8/23 - Virtual Treatment Planning, Trios, Intraoral Scanning Flashcards
what are the different types of imaging
- periapical
- panoramic
- cone-beam computed tomography
advantages of PA radiograph
- high resolution
- detailed
- easy aquisition
- low exposure
- inexpensive
disadvantages of PA radiograph
- unpredictable magnification
- small imaged area (don’t get broad view of pt)
- 2D image
indications for a PA
- determine health of individual teeth
- evaluate bone around implant
- determine angulation during implant placement
panoramic is also called what
orthopantogram
advantages of pano
- easy acquisition
- image both arches (broad view)
- anatomical assessment
- low exposure
- inexpensive
disadvantages of pano
- unpredictable magnification
- lacks details
- 2D image
what is the magnification of a pano
~25% horizontal and vertical magn
indications for a pano
- screening image
- broad pic, image anatomical structures
- rough estimate of distances between teeth and vital structures
what does CBCT stand for
cone beam computed tomography
advantages of CBCT
- 3D representation
- predictable magnification
- detailed
- digital
- images entire arch
- low dose (compared to medical grade CBCT or CAT scan)
disadvantages of CBCT
- special equipment
- expensive
- images entire arch
- requires ‘simulation’ software programs
about how much are the CBCT simulation software programs
$5000
indications for CBCT
- implant evaluation
- pathology
Virtual implant treatment planning programs utilize what type of files
raw dicom files (data from CBCT)
virtual implant treatment planning programs allow simulation of what
implant placement virtually
what simulation software is the sister company for Astra
Simplant
what are examples of simulation software
- Simplant
- coDiagnosiX
- Planmeca Romexis
- Anatomage/Invivo
- Nobel Clinician
- Blue Sky Bio
what are the different anatomical planes that can be used for simulation software
axial, coronal, sagittal
are you able to tell if a pt has a bone graft or sinus lift with simulation software
YES
using the simulation software, can you determine if a significant sinus lift is needed prior to placing implant
YES
All phase I treatment must be completed prior to ___
CBCT
what is part of phase I treatment
- direct restorations
- periodontal therapy
- endodontic therapy
- extractions
- interim prostheses
T/F: comprehensive exams must be completed for all patients except referral patients
FALSE! comprehensive exams must be done including referral patients
what is done during comprehensive exam
- clinical exam
- probe depths
- radiographs
after completing comprehensive exam at step 1, what is done
interdepartmental consultation with prosth
if phase I treatment is necessary, what must be done
initiate disease control treatment plan - don’t include anything dealing with implant
what is the treatment plan during step 1
- diagnostic casts
- implant evaluation
- CBCT (max/mand)
- 3D treatment plan
how much is CBCT
$175
how much is implant evaluation
$100 nonrefundable
how long is CBCT acquisition appointment
1/2 hour
who will interpret CBCT scan and write a report
radiologist
are we responsible for everything captured in CBCT image? will we receive an email when report is ready?
yes, yes
what to do once you have a CBCT report
- correlate radiographic findings w/ clinical evaluation
- schedule 1st look of CBCT w/ prosthodontic faculty
what are indications for scanning
- fixed
- removable
- implants
- ortho - aligner tracking
- restorative
- diagnosis/monitoring
how can you use scanning for diagnosis/monitoring
- gingival changes
- wear (bruxism)
- ortho relapse
- soft/hard tissue monitoring
what Trios do we have at school
- Trios 3 - cordless
- Trios 3 Basic - w/ cord
what lab to select when implant planning
implant concierge
what lab to select when completing crown or implant restoration
Creighton University Fixed Lab
what is the delivery date for a Creighton restoration
3 weeks from scan
where are scanning tips located
dispensing
what is the difference between the scanner tip vs protective cover
scanning tip has a mirror and protective cover has plastic button
does the scanner require time to warm up
yes it might
when scanning, what arch do you start with
lower arch
proper scanning generates what
clicking sound
is it okay if the image on the lower right corner is blurry?
NO! should be clear
outline of the scanning should be what color? if it is what color, it is not scanning.
green; if it’s red, it’s not working
how far from the occlusal should the tip of scanner be placed
~1 inch
what do you do if the scanner starts losing a scan
go back to a scan already done and it will usually re-recognize and then continue to the new location
when completing scan for implants, what must you capture
- edentulous area including several mm’s of mucosa
- clear deifnition of adjacent teeth
what are different post scan functions
- trim
- lock
- zoom
- HD photo functions
order of the different types of scans
lower -> upper -> occlusion
green areas indicate what?
more data is needed
yellow areas/arrows indicate what
more data is needed near preparation
do you scan the occlusion in one whole or separately
separately under ‘Bite 1’ and ‘Bite 2’
how do you typically start oclusion scan
typically start w/ upper molar then move towards canine. begin on single side, scanning distal to mesial, capturing hard and soft tissue w/ rolling motion
during analysis, right side tool bar allows for what
position, colorization, annotation and individual arch removal
during analysis, lower tool bar provides what
potions for direction, margin, clearance, annotation, shade and HD photos
how to finalize and send a scan
- click tools icon to reveal post-processing
- envelope should be present that will allow you to send processed scan to the lab of choice
what are the CBCT atomic planes
transverse, coronal, sagittal
Trios scan is what kind of f ile
.stl
T/F: any pathology in CBCT is your liability and you need to address it appropriately
TRUE
most reliable technique for final implant planning is
CBCT
what does STL stand for
- Standard Tesselation Language file format
- Stereolithography file format
- Standard Triangle Language file format
do CBCT have high dosage
no
do PA radiographs have high resolution
Yes