Remember when you used to go to the dentist or orthodontist, and they would mix up that putty-like impression material in order to make a mold of your teeth? Well, thanks to a modern innovation in radiography, the same thing can now be accomplished by taking three-dimensional images of your jaw and teeth to make digital models without the use of that not-so-comfortable impression material.
Dr. Steven Reese at Peninsula Orthodontics in Newport News uses the iCAT™ Cone Beam 3D Dental Imaging System along with the iTero® Digital Impression System to spot potential problems and to make digital 3D models that can help him create a more accurate treatment plan.
“Even when a patient is already wearing braces, we can scan their teeth with the iTero® system and digitally send it to the lab,” says Dr. Reese. “They can then digitally remove the braces with a computer and have a retainer ready when the patient comes in to get their braces removed.
In really complicated cases like if an adult is missing teeth, maybe they’ve got some periodontal disease, or has dental implants, I can merge the iCAT™ and iTero® scans together, create a digitized model that’s almost like a virtual patient. Now we can see where the roots lie within the bone, how thick the bone is, and what the density of the bone is. So, the quality of the treatment is better and much more accurate.”
The technology is especially helpful when working with younger patients. “In the past, you would look at a 2D image and see that a tooth was impacted, but it was really hard to tell what direction it was taking or why it wouldn’t come in,” says Dr. Reese. “With 3D images, there’s so much more information. You can see, for an example, an impacted canine and it can be coming in toward the palate. It could be because the baby tooth ahead of it didn’t come out as it should have, so the new tooth coming in is sliding down the root of it. With 3D imagery, we can intervene in a more meaningful manner, extract baby teeth if they need to be extracted or intercede a little earlier to guide teeth in. This technology really changes the way we create treatment plans.”
Dr. Reese also explains that the 3D images can help him better explain what’s going on in a patient’s mouth without using a lot of technical jargon. “When you can put up a digital model in 3D and show an impacted tooth that’s coming up toward the nose or palate, parents can see what’s happening and you don’t really need to explain a lot. It helps a lot in that sense.”
In addition to helping orthodontists create better, more efficient treatment plans for their patients, 3D technology can help identify other medical anomalies that can be very serious for the patients if not diagnosed early. “With this technology, we have an image of the skull and we see teeth and bones and jaws and everything, but we also see sinuses,” says Dr. Reese. “We routinely screen through those to see if there is anything abnormal or any pathology, and we had a patient who came in the other day who wanted braces or maybe just wanted Invisalign, but when we were screening through their sinuses we noticed a neoplasm (tumor) that extended either from the brain to the sinus or the reverse, which could be very, very serious. We immediately referred them to their primary care doctor and they are going to do some further studies with some MRIs. We’ve caught a number of things that I probably wouldn’t have seen with ordinary radiographs. That’s what I like about it—the treatment planning, the things you can do with it. It just offers more insight into what you’re doing and adds to the quality of the care you are delivering.”