Carestream CS 9600

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CBCT has radically changed our profession. For many officers using this technology is critical to successful treatment outcomes. Whether the case involves implants, extractions, endodontics, orthodontics, airway management, or a myriad of other procedures, the first step is frequently to take a CBCT of the situation. I tell my patients that being able to sit at my desk and evaluate their imaging from any direction, in any way, to be able to take the image apart in small pieces and carefully evaluate it, makes my treatment plan much more precise. Patients appreciate the investment in technology that our office makes and they have come to expect that the care they receive from us is state of the art care that provides the best possibility for successful and long term clinical outcomes.

CBCT technology continues to evolve and make things easier for doctors as well as both easier and safer for patients. Continuing the evolution of dental CBCT, I'd like to tell you about one of the most state of the art CBCT machines currently available, the Carestream CS 9600.

Efficiency

Efficiency in an office is important, and especially so when radiation is involved. Even though the dosage from a CBCT is low, patients may have concerns. It's also critical that when CBCT imaging is used that the image is taken properly so that all relevant information can be seen. That's why it's important to tell you about the CS 9600's amazing positioning features. The unit has AI positioning for panoramic imaging, which detects and traces the Frankfurt plane. This ensures the patient is correctly positioned and helps reduce the need for retakes. The system utilizes the new Tomosharp algorithm as well as the AI to quickly deliver ultra-sharp panoramic images.

The system also has cameras that provide live positioning views on the unit's touchscreen, which allows for exact positioning. This high tech element removes the need for laser beams, which have been used for decades, since the operator can see exactly what the unit itself sees. The screen is color and provides vivid images which lets the operator see the needed details during the positioning process.

Reducing radiation exposure through proper positioning is important, but the CS 9600 goes even further in that regard. The unit utilizes a feature called SmartAuto Technology that analyzes the patient's individual morphology and then automatically calculates the correct exposure settings as well as the beam trajectory. This feature virtually eliminate the chance of the patient being incorrectly positioned while also increasing the precision of the image. The system software provides guidance through the process allowing even novice users to take great images.

In addition to reducing exposure due to retakes or working from a less than optimal scan due to poor positioning, the device also has a Low Dose Imaging mode for both 2D and 3D imaging. This setting gives the office the option of having a 3D volume at up to 86% lower dosage than 2D panoramic images.

Adaptability

Of course not every patient needs the same treatment and that means that a CBCT system needs to be able to adapt and easily provide the doctor with the images they need to accomplish their clinical goals. The CS 9600 allows the doctor to capture the data volume necessary for that specific treatment. Keeping with the ALARA principle, taking only the necessary images keeps patient exposure low. To aid with that, the unit can take 14 different FOVs (Field of View) which allows the doctor to see only the area needed without unnecessary exposure for the patient. Explaining to the patient that we are only seeing what is needed and keeping exposures low increases patient confidence in the office.

The system can also be equipped with an optional Scan Ceph module that gives the doctor the ability to capture high quality cephalometric scans quickly. This option provides automated cephalometric tracings in as little as ten seconds.

Digital implant planning can be performed via the Prosthetic-Driven Implant Planning Module. This feature allows for digital treatment planning of the entire implant procedure right from the doctor's desk. It allows the doctor to digitally place the implant in the perfect location for the best clinical outcome. The module also provides automatic tracing of the inferior alveolar canal which lets the doctor know the exact location of this critical area. Once the precise location of the implant is determined, the digital implant plan can then be used to create a highly accurate surgical guide which enables the placement of the implant in the exact location and depth the practitioner needs. The module works with files from leading intraoral scanners which helps the guides fit easily and precisely. This greatly reduces the chance of less than optimal implant placement surgeries, which means more precision and predictable results.

For doctors who are providing treatment of patient airways or airway management services, the CS 9600 can be equipped with the CS Airway Module. This module creates colorized segmentation of a patient's airway and automatically segments and measures the upper airway. It provides information such as total volume, minimal cross-section, anterior/posterior, and left/right measurements. The colorized images make it easy to communicate with patients as the color coded 3D views highlight things like constrictions present in the airway. This greatly increases the patient's understanding as they can clearly see the problem.

Images and Resolution

Another thing that factors into a quality CBCT image is how easy structures are to see and identify. To help with that, the CS 9600 has an exclusive ability to reduce metal artifacts. In some CBCT units, the reflection of metal from things such as crowns or amalgam restorations can create a 'sunburst' effect around the restoration that obscures other things from being properly rendered in the images. The CS 9600 utilizes an exclusive feature called CS MAR (Metal Artifact Reduction) that drastically reduces this effect and helps the image appear clear and concise. It also allows you to compare the images dynamically so that the doctor can evaluate both before and after the CS MAR has been applied. The unit also has the ability to reduce beam hardening artifacts and increase contrast of images due to its use of a 120 kV x-ray tube and intelligent filtration that is built in.

For fine detail that might be needed for endodontic treatment, the CS 9600 provides resolution of up to 75 microns. This resolution is a great help for finding lateral canals, fractures, or un-treated canals requiring endodontic re-treatment. This high resolution detail greatly enhances the doctor's ability to find even the hardest to see nuances. Should you need it, the unit can even capture an entire volume at this high resolution.

For surgical, orthodontic, or cometic cases the device has CS Face Scan which generates realistic 3D facial images and automatically superimposes them over the CBCT images and 3D models. This allows the practitioner to see exactly how the facial features appear over the underlying anatomy.

Final Thoughts

As the technology of CBCT has improved, Carestream has taken these improvements and packaged them into a system that can provide critical and state of the art information for the doctor. For the variety of clinical situations we all face, the Carestream CS 9600 can provide you with precise and accurate data. Taking advantage of the optional features helps the doctor to handle almost any procedure and provide the best results possible. This is why the Carestream CS 9600 was the winner of the 2024 Cellerant Best of Class award.