Wednesday, March 15, 2006

2006 Dolphin Meeting - Eric & Marcelle's comments

2006 Dolphin Meeting

Even though the Dolphin meeting is geared for the orthodontist and their staff, the rapid development and acceptance of cone beam technology has propelled Dolphin to offer presentations (and solutions) regarding traditional imaging as well as cone beam imaging in orthodontics.

The presentations we felt were relevant:

1.) What’s new in Dolphin Imaging 10 and the difference between 10 regular and Premiere.
2.) There was a basic cephalometrics course (presented by the beautiful and funny Dr. Quas) with landmark identification, various enhancements and digitizing tools.
3.)The Anywhere Dolphin presentation revealed how referrals and patients can view their records on a secure website. Now that Anywhere Dolphin has progessed past the beta site stage, Dolphin will begin charging a fee based on the amount of storage used.
4.)Dr. David Hatcher presented on 3D Surface & Volumetric Imaging. He has a systems approach to diagnosis and management. Work-up case, define problems and identify solutions. 80% of the orthodontic population falls into regular treatment planning. Remaining 20% have significant anatomical variations. Orthodontists need to use clinical skills and tests (Imaging) to ID these individuals. Typical orthodontic records: Photos, fmx, panoramic, cephalometric profile & tracing. All of which are two dimensional-are they accurate? With cone beam units such as the i-CAT, orthodontists have the option to reveal surgical and/or orthodontic realities that will have significantly improved results, which translates to more accurate patient care.
5.)Dr. James Mah explained how 3D Imaging and modeling in the common orthodontic practice is far beneficial to traditional methods since it eliminates most of the shortcomings of traditional 2D imaging. With the vast amount of anatomical information available through CBCT, Dr. Mah feels there is a responsibility to have the entire volumetric scan read by radiologists for pathology that might be missed by dentists. CBCT can be used by orthodontists, which may change the treatment plan to the patient’s advantage. Also CBCT provides accurate facial analysis and great soft tissue display. Many orthodontists are now using mini screw implants or Temporary Anchorage Devices (TADs) on their adult patients where CBCT would reveal the missing third dimension. The shape and volume of the alveolar ridge is easily viewed in true one to one relationship. Cone beam also makes 3D localization of third molars much easier for oral surgeons. Sinus and airway evaluation is now possible with cone beam technology compared to 2D films. CBCT has had a tremendous impact on implant imaging.1.) It can be used to assess the bone quantity/quality and plan the implant length/diameter/type 2.) Used for image guiding –eyeball correction. 3.) Image guide and drill sleeves. 4.) Image guide with rapid prototyping surgical guides.
Traditional panoramic imaging does not have uniform magnification and the size and shape changes depending on the location. What form of imaging is best for the patient? The traditional 2D with magnification/superimposition or 3D with vastly more useable accurate information. What is considered standard of care? If an implant is placed incorrectly by using a typical panoramic film and damages the mandibular nerve, would it have still happened if cone beam imaging was used? What is the radiation risk versus the benefits? Dentistry is 2.5% of the total annual background exposure, which is considered a negligible risk. Dr. Mah quoted sources detailing the cone beam scanners produce approximately the same (or less) radiation as the18 film Full Mouth X-Ray (FMX) series using D-Speed film with round collimation. Will the additional information of cone beam imaging reduce surgical time and increase accuracy? What is truly best for the patient?
6.) Dr. Paul Thomas gave an insightful presentation regarding the cephalometric editor and overlays. This advanced class was perfect to customize Dolphin for the individual user including scaling and overlays, landmark /structure transfer and PowerPoint integration.

Cone beam scans can assist in the selection of archwire and impression trays, saving staff time. It will reveal developmental patterns and give the orthodontist a new perspective on treatment. Cone beam units open the floodgates for new opportunities to do things never before done because of 3D’s capability.

There were two computer labs set up solely to provide answers to your specific questions regarding Dolphin software. The meeting (and hotel) was completely sold out, even for the vendors! With over 550 attendees, we would have expected a chaotic event. Nothing could have been further from the truth, the entire event was run very professional and on time. The food was strategically placed in various locations so there was hardly any wait. For such a huge event, the food was especially delicious! I almost forgot the best part! For environmental reasons (to save a lot of paper), a complete detailed outline of each speaker's presentation was placed on a CD and given to each attendee.

Next year the Dolphin meeting will be in Florida.

Just to add to Eric’s previous comments:

Dr. Patel from Wales gave a presentation on Practice Management & Team Building. He is one of those great guys who really has figured it out and would be fun to work with. Key points that I thought were valuable:
---Develop a 3 year Vision – where do you want to be in 3 years? Personally as well as professionally.
---Develop a 1 year plan to start achieving your vision
---Use 90 day lists – that are delegated to different members of the staff – to get things done, and not do it all yourself!

I found it relevant because I think all of us iCAT owners are on the verge of something BIG! I think we need to develop strong relationships with our referring doctors now, because competing, cheaper 3d Scanners will be available soon.

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