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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]
