Recent advances in diagnostic aids 2 /certified fixed orthodontic courses by Indian dental academy


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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit ,or call

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Recent advances in diagnostic aids 2 /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education 1
  2. 2. Magnetic Resonance Imaging A type of emission imaging Essentially imaging of water in the tissue 2
  3. 3. Magnetic Resonance Imaging Principle 3
  4. 4. Magnetic Resonance Imaging When images are displayed; intense signals show as white and weak ones as black . Intermediate as shades of gray. Cortical bone and teeth with low presence of hydrogen are poorly imaged and appear black. 4
  5. 5. Magnetic Resonance Imaging MRI can clearly differentiate the soft tissue components Preferred imaging technique when information regarding the articular disc or the presence of adhesions,or joint effusion is desired 5
  6. 6. Magnetic Resonance Imaging Indications Assessing diseases of the TMJ Cleft lip and palate Tonsillitis and adenoiditis Cysts and infections Tumors 6
  7. 7. Magnetic Resonance Imaging Contraindications  Patients with cardiac pacemakers.  Patients with cerebral metallic aneurysm clips. Slight movement of the clip could produce bleeding  Stainless steel and other metals produce artifacts ; obliterate image details of the facial area. 7
  8. 8. Magnetic Resonance Imaging Shortcomings Inability to identify ligament tears or perforations Dynamics of tissue joint not possible Cannot be used in patients suffering from claustrophobia. 8
  9. 9. 3D Imaging Historical perspective 9
  10. 10. 3D Imaging Necessity - Our pts. are 3D therefore we need to record their morphology in 3D - Drawbacks of cephalometrics 2 dimensional representation of a 3 dimensional object 10
  11. 11. 3D Imaging With dimensionally accurate records, not only can t/t be planned and simulated,but implemented through methods such as computerized wire bending & fabrication of appliances by CAD/CAM Development of future technologies and approaches to Orthodontics 11
  12. 12. Basic principles of 3D imaging Two main geometrical strategies 1. Orthogonal measurement 2. Measurement by triangulation 1. Orthogonal – Location of 3rd dimension(z) by a technique separate from that used to measure the other two dimensions.(x & y) - Object sliced in layers – physically or optically 12
  13. 13. Basic principles of 3D imaging 2. Triangulation Images captured from two positions 13
  14. 14. Methods of 3D Facial Imaging LASER (Light Amplification by Stimulated Emission of Radiation) Structured light Laser scanner - Scanner record distortion of projected laser pattern on the face to provide a’ surface map’ 14
  15. 15. Methods of 3D Facial Imaging - Simultaneously image is recorded by a digital - camera This image is layered over the surface map 15
  16. 16. Methods of 3D Facial Imaging Structured Light - Projection of a structure of lines or grids onto the face - As the projected pattern is distorted by the contours of face, this distorted pattern is recorded by a digital camera 16
  17. 17. Obtaining 3D Dental Models Destructive scanning Non destructive scanning Destructive scanning - Variant of orthogonal slicing method - Study cast is invested in a solid matrix of contrasting colour -Surface of the block is then sliced parallel to the occlusal plane - Laser scan of the 2D surface is made - An additional 0.003” layer of the block is ground 17 away and another scan is made
  18. 18. Obtaining 3D Dental Models Non destructive scanning - Laser stripe is projected on the surface of plaster cast and distortion pattern is recorded by a digital camera 18
  19. 19. 3D Craniofacial Skeletal Imaging Anatomic Reconstructions Computed Tomography Scans Cone Beam Computed Tomography 19
  20. 20. 3D Craniofacial Skeletal Imaging Anatomic Reconstructions (CRIL Method) - Integrated 3D model of the craniofacial structures is formed using lat.&fro. ceph; photographs & 3D models of dental casts. - Equipments – i. Calibrated stereo x ray device ii. Calibrated stereo camera iii. 3D models of study casts from Align Technology 20
  21. 21. • Step 1 – generating 3D dental models of upp & low teeth and creating Tiepoint bearing aligners - Tie points are reference points (like implants of Bjork) which facilitates merging of images 21
  22. 22. • Step 2 – placing facial Tie points • Step 3 – generating a 3D photographic model of the face 22
  23. 23. • Step 4 – generating a 3D x ray model of the craniofacial skeleton 23
  24. 24. • Step 5 - Merging the several 3D models - The CRIL software is used to merge the data in a single frame of reference - At least 3 common tie-points are required in each overlapping 24
  25. 25. • Step 6 – Viewing the integrated 3 Dimensional model The resulting 3D craniofacial model is viewed interactively using Align’s TREAT software 25
  26. 26. 3D Craniofacial Skeletal Imaging Computed Tomography Scans - Post processing software allows for reconstruction of transverse slices in any plane 26
  27. 27. 3D Craniofacial Skeletal Imaging Cone Beam Computed Tomography - Like conventional CT but various modifications are done to optimize them for craniofacial imaging - Reduced chamber volume just enough for head and neck - Real time feed back betn sensor and X ray source - Cone beam projection of x rays - Radiation exposure – 20%of conventional CT - Precision of 0.28mm which 5-10 times more 27
  28. 28. Softwares for Orthodontics • Many companies have developed softwares to help the Orthodontist in diagnosis and treatment planning - Dentofacial planner - Vistadent - Sure smile - Dr.Ceph - Digiceph - eModels - OrthoCAD 28
  29. 29. OrthoCAD Diagnosis Space analysis Treatment simulations- tooth movement,extn,occlusal contacts 29
  30. 30. Invisalign • What is invisalign? - Invisible alignment of the teeth - An invisible way to align the teeth • Uses a series of clear removable aligners to straighten teeth without metal wires or brackets. • Developed by Align Technology,CA 30
  31. 31. Impressions are made using Polyvinyl Siloxane After wearing all of the aligners in the series, Impression and bite send along with a detailed treatment plan. advanced imaging technology transforms plaster models into a highly accurate 3-D digital image. A computerized movie called ClinCheck® depicting the movement of teeth from the beginning to the final position is created. Procedure customized set of aligners are made from From the approved file, these models, sent to the laser scanning to build a doctor, and given to the set Invisalign® uses of patient. Pt to wear each actual models that reflect aligner for about two each stage of the weeks. treatment plan. Using the Internet, the doctor reviews the ClinCheck file - if necessary, adjustments to the depicted plan are 31 made.
  32. 32. Invisalign 32
  33. 33. Invisalign Patient gets the first aligner 6 weeks after the 1st visit Most treatments require 20 – 60 aligners  Worn for 2 weeks each Should be taken off only for eating and brushing 33
  34. 34. Invisalign • Limitations Patients with severe malocclusions cannot be treated Children,mixed dentition – growing jaws and erupting teeth too complicated for the computer to model No precise control over root movements 34
  35. 35. References • T M Graber,Vanarsdall R L : Orthodontics-Current • • • • • • Principles and Techniques. Putman C E, Ravin C E : Textbook of Diagnostic Imaging. Jacobson : Radiographic Cephalometry Goaz,White : Oral Radiology – Principles and Interpretation. Harring J I, Jansen L : Dental Radiography- Principles and Techniques Pasler F A : Colour Atlas of Radiology. Kapila & others : Craniofacial Imaging in Orthodontics : Historical Perspective,current status,and future developments. Angle Orthod, 1999; 69:491-506 35
  36. 36. • J J Menig. The DenOptix Digital Radiographic System. JCO,1999; 33: 407-410. • Seminars in Orthodontics, December 2001,Vol 7 No 4 : 1. Baumrind, Boyd : Integrated Three Dimensional Craniofacial Mapping: Background,Principles and Perspectives 2. Hans et al : Three Dimensional Imaging : The Case Western Reserve University Method. 3. O C Tuncay: Three Dimensional Imaging and Motion Animation 4. J Mah, A Bunman: Technology to create Three Dimensional Pt. Record. 5.Curry,Baumrind : Integrated Three Dimensional Craniofacial Mapping at the Craniofacial Research Instrumentation Laboratory/University of the Pacific. 6. W R Redmond : The Digital Orthodontic Office:2001. 36
  37. 37. • Websites : www.cril .org 37
  38. 38. Thank you For more details please visit 38