Expert Reviews

Ready for the road

A look at Europe’s first mobile scanning clinic.

In the unlikely event the name Julian Perry is not familiar to you, here, by way of introduction, are a few facts about someone who has always sought to push forward the boundaries of dentistry.

Julian qualified in 1983 and worked in the hospital system until 1986 when he moved into general practice. He completed his MFGDP Royal College of Surgeons in 1992. He is a past president of the Cosmetic Dental Association and up until 2002 ran a group of 12 cosmetic treatment centres in and around London.

In 2007, Julian took two significant decisions. He opened his private practice, Advanced Dental Solutions, in the quiet Oxford hamlet of Black Bourton and decided to develop an idea that had been on his mid for some time.

“I wanted to cut down the amount of time I was actually practising dentistry and invest more time looking at practical ways I could use my experience to help the profession… I also wanted to do something more than simply duplicate what others were doing and genuinely help my colleagues deliver better dentistry” says Julian.

Julian’s expertise is in placing implants. This he has been doing for more than 25 years. In this time he has seen many advances, but has concerns that today too many implants are being placed without sufficient planning. He has three main areas of concern:

“It is simply too easy for a dentist to practise implantology with only a minimum of training. It worries me that many perceive 3D imaging as a luxury rather than, in many cases, a necessity. I know that, if truth be told, many in the profession struggle to interpret scans accurately”.

Julian believes it is sensible to have too much information rather than too little and every dentist should consider just how that information is gained and then utilised to best advantage. In consequence there are a number of issues he feels dentists sometimes overlook, and the implications are potentially serious.

If a practice is contemplating branching into implantology it should understand the benefits of 3D compared with 2D imagery. It should objectively assess just how much more information is available using 3D digital imaging. It should then look at minimising radiation dosage, the relevance of the field of view available and the advantages of variable FOV now available on some scanners.

‘It should also be borne in mind that image clarity varies from manufacturer to manufacturer, so don’t believe manufacturer’s claims…..check for yourself. And whilst on the subject of checking, if you are thinking of buying a scanner, make sure you have sufficient space to accommodate it and that your facilities will meet the required specifications’, believes Julian.

In Julian’s opinion, if a practice undertakes fewer than 70 implants a year, investing in a 3D digital scanner is not going to prove a viable proposition from a payback standpoint. In these circumstances the options available in relation to referring patients for scans may not be ideal and compromises may need to be considered. For dentists, who like Julian, find compromise difficult to entertain, such a situation needs to be addressed and resolved.

This, in a nutshell, has been the problem for which Julian has sought to provide a practical solution. Cue the Mobile Scanning Clinic; the result of two and a half years of dedicated design, testing and application.

‘The Mobile Clinic is based on the VW Crafter with extra length and height and F1 suspension. It is designed to run off battery, mains or engine and even in battery mode can do 24 scans. Off the mains it can run indefinitely. The suspension, which took an F1 software technician three months to perfect, eliminates all vibration when the engine is running. Commissioning was completed last August and we have spent six months testing to ensure it meets the most demanding requirements. To this end, Andrew Gulson, Head of Cone Beam CT testing at the HPA was asked to oversee the project’, he said.

Because a Mobile Clinic is hardly a typical environment for a scanner, a rigorous appraisal of what was on offer had to be undertaken. Altogether 13 machines were assessed before the Pax-Duo3D from Vatech and E-Woo was chosen. It was selected not simply because of its durability and consistent performance, but because of its image clarity and that it offered a variable FOV.

The Mobile Clinic will be available to dentists throughout the UK and Ireland. If required it will even visit a patient at home or at the workplace.

Julian knows the mobile service will be providing many clinicians with images that will be clearer and sharper than they will generally see. In many instances these will make more information available and informed interpretation is essential. As every dentist knows, in an increasingly litigious society, accurate interpretation of patient X-Ray images is important.

To this end Training Courses are being set up throughout the country to complement the Mobile Clinic service. These courses will be run at local practices and at hotel venues and will enable dentists to hone their diagnostic skills and enhance treatment planning.

Julian is also working on new initiatives that will improve implant placement, help reduce patient pain and assist planning. It is his conviction that ‘Minimal surgery must be the future for implantology and as we progress we must consistently try and achieve perfect delivery.

PUBLISHED IN: The Dentist, July - August 2010
DENTIST: Dr. Julian Perry
DENTAL PRACTICE: Advanced Dental Solutions
ADDRESS: The Studio, Burton Abbots, Burford Road, Black Bourton, Oxfordshire OX18 2PF
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