3D radiography allows for more accurate imaging and has many advantages over 2D panoramic radiography. In this article we will explain why you should choose a 3D X-ray machine for your dental practice and how to make this choice.
The differences between 3D radio and Scan
How does 3D dental radiography work?
To quickly define 3D dental radiography, also known as Cone Beam or "CBCT", it is necessary to understand that unlike 2D scanning, 3D technology makes it possible to have a 3D vision, i.e. to take into account depth. Instead of capturing in pixels, either a square (length x height), radiography makes it possible to capture in voxel, or a cube (length x height x depth). This is made possible by a cone cutting technology rather than a fan cutting technology (see diagram below).
These differences in image capture and the type of result obtained imply a number of advantages and disadvantages that we will define later.
How to x-ray a patient with a cone beam?
Here are a few steps to x-ray a patient using a CBCT:
- Positioning: positioning the patient is much easier with 3D technology, as accuracy has less influence on image quality than with panning.
- Acquisition: First of all, you must determine the examination area precisely, because the image resolution is much heavier than in 2D, for the same expected image quality, you will probably need a large storage space.
- Result and analysis: the radiography will not give you a single image but a computer file. Ask about the software for reading and processing this data if your X-ray equipment does not come with a workstation. Indeed, export software licenses can be quite expensive.
Advantages and disadvantages of 3D radiography
Advantages of a 3D cone beam
- A single image is sufficient for the entire image of the oral structure
- The practitioner can easily examine the image from several points of view
- Thanks to its pulsed and non-continuous radiation, cone-beam allows the patient to be exposed to X-rays for 10 to 30 times less time
- The cost of an x-ray examination is also a little more profitable for cone-beam (between 80 and 200€) than for scanner (200€ to 380€)
- No storage of films or chemicals
Disadvantages of a 3D cone beam
- Space: an X-ray room is required of at least 3 m2 (for panoramic devices equipped with a 3D function) or 9 m2 (for exclusively 3D devices)
- Price: CBCT has a certain cost but it can be a real investment. It is necessary to count between €100,000 and €200,000 on average, amortized for tax purposes over 7 years
- Technical limitations: it must be understood that for technical reasons, it is not possible to obtain a panoramic view so easily, you will have to build it manually with the software
How to choose a cone beam for your dental practice?
What type of cone beam to choose?
Here are the criteria to consider when choosing a CBCT or Cone-Beam:
Type of image sensor
The image sensor can use the image intensifier technique, which, thanks to its high light sensitivity, allows it to work with low doses of X-rays. However, this type of sensor can be relatively large and can generate distortions that must be corrected by the software, thus generating a longer computation time. Flat sensors work like the camera sensors on your phone.
As with panoramic photography, the choice of X-ray tube remains very important. You will need to look at the fireplace, its features and power supply.
Beyond the possible resolution of the image (counting in pixels for panning and voxels for 3D radio), you will need to look at the grayscale via the number of encryption bits. This adjustment is important because a wide range of grayscale levels allows the fabrics to be differentiated in order to isolate them.
Finally, don't forget to look at the resolution and quality of your image monitor. It is thanks to him that you will be able to consult the radiography and deduce the diagnosis, its quality is essential.
Which cone beam to choose according to your dental specialty: orthodontics, implantology, maxillofacial surgery?
Acquiring a CBCT can be quite expensive and it is important to choose your equipment carefully according to your needs and especially your specialty. Some devices are more efficient in implant surgery, others are more specialized in pathology and oral surgery or endodontics. For example, it is possible to choose a device with a small acquisition field or on the contrary a device with a larger acquisition field.
In orthodontics, the practitioner will surely prefer a wide field of acquisition and will opt for a mixed appliance (panoramic and cone beam). As we have seen previously, a panoramic radiograph reconstructed virtually from a 3D volume does not provide the same interpretation and diagnostic assurance as a panoramic. But some x-ray machines allow automatic switching from the panoramic sensor to the 3D sensor. This option is therefore very interesting in orthodontics.
Beyond the choice of equipment, its use and settings can vary according to needs. The selected cut sizes, for example, must be adapted to the type of examination: they will not be the same in orthodontics as in implantology, for instance.
The best 3D cone beam brands
To conclude, you will undoubtedly have understood with this article that the choice of your 3D radiography is important according to your needs and your constraints. Finally, while 3D radiography offers significant advantages over 2D panoramic radiography, the latter surpasses 3D technology and remains very practical for certain specific needs.