Why 3D
3D Dental Imaging: You Treat What You See
Doctors live and work in three dimensions, yet frequently cannot see most of what is needed when using nineteenth century 2D x-ray technology. 2D x-ray images clearly show hard and soft tissue height and width, but not depth. Consequently, many internal and lingual conditions are hidden or distorted. With 3D dental imaging, a doctor can rotate and view critical information from any angle. Only when you see it can you treat it. Cone beam (3D CBCT) is applicable to nearly every dental procedure in which seeing all aspects of the tooth or bone is important.
The below case illustrates the incredible advantage of 3D dental imaging over 2D. The first 2D image on the left implies the patient is free of occult pathology. The image to the right, with a 3D cone beam section just 0.5mm into the mandible, shows a significant periapical lesion that was hidden in the 2D pano.
In another example, the first below image shows the bone resorption around #15 from the buccal aspect, which is the most you could see from a 2D pano. The second image shows #15 from the lingual side, where the resorption is much more prominent. Reveal Diagnostics provides panographic views from the buccal, middle, and lingual sides so you can see pathology no matter where it is.
Dental Implants
With the Galileos cone beam, manufactured by Sirona in Germany, and Galaxis and Anatomage software, our San Francisco dental imaging center can
- View the dental implant area in 3D from every angle
- Measure available bone and soft tissue thickness
- Accurately map the alveolar nerve canal
- Virtually place the final crown in its ideal location
- Virtually place any type of dental implant
- Place multiple and opposing implants at once
- See the precise bone density surrounding the implant
- Measure the remaining bone thickness and distance to nerve
- Know before placement if a custom abutment will be needed
- Create a surgical guide to reduce variation or possible error in implant placement
- Generate a custom report of the 3D dental implant area
In short, Reveal Diagnostics’ Galileos CBCT technology enables San Francisco Bay Area doctors to confidently place your dental implants perfectly on the software before confidently placing them perfectly in the mouth.
Root Canals
Upper first molars have three roots, sometimes more in rare circumstances. Yet in every standard 2D dental x-ray only two roots can be seen. This illustrates the limitation of chairside x-ray images and the need for conebeam dental imaging. This includes when planning a root canal. How can you plan to drill the canals of a molar when you can’t see them all, tell which direction they curve, or even know how many canals you have?
Reveal’s 3D dental imaging uses CBCT to isolate and bisect each tooth, measure the length and angle of each canal, and help you fully treat all of the canal—no more and no less. We show the tooth from 1mm cross sections and from the root apex to the pulp chamber, all in one customized endo report. Please visit our 3D dental imaging centers in San Francisco, Mountain View, and Marin to find out more.
Orthodontics
Orthodontic tracing, once done by hand, is now computerized when combined with a CBCT image. Simply identify the specified reference points and our Anatomage software automatically creates the tracing conclusions. This facilitates treatment and eliminates the possibility of human calculation error.
Extractions
We know pulling teeth is not as simple as pulling teeth! With our 3D dental imaging you clearly see:
- Extra canals
- Lateral canals
- Neighboring obstructions
- Proximity of the nerve or sinus
- Ideal extraction angle
- Surrounding pathology
This knowledge facilitates surgical planning and mitigates complications.
These images can be cut in 1:1 scale slices (or enlarged on your screen to any scale) from mesial to distal, as well as occlusal to cervical. These different views enable you to thoroughly assess the anatomical situation before beginning surgery, increasing the odds of a successful outcome.
Lesions
Cone beam dental imaging detects more periapical lesions and abscesses than conventional 2D x-ray images simply because 3D CBCT can see more. Reveal Diagnostics technologists scrutinize the trifurcations and lingual areas that are virtually invisible on standard 2D x-rays. In the San Francisco Bay Area 3D dental imaging is quickly becoming the standard of diagnostic care for lesion detection and endodontics in general.
In the below cases, compare the 2D panos (left) with the 3D CBCT scans (right). The first is used to identify a hidden lesion. The second shows the extent of a lesion that, without 3D dental imaging, may have been considered for retreatment.
Fractures
Fractures aren’t always apparent in 2D images; something they’re almost invisible from one angle. Reveal Diagnostic’s 3D dental imaging allows you to see everything, every time. The below fracture might be overlooked in the 2D x-ray (left) image. The 3D x-ray (right) shows the true situation.
TMJ Issues
Reveal’s 3D x-ray images and unique software enable you to examine the mandibular condyles and condylar heads from all aspects. We can also image the mouth open and closed to check the range of motion and occluding versus open condylar positions. Information can be delivered in custom reports, condyle slices, reports with patient education annotation, or simply from the axial and coronal views (see below). Reveal Diagnostics’ CBCT capability greatly facilitates diagnosis and treatment planning for San Francisco and Bay Area doctors.
Apnea & Airway
3D imaging is necessary to see airway contours, and hospital-grade CT scans emit 98 times more radiation than our Galileos CBCT to obtain this information. Only with 3D cone beam and advanced software like our Anatomage system can you measure the airway constriction points and the total airway volume in an easy 14-second low-radiation scan. Reveal Diagnostics professionals also generate custom 3D reports indicating differentiation from the norm and color-coding the most severe areas of restriction. This 3D cone beam information can be critical in understanding and diagnosing sleep apnea.
Root Resorption
Because 2D x-ray images often do not clearly reveal much beyond the first few tenths of a millimeter of cortical bone, the roots located within the bone are not always clear. The lingual roots of molars are usually invisible to 2D (below left). With our Galileos CBCT you can even bisect the root to see the real resorption on its lingual side (below right).
Nose & Sinus
Removing nasal obstructions and restoring full, effortless breathing can change a patient’s life. Deviated septums, swollen turbinates, sinusitis, damaged structures, and occult pathology are all revealed with 3D dental imaging. With cone beam you can also measure the density of the bone separating the maxillary sinus from the oral cavity and clearly see if a dental implant or root canal has perforated the sinus.
In the above example 3D x-ray technology clearly indicated the source of a patient’s life-long breathing problem. Even if you are not personally treating the nasal condition or performing the surgery, your patient will probably be extremely grateful if you help diagnose the condition and recommend life-changing or pain-alleviating treatment.
Suspect Pathology
If you notice an anomaly or possible occult pathology during an oral exam or on a conventional 2D x-ray image, you can confirm or rule out your suspicions with a quick cone beam scan. Our Galileos CBCT technology enables San Francisco and Bay Area doctors to:
- View hard and soft tissue from all angles
- Measure the density of bone and soft tissue
- Measure and notate anomalies
- Digitally send the CBCT data to a radiologist
- View the area of concern in higher contrast and cross sections
The above patient was referred to Reveal Diagnostics for 3D dental x-rays and an implant evaluation. Our Certified Radiological Technologist noticed possible pathology that a radiologist confirmed is a growing cyst in the bone… that normally isn’t found until it has absorbed most of the mandible and the jaw needs to be surgically replaced. The cone beam scan and early identification enabled easy removal of the pathology and saved the patient major surgery and possible disfigurement.
Undiagnosed Pain
Undiagnosed Pain, also called Chronic or Phantom Pain, can be the most vexing for doctors and patients alike. The cause is frequently an abscess, perforated root canal, perforated sinus, or fracture that remains hidden from conventional 2D x-ray images. Reveal’s Galileos conebeam and our two complementary software systems (Galaxis (link) and Anatomage (link)) allow you to view anatomy and pathology from all angles and cross sections, even within the bone and between roots.
In addition, our Reveal Diagnostics partners (experienced GPs, periodontists, oral surgeons, endodontists, orthodontists, and physicians of different disciplines) can offer advice on the possible sources of difficult-to-diagnose pain.
Patient care and doctor education are our primary goals. Every member of the Reveal Diagnostics team will always do everything possible to help you effective treat your patients. If we encounter a condition or pathology that you do not recognize, we will devote all of our time and resources to finding you the solution and an experienced doctor who can consult you on treatment options.
Reveal Diagonstics is no mere dental imaging or 3D conebeam scanning center. Reveal is a dental education facility dedicated to improving patient diagnosis and treatment through collaborative planning, peer knowledge sharing, interdisciplinary education, and the information revealed by conebeam.
Pedodontics
When you need to more closely examine the eruption path and obstacles for permanent teeth, Reveal Diagnostic’s CBCT technology provides much more information and than a film-based pano, with much lower radiation than any other San Francisco or Bay Area dental imaging center. To educate our young patients, we provide all children scanned (and adult patients as well) several interesting 3D dental and cranial images of themselves.
