Introduction to Scanning for Cranial Remolding Helmets 1

Course Topics Orientation to hardware and software Cranial Helmet Applications Remolding Helmets: Shape Capture & Modification Protective Helmets 2

OMEGA Tracer Shape Capture Modification Fabrication 3

Fabrication Fabrication Partner Becker ContourMed Danmar Orthomerica 4

Orientation to Hardware and Software 5

Computer Basics Turning computer on Opening software Security Key Internet connection 6

Security Key Maintenance Allow the software to shut completely down prior to removing the security key Premature removal can cause the key to have a fatal error Replacement is the only option if this occurs

File Management Email Software updates Checking In Importing/Exporting Sending to a carver 8

Software Basics Opening a file Saving files / general file management Open sample file John Doe Saving files / general file management Screen Areas Start, Modify and Assistant screens Menus Rotating the model Right and Left mouse controls 9

Orientation Indicator Current Mouse Controls Tracer Menus Tabs Model Area Status Area Notes Area Orientation Indicator Unit of Measurements Current Mouse Controls Left/Right

Modify vs. Assistant Screen Modify Screen Assistant Screen 11

Introduction to Basic Tools and Functions Smoothing Options Build & Carve Undo Preferences 12

Smoothing functions are applied using the Right mouse button Smoothing Modes Smoothing functions are applied using the Right mouse button Fill Only fills the lows Sand Only sands the peaks Blend Averages highs & lows 13

Too Much of a Good Thing… Blend Maximum Blend Maximum Sand Sand 14

Size of Work Area 1” Standard 2” Large ½” Small 15

Build & Carve functions are applied using the Left mouse button How they work Speed dependent Fixed amount The differences between the two Work path size How wide is the “bit” being used Predefined and Custom Sized 16

Build & Carve Work Path of 2” Fixed Amount Speed Dependent Build Carve .5” 1” .5” Carve Fixed Amount Speed Dependent 17

Smoothing vs. Build/Carve Fill Sand Carve 18

Turning ‘Off’ Tools Most Modification Tools can be turned ‘OFF’ by: pressing Esc on the keyboard pressing Stop on the Assistant Screen Opening or starting another tool 19

Set Up Preferences and Tool Options Units of measurement Print options Leave Distal End Open when appropriate Cranial Measurement Method Options Smart blend shortcut set to B 20

Introduction to Shape Capture with the OMEGA Scanner 21

OMEGA Scanner Officially Approved as a Class 1 Laser Device No eye protection necessary Patient movement accommodated during cranial scanning Child can stay in parent’s lap during scanning 22

OMEGA Scanner LEDs illuminate reflective targets on the surface Lasers are used to determine the contours for the surface High resolution digital cameras “see” the lasers and record the position of the reflective targets 23

OMEGA Scanner Features Capable of scanning directly over skin, sock, liner, plaster, or foam Able to scan complex and intricate or detailed shapes and surfaces Can merge two scans to create a shape Can pause and resume during scanning session 24

Completely Portable! 25

Using the Scanner Hold the Scanner approximately 12” from the surface to be scanned Aim toward the center of the area to be scanned & press the trigger Move the Scanner to follow the contours of the surface Green light = OK Red lights = too close or too far 26

Calibration/Optimizing the scanner Optimizing should be performed whenever the scanner has been shipped or transported or if there is difficulty scanning in a surface. If the scanner does not ‘travel’, optimizing once a month is sufficient. Each scanner has it’s own specific optimizing plate that is located in the base of the scanner case. Make sure the serial number on the scanner and the optimizing plate match before optimizing 27

Cranial Remolding Helmets 28

Measurement Methods and Preferences Select the measurement method you will be using Custom Measurements Loveday / Tracer Searched 29

Scanning for Cranial Remolding Helmets OMEGA Scanner provides quick, non-contact shape capture 30

Preparation for Scanning Apply scanning cap Identify landmarks 31

Lt. & Rt. Frontozygomaticus Landmark Guide Landmark Basic Comparison Full Reporting Becker Glabella  Anterior Midline Lt. & Rt. Frontozygomaticus Lt. & Rt. Eurion Lt. & Rt. Top of Ears Lt. & Rt. Tragion Nasal & Subnasale Opisthocranion 32

Cranial Landmarks 33

Cranial Landmarks Defined • Eurion [eu]: The most lateral point on the head (identified in opposition) • Frontozygomaticus [fz]: The most lateral point on the frontozygomatic suture (temporal crest of the frontal bone). • Glabella [g]: The most prominent point in the medial sagittal plane between the supraorbital ridges • Nasion [n]: The midpoint of the nasofrontal suture • Opisthocranion [op]: The most prominent point on the occiput • Subnasale [sn]: In the midline, the junction between the lower border of the nasal septum and the cutaneous portion of the upper lip. • Tragion [t]: At the notch above the tragus of the ear where the upper edge of the cartilage disappears into the skin of the face. • Vertex [v]: The highest point on the head with the head in the Frankfort horizontal plane 34

Cranial Practice Capture the shape Modify Prepare for fabrication Do not use training rod on patients when scanning for cranials. 35

Most Commonly used Tools for Cranial Modifications Relief Pad Symmetry: Copy Region Left/Right Shift Area Build & Carve Trimline 36

How to save them for repeated use? Relief Pads What are Relief Pads? How to create them? How to save them for repeated use? When to use them? 37

Creating and Saving Relief Pads Relief Pads: Custom and Predefined Provides the ability to create and save a specific region in a desired shape, size and amount of change. A Relief Pad can be a build up or an excavation Relief Pads can be created then saved for repeated use on future shapes. Predefined or ‘saved’ relief pads can be edited for shape, size and amount of change. 38

Anatomy of a Relief Pad 1st: Identify Apex First Perimeter of region 1st: Identify Apex First Area of maximum amount of Build up or excavation. 2nd: Identify Outer Perimeter of Region The area the build up or excavation will be blending or the ‘skived’ edge of the total area to be affected. 39

Assigning a Build Up 3rd: 4th: Determine the amount of build up Using the slider, select the maximum amount of build up at the Apex 4th: Save Relief Pad for future use Relief Pads can be saved for repeated use by selecting the Save button on the Raise/Lower screen 40

When to use Relief Pads? Relief Pads: Custom and Predefined Excellent modification tool option for: Plagiocephalic deformities Scaphocephalic deformities Brachycephalic deformities 41

Symmetry: Copy Region What is Symmetry: Copy Region? How to use Symmetry: Copy Region? When to use Symmetry: Copy Region? 42

What is Symmetry: Copy Region? Symmetry: Copy Region Left/Right Provides the ability to identify a region to be mirrored to the corresponding opposite side of the model. 43

How to use Symmetry: Copy Region? 1st: Identify Region Identify the area to either be copied To or From. This example displays area to be copied From. 2nd: A mirror image of the region is created A corresponding region is created in the mirror image of the original region on the opposite side of the model. Note: For best results, select Copy Surface Contour Only. 44

How to use Symmetry: Copy Region? 3rd: Determine the copy percentage Using the slider, select the amount of mirroring to take place, 0-100%. 45

When to use Symmetry by Region? Symmetry : Copy Region Left/Right Excellent modification tool option for: Plagiocephalic deformities Scaphocephalic deformities, ONCE side of head is modified to the desired shape and contour. Contraindicated for Symmetrical Brachycephalic deformities 46

Shift Area What is Shift Area? How to use Shift Area? When to use Shift Area? 47

What is Shift Area? Shift Area: Works like a ‘heat gun’ tool to shift or move an area The defined area can be edited The greatest amount of changed is confined to single point apex Can shift or move an area in more than one direction 48

How to use Shift Area? 1st: Identify Center of Shift Area of maximum amount of Build up or excavation. 2nd: Identify Distance from Center The area the build up or excavation will be blending or the ‘skived’ edge of the total area to be affected. 49

How to use Shift Area? 3rd: 4th: Edit the shape of the region or area To further define or edit the shape of the area selected, pull and drag the blue lines using the left mouse button 4th: Shifting the Area Use the cursor or the arrows on the keyboard to shift the area as needed. Note: This is a ‘View Dependent’ tool, orientate the model as needed to pull and drag the surface of the model 50

When to use Shift Area? Shift Area: Excellent modification tool option for any area that does not require an apex sustained over a large area. 51

Other tools to consider Extend Skeletal Fit Adjust Tool Pages Modification Wizards 52

Length Changing Options Extend or shorten the model using these methods: By Amount By Set Height Interval By Pulling Tissue 53

Using the Extend Options? Extend or shorten the model By Amount: Provides the ability to change the length between two points by a specified amount. Ex: Increase length by .5” Set Height Interval: Provides the ability to specify a length between two points. Ex: Distance from Glabella to Opisthocranion equals 15cm By Pulling Tissue: Allows you to “pull” the distal end of the model by an amount entered while locking the model at the level indicated by Top of Section and maintaining the volume constant. Ex: Elongation of socket by .5” 54

What is the Adjust tool? Adjust: Provides the ability to adjust a model’s circumference, volume, A/P and M/L at specified levels. 55

Select an Adjustment Mode Adjust ‘Modes’ 1st: Select an Adjustment Mode 56

Adjust 2nd: Identify level to be adjusted. Select from the list of landmarks provided 57

Adjust 2nd continued : Identify level to be adjusted Click directly on the model to create custom landmarks 58

3rd : Specify new measurement or amount of change. Adjust 3rd : Specify new measurement or amount of change. Enter the desired amount, or the amount you wish the measurement to change by with the use of a + or – sign. To prevent a specific level from being adjusted enter +0 or click on the ‘Current’ measurement being displayed 59

Adjust 4th : Preview 5th : Lock Select Preview to view the desired changes. 5th : Lock Select Lock to keep the desired changes. 60

What is Skeletal Fit? Skeletal Fit: Provides the ability to set a caliper distance or measurement between two points on a shape 61

Skeletal Fit 1st: Place Arrows These arrows will always be opposing each other. Arrows can be placed by selecting a landmark from the list or by using the left and right mouse buttons as indicated. 62

Skeletal Fit 2nd: Determine movement of arrows. Three options provided: Move each arrow equally Move Red Arrow Only Move Green Arrow Only 3rd: Determine Desired Measurement The Current Measurement will be displayed. Enter the Desired Measurement 63

Skeletal Fit 4th: Applying Lock Points Lock points provide the ability to isolate an area for modification and ‘lock’ or prevent the rest of the model from changing. Add Lock Points to apply. These white arrows essentially build a fence around the area to be modified. Select Done with Lock Points once finished. 64

Skeletal Fit 5th : Preview 6th : Lock Select Preview to view the desired changes. 6th : Lock Select Lock to keep the desired changes. 65

Skeletal Fit 3rd : Determine Desired Measurement The Current Measurement will be displayed. Enter the Desired Measurement 66

What are Tool Pages? Tool Pages: Model specific tool screens that display the useful tools for a specific type of model on one easy to use page. 67

Areas to consider Asymmetrically sloping crown or forehead Neck Extensors Mastoid processes Occipital condyles Over-modifying or 100% mirroring 68

Modification Options by Deformity Modification for Plagiocephaly: Consider using Relief Pad and/or Copy Region Symmetrical Brachycephaly: Consider using Relief Pad Asymmetrical Brachycephaly: Scaphocephaly: Consider using Relief Pad to create the contour of one side, then use Copy Region Left/Right to mirror the contour to the opposite side. Craniosynostosis: Consider using the Adjust tool modification models for changing circumference, M/L or A/P 69

Cranial Comparison Tool Access through the tools menu > cranial comparison Current Model will be shown Browse or use drop down list to select comparison model to superimpose on this model Create Report using the ‘report’ button

Cranial Comparison Tool Allows you to track the progress of a patient by comparing two scans to each other 71

Cranial Asymmetry Report 72

Ordering From Becker, Danmar or Orthomerica

Requirements for Using Cranial Fabrication Services Must be certified or licensed orthotist Must have cranial remolding orthosis experience Must be current on OMEGA account status Must have OMEGA Tracer Version 10.5 or greater Prior to placing first order, must obtain pre-approval as follows…

Limits to Cranial File Size Cranial Shape File size must not exceed 10MB Large photo files attached can stop the file from going through Confirm with fabricator that file was received

Review/Summary Review the series of patient care steps that will now be part of your routine How to get help Additional functional capabilities with the hardware & software Next steps 76

Resource Materials Manuals Available in PDF form Click on any item in Table of Contents or Index to go to desired page 77

Any questions? Thank You 78

Introduction to Scanning for Cranial Remolding Helmets 79