2. ProMax 3D all in one ProMax 3D – Cone Beam Volumetric Tomography
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

3. Upgradeable to all Planmeca ProMax units
New diagnostic possibilities – in dental office

4. Planmeca ProMax
Easy modality change

5. 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)‏

6. 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

7. 3D image volume sizes (dia mm x height mm)‏ Full Size 80 x 80
Maxilla x 50
Mandible x 50
Molar Maxilla x 50
Molar Mandible 40 x 50
Programs to match diagnostic task
Minimize radiated volume

8. Stitching – 3D Large View
Stitches 2 or 3 volumes together horizontally or vertically
Increases the volume size diameter -> 16cm height -> ~13 cm

9. Stitching – 3D Large View
Stitching examples

10. 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
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
Used in Large View mode

11. Comprehensive viewing tools
Planmeca Romexis
Planmeca Romexis software modules for 3D imaging
3D Explorer
3D panoramic view
Implant planning
3D Viewer
DICOM
Comprehensive viewing tools

12. 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

13. 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

14. Planmeca Romexis 3D panoramic
conventional pan
3D panoramic view
No redundant shadows

15. Planmeca Romexis 3D Cross Sections and Implant planning modules
3D panoramic with adjustable cross section views
Mandibular nerve marking
Measurements
Implant placement
Implant models

16. 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

17. Planmeca Romexis 3D DICOM
Standard:
DICOM media import/export
DICOMDIR import export
Optional:
DICOM Storage
DICOM Print
DICOM Worklist
....
3D image transfers via DICOM

18. 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

19. 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

20. 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
Video on ”inserted object”, eli pakattu sisään esitykseen. EH

21. 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 – 8.3 seconds – reduced dose
number of original images is a result of evaluation at the clinical tests
reduced number of original images saves dose, but compromizes image quality

22. 3D Technology
Pulsed X-ray produces sharp images with less dose.

23. 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 pulse length evaluated at clinical test. Initial length 20 ms. Shorter reduces motion unsharpnes, but rduces pulse power, which increases noise in the image

24. 3D Technology – Flat Panel
Planmeca ProMax 3D flat panel imaging chain
Conventional imaging chain with Image Intensifier
X-ray Tube – Patient – Flat Panel - Digital Image
X-ray Tube – Patient – Image Intensifier – TV Camera – Digital Image
Modern Flat Panel Technology for maximum performance

25. 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.

26. 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
less
more

27. 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
Medical CT is decades old technology

28. Planmeca Promax 3D and N-Liten
Planmeca ProMax 3D works with N-Liten

29. Planmeca ProMax 3D and Simplant
Planmeca ProMax 3D works with Simplant

30. Planmeca ProMax 3D and Procera
Nobel Guide impression with markers
Planmeca ProMax 3D works with Procera/NobelGuide

31. Radiation dose Low radiation dose compared to medical CT
Medical CT uSv
Dr Stuart White, UCLA
Radiation dose of CBCT µSv
Same level as 5-10 panoramic images
Same level as full mouth series with film
Essentially lower than medical CT
ProMax 3D µSv (8 x 8 cm), 18 – 80 µSv (4 x 5 cm)
Dig. Pan uSv
FMS 150 uSv
Dr Sharon Brooks, O of Michigan
Low radiation dose compared to medical CT

32. Planmeca ProMax 3D vs Sirona Galileos
Floor space
1.2 x 1.2 m
1.6 x 1.6 m
With Pan/Ceph
yes No
additional office space needed
Patient
seated/standing
flexible, faster
seated
Sensor type
flat panel
Image Intensifier
geometric distortion
Field of view, cm
8x8, 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
10x more radiated volume
Radiated volume for a molar implant study
4x5 cm, 63cm3
42x more radiated volume

33. Planmeca ProMax 3D vs Sirona Galileos
Voxel size, mm
0.16
smallest voxel
0.3
Gray scale
12 bit ?
Scan angle
194 deg
less motion artefacts
270
Scan time
18 s
15 s
kV range
50-84 kV
adjustable according to patient size/age
90 kV
mAs range
12-90 mAs
more powerful generator
28 mAs
Pulsed X-ray
yes
System calibration
No need
Periodical
Software
intra, pan, ceph, 3D integrates to PMS Quick Launch
3D only
isolated

34. Planmeca ProMax 3D vs i-Cat
Floor space
1.2 x 1.2 m
1.3 x 1.5 m
With Pan/Ceph
yes no
additional office space needed
Patient
seated/standing
flexible, faster
seated
Sensor type
flat panel
Field of view, cm
8x8, 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 volume
17x11 cm 2496 cm3
6x more radiated volume for the same clinical need
Radiated volume for single jaw implant study
8x5 cm, 251 cm3
17x7 cm 1588 cm3
6x more radiated volume
Radiated volume for a molar implant study
4x5 cm, 63cm3
17x4 cm 908 cm3
14x more radiated volume

35. Planmeca ProMax 3D vs i-Cat
Voxel size, mm
0.16
smallest voxel
0.4, 0.3 (17x13), 0.2 (17x7)‏
Gray scale
12 bit
Scan angle
194 deg
less motion artefacts
360 deg
Scan time
18 s
10/20/40 s
kV range
50-84 kV
adjustable according to patient size/age
120 kV
additional radiation protection needed
reduced contrast
more scatter
mA range
2-15 mA
more powerful generator
3-8 mA
Pulsed X-ray
yes
System calibration
No need
Daily
Software
intra, pan, ceph, 3D integrates to PMS Quick Launch
3D only
isolated

36. The End More information: Erkki Hiltunen Product Manager, X-rays
tel:
More information:
Osku Sundqvist
Product Manager, Software
tel: