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ADVANCED ORAL AND MAXILLOFACIAL IMAGING FOR IMPROVED PATIENT ...

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  • 1. The American Academy of Oral and Maxillofacial Radiology (AAOMR) and the University of Missouri-Kansas City, School of Dentistry would like to invite you to a great full day event on Saturday November 18, 2006. ADVANCED ORAL AND MAXILLOFACIAL IMAGING FOR IMPROVED PATIENT TREATMENTS 08.00-09.00: Registration 08.30-09.15: “What’s new in dental imaging?” 3D imaging for the dental practitioner” David Hatcher, DDS, MSc, MRCD(C) – Oral & Maxillofacial Radiology private practice, visiting professor University of California in S. Francisco, School of Dentistry The daily practice of dentistry encounters many diagnostic dilemmas that can benefit from appropriate imaging. This lecture will propose imaging strategies employing conventional and 3D imaging modalities to reveal the hidden anatomy of common conditions in a way that aids the clinician with diagnosis, treatment planning and treatment. The ranges of conditions that will be covered include growth disturbances, jaw asymmetries, assessment of implant sites, impacted teeth, incidental findings and pathologies involving the TMJ, airway and sinuses. 09.15-09.45: “Anatomical considerations during implant surgery” How can CBCT assist? Steven Thomas, DDS, MS, MD - President American College of Oral and Maxillofacial Surgeons Christos Angelopoulos, DDS, MS-Assistant professor Oral Pathology, Radiology and Medicine, University of Missouri, School of Dentistry Implant surgery inevitably is very closely involved to a number of vital anatomical structures that some times may be either preventing surgical procedures or may be posing a threat for the patient, if violated. In any case anatomical structures need to be respected and protected during surgery. This presentation will review in detail most of these structures and their appearance with advanced imaging (cone-beam CT)and several cases will be demonstrated in which the addition of advanced imaging has prevented possible complications. 09.45-10.00: DISCUSSION 10.00-10.15: Coffee break
  • 2. 10.15-11.15: “Implant surgery without complications: From treatment planning to placement” -Advanced imaging and minimally invasive surgery Ricardo Gapski, BDS, DDS, MS-Assistant professor Periodontics, University of Missouri, School of Dentistry The objective of this module is to demonstrate the contribution of cross-sectional imaging to flapless implant surgery as well as immediate implant placement into alveolar sockets and discuss indications of these approaches. Both of the above surgical techniques demand a high level of accuracy and precision, fact that makes cross-sectional imaging a “must”. The readily available cone-beam CT scanners in the dental environment, not only provide an accurate and detailed view of the areas of interest but also expose the patient to considerably less radiation in comparison to medical CT. -Interactive implant treatment planning (Available software, solutions) Edward Amet, DDS, BS, MSD- Private practice, Prosthodontics, Implant dentistry William Scarfe, DDS, MS- Associate professor Radiology and Imaging Sciences, University of Louisville School of Dentistry Esthetic and functional restoration of edentulous regions in the jaws with dental implants requires understanding of multiple interacting prosthodontic and surgical considerations. Accurate diagnosis, based on clinical assessment and imaging interpretation, is pivotal to predictable and successful implant placement. The increasing availability of this CBCT imaging now provides the clinician with expanding opportunities to integrate prosthodontic planning, surgical reality and restorative manufacturer. Drs Amet and Scarfe will present the currently available implant treatment planning software solutions and will demonstrate their application to clinical cases. Also, they will discuss advantages and disadvantages, ease of use etc.
  • 3. 11.15-12.00: 3D Imaging in Orthodontics Francisco Eraso, DDS, MS –Associate professor Orthodontics, Indiana University, School of Dentistry Conventional imaging methods have been used in Orthodontics for years. However, the evolution on imaging in the dental field has created unbelievable ways to diagnose, to develop treatment plans and quantify post-treatment changes in Orthodontics. Three-dimensional (3D) imaging in orthodontics by many is the new standard of care, but are we ready for it? Even though Dr. Eraso will discuss very briefly some of the technical aspects of cone beam computed tomography (CBCT) and digital imaging in general, the main objective of this presentation is to demonstrate specific clinical applications using CBCT for Orthodontics. At the end this presentation, the attendant will have a brief understanding of the uses and limitations and how to incorporate this technology in our daily clinical routine. 12.00-12.15: DISCUSSION 12.30-01.45: Lunch break 01.45-02.15: Cervical spine: Common pathology Thomas Underhill, DDS, MS, MD – Private practrce Medical Radiology Cone-beam CT examinations are now being performed for maxillofacial evaluation. Compared to panoramic and conventional tomography, cone-beam CT provides increased visualization of the cranial base and upper cervical spine in the axial, coronal and sagittal planes. This presentation will cover common incidental findings of the cranial base and upper cervical spine. These incidental findings are typically of developmental or degenerative origin. Discussion will include which incidental findings warrant notification of the referring dentist or physician.
  • 4. 02.15-02.45: Teleradiology/ remote Radiographic Interpretation: Are we there? Sharon. Brooks, DDS, MS – Professor Oral and Maxillofacial Radiology, University of Michigan, School of Dentistry As more non-radiologist clinicians purchase cone-beam CT units for their offices, concerns arise about the complete interpretation of these images, not just for implant sites or orthodontic relationships, but also for pathologic lesions throughout the volume. In this presentation we will look at how oral and maxillofacial radiologists are handling this situation in their own states. Are they getting requests for interpretation of images they did not generate? If so, what kind of software are they using and what kind of reporting are they doing? 02.45-03.00: Coffee break 03.00-03.40: What has yet to come in Dental Imaging? David Hatcher, DDS, MSc, MRCD(C) – Oral & Maxillofacial Radiology private practice, visiting professor University of California in S. Francisco, School of Dentistry Cone Beam CT (volumetric scans) and surface scanners have been recently introduced into dentistry. The surface images and sub-surface volumetric scans can be combined into a 3D matrix to create an anatomically accurate re- construction of the dental patient. The anatomic constructs called models, are comprised of individual objects including whole teeth, bones, joints, skin and muscles. This presentation will introduce how the models can be used for biometric analyses, growth simulations, treatment simulations and therapy guidance. The 3D models can be extended into the 4th and 5th dimensions where motion and function can be simulated and analyzed.
  • 5. 03.40-04.40: Advanced dental imaging - Panel discussion: Is there a need for image interpretation by a specialist? Discussants: Dale Miles, BA, DDS, MS, FRCD(C) - CEO Digital Radiographic Solutions Ricardo Gapski, BDS, DDS, MS– Assistant professor Periodontics, University of Missouri-Kansas City, School of Dentistry William Scarfe, DDS, MS- Associate professor Radiology and Imaging Sciences, University of Louisville School of Dentistry Steven Mantegari, DDS, MD-Associate professor Oral and Maxillofacial Surgery, University of Missouri-Kansas City, School of Dentistry Cone Beam CT or Cone Beam Volumetric Imaging is an imaging modality already widely adopted, with many more clinicians, dentists and dental specialists, purchasing this technology each month. Oral and Maxillofacial Radiology laboratory services also provide image acquisition for several thousand referring dentists and dental specialists. There are currently 5 different manufacturer’s machines being sold in North America and at least 2 additional manufacturers ready to release their units for sale in 2006. Cone Beam CT or Cone Beam Volumetric Imaging generates a large image data set for each patient. Who is responsible for interpreting this data? What is the level of training required to interpret these volumes? Does the difference between large and small detector size mean a clinician can restrict his/her interpretation to a more limited anatomic regions that they are confident evaluating? Who is liable for missed findings? Are there training issues or Continuing Education requirements for “qualifying” a dentist to “read” these scans. Come to this panel discussion to hear “all sides” of this debatable issue; that is, “Does it require a specialist to interpret Cone Beam Volumetric Imaging data?”

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