David Gane, DDS, is a graduate of the University of Western Ontario with an honors degree in physiology and pharmacology. Gane has authored many publications on digital radiography and has lectured on this subject internationally. He is a guest lecturer for the Medical College of Georgia, the founder of Orbit Cranio-Facial Imaging Centers, and is vice president of digital imaging for PracticeWorks LLC, the exclusive maker of Kodak Dental Systems.
OP: How does the ILUMA Cone Beam CT System compare to other systems that are currently on the market?
Gane: The ILUMA Cone Beam CT system, powered by Flash CT technology, uses technological advancements to produce quality CBCT images. Using an amorphous silicon flat panel detector, a high-frequency, constant potential generator with continuous x-ray source and variable mA, motion and medical artifact suppression, and ILUMA Vision 3D visualization software, the ILUMA offers a 19 cm x 24 cm cylindrical volume of image reconstruction with ultrathin "slices" at .09 mm.
OP: According to your company, the ILUMA System provides one of the highest image resolutions in the industry. Please explain.
Gane: The ILUMA’s continuous x-ray source provides more "raw" basis images for reconstruction than many other CBCT systems that use a pulsed beam source. This allows the Flash CT software to reconstruct to a standard voxel size of .3 mm all the way down .09 mm. The reduction of image "noise" and artifacts that can be produced from patient movement during the scan or metallic restorations improves image quality. The ILUMA system’s features also allow the clinician total control of mA, (1 mA–3.8 mA) and scan time (7.8, 20, or 40 seconds)—all of which can affect image quality.
OP: What are some of the features of the system that allow an orthodontist to diagnose and treat a patient accurately?
Gane: Rapid reconstruction of anatomically accurate high-resolution 2D panoramic, lateral, AP, PA, cephalometric, and SMV images are important features for the orthodontist in diagnosis, treatment planning, and treatment. ILUMA Vision 3D’s multiplanar and volumetric visualization software is useful for localizing impactions; visualizing the quantity and quality of bone for TAD placement; and reconstruction of cephalometric, panoramic, and temporomandibular joint (TMJ) views for patient communication. In addition, ILUMA Vision 3D soft-tissue visualization filters evaluate the airway space and the paranasal sinuses. ILUMA’s automatic metal artifact reduction algorithms minimize scatter artifact and “noise” that can be generated on the image by metallic restorations and orthodontic brackets. All images can be reconstructed to DICOM 3, making them compatible with all third-party applications that support the DICOM standard.
OP: How is the system beneficial for patients?
Gane: ILUMA’s laser positioning system makes it fast and easy to accurately and comfortably position the patient prior to scanning. ILUMA’s range of scan times and operator control over exposure ensure that the quality of the image and the dose to the patient are tailored specifically for the clinical application at hand. For example, a progress image can be acquired midtreatment in 7.8 seconds at the 1.0 mA setting and a lateral cephalometric image reconstructed at a very lose dose to the patient.
OP: What can be visualized in the ILUMA data set that may be of specific interest to the orthodontist?
Gane: Based on a 20-second ILUMA scan, the orthodontist can gain detailed insight into the patient and their unique dental and skeletal situation. Beyond the construction of traditional panoramic and cephalometric projections from the data that can be analyzed by traditional methodologies, the orthodontist can visualize the patients’ facial tissues, the airways, the paranasal sinuses, the bony anatomy of TMJ, and can determine the Angle classification of the patient. It is also possible to assess the occlusal and root relationships of the teeth, evaluate and quantify any arch length discrepancies, as well as identify and localize any impactions or supernumary teeth. Alveolar bone heights, the quantity of bone around the teeth, root morphology, the presence of root resorption, and the pulp chamber and periodontal ligament can also be visualized with anatomic accuracy.