Page 17 - PlanWorld 2019 EN demo

Dr. Michael Bornstein is a Clinical Professor in
Oral Maxillofacial Radiology and Associate Dean
for Research and Innovation at the University
of Hong Kong. He has followed the ongoing
evolution of low dose CBCT imaging closely,
encourages all clinicians to increase their use
of dose limitation measures, and states that
patient doses will only continue to get lower
going forward.

DR. BORNSTEIN is one of the leading CBCT imaging experts It was always possible to manually adjust the dose levels
in the dental community. He was also one of the speakers at of various X-ray units, but this was just not that easy. Various
Planmeca’s stand at IDS 2019 in Cologne, Germany, with manufacturers have also struggled to maintain a diagnostically
a presentation entitled Low dose CBCT protocols in dental medicine acceptable image quality at lower doses.
and their impact on daily clinical practice. It covered the changes In turn, deploying Planmeca Ultra Low Dose™ is as easy as
and paradigm shifts that have taken place in the field of dental 3D pressing a button. It can be used with any resolution or volume size,
imaging, with a particular emphasis on low dose protocols. as the protocol does not rely on taking fewer frames or using
Cone beam computed tomography – or CBCT – is an imaging a smaller rotational angle to lower the patient dose.
technique that has been a game-changer in dentistry over “Planmeca was one of the first to come up with a pre-set
the last decades. It has allowed clinicians to easily acquire three- modality that makes it very easy to apply dose limitation measures.
dimensional images that have a significantly higher diagnostic By doing this, they were also leading the path for many others.”
value than traditional 2D images.
However, this improvement is not one completely without The broad field of radiology
downsides as the additional dimension comes at the cost of Dr. Bornstein went to dental school at the University of Basel in his
higher effective patient doses. Their exact biological effects native country of Switzerland and then proceeded his studies to
have been hard and sometimes even impossible to measure, become an oral surgeon. Working as a dentist further expanded his
but potential harm from radiation dose levels still should not interests and led him to the world of oral maxillofacial radiology and
be ignored. diagnostic imaging.
Although the risks of CBCT imaging are very small to He quickly noticed that radiology is a quite extensive discipline
individuals, they are still significant when examined in the context that encompasses not only 2D and 3D X-ray imaging but also
of large population bases. Dr. Bornstein states that 6 to 8 patients ultrasound and magnetic resonance imaging in some countries.
per million are at risk of getting cancer that is related to dental “Radiology is a broad and challenging field. Because it is so
imaging in their lifetime. This is why ways to reduce patient doses technically-driven, it is also very innovative. I think these factors
without losing diagnostic image quality are considered together have kept me so interested and enthusiastic about it,”
so valuable. Dr. Bornstein elaborates.
Over the past five years, there has been an ongoing shift in Although he now resides in Asia, IDS still holds a special
the minds of radiologists from ALARA to ALADA – from capturing significance for Dr. Bornstein – as is the case for countless other
images that are As Low As Reasonably Achievable to As Low As dental professionals worldwide. In fact, he has witnessed the
Diagnostically Acceptable. international atmosphere significantly strengthen at the exhibition
You could even say that finding an optimal balance between over the years.
image quality and dose is at the core of modern dental imaging. “Being from Switzerland, IDS has always been on my agenda,
Dr. Bornstein’s own research has indicated that images can although I don’t go every time. In contrast to many other fairs and
be diagnosed as intended also when using ultra low dose exhibitions, it seems to still be growing, and has become more and
imaging protocols. more international,” Dr. Bornstein comments.
“20 years ago, IDS was still very European and German-centric.
From low to ultra low Now, I think it has become much more of a global village
The Planmeca Ultra Low Dose imaging protocol has been leading for dentistry.”
the way in patient dose minimisation over the last five years.
According to research done by John Barrett Ludlow and Juha No limit to how low doses can go
Koivisto a few years back, a mean dose reduction of 77% can Although significant strides have already been made in lowering
be achieved using it as part of CBCT imaging. This figure is set patient doses to levels unimaginable in previous decades,
to improve further with Planmeca’s R&D team steadily working Dr. Bornstein still sees much room for improvement ahead.
towards new technological breakthroughs. “I would say there is no limit really to how much lower doses can
Dr. Bornstein views low dose imaging not only as a mere go. 10 years ago, nobody would have even said that ultra low dose
technological question but also one intricately related to usability. imaging would provide reasonable image quality, so I hope this shift
“We all talk about digital workflows, but they are not always that will continue,” he says.
easy to implement. That is why they need to be straightforward “Maybe in 10 or 20 years the term low dose will not even
and intuitive. I think it is safe to say that our smartphones, for be applied anymore, because all 3D imaging will be low dose.
example, would have never become so popular if they would be Maybe the low doses we talk about today are the regular doses of
very difficult to use.” the future. ◢

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