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

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 size diameter -> 16cm height -> ~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 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

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

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

Planmeca Romexis 3D panoramic conventional pan 3D panoramic view 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 Video on ”inserted object”, eli pakattu sisään esitykseen. EH

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

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

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

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 less more

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

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

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

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

Radiation dose Low radiation dose compared to medical CT Medical CT 1200-3300 uSv Dr Stuart White, UCLA 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) Dig. Pan 4.7-14.9 uSv FMS 150 uSv Dr Sharon Brooks, O of Michigan Low radiation dose compared to medical CT

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

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

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

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

The End More information: Erkki Hiltunen Product Manager, X-rays tel: +358 20 7795 456 erkki.hiltunen@planmeca.com More information: Osku Sundqvist Product Manager, Software tel: +358 20 7795 793 osku.sundqvist@planmeca.com