heel of all types of dental imaging: artefacts and noise.

“When you’re imaging patients, there are all kinds of artefacts you have to deal with,” says Mikko Lilja. “There might be metal in the patient’s mouth, the patient might be moving, or you might want to use a low dose protocol, which can add noise. So these are like an additional layer that you have to tackle to get that nice image.”

Noise and metal artefact removal has long been a standard feature of Planmeca imaging units. Two years ago, Planmeca was also the first dental manufacturer to introduce an end-user solution which detects and compensates for artefacts caused by patient movement – Planmeca CALM™.

Motion-free image through virtual tracking

Patient movement is one of the most significant challenges to image quality, and especially livelier patients such as children can have a hard time calming their movements for the scan. At worst, the resulting image may be diagnostically unusable, necessitating a retake and additional exposure to radiation.

Normally, if a patient moves during the scan, the image reconstruction cannot account for it as no information on it is included in the reconstruction process. Planmeca CALM addresses this problem by taking the unwanted movement into consideration. “Basically, we are virtually tracking the motion of the patient,” explains Lilja, who is also the brains behind the revolutionary algorithm.

“The algorithm ‘makes’ the C-arm of the CBCT scanner virtually follow the motion trajectory of the patient during acquisition. This makes the patient stay still in the imaging geometry, which then translates to a motion-free image.” Indeed, the software has been optimised to handle even the most challenging cases in which offset imaging geometry has been used.

Image is everything

In dentistry, image is everything. Before a single incision is made, an X-ray is always acquired to gauge the area of interest, make a diagnosis and decide what is the appropriate course of action. In order to get the best possible image to answer these purposes, you need an imaging unit which can consistently deliver the three Cs: contrast, crispness and artefact correction.

There is, however, a fourth C which could also be added to the list. Specifically, the third dimension that comes with CBCT can reveal hidden pathology in the mouth and provide new insights into the present condition, improving your treatment planning – and your confidence in it. Essentially, it’s about getting everything you can out of one scan and one exposure. And with all four Cs in place, that great diagnostic image can be the one you take.

Copy: Aleksandra Nyholm

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