Buyer’s Guide: Factors Influencing Your Dental CBCT System Choice

When engaging with your CBCT sales agent, consider essential factors like field of view, configuration, software, and more to make a well-informed decision for your dental practice.

The options for a dental practitioner looking for Cone Beam Computed Tomography (CBCT) machines have grown considerably. This article delves into the world of CBCT technology, shedding light on the top brands and models available in today’s market. For dental practitioners seeking to invest in this cutting-edge diagnostic tool, this guide aims to streamline your decision-making process.

The choice of a CBCT system is influenced by various factors, with cost often being a significant consideration. However, beyond financial aspects, the unique needs of a dental practice play a pivotal role in determining the most suitable machine. Whether the focus lies on acquiring small field-of-view scans for endodontic cases or large maxillofacial scans for complex procedures such as TMJ assessments, airway examinations, or extensive reconstructive work, the market offers a multitude of options.

Product: CS 9600 CBCT

One must bear in mind that acquiring the same CBCT system from different companies can result in distinct ownership experiences, highlighting the importance of thorough research and evaluation when making this investment.

Navigating the Learning Curve: Beyond the Free One-Day Session

CBCT technology introduces a wealth of functionality, elevating digital radiography above traditional two-dimensional panoramic and intraoral radiographs. While most CBCT systems come with a standard full-day, in-office training session, mastering this technology extends beyond that. Proficiency evolves through continuous learning and practice.

Crucially, the company or representative from which a CBCT system is procured must possess expertise in that specific system. Adequate technical support, service, and ongoing training are essential to ensure the seamless integration of the hardware into your practice workflow.

Factors that Influence your Dental CBCT Purchase 

In the ever-evolving landscape of dental technology, few innovations rival the transformative impact of Cone Beam Computed Tomography (CBCT). While digital impressions, handpiece advancements, and laser dentistry have enhanced treatment, CBCT stands as a game-changer in diagnosis. 

Remember this: Your treatment is only as effective as the accuracy of the diagnosis, which hinges on the ability to visualise and understand the patient’s anatomy. Similarly, it is important to comprehend the various features that contribute to a CBCT machine’s diagnostic abilities. 

Two Main Things To Note When Engaging With Your CBCT Sale Agent:

Field of View (FOV)

Across various manufacturers, dental cone beam systems are generally categorised into three FOV groups: small, medium, and large. 

Notably, medium and large FOV cone beam dental systems often possess the capability to collimate down to achieve smaller FOV sizes, if required. Field of view sizes are established by each manufacturer and may substantially vary between models.

Small FOV dental cone beam systems typically encompass a 5 x 5 cm field of view or a comparable dimension. Opting for a small FOV CBCT is prudent if your diagnostic needs involve examining one or two teeth simultaneously, particularly for applications like endodontics and single implant treatments.

The medium FOV CBCT, known for its versatility, is frequently favoured by general dentists and specialists. It effectively captures areas ranging from 5x5cm up to both arches, typically spanning 6-11 cm in height and up to 14 cm in width.

The largest FOVs typically commence at 13-15 cm and can extend to substantial dimensions of 17-23 cm. A large FOV CBCT is an optimal choice for multi-specialty practices offering a diverse spectrum of treatment options, encompassing endodontics to orthognathic surgery. This is due to the system’s adaptability in collimating down to focus on localised anatomy.

Product: X-Mind Prime 3D CBCT dental imaging system

Configuration, System, and Feature Requirements

Moving forward, your designated sales representative will seek additional details about your practice configuration. This information aids in tailoring recommendations to align with your existing space, network and software prerequisites, and adherence to local regulations.

Small FOV dental cone beam systems typically encompass a 5 x 5 cm field of view or a comparable dimension. Opting for a small FOV CBCT is prudent if your diagnostic needs involve examining one or two teeth simultaneously, particularly for applications like endodontics and single implant treatments.

For instance, if you’re transitioning from a current Sirona panoramic system to CBCT, maintaining continuity with the same manufacturer may be advantageous for software and network compatibility. Moreover, if you’re replacing an existing X-ray machine, a cone beam unit generally fits within the same available space.

Regarding 3D volumes, cone beam systems typically come with their own software, enabling easy sharing of scans within the office. However, the image sizes often exceed the capacity of traditional 2D imaging or practice management software. Thus, you have the flexibility to choose a CBCT from a different manufacturer than your existing equipment if it better suits your practice.

Lastly, it is essential to outline the features critical to your practice. Frequently, these features distinguish one manufacturer and product from another. Generally, CBCT imaging technologies closely match in terms of imaging quality. Therefore, dental professionals primarily utilise desirable features like patient motion limitation and extraoral bitewings to assess manufacturers.

Other Factors to Consider:

3D Imaging: Cone Beam CT technology allows dental professionals unprecedented three-dimensional views of teeth, the temporomandibular joint (TMJ), and the airway—a level of insight previously beyond reach.

The mechanics of CBCT bear semblance to traditional radiographic imaging, akin to digital panoramic systems. Here, an X-ray source on one side and a detector on the other play key roles. However, in the case of Cone Beam, X-rays are emitted in a conical pattern. As the device circumnavigates the patient’s head, it collects a series of cephalometric X-rays with varying densities. A sophisticated algorithm then reconstructs these data points into a comprehensive, distortion-free 3D image—a window into the patient’s anatomy.

Radiation Concerns Addressed: Radiation exposure is a paramount concern with any X-ray imaging. Dental Cone Beam systems, however, employ significantly lower radiation doses compared to their medical CT scan counterparts. While medical systems gather data by capturing individual X-ray slices and piecing them together, dental Cone Beam systems seize the entire dataset in a single scan, akin to acquiring an entire loaf of bread at once rather than one slice at a time.

Osstem releases CBCT T2 Plus in Korea

Voxel vs. Pixel: When it comes to digital imaging, resolution is measured in pixels—small squares of data that determine image quality. For 3D images, the equivalent of pixels is “voxels.” These are cubes of information, stacked to compose the image. Remarkably, voxel sizes can be as minuscule as 0.085 mm, underscoring the precision of CBCT imaging.

Compared to its two-dimensional counterparts, CBCT images stand out due to their astonishing precision. Distortion, akin to shadows shifting with the sun’s movement, becomes non-existent.

Precision and Clarity: Compared to its two-dimensional counterparts, CBCT images stand out due to their astonishing precision. Distortion, akin to shadows shifting with the sun’s movement, becomes non-existent. This remarkable clarity enables exact measurements down to the minutest fractions of a millimeter. Furthermore, the ability to isolate and examine specific anatomical planes within a CBCT image, free from obstructing structures, sets it apart from conventional 2D imaging.

Imaging Software: The quality of the imaging software is pivotal in capturing and assessing CBCT images effectively. Some software applications excel in reducing scatter, particularly when X-rays encounter metal objects in a patient’s mouth.

Flat Panel vs. Image Intensifier: CBCT machines come in two fundamental detector types – Flat Panel (direct acquisition) and Image Intensifier (indirect acquisition). While flat panel systems typically offer enhanced efficiency and reduced image noise, they may involve higher radiation exposure. However, recent advances in flat panel technology have mitigated this concern, with doses now comparable to, or even lower than, indirect systems.

Facilitate Surgical Guides: CBCT machines are invaluable in creating surgical guides for dental implant placement. When considering a CBCT system, it’s crucial to ascertain whether this functionality is built into the software or if a third-party application is required. Weigh the associated costs, including those related to image cleanup or guide fabrication.

The Scope of Scanning (Volume): Each CBCT machine is designed to collect data within a specific volume of anatomy. Some machines focus on capturing a single quadrant, while others encompass the entire mandible, maxilla, and even extend to the inferior portion of the orbital cavity.

Exposure and Reconstruction: Exposure time is a pivotal factor, affecting patient comfort and image quality. Shorter exposure times not only minimise patient discomfort but also enhance the likelihood of obtaining distortion-free images. Reconstruction time, on the other hand, influences workflow efficiency, ranging from mere seconds to several minutes.

Patient Positioning: CBCT systems offer flexibility in patient positioning—standing, sitting, or lying down. Each orientation has its advantages, with standing machines conserving space in the practice, while alternative positions facilitate patient comfort during image acquisition.

Physical Footprint: Finally, the physical dimensions of the CBCT machine are crucial considerations. It must harmonise with the available space in the dental office, potentially replacing older equipment. Creative solutions in space allocation can be pivotal in seamlessly integrating this groundbreaking technology into the practice.

SoftSmile’s VISION Treatment Planning Software Integrates CBCT Imaging

Other Important Questions To Consider:

• What are the specifications of my office equipment and the procedures it supports?
• Are dental implant procedures within my area of interest?
• Regarding the machine’s capabilities, is it designed for capturing the TMJ, entire maxilla, or focusing on 2-3 teeth?
• Does my purchase encompass training for both machine operation and software utilisation, and which anatomical structures can it visualise?
• How can I access software upgrades, and what are the associated costs, if any?
• Could you provide information about the warranty terms for the machine?
• What services are covered in the service agreement?
• In case of a machine breakdown, how quickly can a technician be dispatched to my office?
• Will my existing computer network require any modifications or upgrades?

The Emergence of CBCT in Dentistry

The integration of Cone Beam Computed Tomography (CBCT) machines into dental practices has steadily risen in recent years. Dental professionals are harnessing CBCT technology to amplify their diagnostic capabilities, refine treatment planning, improve patient communication, and reduce reliance on external referrals.

This evolution signifies a notable shift towards CBCT becoming the standard of care for a range of dental procedures, including root canal therapy and complex dental implant cases. As CBCT continues to redefine dental practices, staying well-informed about the latest advancements and best practices in its utilisation is imperative for dental professionals.

In conclusion, the world of dental CBCT machines offers a diverse array of options, each presenting unique advantages and considerations. This guide serves as a navigational tool, assisting dental practitioners in unravelling the intricacies of CBCT technology and making informed decisions aligned with their practice’s specific requirements and objectives.