Protocol for importing axial radiographic slices in
Contents
1. QR srl con socio unico T 39 045 8202727 info qrverona it Via Silvestrini 20 39 045 583500 www arverona it EN 37135 Verona Italy F 39 045 8203040 www afpimaging com AN AFP IMAGING COMPANY 1 Generating 3D Surface With the function Select the Volume of Interest a specific volumetric Region Of Interest ROI can be selected Then click on the Settings button and change the HU Haunsfield Unit value for 3D surface Instead of using the values written in the software try a value between 400 and 650 The goal is to segment the bone from the soft tissues Changing the Radius and Standard deviation from 1 10 to 3 12 respectively as in the image below can help as well Generate Surface Settings HU value for 3D surface Ie Change Mask Color Smooth Image Radius colums row slice in pixels Standard deviation colums row slice f 1e 1 Tenant Ha t vt the amp f Keep number of parts O Keep oniy par Safiy ie Murter 735 Comnea Diye Hamis 210 Ao Doe Huri Level a Whirwkey w Sede legale C so Porta Nuova 22 37122 VERONA Cap Soc 10 400 00 R E A VR 221328 Reg Impr VR Cod Fisc Partita IVA 02164000230 REG A E E IT08020000000728 NewTom_Nobel Procera Protocol Final Rev doc Dated September 2008 Pag 6 7 T QR srl con socio unico T 39 045 8202727 info arverona it Via Silvestrini 20 39 045 583500 www arverona it EN 37135 Verona Italy F 32. 2164000230 REG A E E IT08020000000728 NewTom_Nobel Procera Protocol Final Rev doc Dated September 2008 Pag 2 7 4 QR srl con socio unico T 39 045 8202727 info qrverona it l Via Silvestrini 20 39 045 583500 www grverona it 4 EN 37135 Verona Italy F 39 045 8203040 www afpimaging com AN AFP IMAGING COMPANY A Denture Scan NewTom QR DVT 9000 Position the anatomical template inside a water filled plastic tank it can be obtained through Nobel Biocare Make sure than no radio opaque materials especially metal is used to support the anatomical template or is anyway in the path of the x ray beam For example the anatomical template can be supported by a sponge but make sure not to compress it Check the orientation of the anatomical template i e depending whether it is for M axilla or M andible NewTom 3G or NewTom VG No water filled tank is necessary Place the anatomical template in the centre of the scanned area It can be supported with e g a block of polystyrene or a sponge or a thin cardboard case Check the orientation of the anatomical template i e depending whether it is for M axilla or Mandible B Study Reconstruction NewTom QR DVT 9000 If you are using QR DVT 9000 software version 3 30 launch the Primary Reconstruction as usual with or without inclination If you are using QR DVT 9000 software version 3 37 launch the Primary Reconstruction WITHOUT any inclination NewTom QR DVT 9000 NNT
3. 9 045 8203040 www afpimaging com AN AFP IMAGING COMPANY To verify that you are setting the proper value for HU browse through the volume of interest using the sliders for axial coronal slices and sagital slices Adjust the HU value until all the bone tissue is segmented coloured and the soft tissues are clearly visible This is only required for the volumetric Region Of Interest At this point proceed pressing GO Perform the same procedure with the data of the anatomical template If the anatomical template was scanned with the Denture Scan procedure with 3G and VG machines the HU value should be around zero Otherwise if the normal Patient Scan was used also for the anatomical template the HU value should be set in a range from 650 to 400 This depends upon the material of the anatomical template i gt gt gt a gt A gt 5 gt gt gt 9 Sabet tta vaus of mimaa forthe meiogreptec guide anc pem the O0 bagion hihan tha 30 sustece a commisi check f 8 a ci amd goio Hermod tep TE Stings hie Mi a0 aE DoDo e PE sagt Shoe hter 5 6 a z Drog Soe Mune 25 amp Goneg See Ayya 1H z i 3 Ria moe Hirss m 3 Mja Sloe Range 177 F z Lee Th reira 3 a Sede legale C so Porta Nuova 22 37122 VERONA Cap Soc 10 400 00 R E A VR 221328 Reg Impr VR Cod Fisc Partita IVA 02164000230 REG A E E ITO8O020000000728 NewTom_Nobel Procera Pro
4. AN AFP IMAGING COMPANY NewTom VG Integration of NewTom VG and Procera has been tested and validated in Standard mode with axial slice thickness of 0 4 mm The conditions for working with the Hi Res Zoom acquisition mode are still under investigation Anyway the axial slice thickness must not be thinner than 0 3 mm otherwise the Procera software would not accept and work with such a large quantity of axial slices NewTom VG does not need any special set up after the scan to start the Primary Reconstruction of the patient since that occurs automatically C Data export in Dicom format After creating the Studies export the sequence of axial slices in Dicom format You can store the Dicom files on suitable data media M ake sure of using only regular alohanumerical characters in the patient name not special characters like e g lt gt orit will not be possible to save the data With the latest releases of NNT software V2 13 or higher Dicom files can be exported directly from Volumetric Data However this might considerably slow down the operation in Procera The slice thickness will be the same as shown in the menu View gt Document Info gt Axial Thickness Document info Document code 0 2260 61 Document size 187 10 MBytes Rawdata code 4052 37 Patient scan date lun 11 feb 2008 Document creation date ven 29 feb 2008 Scout views 2 Axial images Study reconstruction Detector field J Exp
5. NewTom_Nobel Procera Protocol Final Rev doc Dated September 2008 Pag 1 7 QR srl con socio unico T 39 045 8202727 info qrverona it Via Silvestrini 20 39 045 583500 www arverona it 37135 Verona Italy F 39 045 8203040 www afpimaging com AN AFP IMAGING COMPANY Protocol for importing axial radiographic slices in Dicom format from NewTom DVT 9000 NewTom 3G and NewTom VG into Procera System Nobel Biocare The technology used in CB3D radiographic systems like NewTom for three dimensional x ray scanning requires very low radiation dose For this reason there are some differences in the nature of the reconstructed volumetric data sets and studies with respect to those obtained from conventional CT scanning that require higher radiation dose In particular the 3D rendering of the maxilla could be sub optimal This will not affect the final result and the accuracy of the implant simulation since it is merely an issue of visual rendition CB3D usually has a 100 success on Mandible Do not stop working if the 3D rendition does not appear pretty and shows non existent holes in the maxillary bone go on anyhow with the simulation by assessing the x ray images The x ray cross section images always visible and clear with the Procera software will be used as for reference not the 3D rendition If the user goes on with the work notwithstanding apparent holes in the 3D rendition the simulation and planning will be accurate anyw
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7. Software in a secondary workstation Perform the primary reconstruction with the NNT software in High High Resolution or High Resolution and Large Field For the study reconstruction it s highly recommended to use 0 3 or 0 4mm axial thickness not thinner and no inclination 0 You can check the version with which you are working in the About menu NewTom 3G With NewTom 3G select High High Resolution or High Resolution as parameter for Primary Reconstruction For the study reconstruction it s highly recommended to use 0 3 or 0 4mm axial thickness not thinner If you are using NNT software version 2 04 or earlier perform the Study Reconstruction without inclination 0 If you are using NNT software version 2 11 or later you can perform the Study Reconstruction with the desired inclination The NNT software release should be at least version 2 04 or later Dicom dat must be dated at least 11 Feb 2006 or later This file is in the NNT folder in your C hard disk Sede legale C so Porta Nuova 22 37122 VERONA Cap Soc 10 400 00 R E A VR 221328 Reg Impr VR Cod Fisc Partita IVA 02164000230 REG A E E ITO8O020000000728 NewTom_Nobel Procera Protocol Final Rev doc Dated September 2008 Pag 3 7 QR srl con socio unico T 39 045 8202727 info arverona it Via Silvestrini 20 39 045 583500 www arverona it rN 37135 Verona Italy F 39 045 8203040 www afpimaging com
8. ay thanks to the special features of the Nobel Procera software that allows to superimpose X ray images with the 3D rendition In fact the X ray image correctly shows the available space for implants and the anatomical template data always excellent show how to position and tilt them Two 2 scans must be performed in order to use the Procera system Perform a patient s scan with the anatomical template the part that will eventually become the surgical guide after practising the drill guidance holes in the mouth Be careful to place the anatomical template correctly Stabilise and slightly separate the patient s jaws for instance with a cotton roll Make sure that the patient does not move Perform an x ray scan of the anatomical template only M ake sure to name the obtained data set differently from the one of the patient for instance with the word template as a part of the name For NewTom 3G and VG users a special scanning mode called Denture Scan is provided for scanning the anatomical template only see picture below SCAN MANAGER 5 tocol i can protoca Patient Scan when scanning the patient i Patient Scan with anatomical Wai template in place Denture Scan for the a gt Denture Scan scan of the anatomical template alone NewTom 3G TA Sede legale C so Porta Nuova 22 37122 VERONA Cap Soc 10 400 00 R E A VR 221328 Reg Impr VR Cod Fisc Partita IVA 0
9. osure time Show hide axial reference or Ecol t Sede legale C so Porta Nuova 22 37122 VERONA Cap Soc 10 400 00 REA VR 221328 Reg Impr VR Cod Fisc Partita IVA 02164000230 REG A E E ITO8O20000000728 NewTom_Nobel Procera Protocol Final Rev doc Dated September 2008 Pag 4 7 QR srl con socio unico T 39 045 8202727 info qrverona it l Via Silvestrini 20 39 045 583500 www arverona it N 37135 Verona Italy F 39 045 8203040 www afpimaging com AN AFP IMAGING COMPANY D Import data sets from any NewTom into Procera CAD Design System After creating a new patient you can import the data with step2 of the Procera System Manage CT Data gt Convert CT Data Setact fra ceectory comtarwg the doan bier for pabert wth barani d D3 and peura the GO bien Select the data file path in the import window and press GO Select the patient and the related anatomical template from the list shown It s not necessary to change the settings for level and window By pressing GO the complete set of Dicom data files will be imported otherwise the number of Dicom files to be imported can be selected with the option Dicom files Sede legale C so Porta Nuova 22 37122 VERONA Cap Soc 10 400 00 REA VR 221328 Reg Impr VR Cod Fisc Partita IVA 02164000230 REG A E E ITO8020000000728 Pag 5 7 NewTom_Nobel Procera Protocol FinalRev doc Dated September 2008
10. tocol Final Rev doc Dated September 2008 Pag 7 7 QR srl con socio unico T 39 045 8202727 info arverona it Via Silvestrini 20 39 045 583500 www arverona it rN 37135 Verona Italy F 39 045 8203040 www afpimaging com AN AFP IMAGING COMPANY 2 Searching the markers The final step is the identification location of the markers For this function the area of the Region Of Interest can be decreased as long as the markers are still inside For the Marker Extraction Settings a HU value between 1950 to 2350 is recommended The values for NSI Threshold should normally be 1 1 but very occasionally it may be useful to change it to 1 2 in order to help the SW to automatically locate all the markers The value for Volume Threshold should not to be changed from the standard values that appears on the mask see image below gt iL gt gt H gt Sabet the the vaum of niaaa for tha raken ard pran bhe GO baer Check f fua raian an taui arg gaia ba ran nap Hibastue of fie Brien EE z RESI Thasshe j 11 rz eres Threatened 01s a HLI J The values indicated have been estimated from several cases with different NewTom machines and patients with results which were judged to be good enough for all the relevant specialities This small guide is not a complete user manual For further information about using the Procera System consult its user manual or call Nobel Biocare Sede legale C so Porta Nuova 22 37122 VER
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