3D Symposium

i-CAT dental imaging centers:
The 3d imaging symposium for orthodontists and implantologists will take place on August 1-2, 2008 at the Doubletree Hotel Anaheim in Orange County, CA. The symposium speakers include:
Dr. Aaron Molen - 3DOrthodontics. Dr. Lucia Cevidanes 3D Superimpositions. Dr. Craig Scholz -Outsourcing to a dental imaging center. Dr. David Hatcher -Recognizing pathology. Mr. Chester Wang -Dolphin3D. Dr. Scott Ganz -The Interdisciplinary issues with implantology from diagnosis to treatment. Dr. Jack Krauser-The Interdisciplinary issues with implantology from diagnosis to treatment. Dr. Tom Marcel-Cone Beam in the Orthodontic office. Mr. Chris Land -3DMd. Dr. Joe Caruso -Cone Beam of Loma Linda. Dr. James Mah -Radiation & resolution issues. Mr. Jack Choi - Going Beyond Diagnosis and Mr. Art Curley -Standard of Care: Patient Refusal.

The exhibitors include: APF NewTom, Antomage, ddi, Dolphin, GAC TechnoCenter, i-CAT, Materialize, MME Consultants, Mobile CT Imaging, Orbit Dental Imaging Centers, Ortho II, C dental, Kodak Practice Works, PreSion 3D, Sirona, & SureSmile.
For more details see http://www.3dsymposium2008.com/ Note: the registration ends April 30, 2008.
My idea is to promote dental imaging centers that specifically utilize the i-CAT by obtaining (and sharing) exhibitor space. By combining our resources for this particular event, it would be very efficient marketing since you will not have to take time off of work. This is a cost effective method for you to promote your i-CAT without having to spend two days standing at an exhibit booth. If you wish to attend the symposium, registration is $595 and closes April 30, 2008. We would provide the attendees a folder containing general information about dental imaging centers and the i-CAT. There will also be a list of the i-CAT imaging centers that sponsored the exhibit. The attendee will be asked the location of his/her practice and information (provided by you) describing your particular dental imaging center will be included in the folder.
Unfortunately, it might be too late to promote this seminar to your orthodontic and implant referrals. I am emailing the link to my orthodontic and implant referrals to help them obtain a much better understanding of 3D imaging. Of particular interest is Dr. Craig Scholz’s topic, “outsourcing to a lab”. Part of Craig’s class will cover the extensive computer workup necessary to produce the i-CAT images. Most orthodontists and dental implantologists do not realize the extensive time and expertise required to generate the necessary images.
We do not have much time! The cost for the exhibit space is $1725 for two representatives. If we get six dental imaging labs to join in this venture, the cost will be less than $300 each. Respond now!

How about THIS problem???

My last problem got such a quick response so I thought I'd throw out another one. Since I upgraded to my new XP computer, when I calibrate the machine, it takes 2 full minutes before anything happens. At first I thought the program was frozen so I reset the computer. I called tech support and showed him what was happening. We sat and watched it do nothing, then suddenly it started to calibrate. His comment was, "Oh, I've heard of that." He didn't seem to concerned and didn't offer to try to troubleshoot it. So, while my old Win 2K computer calibrated instantly, this new one sits and waits for 2 minutes before going to work. Anyone else have that problem? Maybe the new Xoran CAT upgrade will fix it?

QA Phantom

I must have my icat machines inspected annually in Colorado. This time the inspector informed me that I needed a QA phantom - they must do it according to the "manufacturers" instructions. I do not have this QA phantom and when I called ISI, they said I must buy it. We are waiting for the fax with the price (3 days!!) but when we called back they said it was about $1000. Also, it will not be the right one for the new machines (which I plan on getting.) This has been yet another frustrating ISI experience but....my question is, does anyone have this phantom that I could borrow, rent, etc? I would pay the shipping of course. Please let me know if you can help me out at 303-759-9445 or marcelle@rmox.com. Thanks! Marcelle

Arun, shouldn't have I gotten this with my equipment (that is what Product Bulletin #1 states). I received the platform and the water bowl but thats all.

Anyone have this problem?

My Windows 2000 computer died last month so I updated my computer to a new XP model. I accidentally did a high resolution scan yesterday and rather than stop in the middle and admit my mistake, I just went ahead with it. However, after reconstruction, it wouldn't open - not enough memory. I called ISI to see what they could do for me and was told that it's a common problem and there's nothing that can be done about it. The next upgrade will fix the problem. In the mean time, I can view the scans in Vision if I want. That seems odd to me. Has anyone else had this problem?

Ordering new i-CATs

Has anyone had any luck contacting ISI about ordering the upgraded i-CATs? I can't seem to get any response.............this is their new customer service????
Marcelle

i-CAT User meeting notes

The i-CAT Users Meeting was held on March 16, 2008 at the Universal Hilton Hotel in Universal City, CA.


The attendees of the i-CAT users meeting were honored to have Arun Singh, the VP of Technology for Imaging Sciences International preside over the entire meeting. We were sorry that Liz Qualtier, the Director of Education for ISI was down with severe flu and was not able to attend.

Chester Wang (Director of Dolphin Imaging & Management) had Swann Liao (Dolphin's Software Engineer) demonstate the new version 11 of Dolphin Imaging software. To discover the complete details of this software, please see the Dolphin Meeting notes elsewhere on the i-CAT blog. Swann did an amazing job of explaining the imaging software and it's newest features. The new tool to measure the airway (volumetrically) will offer the orthodontists a much greater understanding of how their treatments can and will affect the airway, especially in surgical and sleep apnea patients.

With the exponential growth of ISI, understandably it may have become difficult to reach your usual contacts. Now you can contact, Alan Young (Imaging Sciences International's Client service and Special Projects Manager) at his email at alan.young@imagingsciences.com or directly on his cell at (209) 642-5878 as your "Go To" guy to answer your specific questions.

Arun Singh explained that the potential reconstruction time for the i-CAT Platinum will eventually be only 20 seconds. The mechanical platform of the new i-CAT enjoys enhanced stability since there is no vertical movement mechanism.

In three to six months, ISI will be able to offer two i-CAT Classic upgrade plans if you have the 14 bit sensor and one plan for the 12 bit sensor.

14 bit Option A: Software upgrade to reduce scan time from current 20 seconds down to 10 seconds. This is especially significant if you have the Extended Field of View (EFOV) option because it reduces the scan time down from the 2 scan total of 40 seconds to only 20 seconds (plus 20 seconds for rewind/vertical motion). Please note there is no reduction for the 40 second high resolution scan. Cost: $2,500.

14 bit Option B: Exchange your 14 bit i-CAT Classic for the new Platinum i-CAT. This option includes a new computer. Cost: $45,000

12 bit Option: Exchange your 12 bit i-CAT Classic for the new Platinum i-CAT with a new computer. Cost: $75,000


NOTE: A brand new i-CAT Platinum costs $170,000! How many other companies (dental or otherwise) do you know that will allow a trade-in on equipment?


The i-CAT Platinum uses a new reconstruction engine, but it still allows the option to produce the reconstructed volume in XSTD and/or DICOM formats. That means you have the option to use either XoranCAT or i-CATVision, or both.

ISI is working with Codonics to resolve some printer issues.

Carbon Fiber head support is now being beta tested. This new support greatly diminishes patient movement to obtain the best scan possible.

ISI is planning to deploy a new method to formally relay information to all i-CAT users. It will be based on controlled user access with a PIN that is supplemented with email update. An announcement will be made when the new system is ready.

ADA has new codes for cone beam scans.

The latest software version for the i-CAT is 3.1.7.7. This version will almost eliminate the memory issue that required restarting the software. The problem was the software was looking for contiguous memory and the new version can now utilize scattered memory to load the data set.

For i-CAT Vision, the current version is 1.5.3.3. A new i-CAT Vision called “Tigris” will be released in April. It will require the new i-CAT transfer. The iCATransfer upgrade makes the system more reliable but is slower, however, a partial speedup is in the works.

When you use the new version of i-CAT Vision (Tigris), any old workups will not be saved. This fact may be important for some of your referring dentists. If it is necessary to save old workups, you can keep at least one stand-alone (non-networked) WorkStation with the older software and the patient database up to that point.

The i-CATVision. (Tigris upgrade) has full automatic networking capability (scans will be automatically transferred to a central server, and deleted at the scanning station after a safe period.

When viewing i-CAT Vision (implant screen), 3D height sometimes may appear cut off. To rectify, move green and red lines down and up respectively to mark the desired volume and right click to show new volume.

Nerve Canal Estimator will be in “Tigris” version and will require confirmation of 8 points. It also permits manual adjustments if the estimated location strays off course.

The window level of the axial can be adjusted separately from the panoramic and cross section.

Calibration with a special water container will allow more consistent Hounsfield Units (HU) to lessen halo and curtain effect. The physics of cone beam technology limits the ability to completely mimic the HU’s obtained from Medical CT.

A new smaller Field of View model has been introduced by Imaging Sciences under the Gendex brand. This model utilizes a smaller flat panel sensor to produce a 8cm x 8cm (cylindrical) volume, as well as an 8 x 14cm “extended diameter” scan.

Xoran work station key is now available for a nominal fee of only $300. The workstation key makes it possible for a non-acquisition computer to use the Xoran software. Remember that Xoran was a separate company that was married to ISI to develop the i-CAT. Now you have the option to provide your referrals with the i-CAT workstation key to use the acquisition software! This is a prime example of how ISI really listens to the users. Most of you probably do not realize when the i-CAT was initially introduced four years ago, there was no protocol to provide the referring dentists with the ability to volumetrically view the data. Before cone beam technology, if a dentist wanted cross sectional images, the only available option was medical CT. The dentist was not given any option to view the images volumetrically. When the first i-CAT users demonstrated the amazing software, the dentists wanted to fully utilize the ability of the software on their own computers. Xoran gave two options: Purchase the Xoran key for $3,000 or “unlock” a specific case for $100. We had only a few dentists willing to spend $3,000 and most of them opted for the additional $100 that was added to the scan fee. What happened next is a testament to ISI’s exceptional customer service. They saw the problem and developed and released i-CAT Vision! It would have been so easy for ISI to sell i-CAT Vision software for a thousand dollars or more. However, that would not have served in the best interest of the i-CAT users so ISI made i-CAT Vision free software!

When 3DVR was first released, many referring dentists loved it and wanted it! The cost was $1,500 and the dentists simply did not want to pay that much. ISI stepped up to the bat for the i-CAT users and integrated portions of 3DVR into i-CAT Vision. How much? Zero dollars! How many other cone beam units offer any viewing software, free or otherwise?

Starting with the “Tigris” release, the entire 3DVR software is now free of cost, with unlimited copies. Moreover, it would be possible to easily switch between iCATVision and 3DVR, without starting a separate program or re-loading the data.

The i-CAT is optimal for hard tissue viewing. Due to the physics of acquisition, cone beam units are unable to distinguish between different densities of soft tissue at the level of medical CT imaging while MRI is overall the best method for viewing soft tissue anatomy.

Currently, there are three orthodontic software companies that either scan the teeth or scan models to plan bracket placement and arch wires. The major products are Invisalign, SureSmile, and Insignia. For more information about SureSmile, please see last paragraph on i-CAT Blog dated 4/06/08 – Dolphin Meeting.

The 14 bit i-CAT Classic (running software version 3.1.77) has been certified by SureSmile using the .2mm voxel 8 cm height scan. ISI has generated a special scan protocol specifically for SureSmile patients. ISI is concurrently beta testing a special carbon fiber headrest that minimizes patient movement, which is critical for SureSmile scans. The patient should not be in complete occlusion because some separation is necessary for the SureSmile system. Have your referral provide a wax bite or other radiopaque device that stabilizes the position of the teeth. The .25mm full height scan can be reconstructed to .2mm for SureSmile. i-CAT Platinum (the new generation model) is expected to be certified shortly. These are the only units certified so far to have adequate quality and resolution for successful case planning and treatment.

A Research & Development (R&D) project is currently underway to detect and automatically correct for certain types of patient motions, in order to improve the scan quality and retain the necessary resolution/detail, especially for processes such as SureSmile.

User meetings, upgrade options, free i-CAT Vision viewing software with 3DVR, nerve canal estimator, new R&D projects, and the only cone beam unit certified by SureSmile. Are you glad you have an i-CAT?

Review of Dolphin Meeting

• The 2008 Dolphin Meeting was held in the beautiful San Diego town of Coronado, California, on March 6-8. Congratulations to the entire Dolphin team for celebrating their 20th year of excellence in serving the dental community!
  
  The meeting opened with a personal welcome from Chester Wang, director of Dolphin Imaging & Management Solutions. In his opening remarks, he reviewed the company’s history and its enormous impact on the dental specialty community: According to Chester, more than 4,000 private practices worldwide utilize Dolphin on a daily basis! Dolphin’s presence in the academic community is just as impressive: Dolphin software is being utilized in more than 90% of university orthodontic departments, and in 50% of OMS departments. Even the American Board of Orthodontics uses Dolphin software to accept electronic case submissions.
  
  Dr. Bill Arnett briefly discussed the new Arnett/Gunson FAB Analyses, which is part of Dolphin’s new Legend Series of software modules. He and his partner, Dr. Michael Gunson, collaborated with Dolphin developers to create FAB (Face, Airway and Bite), which is treatment planning software designed into two specific components, one each for orthodontic and surgical patients. Consideration for airway measurements will be possible with the soon-to-be-released Dolphin Imaging version 11. TMJ, skeletal and soft tissue 3D measurements, 3D photography and 3D virtual surgery are also integrated in the FAB analysis. Dr. Arnett explained that the development of FAB would not have been possible without the extensive use of i-CAT cone beam technology. Orthodontists and oral surgeons will be able to make predictions much more accurately because of the collective research that Dr. Arnett and Dr. Gunson have established into FAB.
  
  Craig Dial (a past president of AADMRT and co-owner of ddi Imaging Centers) demonstrated how to use Dolphin 3D to create traditional 2D images from volumetric data sets. The three-day program also included sessions covering: customizing cephalometric tracing and photo layouts, AnywhereDolphin.com, Aquarium, and many Dolphin management classes. Dolphin developers, trainers, and technicians joined an impressive roster of industry experts to explain the newest upgrades, features and applications of Dolphin software.
  
  I really enjoyed Dr. Russell Chang’s insightful lecture that demonstrated how using current technology made his office more effective and paperless. The key is to use stable platforms such as Dolphin Management, 3D, Aquarium, Televox, ISI, and other companies that truly believe in customer service. We already all know that the i-CAT is the premiere cone beam unit! My office has Dolphin Imaging, Ceph Tracing, 3D and Televox so we are well on our way to becoming a more effective office.
  
  Dr. Ronald Roncone’s presentation explained the theories behind his own proprietary software suite called the Roncone Modules, also part of Dolphin new Legend Series. “It’s all about metrics,” he told us, and explained that his computerized management system is based upon quantifying every aspect of your practice for the purpose of analyzing and improving. Scheduling, overhead, production, marketing, and of course financials are just a few of the 17areas of his trademarked Just Short Of Perfect (JSOP) practice protocols that can also be used in the dental imaging environment. We picked up several great ideas to incorporate into our own office procedures that will allow us to monitor and track the results of these changes.
  
  Gary Wiseman (Dolphin western regional sales manager) gave us an overview of the upcoming Dolphin Imaging version 11, which is planned to be released in time for the AAO in mid-May. The most significant change is the ability to perform volumetric measurements for the airway, which has clinical applications outside traditional dental specialties, such as sleep apnea. It has also become significantly easier to share 3D records with low-cost viewer licenses that also offer printing capabilities.
  
  Dr. Patel from the United Kingdom gave a thoroughly engaging presentation on building a successful practice and a comfortable quality of life. Dr. Patel runs one of the largest and busiest orthodontic practices in the United Kingdom, and he was willing to share how he achieved such great success. It’s all about planning for the future, he says, and he explained in detail how to create a Vision (keyword). He stressed the importance of long-term planning and short-term goal-setting. To emphasize his message, he quoted thinkers such as Lao Tzu: “The journey of a thousand miles begins with one step!” and Yogi Berra: “If you don’t know where you’re going, you might wind up somewhere else.” Dr. Patel emphasized the importance of setting incremental goals and tasks: “Create a three-year vision, and try to achieve 10 goals every 90 days. They can be business, personal or spiritual. Adjust your plan and make progress reports.” He encouraged the importance of a balance between work, rest and play.
  He also spoke on the importance of leadership, and described his own fantastic team. Did you know that in the UK that the doctor does all the work on patients? There are NO auxiliaries! It’s true, no dental assistants! Dr. Patel used a carefully designed system to customize his champion support team. “A poor team is normally due to poor leadership and poor systems.” Here are a few more of his tidbits on leadership: “Leadership is the ability to get people to do what they don’t like to do, and like it! Leaders must take responsibility, listen, delegate and know where and when to act.”
  
  If you were to ask me what I felt was potentially the most significant session for the entire Dolphin meeting relevant to dental imaging, I would tell you it was Dr. Ed Lin’s session on SureSmile. Dr. Lin’s office incorporates Dolphin Imaging, 3D, Aquarium, E-models, Citrix, Invisalign, i-CAT, and has recently converted his orthodontic practice into a 100% SureSmile practice.
  
  What is SureSmile? The simple explanation is that SureSmile is a digital orthodontic system that uses simulation tools to create a three dimensional model that the practitioner then uses to virtually plan and diagnose before treatment begins. Its proprietary robotic technology employs algorithms to calculate the exact bends and torque required for each case, and then bends the special Copper-Nickel Titanium alloy archwires to the exact specifications. It produces superb outcomes in less time that traditional orthodontic wires and procedures. Think Invisalign, only with archwires instead of trays!
  
  By now you are asking, what does SureSmile have to do with dental imaging? The answer is (I feel like a contestant on Jeopardy!): SureSmile was developed with an intraoral scanner that creates a three-dimensional model of the patient’s dentition and bracket placement. As revolutionary as it was, two main issues kept it from being perfect: lack of root visualization, and a 20-30 minute scan time. That is where cone beam, or more specifically the i-CAT, becomes significant. Initial testing by SureSmile has verified that the i-CAT Classic is currently the only cone beam system that can replace the time consuming intraoral scanner! Imaging Sciences International will have the i-CAT Platinum certified very soon. One of the main problems that SureSmile has determined unacceptable is any patient movement on the scan. Apparently that is the reason other cone beam units are unable to be certified at this time. ISI is testing a specially designed carbon fiber head holder system, that if deemed acceptable will be available soon.
  
  When Invisalign was first introduced there were plenty of skeptics, yet its ultimate success cannot be ignored. Could it be possible that consumers will drive SureSmile to the same stratosphere? Reduced treatment time, less appointments, faster results? The benefits are gained not only by the patient, but the orthodontists too! For a detailed explanation, go to www.suresmile.com
  
  In just a few short years, cone beam imaging has proven to be a major contributor for dental implants. Now we are on the cusp of a revolution that will potentially affect orthodontics to the same degree. Aren’t you glad you have an i-CAT?