1/1/2013
EMPLOYEE
MANUAL
ORTHODENT 3D IMAGING
Cone Beam Computed Tomography and iTero | Lindsey Cantu
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Employee Manual
Lindsey Cantu
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Table of Contents
Cone Beam Computed Tomography(CBCT)
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Scans Offered From iCat
4
Steps to Positioning the Patient(Standard)
5
Steps to Positioning the Patient(Ortho/Ortho Surg)
6
Checking Positioning
7
iTero
10
Safety Rules and Procedures for Orthodent 3D Imaging
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Referring Doctors
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Cone Beam Computed Tomography (CBCT)
If you treated 2D patients, traditional
imaging would be enough. With
OrthoDent 3D Imaging, you can add a
third dimension and give your
diagnostic images the power and
accuracy you need. Because Cone Beam
Computed Tomography (CBCT) adds
another dimension to the power of your
diagnostic images, it is quickly becoming
the standard of care. Our conveniently
located facility offers fast, crystal clear
CBCT images and exceptional customer
service, putting the most sophisticated
diagnostic tool ever available right in
your hands.
Figure 1 shows the iCat machine that
does the CBCT scans.
Figure 1
The iCat machine requires extensive care and the machine must be calibrated once a week.
Figure 2 shows an
example of what the CBCT
scan creates. After the
scan is taken, the iCat
software automatically
creates a dataframe that
requires a workup for the
specific doctor that needs
the scan. Workups change
focal points in the scan in
order to create a pano.
Figure 2
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Scans Offered From iCat
Standard
Standard scans are usually used for patients that are planning to have implants done.
Ortho
Ortho scans are used for patients that are in braces or will be going into braces. These scans are
used to create cephs and panos.
Ortho Surg
Ortho surg scans are used for TMJ patients.
Suresmile
Suresmile scans are used for our suresmile patients. SureSmile combines digital 3D imaging,
computer-aided treatment planning and customized archwires to straighten teeth about 40
percent faster than traditional braces, with fewer office visits, fewer wire changes, and less
overall discomfort.
Figure 3 is an image that can be
created in Invivo. This image is usually
used for TMJ patients. With this view,
doctors are able to clearly view the
condyles.
Figure 3
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Steps to Positioning the Patient (Standard Scan)
1. Make sure chair is lowered so that when the patient sits down they will not hit
their head.
2. Have patient sit in the chair.
3. Place lead apron on patient.
4. Press the red light button. (This has a vertical and horizontal redline that appears
on the patients head. This will help you align the patient).
5. Make sure that the horizontal red line is right at the lip line, and the vertical line
is right in front of their ear.
6. Put on gloves. (Make sure patient is not allergic to latex. If so, put on plastic
gloves).
7. Grab 3 cotton rolls and a tongue depressor.
8. Place two cotton rolls under the tongue on each side of the patients mouth.
9. Place the tongue depressor on top of your last cotton roll and have the patient
bite down on it. (There should be 2 millimeters between the teeth. If not, place
another cotton roll under the tongue depressor until the 2 millimeters are
reached. It is important that the teeth are separated for this particular scan).
10. Close the arm of the iCat machine.
11. Adjust patient so that their chin fits perfectly in the chin cup.
12. Apply headstrap firmly.
13. Step away to start scan.
Figure 4 shows implant planning.
Stand scans are taken for this type of
dental procedure. With our Invivo
software we are able to see how
dense the bone is. We can also draw
in the nerve. After implant planning
we send the scan to Anatomage to
have a surgical guide made for the
doctor.
Figure 4
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Steps to Positioning the Patient (Ortho/Ortho Surg)
1. Make sure chair is lowered so that when the patient sits down they will not hit
their head.
2. Have patient sit in the chair.
3. Place lead apron on patient.
4. Press the red light button. (This has a vertical and horizontal redline that appears
on the patients head. This will help you align the patient).
5. Make sure that the horizontal red line is below the bottom lip, but above the
chin and the vertical line is right in front of their ear.
6. Remove chin cup.
7. Close arm of the iCat machine.
8. Apply headstrap firmly.
9. Make sure patient is biting down firmly on their back teeth.
10. Step away to start scan.
Figure 5 shows an image that can be created from an ortho scan through our Invivo software.
Figure 5
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Checking Positioning
Ortho/Ortho Surg
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Standard
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Suresmile
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Itero
With the ability to scan quadrants and
full arches, iTero allows us to easily
take digital impressions of single-unit
cases as well as more complex
restorative and cosmetic full-arch
treatment plans. Onscreen
visualization of the scan in real time
ensures that preparations are perfectly
completed. The result is a reduction in
seating time and in increased patient
satisfaction.
The iTero machine is used
for the following dental
procedures:
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Invisalign
Digital impressions
Upper expanders
The iTero machine has made many dental
procedures more convienient not only for
the doctor, but also for the patient. This
scan replaces dental impressions. Dental
impressions are uncomfortable for the
patient and are not as accurate as the iTero
scan. Patients can move while the
impression is in their mouth creating a
distortion to the final product. The iTero
scan eliminates that fault to the process of
Invisalign or expanders. This scan also
automatically makes the model. Normally
patients have to wait for their impression to
be made. This way is more efficent.
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Safety Rules and Operating Procedures for Orthodent 3D
Imaging
These instructions are provided to minimize radiation exposure of x-ray personnel and patients
without interfering with the practice of the healing arts.
All x-ray examinations shall be ordered by the patients referring doctor.
Operation of X-Ray Equipment
1.
A restricted area is to be maintained by the operator. The restricted area is the room in
which the x-ray equipment is located. The only person allowed in the restricted area is the
subject to be x-rayed and the operator.
2.
During each exposure employees shall stand behind a protective barrier which is located
outside the exposure room.
3.
Employees should not hold patients during an exposure. If an individual must be held
protective shielding devices must be used.
4.
Only the patient shall be in the useful beam.
5.
Lead aprons will be used on all patients x-rayed in this facility regardless of patent age.
Personnel Monitoring
1.
Personnel monitoring devices are provided for each individual operation the equipment
or anyone who is involved with the restricted areas. Each employee shall wear their assigned
monitor. These devices are to remain in the office when not in use. The control badge is located
in the area of the reception desk. Mandi Vergara is responsible for maintaining exposure
records and exchanging personnel monitors monthly. Exposure record will be kept in the file
cabinet in the reception desk area. Exposure records are available to employees upon request.
2.
No adult employee shall be allowed to receive radiation exposure in excess of 1250
millirems per calendar quarter. No employee under the age of 18 shall be allowed to receive
radiation exposure in excess of 125 millirems per calendar quarter. In the event of a radiation
incident or excessive exposure, the Bureau of Radiation Control, 1100 West 49th Street, Austin,
Texas 78756. The emergency telephone number is 512.458.7460.
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A copy of the Texas Regulations for control of Radiation is available in the office and
operators shall be familiar with pertinent sections of parts 11, 21, 22, and 23.
The x-ray machines are equipped with devices to limit the radiation exposure to patients
and employees; these devices include filters, which reduce unnecessary low energy
radiation from the primary beam, and collimators which restrict the size of the beam.
Employees shall not alter, remove, or tamper with or in any way defect these devices.
Lead aprons with a minimum of .5 millimeters of lead equivalence will be used on all
patients.
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Referring Doctors
Each referring doctor requires a different kind of scan.
General Dentist (GP/General Practitioner): Most People go to a general dentist for the
majority of their dental needs. A general dentist takes care of all kinds of patients, young and
old. They are licensed to do any type of dentistry, but they bring on the liability if they the
procedure is something they do not frequent
Endodontist (Endo): This dental specialist is concerned with the diagnosis and cause of
diseases affecting the pulp or nerve of the tooth, or the tissues on the tooth. These nerves,
arteries and veins inside the tooth help keep the tooth alive. The most common procedure the
endodontist performs is a “root canal”.
Oral Pathologist: Oral pathologists are dental specialists who study the nature of the
diseases altering and affecting all the oral structures (teeth, lips, cheeks, jaw bones) as well as
parts of the face and neck.
Oral and Maxillofacial Surgeon (OMFS, Oral Surgeon): Dentist that have the dental
specialty of oral and maxillofacial surgeon diagnose and surgically treat diseases, defects or
injuries of the mouth, head and neck. They are commonly involved in removing wisdom teeth
but they are also involved with temporomandibular joint disorders (TMJD). Many are now
involved with placing dental implants, which substitute the root part of missing teeth.
Orthodontist (Ortho): The orthodontist is a dental specialist who moves teeth within the jaw
bone to correct forms of malocclusion or bite irregularities. The most common method of
correcting a “bad bite” is with the use of dental braces, but at times only a removable tooth
positioning guard is needed.
Pedodontist (Pedo): Also called a Pediatric Dentist. Having been specially trained to handle
the fears of children as well as watch the growth patterns of a child’s mouth, the pedodontist
treats children from birth through adolescence.
Periodontist (Perio): The periodontist diagnoses and treats diseases of the gum and
supporting bone surrounding the teeth. Most people think of this type of dentist treating
infections of the gums which causes teeth to become loose. Most times the GD will send a
patient to the periodontist for an evaluation to check the “foundation” of the teeth before any
major reconstruction is started. The periodontist is also the dental specialist involved with the
placement of implants for areas of missing teeth.
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Prosthodontist (Prosth): prosthodontists are dentist specialists dealing with the repairing of
natural teeth and/or the replacement of missing teeth on a much larger scale than the general
dentist. The prosthodontist uses artificial teeth, gold crowns, or ceramic crowns to replace the
missing or extracted teeth.
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