Know What You Need in a Digital Imaging Unit

Inside Dentistry interviews Editorial Advisory Board member Gary Radz, DDS, owner of Cosmetic Dentistry of Colorado and the director of industry relations for SmileSource.

Inside Dentistry (ID): How have developments in digital imaging transformed dentistry both in the early years and more recently?

Gary Radz, DDS (GR): Digital imaging has brought modern medical technology into the dental office and helped dentists do better, more accurate work. It has allowed us to show patients their oral situation in ways that we previously could not, enhancing the overall patient communication and education process.

One of the more recent developments in the evolution of imaging has been the ability to merge different technologies together. Once a standalone technology, cone-beam computed tomography (CBCT) units now provide data that the dental team can overlay with other files, such as impression scans, to perform more accurate surgical and restorative planning.

ID: What are some of the most important considerations and differentiating factors for a dentist who is looking to purchase new imaging technology?

GR: The most important things to understand are that there are a variety of different options from different manufacturers in terms of pricing and capabilities and that there is no one product that is best for every office. Each dentist's needs are different depending on the types of services that he or she provides, and these machines require a financial investment in the range of six figures, so becoming educated about the various options available on the market is very important. Some extraoral imaging units can only perform CBCT scans, whereas others have panoramic and/or cephalometric capabilities. Sometimes, those capabilities are add-on options that require an extra expenditure. For the purposes of surgical and restorative planning, dentists who place or restore a lot of implants should ensure that their CBCT units are compatible with their digital impression systems.

It is important to be very specific when discussing your needs with a manufacturer. For example, one increasingly popular application for CBCT scanners is used in the treatment of sleep apnea, but some CBCT units do not have a large enough field of view to extend to the airway and record the information necessary for that type of treatment.

Perhaps the most important consideration to remember is that, regardless of which machine you purchase, a better version will be available in a few years as the technology improves.

ID: What are some of the most important applications for digital imaging?

GR: For dentists who place implants, surgical guides help improve the accuracy, predictability, and safety of not only the implant placement, but also the final restoration. Merging the CBCT scanner with your digital impression technology will give your final results a higher degree of accuracy and predictability. For dentists who perform extensive endodontic work, a CBCT scanner that provides very high resolution in small areas can help locate canals that cannot be found with a file. For those who perform a significant amount of orthodontic procedures, a CBCT unit that can provide a cephalometric view would be very helpful.

Caries detection devices also are making a significant impact because they allow us to visualize areas of decay without using ionizing radiation. In addition, they allow us to better communicate with insurance companies in situations where the problem is not visible on a radiograph.

ID: What advancements would you like to see to help make these technologies even more useful?

GR: Digital imaging technology is good, but it certainly could be better. For CBCT, I would like to see increased resolution with a reduction in the amount of ionizing radiation used—two things that are certainly on the wish list of every manufacturer and every dentist who uses the technology. If we can accomplish these two things as the technology and software continue to improve, we will be able to gather more critical information in a faster and safer manner and be able to identify more disease processes in earlier stages without overexposing the patients. Secondary to that would be the development of a more universal software application that allows clinicians to merge the information gathered from CBCTs with other technologies—most significantly digital impressions—as they continue to evolve.

Another important technology that will be available in our industry in the very near future is ultrasound. The use of ultrasound will be a big part of the future of imaging, and we are on the cusp of seeing products come to market.

GARY RADZ, DDS

Cosmetic Dentistry of Colorado
Denver, Colorado

Faculty Member
University of Colorado
School of Dental Medicine