Digital Imaging Rocks the Rocky Mountains

By Justin Moody, DDS, DICOI, DABOI

Digital radiography plays a vital role in the clinical and business aspects of a dental practice.

With seven offices operating in Nebraska, South Dakota, and Minnesota, and a new dental implant center, the Rocky Mountain Dental Institute (RMDI), in Colorado, I am very aware of the importance and the cost-effectiveness of the equipment that I choose — especially my X-ray equipment. From a clinical standpoint, imaging provides a visual guide to diagnosis, treatment planning, and implementation. Digital 2D radiographs, panoramics, and 3D scans provide data quickly, clearly, and cost- effectively.

From a business aspect, digital radiography has given me a quick return on investment. Traditional film is becoming more and more expensive to maintain. Film prices have gone up significantly in the past three years. One reason for the rising cost of traditional film processing is the materials used to produce the film. The price of one ingredient, silver, has more than tripled since 2009 and is expected to rise sharply in the next 5 years. Other costs related to traditional film X-ray include the price of cleaning and processing chemicals and office supplies such as mounts, file folders, and mailing supplies. A more subtle drain on the budget is the labor expended by my office team, who would spend time in the darkroom developing the film and cleaning and maintaining the processor. I don’t want to subject myself or any member of my staff to those hazardous chemical odors. These chemicals also need to be properly stored and disposed of, which also takes more time and expense. Compare these chores to digital X-ray, where images appear instantly on the screen, with no lag time and no chemicals.

Digital X-ray capture is more comfortable and faster. I have 10 DEXIS Platinum sensors throughout my offices. Their beveled corners don’t cut into the delicate mouth tissues – a fact my patients truly appreciate. DEXIS’ single-sensor concept, along with the ergonomic sensor design, contributes to the fact that an assistant can reduce the time to take an FMX to just 5 minutes. Patients appreciate the shorter appointment, since many are taking time out of their workday or squeezing their visit into busy schedules. And I have the option to spend more time with them when needed or fit more patients into my schedule.

Once the X-rays are captured, digital continues on with diagnostic and patient education benefits. The Platinum sensor offers clear, detailed images that I can expand to the full size of the 22-inch Samsung computer monitors in my operatories. Patients can see even small areas of concern on their teeth, and using annotation and image enhancement tools, I can draw on the image, add colorization or increase contrast to focus on a particular area.

For those patients who need a panoramic image, I use a Gendex 8500. This digital pan delivers clear and sharp image quality due to its small focal spot of 0.04 mm and a feature the manufacturer calls KINEMAGIC™ Articulated Motion Technology. This means the X-ray sensor doesn’t simply rotate around the patient, but it actually follows the patient’s anatomy, which ensures constant focus across the radiograph with consistent magnification.

When patients can understand the steps to achieving our mutual goals, they accept treatment more easily and comply with instructions because they want to be a part of the total success of their treatment.

I have turned to conebeam computed tomography (CBCT) 3D imaging for my implant offices. I have invested in three Gendex GXCB-500HD™ units powered by i-CAT:reg;, a Next Generation i-CAT:reg;, and for the Rocky Mountain Dental Institute, a new i-CAT Precise™. For implants, 3D imaging gives me confidence and the information that I need to address any anatomical issues that the patients present. 3D imaging is imperative for viewing bone structure, tooth orientation, buccolingual dimensions, bone heights and concavities that would not be visible on a 2D radiograph. The amazing aspect of CBCT is the opportunity to see the 3D image from any direction or cut it into slices. I need to know the amount of bone and the exact location and orientation of the nerves and the sinus and relation to other vital structures before deciding on a treatment plan so that I am not faced with a “surprise” after starting the procedure.

In my implant centers, having the right software to plan as precisely as possible prior to these procedures makes a difference. For my i-CAT units, the tools in Tx STUDIO™ software help me to measure bone, find pathology, automatically map the nerve canals, and determine tooth positioning, find impactions, and view the location of the implant site in relation to other vital anatomical structures.

For preplanning, the software is compatible with major surgical guide applications, and it also contains an implant library. I can place virtual implants, abutments, and restorations right into the 3D image. Because the software allows all of this planning to be done chairside, I can show the patient exactly what I want to achieve and how I plan to do it. When patients can understand the steps to achieving our mutual goals, they accept treatment more easily and comply with instructions because they want to be a part of the total success of their treatment.

From a business aspect, digital radiography has given me a quick return on investment. Traditional film is becoming more and more expensive to maintain.

With my CBCT scans, I can control the radiation dose within the limits of ALARA (as low as reasonably achievable) by selecting the easy-to-use, customized scan presets so that every scan is tailored to the patient’s individual need. The i-CAT’s low dose, high-definition 4.8-second scan exposes the patient to a minimum amount of radiation while achieving the diagnostic information necessary.

For all of these forms of digital radiography, communication is easier and quicker. When I want to share the information with a specialist or referring dentist, the 2D X-rays and scans all are securely and immediately transmitted electronically. That way, I can be consulting with my colleagues in seconds instead of waiting for the mail to arrive. For the front office, radiographs can be sent to insurance companies accompanied by any patient history necessary. We know that the information got to its destination, and we do not have to pay for postage.

As I grow my practice through satellite offices and the new RMDI, I know that my reputation depends on the quality of my dentistry and the effectiveness of my equipment. My experience with DEXIS sensors, Gendex pans and CBCT, and Imaging Sciences’ i-CAT in these offices has given me a first-hand look at how important imaging is to a successful dental experience.

Dr. Justin Moody has been in private practice since 1997 and is the director of the Rocky Mountain Dental Institute in Denver, Colorado.