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Planmeca ProMax 3D family offers a solution for the most demanding imaging needs, producing various imaging sizes with one concept – an ideal imaging size for different maxillofacial applications. Flat panel detector Line detector object object Movement of translation and axis of rotation X-ray source X-ray source Cone beam 3D X-ray device takes the whole 3 dimensional volume with wide conical beam in one scan instead of many slices with many scans. •CBCT - Cone Beam Computed Tomography •CBVT - Cone Beam Volumetric Tomography •DVT – Digital Volume Tomography •Real all in one X-ray • 3D imaging • ProFace 3D photo • SmartPan panoramic imaging system (optionally Dimax sensor) • Cephalometry •Simple and easy patient positioning •Robotic SCARA movement, adjustable volume place •Selectable image volume size •Latest flat panel technology •Pulsed X-ray generator • • • • Flexible head band patient support Patient standing or sitting Vertical fine-adjustment of the volume Automatic vertically driving patient positioning system makes the stitching of basic volumes easy • Pre-designed imaging programs for different targets Dental programs: Incisors, Canines, Premolars, Molars, TMJ ENT (Ear, Nose, Throat) programs: Sinus, Middle ear, Temporal bone, Vertebrae, Airways SCARA-arm can position the rotation centre at any place Adjustment of the volume diameter is possible Fine adjustment with thumb wheel, joystick and laser lights Exposure values automatically selected according to patient size and selected program • From small Ø40 x 50 mm to large Ø160 x 160 mm • Ø70mm and smaller volumes can be freely placed in the imaging area and also horizontally stitched. • Maximum FOV (Ø160 x 160) can be reached with automatic vertical stitching program. • Programs match diagnostic task • Minimize radiated volume High resolution mode • Voxel size 100 µm • 400 or 450 frames • Effective exposure time 12 s HD (High Definition) mode • Voxel size 150 µm • 500 or 600 frames • Effective exposure time 15 s Normal resolution mode • Voxel size 200 µm • 400 or 450 frames • Effective exposure time 12 s Low dose mode • Voxel size 400 or 600 µm • 300 or 450 frames • Lower exposure values • Effective exposure time 2.4 s • Remarkably lower dose • Small file size Tooth •Adult: Ø40 x 50 mm, Ø40 x 70 mm, •Child: Ø34 x 42 mm Ø34 x 60 mm •Voxel Size: 100µm, 150 µm, 200µm, 400µm Teeth •Adult: Ø70 x 50 mm, Ø70 x 70 mm, Ø90 x 50 mm, Ø90 x 90 mm •Child: Ø60 x 42 mm, Ø60 x 60 mm, Ø75 x 42 mm, Ø75 x 75 mm •Voxel Size: 150 µm, 200µm, 400µm Jaw •Adult & child: Ø160 x 50 mm, Ø160 x 90 mm •Voxel Size: 200µm, 400µm, 600 µm Face (stitched) •Adult & child: Ø160 mm x 160 mm •Voxel Size: 400µm, 600µm Horizontal pair (stitched) •Adult: Ø40 x 50 mm, Ø40 x 70 mm, Ø70 x 50 mm, Ø70 x 70 mm •Child: Ø34 x 42 mm, Ø34 x 60 mm, Ø60 x 42 mm, Ø60 x 60 mm •Voxel Size: 400µm, 600µm Sinus Adult & child: Ø90 x 90 mm, Ø90 x 160 mm, Ø160 x 90 mm, Ø160 x 160 mm Voxel Size: 200µm, 400µm, 600 µm Middle ear • Adult: Ø40 x 50 mm, Ø70 x 70 mm Child: Ø34 x 42 mm, Ø60 x 60 mm Voxel Size: 100 µm, 150 µm, 200µm Middle ear pair Adult: Ø40 x 50 mm, Ø70 x 70 mm Child: Ø34 x 42 mm, Ø60 x 60 mm Voxel Size: 200 µm, 400 µm Temporal bone Adult: Ø70 x 70 mm Child: Ø60 x 60 mm Voxel Size: 150 µm, 200µm Temporal bone pair Adult: Ø70 x 70 mm Child: Ø60 x 60 mm Voxel Size: 200µm, 400 µm Vertebrae Adult: Ø70 x 70 mm Child: Ø60 x 60 mm Voxel Size: 200µm, 400µm Airways Adult: Ø70 x 70 mm Child: Ø60 x 60 mm Voxel Size: 200µm, 400 µm Impression scan A special Impression Scan program produces very precise 3D images of impressions and plaster casts. • The first CBVT unit integrated 3D surface scan • CBVT volume and 3D photo in one scan • 3D photo acquisition can be acquired separately • Totally radiation-free process • Lasers scan face geometry • Digital cameras capture colour texture • Software calculates information into a 3D photo • No additional equipment required; all components are integrated to sensor housing Images are taken with the same flat panel 3D sensor Work flow is the same as in 2D imaging programs • Same patient positioning • Same image processing parameters Frames grabbed with slit beam and narrow sensor area Tomosynthesis applied to calculate the panoramic images • ~2000 frames, snap shots, are taken during the panoramic scan • 9 different panoramic layers with 2 mm shift are calculated from the frames • +1 panoramic image in which the layer is optimised automatically • 10 panoramic images are saved as a stack • You can browse the images and select the best Optimized SmartPan takes the panoramic image only from teeth area • Reduces the patient dose TMJ’s can be imagined separately • Optimal imaging angle for TMJ’s • Images are save in a study in Romexis • 2D Imaging • • • • • • • 2D Implant Planning 3D Imaging • 3D Explorer • 3D Cross Sections • 3D Implant Planning • 3D TMJ • 3D ProFace Exporting and distributing images Printing & Reporting Patient & User Management Radiology Module Integration / Compatibility Negative Digital Cast Digital Cast tool & STL format export • Instant tool for converting ProMax 3D Impression Scans into digital dental models. • From 3D Impression Scan to STL dental model in less than 2 minutes! • Export 3D rendering surface in STL model directly from Romexis software • STL export especially designed for Digital Cast models • Use STL models in 3rd party software STL model 3rd party software • Digital cephalostat is ideal for cephalometry • all information for orthodontic planning • lower radiation dose • faster procedure • 3D to be used for detailed e.g. occlusion views, impacted teeth etc. if needed • Same Promax unit for both studies • Optimum for orthodontic imaging Flat panel detector • Planmeca ProMax 3D works with cone beam computed tomography (CBCT) principle. • CBCT uses wide conical or pyramid shaped x-ray beam instead of narrow fan beam. • The 3D image is one 3-dimensional volume, not a pile of narrow slices. • CBCT scan is only one rotation around the patient. Medical CT needs several rounds around the patient. • CBCT: • is faster • has lower dose • has better resolution axis of rotation object X-ray source Line detector Movement of translation and axis of rotation object X-ray source • Snap shot images taken with synchronized X-ray pulses • Stroboscopic effect for maximum clarity of the images • Accumulated X-ray exposure time is 2.8 – 18 s – reduced dose • Proprietary 3D reconstruction algorithm • Voxel size 100, 200 or 400 µm depending on resolution mode and volume size • Resolution up to 5 lp/mm (Nyquist) Symmetric scanning • C-ram rotates • Magnification 1.8x • Scan angle 210° • 300 - 500 frames • Max. volume Ø70 x 70 mm Asymmetric off-set scanning • Elbow arm rotates • Magnification 1.44x • Scan angle 360 deg • 450 - 600 frames • Max. volume Ø160 x 90 mm Sensor shift changes the acquisition geometry and reduces the final image quality The shift of whole c-arm keeps the acquisition geometry constant and produces better final image CBCT has always an isotropic voxel The reconstruction can produce any size of voxel The voxel is always perfect cube The measurements are exact Voxel size is typically 0.1 – 0.5 mm CT has an anisotropic voxel The voxel is always a “brick” The pitch (= distance between spiral rounds = layer thickness) varies and causes distortion in the 3D measurements. The layer thickness is typically 0.5 – 0.8 mm Pulsed X-ray produces sharp images with less dose. 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 •Image intensifier has both distortion and brightness non-uniformity which is absent from the flat panel detector •Image intensifier needs periodical maintenance. It has limited life span 3-6 years. •It is sensitive to magnetic or electrical fields. •It is over 60 years old technology. Radiation Life Comparison Normalized Output Signal 1 0.8 0.6 0.4 Flat Panel II Tube 0.2 Poly. (Flat Panel) 0 0 50,000 100,000 150,000 200,000 250,000 300,000 Accumulated Input Dose (R) Image intensifier image quality decreases sharply over time. Flat panel’s life time is longer. •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 • Modern low dose medical CT: 685 1400 µSv (ICRP 2008) • Radiation dose of CBCT: 20 - 1000 µSv • ProMax 3D: 28 - 122 µSv • Panoramic image 3 – 23 µSv • ProMax pan: 10 – 23 µSv • ProMax SmartPan: 12.5 – 30 µSv • Intraoral image <8 µSv Device µSv (ICRP 2007) FOV cm I-CAT Next Generation 83 45 16x13 16x6 Iluma Elite 368 21x14 Kodak 9000 3D 19 40 5x3.7, upper jaw front 5x3.7, lower jaw molar Kodak 9500 3D 136 92 20x18 15x8 Morita 3D Accuitomo 170 54 43 10x5 4x4, lower jaw molar Morita Veraviewepocs 3D 73 8x8 Newtom VG 83 23x23 Newtom VGi 194 265 15x15 12x8 Planmeca ProMax 3D 28 122 8x8, low dose 8x8, high dose Sirona Galileos Comfort 84 15x15 Soredex Scanora 3D 68 46 14.5x13.5 10x7.5 Vatech PaX-Uni3D 44 5x5 Vatech Picasso Trio 81 123 12x7,low dose 12x7, high dose 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] Mark Niemi Product Manager, X-rays tel: +358 20 7795 743 [email protected] 3/2012