Extraoral/intraoral imaging

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1 D E Pr a c t i c e Management In Focus: The Economics of the New Digital Practice Dental Economics, in conjunction with Carestream Dental, looks at how (and why) modern practices have integrated diverse technologies into a seamless practice workflow. From better patient experiences to more robust bottom lines, the trend toward integration is making more sense than ever. SPONSORED BY Supplement to DENTAL ECONOMICS

2 CONTENTS 4 Welcome from Dr. Ed Shellard and Marc Gordon 5 Infographic: Carestream Dental facts 6 Catherine s story 8 The challenge of building an integrated workflow 9 Going digital checklist DPMS 10 Taking your practice to the cloud 13 Forging a strong workflow chain 14 Interview with Alistair Bruce 15 Using eservices to streamline efficiency Extraoral/intraoral imaging 16 Why go from film to digital? 18 How technology helps with patient and referral relationships 19 Building on a legacy: The new RVG 6200 intraoral sensor 20 Top 5 reasons to use an intraoral camera in your office Special thanks for their contributions to this DE supplement Heather Tuggle, the senior communications manager at Carestream Dental, has been writing about dental-related topics for over five years. Her specialty is creating educational content on digital imaging technology and how it can be applied to the practice. Heather is based in Atlanta, Georgia, and enjoys traveling in her spare time. 3D Technology 22 Dr. McAllister presents a CBCT Clinical Case 24 The story of the CS D 25 The CS 9300: Taking the guesswork out of examinations CAD/CAM 26 The CAD/CAM workflow 28 Spotlight on the CS 3500 intraoral scanner 29 Adapting your dental practice for today s reality 30 Event calendar Amanda Gong is the public relations manager for Carestream Dental and has been writing on a technical level for five years. She works to ensure that Carestream Dental s equipment is represented accurately in the media and builds relationships with industry magazines by providing resources, educational content, and general dental information for use in articles.

3 THE WAIT IS OVER CS D 3D imaging is now available for everyone Many have waited for a redefined 2D/3D multi-functional system that was more relevant to their everyday work, that was plug-and-play and that was a strong yet affordable investment for their practice. With the CS D, that wait is over. Versatile programs and views (from 8 cm x 9 cm to 4 cm x 4 cm) New 4T CMOS sensor for detailed images with up to 75 μm resolution Intuitive patient placement, fast acquisition and low dose The new standard of care, now even more affordable LET S REDEFINE EXPERTISE The CS D is just one way we redefine imaging. Discover more at carestreamdental.com Carestream Health, Inc DE CS D AD 0814

4 Welcome We are proud to present, in conjunction with Dental Economics, this special supplement on The Economics of the New Digital Practice. This is an exciting time for Carestream Dental. After launching a new CAD/ CAM portfolio for in-office restorations last year, we introduced a number of new products in From our latest CBCT imaging system, the affordable and compact CS D, to a lower-dose version of the CS 9300, all of our products are designed to meet the ever-changing needs of dental practitioners. To better serve these users, we also launched the RVG 6200, a new intraoral sensor with a streamlined workflow, and a cloud-hosted version of CS SoftDent. While we are always proud to introduce new products into the market, we are most excited about the possibilities they bring to our users the dental professionals. Our products make image capture seamless, allowing users to view images just seconds after acquiring them for a more confident diagnosis and treatment plan. For a more streamlined workflow, you can even save everything right in the patient s chart saving valuable time in the process. And, our imaging systems and software are designed to improve patient education, allowing patients to make better, more informed decisions regarding their proposed treatment plan. At Carestream Dental, we pride ourselves on our ability to understand your practice needs in an intimate way because, quite frankly, that s why we are in business. Of course, this doesn t mean we have all the answers which is the very reason we solicit input from dentists who work in the field. Ultimately, our goal is to provide products that adapt to you, rather than the other way around, using technology that requires no significant changes to your current workflow. In this special issue of Dental Economics, we explore technologies that can help your practice thrive. We walk you through the lifecycle of a product, from development all the way through installation and support. We ll also give you a behind-the-scenes look at our new ad campaign, which highlights the patientdoctor relationship and ultimately explores one of the key reasons you entered the field initially. To the success of your practice, Ed Shellard, DMD Chief Marketing Officer and Director of Business Development Marc Gordon, CFA General Manager, U.S. Equipment and Software 4 CARESTREAM DENTAL Digital Practice

5 YOUR SOURCE FOR TOTAL SOLUTIONS We DEVELOP the technology that defines dental imaging. We MANUFACTURE the software and equipment you want. We CONSULT with your practice to provide the right solutions. We TRAIN your staff to use our products with confidence. We SUPPORT our products with no-hassle, one-call availability. We EDUCATE dental professionals about the latest technology. OVER 800 MILLION IMAGES TRAINING facts at a glance. 600 Each year, Carestream Dental systems produce nearly enough images to take a radiograph of everyone in North and South America combined. That equates to millions of improved diagnoses and treatment plans. 20 TH A MON CERTIFIED TRAINERS Digital Imaging, Restorations, and Practice Management Working Together live webinars a month A YEAR 3 Intraoral 2D Referral Management eservices Extraoral 2D Cone Beam CT For more information, call or visit CAD / CAM Electronic Charting Carestream Health, Inc

6 6 CARESTREAM DENTAL Digital Practice My first thought was, Finally, someone sees it. I just felt so relieved, Catherine remembers. That was the beginning of my story with Dr. Bissell. He definitely made me feel like something great was going to happen.

7 catherine s story the new digital practice isn tjust an idea: it s already changing lives The story of the new digital practice doesn t begin in a magazine (like this one). It begins with patients who have real problems ones that challenge the best minds among us to find innovative solutions. Recently, Carestream Dental decided to turn the tables with its brand identity, focusing on these true heroes of our industry the dental professionals who identify and solve problems. So, the next time you see a Carestream Dental ad, you ll know that the inspiration didn t come from a marketing board room. It came from a story like Catherine s. Catherine and Dr. Bissell When Catherine, a retired technology coordinator from Union, N.J., began experiencing discomfort in the upper right side of her mouth, she was desperate to find someone to help her. I had this pain that was very annoying and unresolved by many dentists, Catherine recalls. They looked at it, X-rayed it, imaged it and took full mouth scans, but they couldn t find out what the problem was. After several rounds of antibiotics, which relieved the pain only temporarily, Catherine believed the problem was neuralgia a sharp pain associated with nerve damage and was prescribed medication for this condition by a neurologist. Unfortunately, despite several attempts to increase the dose, the medicine offered no relief. Frustrated by the chronic pain and lack of answers, Catherine became extremely lethargic, depressed, and unable to function at work. One day, while performing research on the Internet, Catherine stumbled across information about a machine that could do more than take X-rays: it could also capture three-dimensional images with the finest amount of detail. I said to myself, Maybe that s the whole problem. Maybe these dentists just can t see it, but I know it s there, says Catherine. She decided to call the company Carestream Dental to learn more about the 3D imaging machine and how she could get a scan. Catherine contacted a Carestream Dental representative and was referred to Dr. Thomas Bissell, a periodontist based out of Chester, N.J. She immediately called his practice for an appointment. During her initial meeting with Dr. Bissell, Catherine explained her story to him. As she describes, He just looked at me and was very, very calm about it. I said, Dr. Bissell, no one else sees it. I really want to take the x-ray and see if you can see something. Dr. Bissell captured a 3D scan with the CS 9300 system and came back with a diagnosis a punctured sinus cavity caused by an implant and a separated file within the root canal-treated tooth. My first thought was, Finally, someone sees it. I just felt so relieved, Catherine remembers. That was the beginning of my story with Dr. Bissell. He definitely made me feel like something great was going to happen. We did a full evaluation for Catherine, even though her most pressing need was one particular area, explains Dr. Bissell. I couldn t see it clinically, couldn t see it with a traditional two-dimensional radiography, but we were able to find it with the CBCT scan. After two surgeries and a bone graft, Catherine finally found the relief that she had sought for so long. I m without pain now, she states happily. Today, the patient-doctor relationship between Catherine and Dr. Bissell is strong. She s a wonderful patient. She s one of our stars, Dr. Bissell says. We like it when she comes to visit us. She travels quite a distance, so that s a real compliment. We know there are other people she could see, but it really shows we re doing something right when somebody travels a distance to come see us. On her end, Catherine is happy to tell others how Dr. Bissell came through for her by successfully identifying and treating her pain. I enjoyed being with Dr. Bissell because he s very honest, very thorough, and very good, says Catherine. And to think, this story was the result of an Internet search, a phone call to a dental technology company, and a dentist who could be a hero. For more information on the stories captured in these ads, please visit CARESTREAM DENTAL Digital Practice 7

8 the challenge of building a fully-integrated workflow and how carestream dental made things simple By David Little,DDS We all know that the goal of advanced technologies is to simplify procedures, increase patient acceptance of proposed treatments, and allow practitioners to maximize their return on investment (ROI). But as clinicians, we all know this is much easier said than done. With the explosive growth of dental technologies and the myriad partnership options available to us, you might think things have become easier. Yet many of us find that not all systems are created equally. Systems don t always work well together (and sometimes not at all). To determine what technology is right for your office, consider the following questions: Will training and/or support be provided during and after your purchase? How will your new purchases work with other systems, including those already in your practice or those used by specialists to whom you refer? Most importantly, how will these technological acquisitions help you meet goals you ve set for your practice, such as providing an enhanced level of care or meeting a certain ROI level? Most dental practice systems provide an acceptable answer to a few of these questions, but to simplify your workflow and maximize your ROI, an integrated technology platform that works for all aspects of the practice from capturing images to diagnosing diseases, from your front office to your multiple practice operatories is the solution. As both a dentist and a practice owner, I understand the need for technological investments to enhance my practice. For my practice s complex workflow problems, Carestream Dental has provided me with simple, intuitive answers. Finding a Solution Since I began practicing in 1994, my passion has been providing patients with the highest quality dental care. It was with this desire that I founded my practice, Professionals in Dentistry, in San Antonio, Texas. We focus on general dentistry, but we also provide a variety of cosmetic treatments ranging from whitening to veneers. We also place implants and are one of the only practices in our area to offer annual oral cancer screenings. We offer all these services because we believe so strongly in our mission, which is to provide the highest levels of service and professionalism in all areas of oral health. To accomplish our goals, we utilize the latest digital technologies for providing advanced services to our patients, such as laser dentistry and digital imaging. Since we offer a range of services that require a broad spectrum of both hardware and software, we needed to find a partner who shared our passion for high quality dentistry and would enable us to move beyond the typical problems dental practices have with interoperability between technologies. Because we ve committed to Carestream Dental s products, we don t worry about whether a purchase will be compatible with our current equipment. Carestream Dental s products run the gamut from digital imaging systems to practice management software, so our office is well-equipped to treat and diagnose varying conditions. The following sample workflows highlight the unique capabilities of the Carestream Dental system as used in our office. Sample Workflow #1 Let s say a new patient who has not been to a dentist in years visits our office. Carestream Dental s high quality panoramic imaging, which we use on all new patients, allows us to see beyond the scope of traditional radiographs. Our office can carefully monitor the patient s condition more frequently with this panoramic imaging. Therefore, diagnoses such as congenitally missing incisors are much easier to determine. Additionally, this patient may be one of the many patients who benefit from our heavy emphasis on oral cancer screenings. The panoramic imaging allows us to see any suspicious areas that we can then refer out to an oral surgeon for further evaluation. Carestream Dental allows us to easily transfer and share all information with the patient s other healthcare professionals. Sample Workflow #2 Consider a patient referred to our office with significant tooth pain, which his referring dentist is unable to diagnose. Car- 8 CARESTREAM DENTAL Digital Practice

9 estream Dental 3D imaging allows us to gain a clearer, more in-depth picture of the patient s dentition that can then be manipulated for full visual effect. With such technology, we are able to see that the patient suffers from cracked tooth syndrome, which another 2D dental imaging system may not be able to reveal. Use of such technology puts clinicians at a significant advantage because of the overall patient experience. In my practice, we are able to treat patients more efficiently and quickly, as well as educate them about their condition. Patients leave our office satisfied that they are being treated with the latest technologies and receiving the highest standard of care. Sample Workflow #3 Another example is a patient who presents with the desire to replace a congenitally missing tooth. A Carestream Dental 3D imaging system allows us to see that the most appropriate treatment would be an implant. Three-dimensional imaging is also used to plan implant placement and determine the proper length, size, and position, ensuring a predictable outcome. Throughout the patient s consultation, this treatment planning is shared with the patient to educate him/her on the condition of their oral health, what the treatment will entail, and what the final outcome will be. Similar to sample workflow #1, the plan and its supporting image documentation can also be shared among other members of the treatment team. The benefits of Carestream Dental technology are, in this case, twofold. First, we are able to educate patients on the state of their oral health and how treatment options will benefit them. Though we, as dental professionals, may be able to explain such concepts, the visual aids that 3D imaging bring provide the wow factor that no conversation can. This, in turn, leads to greater treatment plan acceptance and an increased ROI for the practice. Sample Workflow #4 Finally, a patient may present for a routine appointment. Radiographs taken indicate an area where caries may be present, but we can t be certain and don t want to risk removing healthy tooth structure unnecessarily. Thankfully, Carestream Dental incorporates Logicon Caries Detector Software that can act as a second opinion when diagnosing decay and its levels. The software works by comparing our radiographs with hundreds of other radiographs of diagnosed caries in various stages, presenting us and our patients with accurate information to assist in diagnoses. It allows us not only to determine whether caries is present, but at what level and whether restorations are required. Use of this intuitive software allows dentists to treat patients with more confidence. It also ensures that the most conservative treatments are employed, making patient acceptance of proposed treatments much more likely and ensuring a steady flow of cases for the dental practice. Conclusion Clinicians have seemingly endless options when adopting or upgrading their practice technology, but such purchases should not be motivated by the simple desire to acquire something new. Rather, dental practices should be outfitted with hardware and software that is easy to use and compatible with other systems in the office, ensuring interoperability for the highest level of patient care. Carestream Dental offers dentists the opportunity to practice at high levels and with ease. David Little, DDS, is an accomplished national and international speaker, professor, author, researcher, and clinician. Dr. Little s private practice in San Antonio includes a multidisciplinary facility and learning center. Dr. Little is an adjunct clinical professor in the dental program at the University of Texas Health Science Center at San Antonio, and he serves on several editorial boards and advisory boards. Dr. Little can be reached by at [email protected]. Going Digital Checklist There s no denying that technology in the industry is rapidly changing more specifically, going digital. Here is a digital product checklist to help you get started: Intraoral - Digital Sensors - Digital phosphor plate system - Intraoral cameras - Digital cameras - Caries detection software - X-ray generator Extraoral - 2D panoramic system (including optional cephalometric) - 3D system (including 2D panoramic and optional cephalometric) Software - Practice management software - Imaging software - 3D imaging software - Electronic services - Charting CAD/CAM - Intraoral 3D scanner - In-office milling machine - Restorative design software Whether it s digital image capture, 3D scanning, or cloud-based solutions, Carestream Dental provides everything to transform an office into a cutting-edge, modern practice while keeping patients at the forefront. For a consultation on your digital imaging systems, please call one of our specialists at or visit CARESTREAM DENTAL Digital Practice 9

10 DPMS Taking Your Practice to the Cloud By Marty Jablow, DMD Cloud technology has changed dramatically over the past few years. More companies have moved their practice management software to the cloud, and dental offices are using more Internet-based services. So what s holding you back? The most frequenly asked questions about the cloud remain the same: Is data just as safe in the cloud as it is on my practice server? Will my data get hacked? What about HIPAA? Can it simplify my Internet technology (IT) needs and reduce costs? Will transitioning to the cloud affect my office productivity? This article will explore the reasons to consider cloud computing for your dental office, along with things to consider when selecting a cloud-based, practice management partner. The term cloud is used as a metaphor for the Internet, based on how the Internet is depicted in computer network diagrams. It s also an abstraction for the underlying infrastructure it conceals. Typical cloud computing providers deliver common business applications online that can be accessed from a web browser, while the software and data are stored on remote servers. Most of us use the Internet everyday for a variety of purposes. We shop, trade securities, bank, pay bills, and book travel online. These tasks revolve around personal and financial information being transmitted over the Internet, so all of these transactions take place in the cloud. That s why using softwareas-a-service (SaaS) for your dental office practice management is likely nothing new to you. As we have seen increased integration of services online, we ve also seen the potential for more and more IT issues to occur. Just think about all of the IT hassles that a dental office has to overcome to have their current client/server practice management system run and integrate with the reminder system, imaging software, tablets, and web-based services. Then, there is the initial capital expenditure for network infrastructure and computer hardware. Moreover, most offices hire an IT professional to keep their computers and network running. Don t forget the constant need for upgrades of hardware and software... All of these things can cost the practice time and money. I don t know of a single dental office that looks forward to a server upgrade. In fact, many offices put off upgrades and are currently running systems on older versions. Not to mention, the ongoing costs associated with upgrades and updates to your practice management system equate to lost time and money over the years. It is so much easier if all an office needs is a simple computer, a tablet, and a web browser. The biggest issue to overcome in dental cloud computing is lack of understanding. We do not stuff large amounts of money in a mattress or bury our jewelry as treasure in the backyard. We entrust banks to handle our financial matters and protect our money. Safes and safety deposit boxes protect our valuables. Why not trust your office data to the cloud? Unfortunately, we are now bombarded in the media with data breaches and online security. It s worth taking a moment to look at some cloud computing benefits and concerns. The first concern is security. Let me ask you, how secure is the data in your office now? If you are not on the cloud, you must make sure that you continually back up your data and provide means to secure the data from the outside world. HIPAA comes into play... and what would happen if there were to be a data breach? Are you doing everything possible to secure your data? When speaking to dentists across the country, I am amazed that 10 CARESTREAM DENTAL Digital Practice

11 CS 3500 NO impression material NO trolley NO focusing on the screen NO limitations NO powder ALL YOU NEED FOR THE PERFECT RESTORATION, AND NOTHING YOU DON T WELCOME TO THE NEW REALITY In the new reality, the CS 3500 intraoral scanner creates highly accurate, true color 2D images and 3D models of teeth without conventional impressions. Truly handheld, portable with no trolley and plug and play Powder-free with slim scanner head for comfortable, custom-fit restorations Unique light guidance system for more patient-focused scanning Part of a flexible and open system, allowing you to choose between in-house or lab milling Enter the new reality at carestreamdental.com/cs3500 or call SCAN DESIGN MILL Carestream Health, Inc DE CS 3500 AD 0814

12 DPMS most dental offices do not adequately safeguard their data. In all cases, data must be taken off site. In reality, data is rarely, if ever, restored to ensure the viability of the backup. I have personally heard of many cases where the supposed backup never was done properly, and the office did not find out until it was too late. Many offices take the data home on a notebook computer or unencrypted external hard drive, which is just a way of asking for it to be lost or stolen. Online backup is not just for data. Now, the entire office server can be virtualized in the cloud for emergencies. This became very evident to me after Hurricane Sandy, when my online backup server was turned on and available. All of my data was still safe in my office, but with no power, I had no access to it. How were we going to let patients know whether they still had an appointment to keep when we reopened? When you use the cloud for practice management, there are continual backups up until the last data inputted. This is like an off-site redundant array of independent disks (RAID) arrangement. The data is stored in a secure data center in multiple geographic locations, protected at all times. You will no longer have to worry about backup strategies, what happens if your office is burglarized, or the dreaded hard drive crash and resulting time loss for recovery. Forget the implications of getting a virus and having it do something to your data. Your data is encrypted in transit and stored remotely, so it will not be susceptible to any viruses that could invade your office computer. Cloud computing also provides a consistent cost structure that helps you plan and minimize unplanned capital costs, such as a server crash or loss. You might be thinking, What happens if my office loses Internet access? Depending on the reason for your data outage, it is usually a minor hiccup. Most commercial Internet service providers (ISPs) guarantee 99% up time and credit you for any down time. This means your commercial account should always be available, or it does not cost you for the missed service. Another question might be: What happens if my Internet service (DSL, cable, or T1) line does go down for an extended period? You must have a redundant system in place. Consider the PACE plan. PACE stands for Primary, Alternate, Contingency, and Emergency. In my office, we use cable, but we still maintain the DSL line as a backup. Contingency Internet access is available from cellular service providers. It can be as simple as using a cellular modem hotspot for a backup Internet connection. Many offices have 4G or LTE hotspot available that will provide ample speed for accessing the system to run your practice until service is restored. In my case, we used When you use the cloud for practice management, there are continual backups up until the last data inputted. an ipad. The speed may not be as fast as your typical wired connection, but it should be able to keep you in business until your regular ISP comes back online. During emergencies, a cellular telephone that can be used as a modem could be paired with your computer network. What about imaging? Many cloud-hosted software solutions allow access to patient images. You may have a full array of sensor choices. The number of products for integrating has expanded, making accessibility less of an issue. Check with the software vendor to see if they integrate with your X-ray sensor. Real-time synchronization is now possible, so images acquired in your office can be made available from the cloud. Access is another benefit to the cloud. For multi-office practices, a single cloud-based database will allow easier access to patient data then the normal client/server configuration. So, are you ready for dental cloud computing? If you currently are looking for new software or to lower your IT costs, then web-based software is the answer. These products have come a long way in a short period of time, becoming more robust and powerful and, in many cases, exceeding the capabilities of their client/server heritage. Of course, due diligence is necessary in all software purchases, including web-based ones. Eventually, we all will migrate to the cloud. It is just a matter of time. For more information on Carestream Dental s cloudbased software, such as CS SoftDent Cloud, please call , or visit Martin Jablow, DMD, is a clinician, speaker, and author who presents and publishes on dental technology, materials, and other topics. Dr. Jablow is the president of Dental Technology Solutions, and he has achieved fellowships in the Academy of General Dentistry and the International Academy of Dental Facial Esthetics. He also serves on the advisory boards for both Dentalcompare Continuing Education and the Eco- Dentistry Association. To learn more about Dr. Jablow, visit his blog at dentechblog.blogspot.com. 12 CARESTREAM DENTAL Digital Practice

13 DPMS Forging a Strong Workflow Chain: Dental Practice Management Software, Imaging Software, and Imaging Systems A chain is only as strong as its weakest link; therefore, an efficient workflow demands that every link plays its part. When dental practice management software, imaging software, and digital imaging systems integrate, it improves the workflow process, saving doctors valuable time that can be spent caring for patients. This integration provides dental practices with numerous benefits: Patient Information Stored in a Centralized Location: When imaging systems work in sync with dental practice management software (DPMS), it s easier to store patient images and clinical records all in one place. Being able to view a patient s chart and clinical images all on one screen is also convenient. Reduced Number of Clicks: Information is shared through a single database, saving time and reducing the number of clicks. This directly contributes to office productivity and efficiency no more wasting time on different systems. Plus, navigating from DPMS to imaging software is easy and intuitive and doesn t require searching for patients on each software platform. Improved Revenue Stream: A streamlined process from start to finish means faster reimbursements and payments. Using dental practice management software to digitally attach images captured by imaging systems allows a practice to electronically transmit X-rays, charts, intraoral photos, explanations of benefits, and any other required information for insurance carriers to view in support of patient claims. Extra documentation that supports a doctor s treatment recommendation could mean the difference between a successful claim and a rejection. Easily Share Images with Referrals: Similarly, the convenience of electronic images makes sharing files with referrals easier, which can lead to better working relationships with other practices and doctors, as well as a quicker turnaround between diagnosis and treatment for patients. Increased Case Acceptance: The integration between imaging systems and software allows doctors to supplement their diagnoses with images enhanced with the aid of imaging software to improve turnaround times and increase the likelihood of approval by the third-party payer. Plus, when patients know that their claim will be accepted, they are more likely obtain treatment, leading to increased case acceptance. A Smoother Process for Patients: Keeping a patient s information all in one place allows for a seamless workflow between the front and back office taking credit card pay- ments, capturing radiographs, scheduling appointments, etc. increasing patient satisfaction and allowing doctors to retain patients while at the same time opening the door for word-ofmouth referrals As doctors consider purchasing new equipment and software, this ease of integration is crucial to keep in mind. One of the first questions a practice should ask a provider is, What is the extent of the technical support? If existing third-party software does not integrate with a new imaging system, does a practice need to call the software company or the equipment company? Will automatic updates to new software make it incompatible with the imaging system? Carestream Dental is one of the few companies that manufactures all three links in the chain: dental practice management software, imaging software and digital imaging systems. This means users will work with just one company, making troubleshooting easier. Instead of calling a number of different companies for assistance with DPMS, imaging software or imaging systems, offices rely on one company for support allowing a practice to get up and running faster. Additionally, updates to any of the three components are coordinated to complement each other. Upgraded management software will remain compatible with imaging software that might not be as up-to-date, and vice versa. To better serve patients, practitioners rely on repeatability and an established sequence of events from when a patient first comes to the front desk to when they schedule their next appointment on the way out. The integration of practice management software, imaging software and imaging systems forges a consistent chain, streamlining workflow and leading to more efficient practices and happier patients. For more information on Carestream Dental s software and imaging system integration, please call or visit today. CARESTREAM DENTAL Digital Practice 13

14 DPMS DE Interviews Alistair Bruce DE recently had the opportunity to speak with Alistair Bruce, Carestream Dental s general manager for global practice management software, about trends in the field and how the company develops their systems. DE: What features are dentists looking for in practice management software? Bruce: Dentists care about going through as few clicks as possible. They really care about productivity in their offices; particularly going from the front office back to the operatories. From the moment that a patient arrives at the office, until the time they leave, the doctor wants that to be as seamless as possible and for every part of the visit to be tracked in the software. Doctors insist that their practice management software is tightly integrated with their imaging systems. Whether its intraoral sensors, 3D systems, CAD/CAM or an intraoral camera, it s crucial that the images load seamlessly into the software. Dentists don t want to take a radiograph and then have to take 15 clicks to get the image into the patient file. For this reason, we re really proud of how our imaging systems and practice management software works together. DE: What is the role of customer feedback in your development process? Bruce: Customer feedback is absolutely the most important driver in our software development process. Dentists want to see their software vendor adding enhancements and value to their chosen practice management solution. At Carestream Dental, we have created an online forum called the Idea Exchange where our customers can recommend enhancements and even vote on ideas submitted by others. For one of our most recent software releases, we implemented the top 25 ideas submitted through the forum. I think it s important that we listen to the end users the dentists and office staff and are responsive to their needs. We also comb through our support data to prioritize the items to implement in the development process. Whenever an office calls with a support issue, or asks how to take an action within the software, we track that data. Once a week, our software managers will receive this data in order to analyze it. From this data, they identify the opportunities for improvement and use the information to develop the product roadmap. Our company is also dedicated to obtaining feedback through customer satisfaction surveys. Every month, we send out hundreds of questionnaires, and we have a very strict process for analyzing the data and driving product decisions through that. DE: How does Carestream Dental s dental practice management software offerings CS SoftDent and CS PracticeWorks in particular help the way dentists work? Bruce: Our software was built specifically for the dental practice. Functions like six-month recalls, and other scheduling needs specific to dentistry, are built right into the software. Our software also allows for user customization, in modules like charting, to streamline the way dentists work. In addition, we offer strong financial and billing capabilities that help the Doctor manage their business. Our software and imaging system integration is seamless, which is a benefit to users who want to quickly capture an image and attach it to the patients chart in just a few simple clicks. DE: I know that cloud-based software is gaining in popularity and that includes in dentistry. Could you tell me about your decision to start adapting to this technology? Bruce: Our customers are increasingly demanding a cloudbased option for their practice management system. While it s not for everybody some customers are always going to prefer to have their server in the local office others want the ability to get rid of that and run remotely with all the advantages that brings. We ve had great early success with our cloud offerings for orthodontists and oral surgeons, and are now taking this to the dental market with the launch of CS SoftDent Cloud. Many of our cloud users tell us that, with the cloud option, they no longer have to maintain such a costly IT infrastructure, and they are able to get away from the office to do their more tedious tasks. One of our orthodontic customers even does his charting at his son s basketball games! 14 CARESTREAM DENTAL Digital Practice

15 DPMS Using eservices to Streamline Efficiency in Practice Management Software The days of paper appointment books, waiting on hold with insurance companies and desks stacked with outgoing bills are coming to an end. Today, a digitized practice means a more efficient practice for doctors, staff and patients alike. Beyond the cutting edge technology found in the operatory, adding eservices to your Carestream Dental practice management software integrates workflow, from scheduling to credit card payments. eservices allow an office to customize its practice management software in a unique way to meet the needs of the practice and the expectations of its patients. An eservice like ereminders streamlines the interaction between staff and patients before patients even arrive in the office. Studies show that using appointment reminders can reduce noshows by up to 30 percent. By selecting a contact message and specifying a timeframe and frequency, ereminders automatically reminds patients of upcoming appointments. Practices can reach out to their patients through text messages, s or a voic ; no user intervention is required. Once reminded of upcoming appointments, the newest tool in the eservices toolkit, eforms, allows patients to fill out their registration and health history forms before even walking in the door. All they need is Internet access. eforms can also be used through a kiosk PC or ipad located inside the practice. Moving the registration process from clipboards to tablets saves staff valuable time and reduces clerical errors, as the need to re-enter patient information is greatly reduced. eforms also lets patients sign all treatment consent forms chair side, improving the workflow of the back office. Once the patient has been treated, epayments automatically tracks and stores credit card payments to a patient s ledger, saving time spent on insurance payments, reducing accounts receivable errors and improving overall practice efficiency. Automated Statements lets dental practices eliminate the need to print and mail statements. Instead, statements are processed by the Carestream Dental clearinghouse, where they are laser-printed and mailed first class. Automated Statements also allows for custom messages on all statements, or specific messages on individual statements, which keeps the practice in control of the billing process. Physically removing the mailing process from the practice can lead to a more efficient office, from freeing staff time for higher-value patient focus to the simple fact that forms and envelopes do not need to be stored onsite. An important detail for any practice is a patient s insurance eligibility. everifications quickly checks patients eligibility, benefits and claims status online, doing away with the need to wait on hold or play phone tag with insurance companies. Tracking claim statuses keeps claims moving toward payment, and up-todate insurance information helps doctors and patients make informed decisions and address issues that might slow treatment acceptance in advance. Once a practice has verified a patient s eligibility, eclaims distributes insurance claims to companies that accept electronic claims, while identifying payers that accept only paper claims. As paper claims are routed through the Carestream Dental clearinghouse, the need to mail claims from the office is eliminated, resulting in consistent, timely delivery of claims and quicker processing Finally, receiving an explanation of benefits (EOBs) electronically and posting the associated payment information can be accomplished automatically with epostings. Waiting epostings are automatically downloaded into existing practice management software at the same time reports are retrieved when submitting electronic claims. This intuitive eservice automatically matches payment information to the appropriate claim and posts data directly to patients accounts, reducing risk of errors and leading to more accurate records. Of course, none of these eservices would be effective if a practice cannot access its patient records. On average, practices using their own data recovery methods find that at least 28 percent of files are either faulty or unreadable. ebackup transfers valuable practice management and image data to be stored on Carestream Dental s secure servers, where it can be easily accessed if needed. In the event of hardware failure, ebackup ensures that a practice can quickly return to normal operation with one call to the support team. Technology is rapidly advancing in both the back and front office. Integrating one or more eservice modules with Carestream Dental practice management software leads to a more modern office and streamlines workflow overall. To incorporate eservices into your practice, please call or visit today. CARESTREAM DENTAL Digital Practice 15

16 Extraoral/Intraoral Imaging Why Go from Film to Digital? For many dental professionals, transitioning to digital radiography after using film for most of their careers can seem like a monumental change. As the saying goes, if it ain t broke, don t fix it. However, the truth is that digital imaging systems offer a number of advantages over traditional radiography and some even allow dentists to continue using a workflow similar to film. The benefits of digital radiography extend far beyond the practitioner and staff. Patients, as well as the overall community, can reap the benefits of digital imaging. The following are just a sample of the advantages of choosing digital over film. Improved Patient Experience By switching to digital imaging, practices can clear out their film/ chemical storage room and darkroom in order to have more productive space (such as an extra operatory or consultation room). This extra space, in turn, improves patient experience by reducing wait time and, in many instances, shortening visits. Reduced image processing time is yet another way to promote a better experience for patients, as the time spent waiting for images can be rather unproductive. And, if retakes are needed, the practice loses even more time. Digital radiography, on the other hand, is much faster rather than waiting for an image to be developed and scanned, it is instantly viewable. Because digital images can be enhanced through imaging software, dental practitioners can provide faster and better diagnoses. Filters and powerful imaging software now allow dentists to customize the look of the images they capture, so they can uncover exactly what they were looking for. Digital imaging also plays an important role in patient communication and education. Unlike a broken arm or other noticeable physical injury/ailment, many patients are unable to see what is happening inside their mouth. When patients can see an image on the monitor, it s easier for their dentist to point out areas of interest. By co-discovering a problem, patients are more likely to accept their proposed treatment plan, as well as follow any prescribed at-home care. What s more, because digital radiography allows dentists and patients to co-discover an issue instantly, it heightens patient responsibility and helps them own their disease and understand the importance of treatment. Ultimately, this results in improved case acceptance, which has a positive impact on practice revenue. Powerful Return on Investment The costs of purchasing a new imaging system, as well as computerizing the back office, are often the most common concerns for practices that are considering switching from film to digital radiography. However, while digital systems may require a large upfront investment, many practices experience longterm financial benefits once they make the leap. Consider the case of a doctor who must purchase consumables (such as film and processing chemicals, for example) on a regular basis. In addition to these recurring costs, there are other hidden expenses associated with film, such as system downtime if the film processor breaks down and the amount of time that is lost waiting for images instead of serving other patients. Digital radiography, on the other hand, requires few expenses after the initial purchase. Indeed, many practices see financial benefits in the first month of eliminating film and transitioning to digital radiography. Green Technology Helps the Environment The term going green usually brings to mind images of recycling bottles, cans, and paper. However, dental practitioners can also support these environmental efforts by making a few changes to their working habits. For example, because a number of toxic fixers and chemicals must be used to process film, a professional service must be used to safely dispose of these materials. Switching to digital, meanwhile, allows practices to eliminate these toxic elements completely (and save money on waste removal at the same time). Learn More about Making the Switch For more information on making the switch from film to digital radiography, offers a number of educational articles, with topics ranging from why upgrading to digital radiography is important to practical steps that dental professionals should take to ensure a successful transition to the technology. 16 CARESTREAM DENTAL Digital Practice

17 CS 3000 CS RESTORE A FEW CLICKS FOR A CROWN WELCOME TO THE NEW REALITY In the new reality, you can design high-quality restorations in just a few clicks with our CS Restore software and then mill them in-house in minutes with the CS 3000 milling machine. Built for the long-term, the robust and reliable machine is extremely quiet and intuitively delivers smooth, durable crowns with 25 microns of precision. As part of an open system, it gives you the flexibility to meet the needs of your practice while being extremely easy to use and maintain. Enter the new reality at carestreamdental.com/cs3000 SCAN DESIGN MILL Carestream Health, Inc DE IN AD 0814

18 Extraoral/Intraoral Imaging Improving Patient and Referral Relationships through Technology If there is one field where relationships really matter, it is dentistry. While relationships with patients and colleagues may be based on personality or common goals (such as providing oral healthcare), technology also plays an important role in these partnerships. After all, patients are the backbone of any dental practice, and referring doctors are important to the practice s bottom line as such, it s important to keep both of these relationships healthy and mutually beneficial. Patients and Technology Most dentists would argue that clinical expertise and experience are the most important factors a patient considers when selecting a practitioner. The truth, however, is that patients judge their doctors by the technology they use and while it may take 25 years of practice to become a great dentist, it only takes 25 minutes to look the part. Long before they ever walk through the door, patients are judging their dentists technological expertise. In most instances, the patient s initial impression will be based on the practice s Internet presence and from there, everything from the front desk staff to the technological savvy of the person performing the clinical exam. As a result, it is more important than ever for a practice to utilize the latest technology if they want their patients to maintain a positive impression right from the start. So how does imaging technology strengthen relationships with patients? Perhaps the most important effect is seen in the way that technology facilitates workflow. Patients are busy and whether it s a parent bringing in a child, or someone taking the day off from work, their time is valuable. And, if technology can improve how a staff member positions a patient or make image acquisition easier, it can also improve the overall patient experience. CAD/CAM systems are a growing trend in the dental field. With this type of technology, patients can come in and leave with a newly milled crown in place. Some practices even get patients into the action, allowing them to watch as the restoration is being designed or the crown is being milled. Understandably, CAD/CAM technology appeals to patients who want to reduce their number of appointments, and it can also help a practice stand out from others in the area. Technology can also enhance the communication process. From sending text messages to confirm appointments to highly detailed 3D images that clearly show existing pathologies, patients want to be involved in their oral healthcare and they want it on their terms. In general, everything is going digital these days, and patients are going to make assumptions good or bad when they step into an office with outdated technology. For this reason, dentists must make the best possible impression in order to retain and attract their patient base. Colleague Relationships (and Referral Business) Collaborating with colleagues is an essential part of interdisciplinary healthcare. As with patients, many would assume that clinical competency is the #1 reason a general practitioner would refer a patient to a particular specialist; however, a study by the American Association of Endodontists found that technological competency is actually the deciding factor in referral selection. Imaging technology is one of the best tools to facilitate referrals between generalists and specialists. When dentists refer their patients to a specialist, they must be kept informed of the progress and outcome of their patient s treatment. By electronically sharing secure patient information, dental professionals are better equipped to collaborate with colleagues and make better treatment decisions to improve the quality of care for their patients. Of course, misunderstandings between general practitioners and specialists can happen from time to time; however, eliminating miscommunication issues is imperative to colleague collaboration when a patient is being mutually treated. Using technology that promotes clear reporting and expedites sharing allows for smooth communication between two different offices. Finally, patient care and treatment is even more important than communication. When a dental professional makes the critical decision to refer a patient to another practitioner, he or she wants to know the other practice has the necessary technology to diagnose and treat the patient s problem. Depending on the specialist, this could mean having the right imaging technology necessary for diagnoses and treatment planning. 18 CARESTREAM DENTAL Digital Practice

19 Extraoral/Intraoral Imaging Building on a Legacy: The New RVG 6200 Intraoral Sensor After nearly 30 years of use in dental practices, digital intraoral sensors have revolutionized the way dentists diagnose and treat their patients. In 1983, Trophy Radiologie, which became a part of Carestream Dental in 2002, filed a patent for the world s first dental intraoral sensor. At the time, RadioVisioGraphy (RVG) technology represented a whole new method of diagnosis and led the way in digital technology. A few years later, the RVG came to the market, and the technology only continued to advance from there. Over the years, sensors became smaller and less intrusive. It s a technology that Carestream Dental continues to advance to this day. The RVG 6200 is the newest addition to Carestream Dental s robust portfolio of digital intraoral sensors. Continuing the RVG legacy of durable, digital intraoral sensors, this new system provides practitioners with high-resolution images, and further shapes the technology around users, offering an efficient threestep acquisition process: position, expose and view. Users simply position the sensor in a patient s mouth and capture the image; the image appears within seconds for faster diagnoses. Clinicians can optimize image contrast according to their diagnostic needs or visual preference by using the endodontic, periodontic or dentin-enamel junction (DEJ) filters. The endodontic filter optimizes the contrast values in the entire range of the image, while the periodontic filter optimizes the display of periodontal tissues. Practitioners can also enhance the values at the crown, the dentin-enamel junction, and roots with the DEJ filter. In addition to the anatomical modes, the RVG 6200 s easy-to-use sharpness filter enables dentists to customize the appearance of images to their preferred look and feel. The filter displays contrast changes in real time, and six different sharpness options on the dynamic slider bar ensure practitioners are able to find their ideal image cosmetic. With 24 lp/mm true image resolution*, the RVG 6200 sensor delivers exceptional image quality, enhancing doctors diagnoses. A convenient dose indicator helps identify over or underexposures, helping the operator quickly readjust settings and refine their x-ray generator setting. For greater flexibility, the sensor offers a broad exposure range for image capture; this allows the sensor to produce clinically useful images for a full mouth series without changing the setting of the generator. Unlike many other models on the market, there is no need to arm the RVG 6200 or open the image acquisition interface to prepare the sensor for single image acquisition. Without a control box on the cable, the new sensor is designed to always be armed and ready to acquire images. This also means, in the event of a positioning problem, there is no need to rearm the sensor for acquisition. Along with its standard rear-entry cable that makes for easier positioning, the RVG 6200 offers practitioners enhanced ergonomics for increased patient comfort. In addition, the cable is securely attached and tested to support over 100,000 strong flexions the equivalent of ten years of very intense use. RVG 6200 sensors are durable with a shock-resistant casing designed to withstand bites, shocks, and drops. RVG 6200 sensors are also completely waterproof to support immersion in disinfecting solution for hygiene and safety as well as to protect against corrosion. Finally, the RVG 6200 features a user-friendly interface, making it easy to share, print, import and export images, as well as send via or with a viewer. The system is the only sensor on the market that supports Carestream Dental s Logicon Caries Detector Software. Logicon provides a more precise and efficient method of determining the presence of early caries than traditional methods like the visual examination of a radiograph or an oral examination. The RVG 6200 system is also TWAIN-compliant and compatible with other third-party imaging software for a simplified workflow Intraoral sensors have come a long way in the last three decades. While the elegant and intuitive RVG 6200 might not look anything like the bulky RVG released in 1987, each iteration of RadioVisioGraphy technology has transformed the way dental professionals diagnose their patients, ultimately leading to more accurate and affective treatment. While the RVG 6200 represents the latest in digital intraoral sensors, Carestream Dental is dedicated to continuing to advance the technology into the future. To learn more about Carestream Dental s RVG 6200 sensor, please call or visit *Sensor manufacturers generally publish theoretical resolution, which is a calculation of what the sensor is capable of in an ideal world, based solely on the number of pixels and pixel size of the CMOS sensor. In contrast, the RVG 6200 true resolution of 24 line pairs/ mm adds in the components of the finished product, including sealants, shock layers, scintillator and protective housing, as well as detector noise to determine the measured resolution in line pairs/ mm from an image actually acquired by the sensor. CARESTREAM DENTAL Digital Practice 19

20 Extraoral/Intraoral Imaging 20 CARESTREAM DENTAL Digital Practice

21 Extraoral/Intraoral Imaging Top Five Reasons to Use an Intraoral Camera in Your Office Every practitioner knows that images are a powerful tool in the dental field. In addition to aiding in diagnoses, treatment planning, and post-treatment evaluations, images have the potential to boost a practice s patient care and revenue. However, it is important to remember that digital intraoral sensors and panoramic systems aren t the only tools you can use to obtain images intraoral cameras can also be a huge benefit to your practice. Here are five reasons to consider using an intraoral camera in your practice if you are not already doing so: 1: Improve Patient Communication and Case Acceptance An intraoral camera may seem like a simple solution to individuals who work in the dental field, but it can actually be extremely impressive to patients. For example, by connecting an intraoral camera to a monitor, dental professionals can point out an area of interest and discuss it with their patients. As a result, patients are able to visualize their teeth in a way they ve never been able to in the past. In addition, dental professionals can also print the images for patients to review later. The improvement in patient communication and education also plays a direct role in case acceptance. How many times have patients delayed treatment or worse, rejected a treatment plan because they discount the severity of their problem? With an intraoral camera, dental professionals have the opportunity to co-discover the problem with the patient. Understandably, once patients see their problem area on the monitor, they have no choice but to take ownership for it; as such, they are also more likely to accept their proposed treatment plan. 2: Improve Diagnoses through Enhanced Visualization Some conditions such as open margins, caries, fractures, and soft tissue lesions can be difficult to see with the naked eye. Fortunately, high-quality intraoral cameras deliver superior resolution and allow dental professionals to magnify images so they can spot problems that would have been previously missed. With magnification up to 40x, intraoral cameras allow users to see things that aren t readily visible to the naked eye. The intraoral camera can be used creatively to visualize details of an impression margin, the internal surface of a casting, or the way a crown or inlay fits on a stone die just to name a few examples. 3: Enhance Patient Satisfaction An intraoral camera is a great way to track a patient s treatment progress. Using a camera to capture before and after images can lead to greater patient satisfaction and motivate him or her to keep up with future appointments, as well as continue any prescribed at-home care regimens. Of course, intraoral cameras do far more than capture images inside the mouth dental professionals can also take pictures of their patients faces so staff can easily recognize them the next time they are in the office. When team members can identify patients in the waiting room, look them in the eye, and call them by their name, it not only personalizes the patient s experience, but also improves patient-staff interaction. 4: Facilitate Record Keeping and Sharing Information Sometimes notes simply don t provide enough information about a patient s history. An intraoral camera allows dental professionals to document concerns and treatment outcomes so they have a strong history of the patient s past. When submitting insurance claims electronically, photographic documentation can increase the chances of the provider approving the procedure in a timely manner. This, in turn, allows practices to provide quality patient care and generate more revenue. Images captured with an intraoral camera can also foster better communication between colleagues, which translates into more accepted insurance claims and improved patient care. 5: Internal and External Marketing Dismissing patients with photos that can be shared with others to show their finished treatment or posting printed camera images to a cavity-free club display is a great way to generate buzz around your office. These types of promotions not only get patients involved in their oral healthcare, but can also lead to word-ofmouth referrals from happy patients. Carestream Dental offers multiple intraoral camera models to suit any dental professional s imaging needs. For more information, call or visit CARESTREAM DENTAL Digital Practice 21

22 3D Technology CBCT Scan Verifies Palatal Root Fracture Prior to Proposed Sinus Lift By Bradley McAllister, DDS Cone beam computed tomography (CBCT) has been a part of my practice since I first implemented a unit in my office eight years ago. It s proven to be a critical part of my diagnoses and treatment planning especially in cases of root fractures. Clinical Case Recently, a 55-year-old female was referred to my practice for implant replacement of a maxillary first molar. The referring dentist recommended evaluation for a possible sinus lift prior to implant placement due to inadequate bone and evaluation of tooth No. 15. A periapical radiograph taken at a two-month follow up was included. I prescribed a CBCT scan to evaluate site No. 14 prior to implant placement and to evaluate tooth No. 15. After capturing a CBCT scan on the CS 9300 (with a 5 cm x 5 cm field of view and a resolution of 90 μm), the image clearly showed a palatal root fracture on tooth No. 15 across from the cross-sectional and axial scan views ( figs. 1, 2). Thanks to the enhanced diagnostic quality of the images, we decided to extract the tooth. I acquired a post-extraction, small-field CBCT scan to evaluate the edentulous site for sinus health and bone height prior to sinus lift and simultaneous implant placement ( fig. 3). Measurements from the crest of the alveolar ridge to the floor of the sinus were taken at the sites of the first and second molars, and were found to be 3.8 mm of bone height and 4.8 mm of bone height, respectively. After reviewing the image, we performed a sinus lift procedure and placed two implant fixtures. A follow-up CBCT volume was taken one month later to check for overall healing, graft containment and sinus health ( figs. 4, 5). The scan demonstrated normal healing from all perspectives. The patient went on to have the implants successfully restored once integration was clinically confirmed. fig. 1 fig. 2 fig. 3 fig. 4 fig. 5 Role of CBCT in Diagnoses and Treatment Planning This was a case that clearly demonstrates the value of CBCT imaging in diagnoses and treatment planning. While the fracture was not clearly seen on a traditional 2D radiograph, it was confirmed with amazing clarity using small-field CBCT. Such an issue could have severely compromised the patient s initially proposed treatment plan. In cases where traditional 2D radiography is uncertain or inconclusive, high resolution CBCT 3D imaging may eliminate any questions or variables, and should be considered to achieve the highest standard of diagnosis and treatment. The growth of CBCT has been amazing to watch seldom do we see such a rapid growth rate in dentistry of such a high-dollar product, indicating the importance and usefulness of the technology. I have never met anyone who regrets the decision of purchasing a CBCT unit and I would advise anyone who is thinking of incorporating a system into their practice to take the plunge, they won t be disappointed. Bradley McAllister, DDS, received his Doctor of Dental Surgery degree from the University of Washington and completed his periodontal specialty training and his doctorate at the University of Texas. A board-certified diplomate of the American Board of Periodontology and International Congress of Oral Implantology, he is a part-time faculty member at the Oregon Health Sciences University. Dr. McAllister can be contacted at [email protected]. 22 CARESTREAM DENTAL Digital Practice

23 Find your freedom with CS SoftDent Cloud Discover the convenience and flexibility of around-the-clock access Spend more time with patients, less on technology. CS SoftDent Cloud provides plenty of bottom-line benefits, from cutting IT costs to improving productivity. But the biggest advantage is how it opens up more time for the most important part of your practice, your patients. Free from the chains of servers and software update hassles, you can focus on serving your patients even better. When patient data is mobile, your life is too. Access CS SoftDent Cloud from your mobile phone, tablet or ipad and on any computer, including Mac. Adding multi-locations has never been easier. Enjoy greater flexibility with offsite and HIPAA-compliant storage. For a single monthly fee, we provide all of the support, updates, upgrades, data storage and real-time data backup you need. Call or explore the Cloud here carestreamdental.com Carestream Health, Inc CS SoftDent is a trademark of Carestream Health. ipad is a trademark of Apple, Inc., registered in the US and other countries DE AD 0814

24 3D Technology From Concept to Practice: the Story of the CS D Products are launched all of the time in the dental space but just what goes into developing, manufacturing, and ultimately installing, a dental imaging product? A lot, it turns out. This is the story of the CS D, from start to finish. Idea through Development In a beige and brick, nondescript office building just outside of Paris near Disneyland Paris stands Carestream Dental s digital imaging system production hub. Featuring complete research and development, mechanical, software, embedded image reconstruction, and electrical departments, a number of imaging systems including the new CS D are developed and manufactured in this Marne-la-Vallée (MLV for short) facility. Introducing innovative extraoral technology that is accessible to all dental professionals has always been a priority for Carestream Dental. Starting with the introduction of the 8000 extraoral imaging system 12 years ago, all the way to the launch of the award-winning CS 8100 panoramic system, the CS D was part of a plan to open the door to affordable and easy-to-use imaging systems for all dental professionals. While developing the CS D system, the voice of the customer played a critical role. When we talk about voice of the customer, we re not talking about a meeting and a few phone calls, says David Roudergues, director of U.S. equipment product line management. This is rooted in a 100-year history of working side by side with doctors to develop products that are an asset and not a hindrance to their practice. Through feedback, David and his team quickly learned that real estate must be taken into consideration when introducing new technology. Many doctors wanted the benefits of CBCT, but did not want to give up too much space to the machine. Fortunately, miniaturizing is a trend across the board in the technology industry. From televisions to phones, technology is becoming more compact than ever and the CS D is no exception. When things get compact, you have to be clever, says Roudergues. Removing the laser beams for patient positioning was the first step of simplifying the unit. Without laser beams, designing the optimal process for positioning patients was important. To ensure consistent results and eliminate the risk of a retake, a bite block was developed to make positioning the patient easier. Now, the doctor simply chooses the area of interest and communicates this to the staff, says David. David Roudergues, director of U.S. equipment product line management After conducting trade trials all over the globe, with several located near the company s Atlanta headquarters, the CS D was ready to go to market. The system was officially launched in the United States at the American Association of Endodontists Annual Session on May 1, Installation, Training and Support To expedite the implementation of the CS D into the practice, a lot of energy went into the installation procedure. Using a patented process of breaking down the pieces into different parcels, one person can assemble the entire CS D unit by using the crates the machine is delivered in. With this method, installation only takes half a day. While the CS D is easy to use, its technology is still quite sophisticated. To ensure users get the most out of their machine, practices have the option of receiving a full day of training with a certified in-house trainer. The training team also developed a number of training videos that can be opened from the user interface, along with online content, user manuals, and hands-on 3D courses. To get the U.S. support team ready for the launch of the CS D, Carestream Dental sent Atlanta-based staff to France for three and a half weeks to learn the system. Upon returning to the United States, the support staff developed recorded sessions and hands-on training to get the rest of the team and Carestream Dental s national service providers ready to support the system. Experience the thoughtful design of the CS D for yourself. To schedule a demo, please call CARESTREAM DENTAL Digital Practice

25 3D Technology CS 9300 Takes the Guesswork out of Examinations Over the past few years, 3D imaging has become an important tool to the modern dental practice. 3D imaging systems provide enhanced images that allow practitioners to uncover critical information that cannot be detected when relying solely upon 2D imaging. In addition to improved diagnoses and treatment planning, practitioners who have taken advantage of 3D imaging systems have discovered an improvement in doctor-patient communication, as patients are more likely to comprehend their diagnosis when the clinician can point out the problem on a more realistic 3D image rather than a static 2D image; ultimately resulting in increased case acceptance. Today, insightful practitioners are implementing systems that give them the flexibility of both cone beam computed tomography (CBCT) and 2D imaging. The CS 9300 combines 3D technology with industry-leading panoramic imaging, and an optional one-shot cephalometric module to offer unprecedented diagnostic capabilities. The unit produces precise images in every modality enabling the user to see any anatomical examination from every angle with 1:1 accuracy. The CS 9300 features 3D imaging with up to seven selectable fields of view, ranging from 5 cm x 5 cm to 17 cm x 13.5 cm. Most important, the CS 9300 gives practitioners more control in limiting radiation exposure to patients. Adhering to the As Low As Reasonably Achievable (ALARA) principle, Low Dose mode delivers a significantly lower radiation dose than standard CBCT programs in both configurations of the CS 9300 units. In fact, it allows for 3D imaging at a lower dose than panoramic imaging. The newest technological advances in software algorithms and noise reduction processing allow the units to capture effective low-dose 3D images. Additionally, the ability to focus on a specific region of interest limits radiation to only the relevant anatomical structure(s). Low Dose also reduces the overall length of exposure, capturing images in as little as 13 seconds. Low Dose mode is available for all 3D programs, and existing units can be retrofitted with the Low Dose module. In addition to low-dose 3D, the CS 9300 also lets you keep the flexibility of incredible quality 2D panoramic and one-shot cephalometric images when desired. The CS 9300 also allows the user to collimate the imaging area based on clinical needs to further reduce radiation exposure. The unit is equipped with preview image scout technology, allowing users to evaluate patient positioning before 3D acquisition. This combination of speed, image quality and precision placement dramatically reduces the need for retakes. Optional cephalometric modality features one-shot technology that captures images in less than a second, reducing exposure time and the risk of retakes. Despite the recognized clinical benefits of 3D imaging, some practitioners are reluctant to implement a 3D system in their practice out of concern for a presumed learning curve; dental professionals seek effective and intuitive tools that make their workflow easier, not overly-complicated. In response to these concerns, Carestream Dental s 3D Imaging software can be integrated with leading imaging programs such as NobelGuide, Simplant and SureSmile. Users can examine images in stunning detail, slice-by-slice in axial, coronal, sagittal, cross-sectional and oblique views for enhanced diagnostic interpretation. CS 3D Imaging includes a sophisticated implant planning feature that comes with pre-loaded libraries from implant manufacturers, as well as allows practitioners to create their own custom implant sizes. Ultimately, 3D images deliver the most accurate view of patients anatomy for improved diagnostic treatment planning. The CS 9300 is an excellent way for professionals to integrate CBCT technology into their practices, as it offers the most extensive capabilities in one system and enables better communication between dentists and patients. This modern 3D technology impacts not only the initial diagnoses of patients but also their continual review and treatment, boosting the diagnostic confidence of the practitioner as well as the patient s confidence in their dentist. To learn more about the CS 9300, as well as Carestream Dental s other CBCT systems, please call or visit carestreamdental.com. CARESTREAM DENTAL Digital Practice 25

26 CAD/CAM CS Solutions Streamlines the CAD/CAM Restoration Process Computer-aided design/computer-aided manufacturing (CAD/CAM) technology allows users to scan, design, mill and place a crown in a single appointment, and it s changing the way dentists practice. Carestream Dental offers a robust and reliable CAD/CAM portfolio, known as CS Solutions, which includes an intraoral scanner, cone beam computed tomography (CBCT) impression scanning systems, restoration design software, and a milling machine. Step One: Prep the Tooth Prepare the tooth of interest as normal. Step Two: Scan CS Solutions is all about flexibility, so scanning can be accomplished in one of two ways digitally scan teeth with the CS 3500 intraoral scanner or use a Carestream Dental CBCT system to scan traditional impressions. With the CS 3500, practitioners can easily acquire true color 2D and 3D images (see page 28 for more details). Practitioners may also acquire scans with one of Carestream Dental s CBCT systems such as the CS D, CS 9300 or the new CS D to quickly create accurate 3D models. CBCT systems ensure comprehensive, 360 degree scans of traditional impressions, capturing every detail. Plus, using CBCT scanning is fast a full arch impression scan takes two minutes or less depending on the system. Utilizing CBCT to capture digital scans is a sensible option for many dentists. CBCT impression scanning for CAD/CAM applications enables practitioners to maintain a workflow they re familiar with since they continue to take conventional impressions. It s simple to switch from extraoral exams to impression scanning. A user-friendly interface guides users through the scanning process, and a dedicated platform optimizes impression placement on the unit. This method requires a minimal learning curve and results in less disruption to a dentist s workflow. 26 CARESTREAM DENTAL Digital Practice

27 CAD/CAM Step 3: Design Carestream Dental s CAD software, CS Restore, simplifies and automates the restoration design process for full crowns, inlays and onlays. A 3D model is ready for design with almost no manipulation; teeth are segmented and labeled; and the digital impression and antagonist are aligned by the software. Practitioners have the option to clip the size of the 3D model on the margin drawing screen, while removing adjacent teeth from view helps when drawing the margins on inlays. Free form tools allow the user to make adjustments to the restoration, such as smooth, increase, decrease and carve. CS Restore enables practitioners to create natural and functional single tooth restorations with fewer steps and clicks. Step 4: Mill The CS 3000 milling machine uses industry standard all-ceramic, hybrid ceramic or resin-based materials to mill the crown. With a milling accuracy of +/- 25 µm, the CS 3000 s four-axis brushless motor produces high-quality anatomically accurate shapes without undercuts. The system s compact design and quiet, vibrationfree milling ensures smoother surfaces for more durable results, and the average milling time for a crown is less than 15 minutes. Step 5: Finish and Place Once the crown is milled, practitioners stain or glaze the milled restoration as needed for a perfect match to the patient s teeth. Placing the finished restoration is the final step in the process no temporary crown or second appointment necessary. It s all done in less than two hours. An Open Solution CS Solutions features an open architecture, giving practitioners the flexibility to choose from several alternative solutions that can be adapted to their preferred workflow and practice layout. The open STL format files created during the scanning process can easily be imported into open third-party systems. Doctors have the choice to use digital impression files to design and mill restorations in-house in conjunction with other products in the CS Solutions portfolio or send data to a lab to be designed or milled, or both. For more information on how CS Solutions can change the way you perform restorations, please call or visit today. CARESTREAM DENTAL Digital Practice 27

28 CAD/CAM Spotlight on the CS 3500 Intraoral Scanner Traditional impressions present a number of issues for dental professionals. In addition to the costs associated with consumables (such as the trays and alginate material), patient comfort, and integrity of the impression are concerns when it comes to taking a mold of the teeth. Fortunately, the CS 3500 was designed to eliminate many of the problems associated with traditional impressions and more cumbersome scanners. Features of the Scanner Image quality and ease of use are important factors when choosing an intraoral scanner. The CS 3500 delivers on both fronts. With scanning depths ranging from -2 to +13 mm and an average precision of 30 μm, the CS 3500 allows dental professionals to capture true-color 2D and 3D images. The highquality images enable practitioners to clearly identify margin lines, undercuts, contact points and other critical anatomical details, as well as distinguish the differences between natural tooth structures and existing restorations from gingival tissues. Focusing on the patient s mouth during scanning not only expedites scan time, but also improves patient care. In light of this, the CS 3500 features a light guidance system that minimizes the need to watch a monitor during image capture by indicating when the acquisition is successful. As a truly portable scanner, the CS 3500 eliminates the trolley and proprietary computer allowing it to easily be shared between operatories. The scanner can be connected to a PC workstation or laptop via USB 2.0 cable. To ensure proper sanitation, the CS 3500 features autoclavable replaceable tips, which come in two sizes to meet your patients needs. The CS 3500 also integrates with a variety of practice management systems, which means that patient information doesn t need to be reentered when taking a scan. For further convenience, the data is stored within the patient s record in the same manner that other types of images are stored. Patient Comfort Many patients are sensitive to having impression materials in the mouth, resulting in a diminished patient experience. Not to mention, if the impression was of poor quality, they have to go through the process once more. Scanners that require powder in the mouth can also make for an uncomfortable patient experience. However, the CS 3500 does not require practitioners to apply anti-reflective spray powder or liquid to patients teeth and tissue prior to acquiring an image. The end result? Happier patients and better outcomes. Flexible, Open System with No Click Fees While the CS 3500 can be integrated with the other products within the CS Solutions CAD/CAM restoration portfolio, practitioners also have the flexibility of capturing digital impressions directly with the intraoral scanner and sending the openformat STL files to the lab of their choice without the click fees commonly imposed by other scanner manufacturers. And, because the scanner captures true-color, close-up images, this can help the lab when color matching the restoration. With the CS 3500, doctors have the option of using their preferred labs that accept digital data. Carestream Dental has partnered with a number of national dental laboratories, so practices using the CS 3500 scanner benefit from multiple options when sending the restorations off for fabrication. Currently, there are more than 100 labs that accept scans from the CS 3500, with this number growing at a rapid pace. To view the complete list of labs that can receive and work with digital impression files created from the CS 3500, please visit CS3500labs. If your preferred lab is not listed, Carestream Dental can work with the lab to ensure they can use our files. There are no fees on the lab or doctor side associated with this. For more information on the CS 3500 intraoral scanner, call or visit today. CS 3500 Benefits at a Glance Eliminate the cost of traditional impression consumables Portable can be shared between operatories Autoclavable tips come in two sizes No external heater Light guidance system streamlines image acquisition More comfortable for patients Files can be sent to more than 100 labs nationwide No click fees 28 CARESTREAM DENTAL Digital Practice

29 CAD/CAM Adapting Your Dental Practice for Today s Reality By Dan Delrose, DDS Consider this scenario: A dentist meticulously prepares an injured tooth for an ideal restoration, occlusal clearance is verified, and the dentist grabs rubber base impression material. An impression, a duplication of the preparation, is sent to the lab. The lab replicates the jaws of the patient with gypsum... and by now the distortions are already becoming exponential. What s today s reality? It s this: The analog impression material may be considered state of the art for duplicating a preparation, but it is the beginning of incorporating numerous errors, which are then reflected as the dentist delivers that restoration to the patient. Keep in mind, the patient is under the illusion that his or her dentist did all the lab work. So if the fit is a challenge, the patient may think that the dentist s work was substandard. But, in reality, the impression was the beginning of the demise. The advantage of using a digital scanner (digital impression) is you have virtually no errors. Today, most of our dental laboratory partners take the analog rubber base impressions and create digital models for virtually fabricating the restoration. Labs have known for the last few years that the digitized model will yield the most accurate model to build a restoration. But don t take my word for it. Consider this quote by Kevin Hudi of DSG Clearwater: Five years ago, less than 5% of the fixed work produced at DSG Clearwater was made using any digital technology. Currently, between 85% to 90% of the fixed cases use some form of digital technology. As the dental physician, why not give your laboratory the information they are using anyway and eliminate the errors in impressions and mounting? Or maybe fabricate the restoration in the office, where the dentist and his team control the contacts, occlusion, surface morphology, contours, and characterizations? CS Solutions was designed to meet dentists where they are, from their education level to their skillset. CS Solutions helps the neophyte dentist get involved in digital dentistry without changing his workflow. They just make the workflow more intuitive. The relevant issues for adapting a dental practice to digital impression are none. The only thing the dentist changes is how he duplicates the patient s preparation. In lieu of physical impression material, the dentist uses an intraoral scanner and takes a digital impression. Today s reality of using an intraoral scanner is as easy as using an intraoral camera, and the supporting software is very intuitive. The scanner of choice is the CS 3500, part of CS Solutions. The accuracy is comparable to any of the best intraoral scanners for this newcomer to CAD/CAM dentistry. Carestream Dental, not some third party company, developed the technology, so the support for any of the Carestream Dental products is unparalleled. Carestream Dental is the developer, the manufacturer, the distributor, and the support! The results are a better-fitting restorations, marginal integrity, occlusal relationship, mesial and distal contacts, and surface morphology. When using the CS 3500 scanner, the dentist becomes a better dentist. How? It starts when the dentist can see the preparations magnified about 30x on his workstation s monitor, not some disconnected trolley. This is better than the loupes he wears. The dentist can then easily refine his preparation and rescan with no waste of impression materials. Redoing a digital impression costs the practice nothing and will give the duplication of the preparation that the dentist and the lab desire. Also, there are no pulls or missed margins with the CS 3500 scanner. Sometimes, dentists let the impression material push the sulcus and hope they duplicate that margin. There s no hoping here you see it immediately, much larger than life. I ve mentioned monetary savings of impression material, but what is the real ROI? There are many different metrics available to show the savings in lab costs, redoing ill-fitting laboratory restorations, and wasting impression material. Using the CS 3500 scanner is a no-brainer, from the accuracy of duplication and monetary rewards. However, the real ROI is much more. There s the Wow! factor the practice gives the patients by being on the cutting edge of dentistry. Finally, don t forget that delivering the restoration in one appointment saves the patient (and you!) valuable time. Daniel C. Delrose, DDS, entered private practice in 1997 after leaving his branch prosthodontist position in the U.S. Navy. Dr. Delrose is a past president of the Academy of CAD/CAM Dentistry, a member of numerous associations, and a key opinion leader for Carestream Dental. He spends four days a week at his private practice, where he faces challenges in dentistry and solves them with technology. Contact him at [email protected]. CARESTREAM DENTAL Digital Practice 29

30 Calendar of Dental Events Reading about technology is one thing actually experiencing it for yourself is quite different. Please visit us at our summits, hands-on workshops, and tradeshows throughout the year for an interactive demonstration of our imaging and software products, as well as a personalized ROI consultation with a member of the Carestream Dental team. Conferences Dental Summit November 7-9, 2014 Oral and Maxillofacial Surgery Summit January 24-26, 2015 Orthodontic Summit March 13-15, d Hands-on Workshops October 17, Charlotte, N.C. October 17, Brea, Calif. November 14, Kirkland, Wash. November 21, Portland, Ore. November 21, Edison, N.J. For more information on Carestream Dental s 3D hands-on courses and to sign up please visit CarestreamDental.com/3Dcourses. CS Solutions Intraoral Scanning and CAD/CAM Events Digital Impressions and Chairside Restorative Dentistry September 24, Washington, D.C. Digital Impressions and Chairside Restorative Dentistry September 26, Minneapolis, Minn. Digital Impressions and Chairside Restorative Dentistry October 17, St. Louis, Mo. Digital Impressions and Chairside Restorative Dentistry October 25, Dallas, Texas Digital Impressions and Chairside Restorative Dentistry November 7-8, Atlanta, Ga. Streamlining Your Practice with Digital Impressions November 14, Boulder, Colo. Digital Impressions and Chairside Restorative Dentistry November 15, Parsippany, N.J. Streamlining Your Practice with Digital Impressions December 5, Chicago, Ill. Digital Impressions and Chairside Restorative Dentistry December 6, Atlanta, Ga. Digital Impressions and Chairside Restorative Dentistry December 6, Scottsdale, Az. For more information on Carestream Dental s hands-on CS Solutions workshops and to sign up please visit CarestreamDental.com/2014Solutions. Major Trade Shows American Dental Association October 9-11, San Antonio, Texas Greater New York Dental meeting November 30-December 3, New York, N.Y. Yankee Dental Congress January 29-31, Boston, Mass. Chicago Mid-Winter February 26-28, Chicago, Ill. Hinman Dental March 26-28, Atlanta, Ga. California Dental Association South April 30-May 2, Anaheim, Calif. Visit for a complete list of events. 30 CARESTREAM DENTAL Digital Practice

31 TECHNOLOGY THAT WORKS THE WAY YOU DO DEJ SHARPNESS PERIO C CUSTOM ENDO LOGICON RVG 6200 FULL RANGE IMAGING FOR DIAGNOSTIC CONFIDENCE RVG 6200 intraoral sensor technology is built with you in mind. Image processing tools can be customized through new user-defined and pre-programmed filters to assist your optimal diagnosis. With an intuitive approach the RVG 6200 delivers: ENHANCED WORKFLOW optimized to the extreme: Position. Expose. View. ROBUST DESIGN for maximum durability SUPERIOR ERGONOMICS for best-ever patient comfort BROAD EXPOSURE RANGE during image capture NEW IMAGE PROCESSING TOOLS customized to your preference SERVICE MADE SIMPLE simple installation and compatible LET S REDEFINE EXPERTISE The RVG 6200 is just one way we redefine imaging. Call or visit carestreamdental.com to discover more. Carestream Health, Inc RVG is a trademark of Carestream Health DE RVG 6200 AD 0814

32 Catherine s pain was unbearable. Dr. Thomas Bissell, Chester, New Jersey, with Catherine Dr. Bissell s desire to cure it was unstoppable. Catherine had visited several physicians and dentists, but nobody could find the origin of her intense tooth pain. Then Catherine found Dr. Bissell, who combined his passion for helping patients with the power of the CS D. With that one scan, Dr. Bissell was able to give Catherine the one thing she wanted to hear: a diagnosis. After a successful treatment plan, Catherine now has a pain-free life. And her beautiful smile back. Learn more about how the CS 9300 system redefined Catherine s life. Visit Carestream Health, Inc DE AD 0814