Monday, October 28, 2013
The dentists and team members who gathered in Boston this past weekend for i-CAT’s 7th International Congress on 3D Dental Imaging learned a lot about how, when and why to apply cone beam 3D imaging in their practices, and there seemed to be a singular message connecting every presentation.
In one way or another, speaker after speaker brought home the message that patients are 3 dimensional, their problems are 3 dimensional and 3 dimensional imaging is the most accurate way to diagnose problems and plan treatments which also will be 3 dimensional.
Here are my impressions of the event.
At the center of everything during the weekend was i-CAT’s latest imaging system, the i-CAT FLX. The system’s ability to capture detailed 3D images with radiation doses below those for some 2D panoramic images was discussed by many speakers and something attendees said was important because patients are more educated than ever about radiation exposure from medical and dental imaging.
While sessions focused on using cone beam CT imaging for specific dental implant and orthodontic situations, the main focus of the event was really clinicians excited about using the latest imaging technology sharing best practices for capturing images, reading and evaluating scans and finding ways to make sure the expensive technology provides a practice with a financial boost.
Dr. Lou Chmura provided an eye opening look at dental sleep medicine, sharing his personal story of struggling with sleep apnea and how this has helped him focus his practice on bringing pediatric sleep apnea cases to light. His message was that the dental community can help screen and treat many apnea cases early and 3D imaging technology can be a big part of planning for successful treatment.
While only using 3D imaging for four years, orthodontist Dr. Martin Van Vliet told the crowd that he’s made the technology a central focus of his practice with cone beam scans being used for enhanced diagnosis, treatment planning and patient education. It’s a marketing tool he uses when promoting his practice as a referral partner for general practitioners, as well as for promoting his practice directly to patients.
“This thing has to work for you financially,” he said. “You have to use this thing every day.”
Still, patients are more educated than ever about the potential dangers of 3D imaging technologies, and this is especially true for an orthodontic practice which treats a younger patient population. Dr. Van Vliet said he uses the smallest field of view possible for every scan and the FLX allows him to expose patients to as little as 5 microsieverts of radiation in some cases.
This message of knowing the radiation risks for patients, understanding it and effectively talking about it was continued by Dr. Bruce Howerton. His presentation began with a technical explanation of how radiation-based imaging works and what the risks to patients really are. Dr. Howerton made the point that while there is a small health risk from the scans, it is in the range of 1 to 4 in a million, and thus the clinical benefits of dental cone beam technology far outweigh the risks. He then went on to walk the attendees through thorough examinations of several scan volumes, showing how to review a scan for abnormalities that might be cause for concern.
“Once you learn it, you can tell so much more about your patient, and it’s not difficult to do,” he said.
This message carried over into day two when Dr. Richard Monahan took advantage of his dual training as both a dentist and a lawyer to provide insight into the legal issues that can surround dental imaging and dental care in general. A big fan of what the technology can do because he sees that the industry is, “in the era or more complex treatment, and we need more information,” Dr. Monahan still feels dentists need to be aware of potential legal complications.
Clinicians need to use good judgment when deciding which cases need 3D imaging and how much anatomy needs to be captured by the image. However, regardless of the case at hand, every CBCT scan taken must be reviewed in full so the patient can be fully advised about anything abnormal captured by the scan. He explained that the reasoning for this is that the full diagnostic potential of all imaging needs to be taken advantage of. However, this does not mean all scans must be read by a trained radiologist, just that they must be reviewed by a clinician who has been trained in how to read the images.
But while legal issues, radiation concerns and insurance claims details were practical parts of the event, the mood throughout the weekend was one of excitement as clinicians experienced with cone beam or just considering adding the technology took a lot away from their time in Boston. Many attendees said they planned to add cone beam to their practice soon, or if they already had a system, they were looking for the right time to upgrade to the latest technology.