Expert Reviews

Superior surgical planning

Devizes-based implant dentist Dr Martyn Cox describes how Vatech’s PaX-i3D CT scanner offers superior surgical planning and optimal risk assessment for his treatment.

As the digital workflow becomes increasingly embedded within modern dentistry, the potential for enhanced diagnostics and treatment planning has grown exponentially. Cutting-edge technologies now provide outstanding visualisation of anatomical structures, allowing professionals to deliver first-class patient care. Dr Martyn Cox of Ferndale Dental Implant Clinic considers how the PaX-i3D from Vatech has affected his own practice.

He comments, ‘The clarity of Vatech sensors is fantastic and the image quality is sublime compared to other manufacturers that we’ve used. The ability to manipulate images and reproduce the same high quality is just as important.’

‘I initially came across Vatech after speaking to Dr Bill Schaeffer of the Implant Centre, Haywards Heath, West Sussex. If Bill recommends the technology and the service that was good enough for me! When I researched the software, I thought it was well priced and very intuitive to use. I have been using other mainstream CT software packages for years and found them to be somewhat clumsy programmes and I was always trying to find easier ways of doing things; this is not the case with Vatech.’

‘As Dr Cox goes on to explain, ease of use is just as important to him as a short learning curve. While improving his diagnostic processes, he believes key features of the PaX-i3D also help to streamline his workflow. ‘The thread of the workflow follows through efficiently, providing a seamless integration of digital technologies allowing for superior surgical planning and optimal risk assessment for all my patients at Ferndale Dental Implant Clinic.’


‘The software is very easy to use and patient positioning is straightforward,’ says Dr Cox. ‘Patients also tolerate it well, since it has an ergonomic, open design, it looks good and adds to the practice’s interior aesthetics. What’s more, it is easy for members of my team to inspect the machine on a monthly basis, so we can maintain high quality assurance protocols, ensuring patient safety.

‘In practice, implant treatment planning can be carried out very quickly. This means I can create the preliminary plan while the patient is still in the surgery; the speed and ease-of-use of the Vatech software makes this possible, plus the extensive implant library is essential and the safety features provide a warning if nerves are hit or platforms collide during the planning process.

‘Currently, we are taking an increasing number of referrals for patients whose implant work was performed abroad and has since failed. The CT scanner has been fundamental in analysing these cases, aiding my formulation of definitive, corrective treatment plans. It is difficult to pick up other clinicians’ implant work when errors have been made, so the image quality provided by the PaX-i3D is crucial in this respect.

‘As I focus on placing short implants, the CT scanner allows me to plan surgery effectively -where atrophied ridges or minimal bone are present, it can remove the need for bone grafting procedures and therefore reduce post-op morbidity for the patient. In addition, the multiple fields of view available provide the flexibility to limit radiation dose in single implant cases.’


‘The Vatech OPT is also of a higher more superior quality than models I’ve used in the past, with sharper, more-defined images. Some people might say you can’t diagnose tooth pathology from an OPT, but with the Vatech machine, caries and decay can be clearly detected. Another beneficial function of both the OPT and CBCT from Vatech is the bitewing facility – it’s a periapical facility on both sides, providing a really good image that saves the patient from internal periapical (PA) radiographs.

‘As we see time and time again in dentistry, it doesn’t matter how good the technology is, if the supplier’s customer service does not reflect the same high quality. This has not been a problem for Dr Cox, ‘The service from Vatech is second-to-none. The installation was very smooth and the servicing is good. Also, if I’m on the phone to our account manager regarding a glitch we’ve come across, by the time I’ve put the phone down, an engineer is already dialled into the software solving the issue. The quality of this service gives me confidence to recommend Vatech technologies to others – which I have done on several occasions.’

A 60-year-old female who presented to Ferndale Implant Clinic with a failing upper right quadrant four-unit bridge.

Figure 1 shows a sectional view taken with the PaX-i3D of the carious and failing bridge at UR4-UR7. The bridge and abutment teeth were planned for removal and implant placement at upper right first premolar and first molar sites.

Figure 2 shows the cross sectional view of the pre-extraction site at the upper right first pre-molar, with the predicted implant position, indicating that guided bone regeneration would be required to augment the facial bone and long-term soft-tissue stability.

Figure 3 shows final implant placement at the UR4 and UR6 positions, following Vatech CBCT planning and surgical guide fabrication. This allows for precise and accurate implant positioning and screw retention of the final bridge prosthesis.

Figure 4 shows the screw-retained, three-unit bridge with excellent tooth aesthetics, due to the superior surgical planning allowed by the PaX-i3D CBCT protocol.

Clearly more than happy with his technology and the service he’s received, Dr Cox turns his attention to the future and offers his own prediction as to where digital dentistry might take us.

‘Looking to the future, the digital workflow is here to stay and will continue to influence dentistry even more,’ Dr Cox concludes. ‘I am currently using several guided-implant-surgery protocols, using state-of-the-art technologies such as the Vatech PaX-i3D, intra oral scanners and 3D printing to provide both conventional and flapless, painless implant treatment and our practice will continue to embrace this technology as our own success and the evidence to support these protocols strengthens.

‘In the next five years, we will see an explosion of digital protocols both surgically and prosthetically and only practices which invest in such 3D-technologies will remain at the cutting edge of patient safety and expectations.’

PUBLISHED IN: Private Dentistry, March 2017
DENTIST: Dr. Martyn Cox
EQUIPMENT: PaX-i 3D (8x8cm)
DENTAL PRACTICE: Ferndale Dental Clinic Ltd
ADDRESS: Estcourt Street, Devizes, Wiltshire SN10 1LQ
TELEPHONE: 01380 725225
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