International Journal of Computerized Dentistry, 03/2010

Cone beam computed tomography (CBCT) is a radiological technique available since 1998 in dental and oral medicine in which a cylindrical volume is acquired with a conical x-ray beam during one rotation around the head of the patient (cone beam computed tomography, cone beam CT). This technique is increasingly replacing conventional radiological procedures due to the possibility of arbitrary reconstructions and views free of superimposition. CBCT focuses on the display of the bones of the jaw, so that its use concentrates on problems in implantology, before surgical removal of impacted and displaced teeth, in traumatology, and in craniofacial malformations. The objective of this overview was to emphasize the advantages of cone beam computed tomography in the individual disciplines. However, schematization of examinations should be avoided for reasons of radiation protection and for avoiding forensic pressure. The limits of CBCT and thus an indication for computed tomography exist where there is suspicion of bone tumors with soft tissue participation as well as in extensive fractures with suspicion of craniocerebral trauma. In the case of tumors in the soft tissues and of functional temporomandibular joint symptoms, magnetic resonance tomography is preferable to CBCT. Keywords: Cone beam CT, volumetric CT

Prosthetically based implant planning is necessary so that implants are set expediently and correctly during surgery. A clinical case is presented to describe how this can be performed today purely digitally. Prosthetic planning was undertaken with the Cerec CAD/CAM system. The data record created was transferred and superimposed on a CBCT 3-D radiograph. The position of the implant was planned taking the prosthetic planning into account. Keywords: CAD/CAM, Cerec, cone beam computed tomography, 3-D x-ray, implant planning, prosthetic planning, drilling templates

Treatment data from practices and specialization centers, especially in the increasingly specialized areas which university clinics do not cover, are very important for evaluating the effectiveness and efficiency of dental examination and treatment methods. In the case of paper-based documentation, the evaluation of these data usually fails because of the cost it entails. With the use of electronic medical records, this expense can be markedly lower, provided the data acquisition and storage is structured accordingly. Since access to sensitive person-related data is simplified considerably by this method, such health data are protected, especially on the European level.Other than generally assumed, this protection is not restricted solely to the confidentiality principle, but also comprises the power of disposition over the data (data protection). The result is that from a legal point of view, the treatment data cannot be readily used for scientific studies, not even by dentists and physicians who have collected the data legally during the course of their therapeutic work. The technical separation of treatment data from the personal data offers a legally acceptable solution to this problem. It must ensure that a later assignment to individual persons will not be feasible at a realistic expense ("effective anonymization"). This article describes the legal and information technology principles and their practical implementation, as illustrated by the concept of a respective compliant IT architecture for the dentaConcept CMDfact diagnostic software. Here, a special export function automatically separates the anonymized treatment data and thus facilitates multicentric studies within an institution and among dental practices. Keywords: person-related data, treatment data, virtual anonymization, IT architecture, relational databases

After a brief historical introduction of virtual reality, the article focuses on why virtual reality is the next step in dental education. Contrary to existing systems for preclinical courses, such as plastic teeth and dummies, virtual reality has no limitations in terms of clinical case studies, objective evaluation, and interactivity. For the past six years we have been developing innovative concepts using force feedback arms and computer 3D simulation at the University of Geneva. After describing the simulator itself, we discuss the results of a preliminary survey we initiated in 2006. The survey concerns the teaching of dental anatomy using 3D rendering capabilities of the simulator for third-year students of the University of Geneva. The aim was to validate the added value of IT integration into our curriculum. The results showed that 70% of the students were satisfied or very satisfied with this module and that the simulation boosted their motivation to learn anatomy. It also became evident that IT did not introduce a supplemental complexity that reduced teaching efficiency. This was a clear message for us to develop a second-generation virtual reality dental simulator with improved tactile features to teach drilling procedures. Keywords: virtual reality, preclinical courses, dental education, force feedback arms, dental simulator, information technology (IT) survey

With the software version 3.80, the Sirona company also delivers the Buccal Scan feature, among other features. This opens up a completely new way of high-precision registration of the occlusion. The new method can be used easily and universally. Keywords: occlusion registration, buccal scan, bite registration, bite impression, virtual articulator

Quadrant restoration has been an integral part of the software since the Cerec 3-D program was introduced. In the new 3.80 version, the program also offers the option of scanning the opposite jaw and correlating it with the prepared jaw by a buccal scan. This innovation is especially appropriate when several teeth in a quadrant are being restored. The procedure is described in detail in this article. Keywords: Cerec, biogenerics, buccal registration, case description, artifact