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Discovering a New Dimension
in Dental Care

August 2004

by Natalie Gutierrez

Small, dark craters and gentle ridges cradle deep canals. Smooth plateaus seem to go on forever and then suddenly drop off into a shadowy abyss. With the push of a button and the click of a mouse, youíre taken on a voyage through a mysterious canal. The ghostly images you see arenít being projected from NASAís Hubble Space Telescope; theyíre coming from the new 3-D Accuitomo Cone Beam Micro CT imaging system in the Dental School at the Health Science Center. The incredibly detailed three-dimensional pictures arenít of the lunar surface, although the resemblance is uncanny. Instead, theyíre of teeth, bone and tissues of the human mouth.

Faculty members at the university recently acquired a new 3-D Accuitomo Cone Beam Micro CT imaging system. The Health Science Center is one of only three universities in the nation and the only public university to have this equipment. The other two dental schools are the University of the Pacific in San Francisco and The University of Southern California in Los Angeles.

Maria Elena Serrano sits comfortably in the 3-D Accuitomo Cone Beam Micro CT imaging system while it takes images of her jaw.

Maria Elena Serrano sits comfortably in the 3-D Accuitomo Cone Beam Micro CT imaging system while it takes images of her jaw.

Dental School faculty and students can now view never-before-seen, high-resolution CT images of the jaws to study implants, abscesses, impacted teeth and other jaw disorders in patients. Using specialized computer software, dentists can view images of jaw structures in several layers from three different directions simultaneously, with very high resolution and definition. With the click of the mouse, radiologists can see a detailed view from one end of a personís jawbone to the other by moving directly through the nerve canal in the mandible, for example.

"Itís like traveling through a tunnel," said Marcel Noujeim, D.D.S, a resident in dental diagnostic science. "We can see the bone, teeth and nerves inside, section by section," he said.

"This machine allows us to see whatís going on in a patientís mouth with nearly 10 times the resolution that regular CT machines deliver," said Robert Langlais, D.D.S., professor and director of the graduate oral and maxillofacial radiology program in the department of dental diagnostic science at the Health Science Center.

The machine is a dream come true for faculty and students in the Dental School, especially since in February the school was accredited by the American Dental Associationís Commission on Dental Accreditation to train oral and maxillofacial radiology specialists.

Worth approximately $200,000, the imaging system, distributed by J. Morita USA Inc., based in Irvine, Calif., arrived Feb. 16.

"Regular CT machines achieve images by using a beam of radiation that rotates around a patient multiple times, depending upon the part(s) of the jaw or body being scanned," Dr. Langlais said. "Our new Accuitomo imaging system can achieve a complete scan of the desired part of an individualís jaw, for example, with one quick beam in about 17 seconds at up to 100 times less radiation dose to the patient."

Not only does this mean less time, less radiation and more precise images,
Dr. Langlais said, it also means less cost to the patient. Regular CT imaging of the jaw costs anywhere from $600 to $800. An Accuitomo imaging session at the Health Science Center costs from $200 to $300.

Back in the late í70s, Maria Elena Serrano lost molars on both sides of her mouth. At that time, she was dead set against getting dentures. Today, at 51, Serrano decided she is still too young for dentures. Instead, sheís preparing to receive dental implants.

"Because Maria was missing teeth for an extended period of time, some of the supporting bone in her jaw was resorbed," said Mark Lucas, D.D.S., resident in the department of periodontics who is treating Serrano. "With the new imaging system, our dental radiologists were able to measure the amount of bone in her jaw available to support an implant as well as the distance between vital nerves and the intended implant location. Without the Accuitomo imaging system, we would not have been able to measure with this accuracy." As it turns out, the imaging system revealed that Serrano would need a bone graft to help support an implant and protect nerves.

"Itís amazing what this machine can do. Itís making oral surgery safer and more affordable nowadays," Serrano said. "San Antonio is very fortunate to have this technology available."

Images captured by the Accuitomo imaging system can also be converted into three-dimensional, life-size images of the mouth. With the 3-D images, radiologists can create life-size wax models in order to see tumors in the jaws, for example, and measure with exact precision how much tissue from a personís mouth would need to be removed and/or replaced during surgery.

Dr. Langlais said he and other faculty have initiated discussion with faculty members in the School of Medicine at the Health Science Center to apply the technology to others areas of health care.

"Soon a wide variety of applications in all areas of dentistry will be realized, with additional applications in medicine as well," Dr. Langlais said.



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