Cone Beam CT Scanning for Dental Imaging

I heard there was a "per scan" option available instead of a full purchase.

As the technology changes, which it will, the per click makes a better choice and lower cost of ownership.

Clearly this technology is excellent and when indicated is appropriate. However, the company is attempting to foster the belief that office based Cone Beam CT Scanning is the new standard of care. This company has been very aggressive selling the technology. I believe it is inappropriate for dentists to allow corporate interests to establish or even infer that their new technology sets the standard of care for our patients.

I second the last comment. While it offers many advantages, but please don't forget the increased radiation to patients (as compared to conventional radiology) and the tendency to over-rx the scan.

guy i went to a meeting and saw the iluma from imtec, this makes sense using it as a "pay per scan".buying from Image life sciences is a no brainer. technology is at its fastest today as it has been in the past. I rather pay per scan than invest on an atari when tomorrow playstation will outperform in lower dose of radiation exposure and cost.

The J Morita Accuitomo has an effective dose of only 7.4 usieverts - the same as a panoramic scan. The image quality and resolution is better as well.

I do not believe that the Accuitomo by Morita is more accurate. The Iluma interested me because of the greater dynamic range for the same resolution. This would mean a much broader gray scale and substantial improvement in ability to discern structures and small changes.

At the AAOMR Meeting in Charleston, SC, and the AADMRT Meeting in Phoenix, AZ, back in 2005, Iluma/Imtec admitted that the scans they were displaying were taken on cadavers at a significantly higher radiation dosage than the unit is supposed to operate at. This calls into question the quality of the images that the end user can realistically expect to get with their system. I would try to contact clinics where they are actually using the Iluma system and see images taken on real patients before deciding to sign into a long-term agreement with them.

In a study done by Dr. Mah at USC, they compared CT to CBCT and panorex. The exposure of CBCT is equivalent to panorex or less if taken in 6 inch field of view. There can be no rationalization NOT to use this technology when available. Becuase of the explosion of 3D scanners of ANY type, this has become the de facto standard of care. If you have an injury related to implant surgery, and this could have been avoided using volumetric scanning and an appropriate surgical guide, you will have NO defense in court.

I disagree. The "de facto standard of care "varies among communities and among states.

Are all dentists trained to read images? I think not. There is a specialty called Oral Radiology. I don't think that everyone is in the capacity of diagnosing and reading images. A moral and ethical issue is raised here or is there something like pathologist placing implants?

The CT Scan will become the standard of care for mandibluar posterior implants and when ever sinus grafting is indicate. In addition, I believe, that virtual implant placement will eventually be the standard of care.

This is wonderful technology, but all medical CT scans are read by a radiologist. Who is reading these scans. Most dentists have no training in reading CT scans and they don't even get to see the whole volume acquired. This is a lawsuit waiting to happen.

Yes, i agree a lawsuit waiting to happen...I send out to a facility for the CT and have the raw data read for a written report provided to me. Would I own a CT scanner when I could send the patients to a facility rather than take on the liability..you bet ya! patients also question a doctor owning his own scanner remember the problem with docs referring to their own MRI facility! I can not be a master of all trades!

I agree with law suit waiting to happen! We should not own a CT in our office, either a seperate llc or send out! I am not willing to take the chance of my practice being taken away in a law suit to clear $150.00 per patient for the scan!

I have just been informed that I am in violation of the stark law. I own a dental practice and an i-cat facility. I do refer patients to my facility but they pay cash, I do provide them with a receipt for them to submit to their insurance. If I move the scanner into my office what is the difference? I thought that this was strictly for med-care/caid patients? can I accept cash from the patients and not submit a bill to med-care/cade?

I own a scan facility as well. One of the misconceptions about the Stark law is that you cannot send your patient to a scan facility that you own if it is off premises. If you apprise the patient that you have ownership in this facility, you can LEGALLY refer patient there. You are in violation only if you do not satisfy this requirement.

I was wondering what happened with the lawsuit? It is my understanding as well that the Stark statute applies only to physicians who refer Medicare and Medicaid patients for specific services ("designated health services," or DHS) to entities with which they (or an immediate family member) have a "financial relationship." CT scanning apparently is a DHS and a DDS or DMD falls under the physician definition. What needs to be clarified is if you are referring non-medicaid/care patients do you still need to have the imaging center on premises or what is considered as in-office ancillary service? Additionally, if your referred patients are medicaid/care patients and you charge them cash at your CT business and they submit the expense to Medicaid/Care, would that be considered a Stark violation? If there are any health lawyers with dental degrees out there I'd be interested in getting your feedback on this issue? P.S. I'm not a doctor of any sort but am considering opening a CBCT imaging center with a few dental specialists as partners.

CBCT paired with software mapping systems undoubtedly offers an unparalleled level of preoperative planning. The price tag, apart from the financial, is near diagnostic quality evaluation/ visualization of soft tissues in an extremely anatomically dense region of real estate. This area needs to be carefully evaluated on each study. Early disease detection and intervention in this region can dramatically change morbidity and mortality. True as said above: there are the Stark statutes and state specific statutes some identical to Stark, some adding their own regulations some less specific.

Hi, We have an imaging center in Mexico. We are looking itno purchasing a CBCT. The problem is that the only 2 machines registered at the Mexican Health Ministry are : Imtec Iluma and Sirona Gallileo. What can you please tell me about these machines. Thanks in advance

There are many NewToms in Mexico also by AFP Imaging

My daugher has TMJ so severly that she cannot open her mouth and her teeth are crumbling. U of I hospital doctor told her to get a Cone Beam CT Scan so they could decide what they can do for her. She is on disability and Medicaid... so she cannot go out of Illinois for this test. Is there a hospital here that she could go to for the scan? Her and her husband are both disabled and cannot afford to pay an out of state hospital. She also has Chiari and a stent from her brain down to her stomach to release the build up of fluids which cause severe headaches. Please let me know if ther is a hospital in Illinois that she can go to. Thank you.

STARK comes into play at any CBCT / Imaging facility you refer patients to and own. There are two main issues. 1) You MUST disclose that you ? fam. member have a financial inetrest. 2) You cannot give some patients a discount or free service to entice their general dentist to refer patients to you. To my knowledge Stark does not come in to play if the pt pays cash and then insurance reimburses, unless you have a contract with the carrier, or state law, that requires you to bill the insurance for any covered procedure as long as you are a provider. LAWSUIT. What matters is not MD vs DDS, but wether or not you are qualified to interpret EVERY imaging test done in your office or facility. If you can't read a skull-base or brain CT, you must e-mail the scan to a Radiologist who can provide an interpretation of the medical image. Then you are responsible for appropriate referrals. Once that is done, you are free to play with your Simplant or Procera software.

I read the post with great interest and appreciate the high level of dedication that each of you, the dental professionals, exhibit for your patients. I believe that almost all agree that CBCT imagining is advancement in patient care. There have been many valid issues raised as to the amount of radiation, who can read scans as well as the significant investment one must make to incorporate the CBCT available in their practice. There are options available. 1. Many have indicated that they would utilize CBCT if they had one available in their practice on a “pay by the scan basis". 2. Some refer their patients to outside imaging centers. A new option is available in many areas. The Mobile Dental Imaging Center that will arrive at your practice provides CBCT imaging for your patients. The Mobile CBCT concept answers many of the challenges, no significant investment of capital, time, office renovations, additional personnel and transmit your patients images immediately an Oral Radiologist for a report direct to you.

Who stated that and on what basis, is a dentist at risk for reading a CBCT for implant tx? How can not using a CBCT be a viloation of the standard of care, when only 30 or so were sold in the U.S.A.? I ask my fellow dentist to think and not fall for the hype!