Tuesday, August 22, 2006


I had a Dr. visit me recently and I could tell he is thinking of buying an i-cat for himself. He thinks that if he buys this piece of equipment and it is paid for in 5 years, that he will be in good shape and not have to buy anything else. I told him although the CBCT unit is good, it won’t be the same machine in 5 years. So I thought I would put a time line together and show Dr.s the pace of change when it comes to imaging and advancing technology. This is to not only discourage my referrals to buying CBCT’s , but also show that my company has kept up with the ever changing world of this technology and that the imaging lab is the best place for emerging and updating equipment as it becomes available.

Please see below my idea and outline. Feel free to use it for yourselves if you feel it has any value, I would also ask for input as to how to finish this……..

Time line of Advanced Dental Imaging

15 years ago: Linear Tomography was state of the art for cross sectional imaging
10 years ago: Complex Motion, computer assisted tomography replaced Linear
5 years ago: 8 bit cone beam (CBCT) scanning replaced complex motion tomography
2 years ago: 12 bit CBCT came on the market, replacing the 8 bit system
Today: 14 bit CBCT is replacing 12 bit CBCT
Tomorrow: 16 bit will replace the 14 bit systems of CBCT
Future beyond: Computer guided procedures will become available

Don’t get caught in buying a digital x-ray machine. You may think you have state of the art equipment, but technology changes very fast. Allow DDI to continue to be your imaging recourse for state of the art technology. DDI has always been on the cutting edge, bringing to you the very latest in technology. With DDI, you will always have the very best and latest imaging available. Don’t get caught in the 5-year payment plan of equipment, by the time it is paid off, it will be outdated. DDI can keep you up to date. We research and re-invest to bring the dental community the very best and future imaging products, allowing our referrals access the future. Blah blah blah………

Monday, August 14, 2006

Link to i-CAT users meeting sign up sheet

On behalf of Imaging Sciences International we would like to alert youto an upcoming i-CAT Users Meeting on Thursday, Oct. 19, from 9 a.m.to 1 p.m., at the Monterey Marriott in Monterey, Calif. The UsersMeeting will be an informal discussion, with an exchange of ideas & experiences as well as a few short presentations. There is no charge for your attendance. This meeting is being held in conjunction with the AADMRT (American Association of Dental & Maxillofacial Radiographic Technicians) annual conference on Oct. 19 to 21. The Users Meeting is open to all, and theAADMRT would certainly welcome non-members to stay for its conference.
For those who are not familiar with the AADMRT, it is primarily comprised of X-Ray technologists associated with dental imaging centers, dental practices, and universities. The members are deeply involved in all aspects of oral and maxillofacial imaging in their daily routines. The AADMRT is an excellent forum for continuing education and exchanging ideas, which helps the participants stay current with the latest trends and developments. The AADMRT has asked us to extend an invitation to you to join the association as well. A program booklet for the AADMRT Annual Convention, which contains all details of the meeting and its location, can be accessed on their Web site, www.AADMRT.com. Hotel information is in the AADMRT program booklet as well as the attached i-CAT Users Meeting sign-up sheet. If you are interested in attending, please use the following link to access the sign-up sheet. Once completed, please return to Imaging Sciences by October 1.

Space is limited so please sign up now. We hope you can make it, and we look forward to seeing you there. If you have any questions please contact Liz Qualtier, Director ofEducation and Training, at 215-997-5666 ext. 284.********************************************

Alicia Buonanno
Senior Account ExecutiveGREGORYFCA
27 W. Athens Ave.Ardmore, PA 19003
(610) 642-8253 ext. 118 (ph)
(484) 829-0200 (fx)

Thursday, August 10, 2006

The Unexamined Life

The unexamined life is not worth living (Socrates). Do you ever realized how fortunate we are to not be living in the short hand, steno pad, IBM Selectric, white out, carbon paper, bankers hours world than many (some) of our parents grew up in? Our world is one that is characterized by version numbers, megahertz and gigabytes. We live in a time where brand new technology can be developed, introduced, and find it's way into our lives in less time than it takes for the lease on our car to expire. In my business, I am constantly asking the question, "Why do we do it like that?" Why do we schedule patients, pay bills, make payroll, do bookkeeping, print photos, take 40 second i-CAT scans, (etc.) the way we do? The question that follows is often, "Is there a better way?" Some people are content simply knowing that something works. I am not content until I know WHY it works, and if I've done everything in my power to optimize it. That is why this group of people (i-CAT Users Group) has become so significant to me. Kathleen Cox wrote recently that you "rock her world". Well you rock MY world too! To be able to post and respond to questions using this forum is an amazing thing. Do you think I post too much or too often? Be glad I don't post EVERY thought that enters my mind regarding how and why the amazing i-CAT machine works! Patty Austin sings a song that includes the lyrics "Sometimes I drive so fast I scare myself!" That's how I feel sometimes. There's so much to learn and know, and things change so fast that just keeping up with it can be a monumental task. Forget about getting ahead... keeping up is a full time job! So, don't minimize the importance of this forum. If you have a question, ASK IT! If you have a suggestion, SHARE IT! Together we can help each other keep our heads above water and prepare for each wave of technology that is destined to wash over us.

Wednesday, August 09, 2006

Thank-you for being here

I cannot express enough gratitiude for this Blog and the I-Cat user community in general. I read this often, think about all the postings to learn better techniques for providing care for my patients and want to thank everyone for sharing lessons learned and better ways to do scans. You all rock my world! Kathleen Cox

Tuesday, August 08, 2006

i-CAT Users Meeting

Arun Singh (Senior Vice-President & Chief Technology Officer) from Imaging Sciences International (ISI) will chair the next i-CAT users meeting to be held at the Monterey Marriott in Monterey CA. on Thursday, October 19 from 9am -? If you plan to attend the users meeting, please indicate in the comments section of this blog your name and contact telephone number.

The i-CAT users meeting will precede the American Association of Dental Maxillofacial Radiographic Technicians (AADMRT) Annual convention to be held at the same hotel. For more information regarding the AADMRT meeting, check out www.AADMRT.com The packed agenda includes cephalometric landmarks, digital photography, implant technology, prosthetic considerations for implants, Dolphin 3D, Invisalign, Cone Beam CT, marketing, carotid calicifications, imaging for research, teaching and diagnosis and a round table discussion.

Arun will start the i-CAT users meeting with a general update of ISI company news and product information. Matt Kroona will demonstrate his CBCT Viewer he creates that allows the doctor to explore the CD for reports and data, view his 3D animations and run i-CAT Vision. A round table discusion will answer any of your questions regarding hardware, software and technical questions.

If you plan to attend the i-CAT users meeting, use the comments section of this blog and leave your name and contact telephone number.

Friday, August 04, 2006

Export DICOM

After you make changes in the patient orientation in the MPR views, if you export to DICOM using "Image Output", the changes will be saved in your DICOM data. The setup is pretty simple BUT the one trick is if you set it up for .4mm slices and you do your scan in .3mm, you have to go in and change the "Thickness" (red circled number) to match the "Pitch", save the change and then do the export from the "Image Output" menu. If you go back to .4mm, you have to AGAIN go in and change the "Thickness". On my sample, I export to a folder (green circle) where I keep my patient data. Then I copy the exported DICOM folder and paste it into the patient's folder. It's a pretty simple process once you get it down. Double click on the sample for a larger view that's easier to read.

Wednesday, August 02, 2006

Leveling occlusion for NobelBiocare

Any ideas how to level the occlusion in a first scan in NobelBiocare? The patient wears a guide and an occlusal splint that locks in the opposing teeth, which closes and locks the biting plane. The iCAT lines the patient up on one side, but I am getting slightly lopsided scans from the patient, and have to readjust and rescan.


Sometimes the 40 second scan is necessary. There are trade offs for quality, and dose. As an example, if a lesion or cyst is the area of interest to be scanned, then small voxels and more sampling is necessary. Otherwise the radiologist or dentist may not be able to understand the lesion or cyst properties, and therefore not able to diagnosis the patients problem. So a lower resolution scan would be worse since it has little or no values and a second scan would be needed, therefore exposing the patient twice.

The rule is to measure the risk (radiation) with the clinical question being asked, and make the proper choice for scan protocols. As an example, we do NOT need to do a 13cm scan and 20 -40 seconds for an open TMJ or w/Appl. view. Please see attached outline as a sample chart for choosing the best protocol to benefit both the patient and the Dr.

Tuesday, August 01, 2006

A method to immobilize patients without the chin cup

Diane from Yamamoto Radiography in Beverly Hills felt the chin cup did not work adequately for the 40 second scan i-CAT patients so she devised an alternate method that turns out to be very fast, simple to use and works every time.

Diane purchased a two inch wide Velcro strap (available from any home center) and wraps it very snugly around the patient's symphysis (see photo). A second strap (provided by ISI) stabilizes the forehead of the patient. Combined, the two straps virtually eliminates any patient movement. The added benefit is that the straps work on any size patient and is very fast to use.

This method is quick, easy to use and works so efficiently that we have implemented Diane's method in our own office.

Notice the straps are covered with blue Allrap for simple infection control.