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31 Mar 2017 | Australasian Dental Practice

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Morita CBCT unit proves to be ideal diagnostic system for implant practice

By Joseph Allbeury

Cone Beam Computed Tomography

On the eve of the launch of Morita's latest Veraview 3D CBCT imaging system, specialist prosthodontist, Dr Christopher Ho, recaps why Morita sets the standard with CBCT and why he chaose a Veraview R100 for his practice.

Dr Ho, please describe your practice and the type of cases you typically treat.

My practice is dedicated to the practice of prosthodontics and implantology. Although my specialty is prosthodontics, I actually practice as an implant surgeon the majority of the time, placing implants for referring dentists who then restore the cases when patients return to them. I also treat patients that have aesthetic and tooth wear issues, as well as referred implant cases that have experienced problems which are always complex to rehabilitate.

Why did you decide to buy a CBCT system?

Due to my practice's emphasis on implant therapy, the use of CBCT has always been a very important part of the treatment planning process to assess both anatomical constraints as well as bony volume for the placement of implants. Additionally, the use of CBCT has allowed a comprehensive radiographic examination that is important in full mouth rehabilitation to assess any endodontic problems as well as examining bony changes within the periodontal structures. 2D imaging through OPG and peri-apical radiography has been the mainstay of dental radiography, however with the adoption of CBCT, this has opened up another world for diagnosis and treatment planning. The ability to see in 3D and not have structures superimposed as in 2D radiography is superior for diagnosis and the absence of magnification errors that are often seen in OPG radiography, planning is simpler. Additionally, with the adoption of the 3Shape TRIOS intraoral scanner and 3Shape Implant Studio software, we can merge the intraoral scan with the CBCT to allow guided planning of implant placement. This ideal planning gives me peace of mind when placing implants rather than using either freehand or conventional radiographic guides, allowing more accurate placement.

What lead you to choose a Morita CBCT system and what are the important points for a clinician to consider when making a similar decision?

The Morita CBCT system is an advanced system that uses a completely unique 3D Reuleaux Full Arch FOV (field of view) - which is effectively a new convex triangular shape. By more closely matching the natural dental arch form, this groundbreaking FOV reduces dosage by excluding areas outside the region of interest and allows a complete scan of the maxilla and/or mandible. Additionally, the high resolution 125µm voxel size provides excellent images to a level I have not seen in other machines. I've previously had CBCT machines from two other manufacturers, as well as viewing many other images and feel that the Morita system provides superior image resolution and clarity. The machine also has the ability to perform true OPG radiographs, rather than reformatting the OPG based on a CBCT slice, which is common in other machines. The 3D R100 offers a total of 6 exposure areas from 40 x 40 mm up to 100 x 80 mm for various diagnostic needs, allowing me to follow the ALARA principles of providing the best image with the lowest radiation dose.

What are your experiences with Morita's service and support?

My experience with the CBCT system is first class from the team at Morita. They have been excellent in terms of service as well as follow-up with their products. Moreover, they go above and beyond to not only provide the equipment but also the training to use this technology.

Are there any particular cases that come to mind where the CBCT system has proven particularly invaluable?

There are many cases that have been identified with the use of CBCT from ameloblastomas, to supernumeraries, endodontic and perio problems that were not visible in other radiography.

Is the software easy to use and intuitive? Does it have all the features you need?

The software is excellent and intuitive to use, with all the features required for diagnosis and planning for both implants and other treatment modalities. The software allows very simple manipulation of the most common diagnostic tools and can even be used for education during consultations with patients. 

Apart from implant cases, what else do you or your associates use the CBCT system for?

The CBCT is useful for assessing the proximity of third molars to the inferior alveolar nerve, as well as assessing the periodontal and endodontic status of teeth. There have also been many occasions where sinusitis or mucosal polyps have been identified in the CBCT scans and appropriate referrals managed. 

What are the limitations of the technology?

The cost has always been a limitation, however the costs of these machines are now approaching that of what an OPG used to be priced at so as a result, have become more commonplace in dental practices. There is a learning curve with adopting anything new within the dental practice but with the assistance of Morita, this transition is expedited.

How do you see the future application of 3D imaging in dentistry and what would you like to see from the technology moving forward.

I see the application of 3D imaging in dentistry merging with facial scanning allowing one to plan cases in a 3 dimensional manner, with the use of digital smile design allowing clincians to plan and also superimpose future restorations onto the scans allowing patients to evaluate future treatment and allowing better visulaisiton, case acceptance and consent for clinicians.

Dr Christopher Ho is a specialist prosthodontist in private practice in the Sydney suburb of Chatswood.

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