3D a dental diagnostic tool

Dr. Thomas Lovlien, left, and Dr. Duncan Puffer and Northern Oral & Maxillofacial Surgeons are now using three-dimensional images to more accurately identify bone density, bone height, unerupted teeth and impacted teeth as well as to assess bone quality, anatomic features and their exact spatial dimensions. (Submitted Photo)

A 22-year-old man discovered the source of his constant toothache when oral surgeon Duncan Puffer showed him an x-ray that revealed a second tooth growing into the roots of a molar. The image was taken on a new 3D radiograph apparatus recently purchased by orthodontist Thomas Lovlien and the Northern Oral & Maxillofacial Surgeons group consisting of Duncan Puffer, DDS; Charles Babst, DDS; Marty Espe, DDS, MD and Peter Mayer, DDS, MD.

"In this case, the three-dimensional digital image allowed me to pinpoint the exact source of the patient's pain, and it gave me a tool for the patient consultation," Dr. Puffer said. "This young man was able to view the 3D images as I explained potential problems and detailed diagnosis and treatment options."

The dental specialists will selectively utilize the new three-dimensional conebeam technology for complicated cases involving implants, oral and maxillofacial surgery, periodontics, TMJ (painful inflammation of the joint that connects the jaw to the skull) and orthodontics.

"The images are similar to those medical doctors have had available to them through MRI and CT scans but at a greatly reduced radiation exposure," Dr. Lovlien said. "A huge advantage is that we get a more complete diagnosis with the three-dimensional image versus a conventional, two-dimensional x-ray. That allows us to more accurately plan surgery and orthodontic management."

Standing within the apparatus, the scan is completed in 15 seconds. The dental specialists view the resulting images within minutes and are provided with information that has not previously been available through traditional radiographs.

Three-dimensional images allow the orthodontist and oral surgeons to more accurately identify bone density, bone height, unerupted teeth (teeth that remain below the surface of the gum and sometimes bone) and impacted teeth as well as to assess bone quality, anatomic features and their exact spatial dimensions.

In the case of impacted wisdom teeth that sit over nerves, the three-dimensional imagery shows the exact location of the tooth and surrounding nerves and allows the oral surgeon and patient to qualify benefits and risks on a difficult removal.

While not all patients will be recommended for 3D imaging, the patients who are selected can be assured that a clear, three-dimensional image improves treatment outcomes. In the case of congenitally missing teeth, the three-dimensional image allows the viewing of available bone and whether a bone graft is necessary prior to implant placement.

In the case of unerupted permanent teeth in teens, the three-dimensional image, in conjunction with a physical exam and historical data, allows for the precise surgical uncovering of the impacted tooth with more precise orthodontic management.

In the case of implants in adults, the three-dimensional imagery allows for a high degree of precision to minimize adverse effects to adjacent teeth. Following a scan, the data is sent to a specialized dental lab and converted to a "surgical placement guide," that allows for exact surgical placement of implants.

General dental practitioners in the area will be able to refer challenging cases to Lovlien and Northern Oral Surgeons for diagnostics. This may be helpful in patients who have undergone a root canal but are still experiencing pain. The three-dimensional images can easily detect inflammation in a pulp chamber and whether additional treatment is necessary to complete the root canal and alleviate pain.

"The good news is that this technology allows us to determine faster, more accurate and less invasive treatment plans and procedures, and that means less pain and faster recovery times for the patient," Puffer said. "Since this technology is now available in the Chequamegon Bay area, patients will no longer have to drive to Duluth or Wausau."

To find out more or schedule an orthodontics appointment, call Dr. Lovlien's office in Ashland at (715) 682-5958. To schedule an appointment with one of the oral surgeons at Northern Oral & Maxillofacial Surgeons, call the Ashland office at (715) 682-2660.

(Copyright © 2020 APG Media)

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