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TECHNOLOGY NEWS
AS SEEN IN HB MAGAZINE
Dentistry & Plastic Surgery in 3D
I was watching a movie called “Aliens in the Attic” the other day with my daughter, and I found it funny when the grandmother tried to bite one of the characters in the movie and the denture came out of her mouth and got stuck to his arm.
This was funny in the movie but in real life, having your denture coming out of your mouth can be anything but funny. Denture was the standard of care not that long ago. It was considered normal for you to get old, lose your teeth, and get dentures. The ubiquitous image of an older person going to sleep with his or her teeth on the night stand has lead many to believe that this is acceptable.
This need not be so. The current standard of care for patients who lose their teeth either at old age or even those who are younger is dental implants. Over the last decade, the technology and methodology for dental implantation has improved so significantly, that dental implants are now considered routine. The advantage of dental implants over denture or bridge is in both form and function. The dental implants function almost as well as normal teeth. The patient can chew and eat like any normal person. They can talk and smile with the natural appearance of an individual with a full set of teeth.
Even though dental implants are very functional and attractive, a vast number of individuals still languish with poor fitting and sub-optimal functioning dentures and bridges. The New York Times did a great service to this population a couple months ago by detailing the benefits of dental implants over dentures. The more patients are aware of the benefits of dental implants, the more likely they are to ask their dentist about them.
Dental implantation like the rest of the development in the field of dentistry, is highly dependent on the technology employed in the diagnosis, treatment planning, and execution of the procedure. It is not uncommon to hear patients say, “my dentist said he can do dental implants.” The reality is that embarking on the practice of dental implantation involves significant investment in high tech equipments that many general dentists are not willing or able to commit if they do not perform a high volume of dental implants.
One of this technology is the cone beam 3-D scanner. This very expensive but amazing scanner allows the implant specialist to see the amount and orientation of your bone, remaining teeth and the nerve canal to determine the appropriate steps in the reconstruction of your teeth. It also allows the patient to fully see and understand the rationale of the specialist’s treatment plan. The 3-D scanner can also help the dentist see the exact position and orientation of wisdom teeth, supernumerary (extra) teeth, root canals, TMJ (temporomandibular joint), sinuses, airway and other major structures. The other day, we performed this scan on a patient who has had her implants done by another local dentist. We noted and was able to show the patient the problems with her current implants. We were also able to develop a clear and understandable plan to save her implants.
The future of tooth replacement is already on the horizon. Scientists have been able to create a stem cell package that when implanted into the jaw bone of experimental animals resulted in a well developed and functional tooth. But until this technology is perfected, dental implant is the next best option.
This 3-D scanner also has significant number of applications in plastic surgery. The ability to see the patients’ bone and soft tissue structure in 3 dimensions can facilitate the surgical planning discussions with the patients. From straight forward facelifts to nasal surgeries to complex cheek bones and jaw bone surgeries, the incorporation of the 3-D scanner greatly enhances the safety, predictability, and quality of the surgical result. Facelift patients can benefit from the discussion of bone and soft tissue augmentation in conjunction with their facelifts because a significant part of the aging face is the loss of bone and soft tissue. In nasal surgeries, the presence of asymmetry, septal deviations and airway obstruction can allow treatment of the associated nasal problems at the same time as the cosmetic rhinoplasty. In patients who have wide faces and desire a smaller facial contour, the 3-D scanner can help both the patients and the surgeon in achieving the optimal and safe outcome.
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