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ProMax 3D
• ProMax 3D – Cone Beam
Volumetric Tomography
• all in one
– 3D
– Panoramic
– Tomography
– Cephalometry
• Simple and easy patient
positioning
• Robotic SCARA movement,
adjustable volume place
• Selectable image volume size
• Latest flat panel technology
• Pulsed X-ray generator
all in one
Upgradeable to all Planmeca ProMax units
New diagnostic possibilities – in dental office
Planmeca ProMax
Easy modality change
Simple and easy patient positioning
• New patient support for 3D
imaging
• Patient standing or sitting
• kV/mA automatically
selected
according to patient size
(possibility to overdrive)
3D image volume location
Pre-programmed areas for
• dentition
• TMJ and ramus
• Ear
• Sinus
• Vertebrae
• Airways
• Position adjustment possible
with SCARA arm
• Fine adjustment with
joystick
• Easy positioning
3D image volume sizes
(dia mm x height mm)
• Full Size
80 x 80
• Maxilla
80 x 50
• Mandible
80 x 50
• Molar Maxilla 40 x 50
• Molar Mandible 40 x 50
• Programs to match
diagnostic task
• Minimize radiated volume
Stitching – 3D Large View
• Stitches 2 or 3 volumes
together horizontally or
vertically
• Increases the volume size
diameter -> 16cm
height -> ~13 cm
Stitching – 3D Large View
Stitching examples
Imaging modes
• High resolution mode
• Very high resolution for high
precision imaging
• 0.16 mm voxel
• Effective exposure time 12 s
• Patient dose 50% lower than
before
• Normal resolution mode
• High resolution with 50% lower
dose
• 0.32 mm voxel
• Effective exposure time 12 s
• Optimized for implant planning in
Simplant and Procera
• Small volume size 30 MB
• Low dose mode
• 0.32 mm voxel, lower resolution
• Effective exposure time 2.8 s
• 90% lower dose
• Small volume size 30 MB
• Used in Large View mode
Planmeca Romexis
Planmeca Romexis software
modules for 3D imaging
• 3D Explorer
• 3D panoramic view
• Implant planning
• 3D Viewer
• DICOM
Comprehensive viewing tools
Planmeca Romexis 3D Explorer
• 3D volume viewing:
• Image acquisition
• sagittal, coronal and axial
views
• real time adjustable
viewing angles
• contrast & brightness
• measurements
• export as DICOM
• Quick Launch
• Fast and convenienat
multi-planar projection
viewing
Planmeca Romexis 3D Panoramic module
• Focal through path defined
by user on axial view
• Layer thickness selectable
and constant
• No redundant shadows or
artefacts
• Constant magnification
• Free selectable panoramic
layer
Planmeca Romexis 3D panoramic
conventional pan
3D panoramic view
No redundant shadows
Planmeca Romexis 3D Cross Sections and
Implant planning modules
• 3D panoramic with
adjustable cross section
views
• Mandibular nerve marking
• Measurements
• Implant placement
• Implant models
Planmeca Romexis 3D Viewer
• Included in CD with 3D
studies
• Basic viewing and
measurements
• Includes Explorer,
Panoramic and Cross
Section views depending
on master licence
• Requires Java
• Enables 3D study viewing
remotely
Planmeca Romexis 3D DICOM
• Standard:
• DICOM media import/export
• DICOMDIR import export
• Optional:
• DICOM Storage
• DICOM Print
• DICOM Worklist
• ....
3D image transfers via DICOM
3D Quick Launch
Planmeca Romexis 3D Explorer with
Quick Launch Button
• Starts alternative implant planning software through
DICOM : Simplant, Cybermed N-Liten3D
• Transfers open patient study and patient ID
• Fast and convenient integration:
• Romexis 3D Explorer is used to control and acquire
ProMax 3D study
• 3rd party software is used to manipulate the study as
desired
Planmeca ProMax 3D and Cephalometry
• Digital Ceph ideal for
cephalometry
• all information for
orthodontic planning
• lower radiation dose
• faster procedure
• 3D to be used for detailed
e.g. occlusion views,
inpacted teeth etc.if
needed
• Same Promax unit for
both studies
• Optimum for orthodontic
imaging
3D Technology
• CBCT - Cone Beam
Computed Tomography
• CBVT - Cone Beam Volume
Tomography
• Technological advance
from traditional fan beam
CT
• Image data is a cylinder,
not a set of single slices
• Click here to play movie
Windows Media
Audio/Video file
3D Technology
• One 18 second scan
• 194 degrees scan angle
• 300 snap shot images
taken with synchronized Xray pulses
• Stroboscopic effect for
maximum clarity of the
images
• Accumulated X-ray
exposure time is 2.8 – 8.3
seconds – reduced dose
3D Technology
Pulsed X-ray produces sharp images with less
dose.
3D Technology
• 300 basic images
• Proprietary 3D
reconstruction algorithm
• Image volume is
8 x 8 cm cylinder of 120
million voxels
• Voxel size 160 x 160 x
160 µm
• Corresponds to 3 lp/mm
(Nyquist)
3D Technology – Flat Panel
Planmeca ProMax 3D flat
panel imaging chain
X-ray Tube – Patient – Flat Panel
- Digital Image
Conventional imaging chain
with Image Intensifier
X-ray Tube – Patient – Image Intensifier – TV
Camera – Digital Image
Modern Flat Panel Technology for maximum
performance
3D Technology – Flat Panel
• Image intensifier has
both distortion and
brightness nonuniformity which is
absent from the flat
panel detector
• Image intensifier needs
periodical maintenance.
It has limited life span 36 years.
• It is sensitive to
magnetic or electrical
fields.
• It is over 60 years old
technology.
3D technology – Tube Current Modulation
• Different attenuation
properties across and
along the patient's head
• Tube current (mAs) can be
dynamically adjusted
• Reduces patient dose and
improves image quality
less
more
3D vs Medical CT
• Planmeca ProMax 3D:
• cone beam
• 194 degrees = half a circle
• 18 seconds scan
• 6 seconds pulsed X-ray
• Medical CT with 0.6 mm
slice:
• fan beam
• 16 spiral rounds
• continuous X-ray
Medical CT is decades old technology
Planmeca Promax 3D and N-Liten
Planmeca ProMax 3D works with N-Liten
Planmeca ProMax 3D and Simplant
Planmeca ProMax 3D works with Simplant
Planmeca ProMax 3D and Procera
Nobel Guide impression with
markers
Planmeca ProMax 3D works with
Procera/NobelGuide
Radiation dose
Medical CT 1200-3300 uSv
Dr Stuart White, UCLA
Dig. Pan 4.7-14.9 uSv
FMS 150 uSv
Dr Sharon Brooks, O of Michigan
• Radiation dose of CBCT 30- 900
µSv
• Same level as 5-10 panoramic
images
• Same level as full mouth series
with film
• Essentially lower than medical CT
• ProMax 3D 45-200 µSv (8 x 8
cm), 18 – 80 µSv (4 x 5 cm)
Low radiation dose compared to medical CT
Planmeca ProMax 3D vs Sirona Galileos
Planmeca Promax 3D
Sirona Galileos
Floor space
1.2 x 1.2 m
1.6 x 1.6 m
With Pan/Ceph
yes
No
•additional office space needed
Patient
seated/standing
•flexible, faster
seated
Sensor type
flat panel
Image Intensifier
•geometric distortion
Field of view, cm
8x8, 8x5, 4x5, cylinder
15x15, sphere
•FOV selectable to diagnostic task
Rotation location
movable (SCARA robot arm)
fixed
Radiated volume for complete
dentition
8x8 cm, 402 cm3
15x15 cm 2650 cm3
• 6x more radiated volume for the
same clinical need
Radiated volume for single jaw
implant study
8x5 cm, 251 cm3
15x15 cm 2650 cm3
• 10x more radiated volume
Radiated volume for a molar
implant study
4x5 cm, 63cm3
15x15 cm 2650 cm3
• 42x more radiated volume
Planmeca ProMax 3D vs Sirona Galileos
Planmeca Promax 3D
Sirona Galileos
Voxel size, mm
0.16
• smallest voxel
0.3
Gray scale
12 bit
?
Scan angle
194 deg
• less motion artefacts
270
Scan time
18 s
15 s
kV range
50-84 kV
• adjustable according to patient
size/age
90 kV
mAs range
12-90 mAs
• more powerful generator
28 mAs
Pulsed X-ray
yes
yes
System calibration
No need
Periodical
Software
intra, pan, ceph, 3D
to PMS
Quick Launch
integrates 3D only
isolated
Planmeca ProMax 3D vs i-Cat
Planmeca Promax 3D
I-Cat
Floor space
1.2 x 1.2 m
1.3 x 1.5 m
With Pan/Ceph
yes
no
• additional office space needed
Patient
seated/standing
•flexible, faster
seated
Sensor type
flat panel
flat panel
Field of view, cm
8x8, 8x5, 4x5, cylinder
16x22, 17x13, 17x11, 17x7,
• FOV selectable to diagnostic task 17x4cm, cylinder
Rotation location
movable (SCARA robot arm)
fixed
Radiated volume for complete
dentition
8x8 cm, 402 cm3
16x22 cm 4421 cm3
• 11x more radiated volume
17x11 cm 2496 cm3
• 6x more radiated volume for the
same clinical need
Radiated volume for single jaw
implant study
8x5 cm, 251 cm3
17x7 cm 1588 cm3
• 6x more radiated volume
Radiated volume for a molar
implant study
4x5 cm,
63cm3
17x4 cm 908 cm3
• 14x more radiated volume
Planmeca ProMax 3D vs i-Cat
Planmeca Promax 3D
I-Cat
Voxel size, mm
0.16
• smallest voxel
0.4, 0.3 (17x13), 0.2 (17x7)
Gray scale
12 bit
12 bit
Scan angle
194 deg
• less motion artefacts
360 deg
Scan time
18 s
10/20/40 s
kV range
50-84 kV
• adjustable according to patient
size/age
120 kV
• additional radiation protection
needed
• reduced contrast
• more scatter
mA range
2-15 mA
• more powerful generator
3-8 mA
Pulsed X-ray
yes
yes
System calibration
No need
Daily
Software
intra, pan, ceph, 3D
to PMS
Quick Launch
integrates 3D only
isolated
The End
More information:
Erkki Hiltunen
Product Manager, X-rays
tel: +358 20 7795 456
[email protected]
More information:
Osku Sundqvist
Product Manager, Software
tel: +358 20 7795 793
[email protected]