ProMax 3D

• ProMax 3D – Cone Beam Volumetric Tomography• all in one

– 3D – Panoramic– Tomography– Cephalometry

• Simple and easy patient positioning• Robotic SCARA movement,

adjustable volume place • Selectable image volume size• Latest flat panel technology• Pulsed X-ray generator

all in one

Upgradeable to all Planmeca ProMax units

New diagnostic possibilities – in dental office

Planmeca ProMax

Easy modality change

Simple and easy patient positioning

• New patient support for 3D imaging• Patient standing or sitting

•kV/mA automatically selected according to patient size (possibility to overdrive)

3D image volume location

Pre-programmed areas for• dentition • TMJ and ramus• Ear• Sinus• Vertebrae• Airways

• Position adjustment possible with SCARA arm• Fine adjustment with joystick• Easy positioning

3D image volume sizes

(dia mm x height mm)•Full Size 80 x 80•Maxilla 80 x 50 •Mandible 80 x 50•Molar Maxilla 40 x 50•Molar Mandible 40 x 50

•Programs to match diagnostic task

•Minimize radiated volume

Stitching – 3D Large View•Stitches 2 or 3 volumes

together horizontally or vertically

• Increases the volume sizediameter -> 16cmheight -> ~13 cm

Stitching – 3D Large View

Stitching examples

Imaging modes• High resolution mode

• Very high resolution for high precision imaging

• 0.16 mm voxel• Effective exposure time 12 s• Patient dose 50% lower than

before• Normal resolution mode

• High resolution with 50% lower dose

• 0.32 mm voxel• Effective exposure time 12 s• Optimized for implant planning in

Simplant and Procera• Small volume size 30 MB

• Low dose mode• 0.32 mm voxel, lower resolution • Effective exposure time 2.8 s• 90% lower dose• Small volume size 30 MB• Used in Large View mode

Planmeca Romexis

Planmeca Romexis software modules for 3D imaging

• 3D Explorer• 3D panoramic view• Implant planning• 3D Viewer• DICOM

Comprehensive viewing tools

Planmeca Romexis 3D Explorer

•3D volume viewing:• Image acquisition•sagittal, coronal and axial

views•real time adjustable

viewing angles•contrast & brightness•measurements•export as DICOM•Quick Launch

•Fast and convenienat multi-planar projection viewing

Planmeca Romexis 3D Panoramic module

• Focal through path defined by user on axial view • Layer thickness selectable

and constant• No redundant shadows or

artefacts• Constant magnification• Free selectable panoramic

layer

conventional pan

3D panoramic view

Planmeca Romexis 3D panoramic

No redundant shadows

Planmeca Romexis 3D Cross Sections and Implant planning modules•3D panoramic with

adjustable cross section views

•Mandibular nerve marking•Measurements•Implant placement•Implant models

Planmeca Romexis 3D Viewer

•Included in CD with 3D studies

•Basic viewing and measurements

•Includes Explorer, Panoramic and Cross Section views depending on master licence

•Requires Java•Enables 3D study viewing

remotely

Planmeca Romexis 3D DICOM

•Standard:•DICOM media import/export•DICOMDIR import export

•Optional:•DICOM Storage•DICOM Print•DICOM Worklist• ....

3D image transfers via DICOM

3D Quick Launch

Planmeca Romexis 3D Explorer with Quick Launch Button• Starts alternative implant planning software through

DICOM : Simplant, Cybermed N-Liten3D • Transfers open patient study and patient ID

• Fast and convenient integration:• Romexis 3D Explorer is used to control and acquire

ProMax 3D study• 3rd party software is used to manipulate the study as

desired

Planmeca ProMax 3D and Cephalometry

•Digital Ceph ideal for cephalometry• all information for

orthodontic planning• lower radiation dose• faster procedure

•3D to be used for detailed e.g. occlusion views, inpacted teeth etc.if needed

•Same Promax unit for both studies

•Optimum for orthodontic imaging

3D Technology

• CBCT - Cone Beam Computed Tomography• CBVT - Cone Beam Volume

Tomography

• Technological advance from traditional fan beam CT• Image data is a cylinder,

not a set of single slices

• Click here to play movie

Windows Media Audio/Video file

3D Technology

•One 18 second scan•194 degrees scan angle•300 snap shot images

taken with synchronized X-ray pulses

•Stroboscopic effect for maximum clarity of the images

•Accumulated X-ray exposure time is 2.8 – 8.3seconds – reduced dose

3D Technology

Pulsed X-ray produces sharp images with less dose.

3D Technology

• 300 basic images• Proprietary 3D

reconstruction algorithm• Image volume is

8 x 8 cm cylinder of 120 million voxels

• Voxel size 160 x 160 x 160 µm

• Corresponds to 3 lp/mm (Nyquist)

X-ray Tube – Patient – Image Intensifier – TV Camera – Digital Image

X-ray Tube – Patient – Flat Panel- Digital Image

Modern Flat Panel Technology for maximum performance

3D Technology – Flat Panel

Planmeca ProMax 3D flat panel imaging chain

Conventional imaging chainwith Image Intensifier

3D Technology – Flat Panel

•Image intensifier has both distortion and brightness non-uniformity which is absent from the flat panel detector

•Image intensifier needs periodical maintenance. It has limited life span 3-6 years.

• It is sensitive to magnetic or electrical fields.

• It is over 60 years old technology.

3D technology – Tube Current Modulation

• Different attenuation properties across and along the patient's head

• Tube current (mAs) can be dynamically adjusted

• Reduces patient dose and improves image quality

more

less

Medical CT is decades old technology

3D vs Medical CT

•Planmeca ProMax 3D: •cone beam•194 degrees = half a circle •18 seconds scan•6 seconds pulsed X-ray

•Medical CT with 0.6 mm slice:

•fan beam•16 spiral rounds•continuous X-ray

Planmeca Promax 3D and N-Liten

Planmeca ProMax 3D works with N-Liten

Planmeca ProMax 3D and Simplant

Planmeca ProMax 3D works with Simplant

Nobel Guide impression with markers

Planmeca ProMax 3D and Procera

Planmeca ProMax 3D works with Procera/NobelGuide

Radiation dose

• Radiation dose of CBCT 30- 900 µSv

• Same level as 5-10 panoramic images

• Same level as full mouth series with film

• Essentially lower than medical CT• ProMax 3D 45-200 µSv (8 x 8 cm),

18 – 80 µSv (4 x 5 cm)

Low radiation dose compared to medical CT

Medical CT 1200-3300 uSvDr Stuart White, UCLA

Dig. Pan 4.7-14.9 uSvFMS 150 uSvDr Sharon Brooks, O of Michigan

Planmeca ProMax 3D vs Sirona GalileosPlanmeca Promax 3D Sirona Galileos

Floor space 1.2 x 1.2 m 1.6 x 1.6 m

With Pan/Ceph yesNo •additional office space needed

Patientseated/standing•flexible, faster

seated

Sensor type flat panelImage Intensifier•geometric distortion

Field of view, cm8x8, 8x5, 4x5, cylinder•FOV selectable to diagnostic task

15x15, sphere

Rotation location movable (SCARA robot arm) fixed

Radiated volume for complete dentition

8x8 cm, 402 cm3

15x15 cm 2650 cm3

•6x more radiated volume for the same clinical need

Radiated volume for single jaw implant study

8x5 cm, 251 cm3 15x15 cm 2650 cm3

•10x more radiated volume

Radiated volume for a molar implant study

4x5 cm, 63cm3 15x15 cm 2650 cm3

•42x more radiated volume

Planmeca ProMax 3D vs Sirona GalileosPlanmeca Promax 3D Sirona Galileos

Voxel size, mm0.16•smallest voxel

0.3

Gray scale 12 bit ?

Scan angle194 deg •less motion artefacts

270

Scan time 18 s 15 s

kV range50-84 kV•adjustable according to patient

size/age90 kV

mAs range12-90 mAs•more powerful generator

28 mAs

Pulsed X-ray yes yes

System calibration No need Periodical

Softwareintra, pan, ceph, 3D integrates to PMSQuick Launch

3D onlyisolated

Planmeca ProMax 3D vs i-CatPlanmeca Promax 3D I-Cat

Floor space 1.2 x 1.2 m 1.3 x 1.5 m

With Pan/Ceph yesno•additional office space needed

Patientseated/standing•flexible, faster

seated

Sensor type flat panel flat panel

Field of view, cm8x8, 8x5, 4x5, cylinder•FOV selectable to diagnostic task

16x22, 17x13, 17x11, 17x7, 17x4cm, cylinder

Rotation location movable (SCARA robot arm) fixed

Radiated volume for complete dentition

8x8 cm, 402 cm3

16x22 cm 4421 cm3

•11x more radiated volume17x11 cm 2496 cm3

•6x more radiated volume for the same clinical need

Radiated volume for single jaw implant study

8x5 cm, 251 cm317x7 cm 1588 cm3

•6x more radiated volume

Radiated volume for a molar implant study

4x5 cm, 63cm317x4 cm 908 cm3

•14x more radiated volume

Planmeca ProMax 3D vs i-CatPlanmeca Promax 3D I-Cat

Voxel size, mm0.16•smallest voxel

0.4, 0.3 (17x13), 0.2 (17x7)

Gray scale 12 bit 12 bit

Scan angle194 deg •less motion artefacts

360 deg

Scan time 18 s 10/20/40 s

kV range50-84 kV•adjustable according to patient

size/age

120 kV•additional radiation protection

needed•reduced contrast•more scatter

mA range2-15 mA•more powerful generator

3-8 mA

Pulsed X-ray yes yes

System calibration No need Daily

Softwareintra, pan, ceph, 3D integrates to PMSQuick Launch

3D onlyisolated

The End

More information:Erkki HiltunenProduct Manager, X-raystel: +358 20 7795 456 erkki.hiltunen@planmeca.com

More information:Osku SundqvistProduct Manager, Softwaretel: +358 20 7795 793osku.sundqvist@planmeca.com