side of a teaching institution , with a very large field of view allowing for full maxillofacial and cranial three-dimensional imaging , no longer requiring referral out to a medical or dental imaging center , and allowing for fabrication of stereolithographic models when needed .
Photos by Ray Bryant , Bryant Studios
Rounding out the facility ’ s commitment to complete digital conversion , a digital intraoral scanner eliminates the need for impressions and models and articulators previously required for planning orthognathic surgery , a primary focus of Dr . Bates and his practice . “ For several years now , all of our surgical planning has been done digitally , without the need for conventional model surgery . We stitch full arch scans with high-resolution maxillofacial CTs , plan the surgery online via a web meeting with the patient ’ s orthodontist , prosthodontist or restorative dentist , and surgical splints and guides are 3D-printed .”
Dr . Bates ’ ability to review and analyze imaging studies done outside the facility , such as MRIs , is truly unique . “ We routinely order TMJ MRIs , and these are nothing new . What is new is that we can now digitally review and manipulate
Patients are greeted by a team member they have developed a relationship with over the months of pre-surgical treatment .
these studies in three dimensions in our facility by loading the raw DICOM data into professional radiology imaging software on our network .” DICOM is the internationally-recognized standard format for medical and dental digital images , and each clinical workstation as well as the operating room are outfitted with large high-resolution monitors for reviewing and demonstrating 3D images to patients and their families . As Dr . Bates notes , “ For example , we routinely use CT data to treatment plan three-dimensionally for dental implants , and we can show a patient their joint pathology in three dimensions on a TMJ MRI .”
PATIENT EDUCATION
For any surgical procedure , Dr . Bates and his team provide substantial patient education information at both the initial consultation and all pre-operative visits . The facility has a dedicated consultation room which provides a comfortable , nonclinical setting for this discussion . At an initial consultation , the patient ’ s first contact with Dr . Bates is in this room , where a detailed medical and dental history is obtained .
“ We think it ’ s crucial to initiate that first contact with a very open discussion of the patient ’ s concerns , desires and goals . Of course , there are the straightforward cases where a patient is referred for removal of wisdom teeth , but they ’ re managed in the same , deliberate way . Complex cases involving reconstructive issues or temporomandibular disorders require a much more detailed , involved discussion with the patient and his or her family . Doing this in an environment that is warm and inviting , and in comfortable seating rather than a dental chair , helps the patient open up and tell us their story .”
Each morning , the entire team assembles together in the conference room for a staff meeting where each team member participates and a formal agenda is followed .
Prior to any surgical procedure , the patient returns to the consultation room for detailed pre- and postoperative counsel-
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