Erko Dental is the brand new practice of Drs David Leong and Angela McCarthy in the trendy inner Sydney suburb of Erskineville. A plethora of decisions confront anyone setting up a practice from scratch and Erko Dental was no different. From the outset, however, Dr Leong knew that a 3D cone beam imaging system was a must.
"I'm not placing implants yet, but I'm planning on going down this path in the future now that we've set-up a practice of our own," Dr Leong said. "So this was the main reason we wanted a CBCT unit. We could have waited, but we wanted to ensure we had enough space to install a system, so we went shopping in the planning stages of the new practice.
"I looked at a lot of cone beam imaging units before choosing the NewTom Giano from Inline Medical and Dental. The decision was based on price performance – the Giano has a combination of a large field of view at an affordable price with excellent image quality.
"We particularly wanted a system with a dedicated cephalometric arm and the NewTom Giano's ceph arm is very compact, which was a further factor that counted in its favour as it required less space for installation.
"Mike and the team at Inline Medical and Dental were also great throughout the assessment, purchase and installation process. The after sales service has been fantastic as well; any problems and they are here to fix it. Mike also helped us to design the room to house the system when we were planning the layout of the practice.
"The NNT imaging software supplied with the system gives you all the functionality that you need and Inline provided us with comprehensive training on how to get the most from the software and the system. If we ever have a question, they call us straight back with the answer and they really know their stuff."
Dr Leong's interest in 3D cone beam imaging as a diagnostic aid was sparked following several courses he attended.
"I've done a course on interpreting CBCT scans and I understand the benefits of 3D imaging," he said. "I've also been exposed to cone beam diagnostics through courses I've been to on implants and orthodontics as well as from reading articles about it.
"The level of diagnostic information it returns is simply amazing. There is just so much detail. Looking at images in 3D gives you a completely new perspective and you see so much more than on a traditional radiograph."
Whilst Dr Leong is yet to commence placing implants, the NewTom Giano has been actively utilised on a daily basis in the six months since the new practice opened.
"One of the areas we use the Giano for is third molar extractions. We take an OPG first to gauge the curvature of the root and overall positioning of the tooth in the jaw. If it appears problematic, then we take a CBCT scan to get a complete view of the situation and position of the nerve.
"We also use CBCT for endodontics. The 3D image takes the guess work out of molar endo and there are no longer any hidden surprises that can sometimes get missed. With upper molars in particular, so much gets in the way of a 2D x-ray which can prevent you from getting the information you need. The CBCT scan takes all the guesswork out of it and gives you certainty.
"Being able to see all the roots on a molar or the orientation of a tooth in the bone helps you to diagnose and treatment plan far better and it helps you to be a better dentist overall."
Other contributing factors to Dr Leong's purchase of the NewTom Giano included its open DICOM format and the low radiation dose required to achieve exceptional image quality.
"The Giano has a low dose compared to other systems on the market. Even so, to minimise the exposure as much as possible, we can dial the field of view down to a 5 x 5 x 5cm cylinder and there is the option of standard or hi-resolution. For endodontics, we use that small field of view at hi-res, whereas for extractions, standard resolution is sufficient.
"I also wanted a system that could export in an open, DICOM format. We purchased a Carestream CS 3500 intraoral scanner and CS 3000 milling machine that both operate in open STL format and this is important to me. There is a continued convergence of CBCT and CAD/CAM and I believe purchasing open systems will allow us to take full advantage of these advances as they become available."
Erko Dental featured in the surgery design section of Australasian Dental Practice Volume 26 No 2, March/April 2015.