“3D imaging is even better than a microscope”
When Dr Sirpa Pöyry makes a diagnosis, she is always confident in her findings. That’s because, more often than not, she has based her decision on a detailed 3D image of the area of interest. Today, the 3D images obtained with the clinic’s Planmeca Viso® G7 CBCT imaging unit are an indispensable part of her daily work and a tool she “would never go without.”
It’s a common enough story. The patient complains of a tooth ache. Their treatment history shows the tooth has undergone root canal therapy some years ago. The panoramic image reveals an infection at the root. Will retreatment be enough to restore it?
Dr Sirpa Pöyry (DDS) would take a 3D image first before making a decision. Dr Pöyry is a specialist in endodontics at Qmedical Pikku Huopalahti in Helsinki and has amassed more than 15 years’ comprehensive experience in analysing CBCT images for diagnosis and treatment planning. For her and her team, the clinic’s Planmeca Viso® G7 CBCT imaging unit is an indispensable part of the daily work.
“All of our dental nurses are trained in taking 3D images, which means that we can usually take the image pretty much right away. If the condition is endodontic, then I make the interpretation and start working on the treatment plan. Without this capability, we would first have to book a separate imaging appointment, wait for the radiologist’s interpretation and then wait another week to get started on the treatment. Being able to take the image here at the office is absolutely the best for the patient,” Dr Pöyry declares.
“A tool I would never go without”
As with any X-ray image, Dr Pöyry opts for a CBCT image only when she needs it. Typical cases include tooth aches, tooth resorption and trauma as well as persistent sinus infections which may be caused by a bad tooth. “When I need a 3D scan, I always oversee the imaging session and the positioning of the FOV to be sure that it provides additional data and that we get the right image the first time,” she explains. “For me, it’s even better than a microscope, because you can see more in-depth.”
“Then we can also better explain to the patient what’s the underlying cause for their discomfort, why the condition must be treated and what’s the right treatment. With a 3D image, it’s easy to stand by your decisions as a clinician, because there’s no need for guesswork.”
“Of course, before 3D imaging, we all had to manage with panoramic imaging – and we did. But today, 3D is a tool that I, as an endodontist, would never go without.”
Seeing is revealing
That said, Dr Pöyry does by no means want to diminish panoramic imaging and its uses. “2D gives a good overview of the area of interest. A lot of times, a panoramic X-ray is taken first to show the doctor where to look. It is absolutely a good basic image which allows you to see some things – just not everything.”
The 3D image of this patient revealed a vertical fracture and an apical infection in tooth d.36. Because of the fracture, the tooth could not be treated with root canal therapy. Click here to see a larger version of the image.
Does a 3D image reveal more, then? Dr Pöyry certainly thinks so. Going back to the patient with the tooth infection, this was in fact a real patient case in which Dr Pöyry opted to take a 3D image with Planmeca Viso G7 for a more detailed look at the situation. The 3D scan soon revealed that the tooth had a vertical fracture which made any conservative treatment futile.
“Based on the 2D image alone, a new root canal treatment might still very well have been an option. But having seen the full scope of the situation, I referred the patient directly for tooth removal and implant surgery.”
According to Dr Pöyry, the level of detail offered by 3D imaging also facilitates consultation and cooperation between different specialists. “Oftentimes, we can see that the aching tooth is fractured and must be removed, and we’re immediately able to refer them to our oral surgeons. At other times, an image taken by another specialist shows that the patient has a root canal infection that is treatable, and they send the patient over to me.”
“It’s quick and consultation-friendly, and the patient doesn’t have to run around from one treatment room to another. We work together a lot in this way, because it’s part of our treatment culture to do everything for the patient. I love that.”
Copy: Aleksandra Nyholm
Images: Dino Azinur, patient images courtesy of Dr Sirpa Pöyry
Planmeca Oy and Planmeca Group
Planmeca Oy is one of the world's leading dental equipment manufacturers, with a product range covering digital dental units, CAD/CAM solutions, world-class 2D and 3D imaging devices and comprehensive software solutions. Privately owned and headquartered in Helsinki, Finland, the company offers a portfolio of products distributed in over 120 countries worldwide. Planmeca Oy is part of the Finnish Planmeca Group, which consists of several healthcare technology brands, each committed to innovation and design. With 4,500 employees worldwide, Planmeca Group companies achieved a combined pro forma turnover of EUR 1.2 billion in 2021.
www.planmeca.com
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