Sailors Bay first with Sirona's Galileos

Sailors Bay Dentistry, a busy, 6-chair upmarket practice in Northbridge on Sydney's lower north shore is the first practice in Australia to install Sirona's new Galileos 3D cone beam imaging system.

"Cone beam computed tomography is the next generation in dental diagnostics," said Dr Chris Watt, one of the principals of Sailors Bay Dentistry. "We've been very aware of what this technology can offer in terms of raising the bar in clinical care and we have been watching the market for some time waiting for the right time to buy in.

"The new Sirona Galileos was the system we've been waiting for in terms of the imaging options it can deliver plus the backup service and support you need when working with any complex technology." The new Sirona Galileos was developed in conjunction with Siemens Medical who have extensive experience in the manufacture of fan beam CT scanners and other medical imaging equipment. Galileos uses image intensifier technology to deliver a large 150mm diameter image using a relatively low radiation dose.

"We've looked at several cone beam systems over the years but it is a large investment and we didn't want to rush in. We've been using [fan beam] CTs for some 20 years but radiation was always a concern. A CT scan of the jaw is 350μSv whereas the Galileos is around 30μSv, which is lower than many other cone beam systems as well, so this aspect made it very attractive (lower dose settings for children and a 2-D snapshot feature are also available).

"We also utilise a lot of Sirona equipment in the practice already so we know their service and support is second to none and their head office is based in Sydney, so that was an important consideration as well.

"Clinically, the image quality is outstanding, the price is competitive with other cone beam systems in the market and above all, it is incredibly easy to use and very intuitive."

Dr Watt estimates the unit itself and the practice's technology upgrade price tag of $300,000 associated with the installation will be recouped within 3 years.

"We installed the system in July and are taking around 70 images a month," Dr Watt said. "We place lots of implants and it is ideal for that and the orthodontist who works with us two days a week is also finding it invaluable.

"Apart from implant planning, we can look at root structures for endodontics, we can look at periapical areas - we see things that you can hardly see on even the best PA - much bigger and in 3D. We can visualise bony defects and analyse for disease, we can see nerve bundles in the mandible and whether there will be problems when we extract wisdom teeth. We can see the condyles in 3D and assess them for arthritis or visualise changes in the head. We can see the sinuses in great detail and it is ideal for ENTs. It is fantastic for impacted teeth and our orthodontist now has a clear view of root angulation and even the airway. You can take measurements accurate to 150μm! It really opens up a whole new world of dental diagnostics."

Dr Watt said that a full scan takes 14 seconds to complete. There is then a four and a half minute wait while the file is "processed". A software upgrade due in a few months will reduce this time to 3 minutes.

He stressed the importance of ensuring your IT infrastructure is to a high enough standard to accommodate the large file sizes - up to 500Mb each - that the Galileos produces. In preparation for the installation, the practice upgraded their network from Cat 5 to Cat 6 cabling. The computers in the treatment rooms and the consult room were "beefed up" and larger, hi-res monitors installed. A new file server dedicated to the Galileos was also installed that includes 3 terabytes (3,000+ gigabytes) of storage and a tape backup system.

"The installation went perfectly," Dr Watt said. "Our IT consultant, Jan from Micropol, is first rate and followed Sirona's specifications to the letter. He had everything in place and Sirona came on a Saturday morning and we were using it the same day. We were live at the practice on Monday morning.

"Sirona worked with Micropol to ensure the installation went perfectly and it did. Sirona provided outstanding support throughout the process but the lesson to learn is that your own equipment in the practice - your computers, monitors and networking - must be first rate to fully appreciate the power of what volumetric imaging can offer."

Dr Watt said that the Galileos images can be exported as a DICOM formatted file that can be used by implant planning software such as NobelGuide, Simplant and Med 3D. The practice uses the latter for their implant planning and the laboratory located in the same complex as the practice, Fisodent, has the Med 3D system to produce the surgical guides in-house.

The Galaxis software that comes with Galileos also includes an implant planning module that allows you to drag and drop implants onto the 3D image. A surgical guide based on the planned treatment can subsequently be ordered from Germany.

"The ease of use of the system has been a surprising feature," Dr Watt said. "You can literally show someone how to operate it in 10 minutes. Every practitioner here uses it and the amount of information a scan provides it incredible. It also integrates seamlessly with our existing Sidexis imaging software and Oasis practice management software.

"With Galaxis, you can view the image as a pan or a ceph or in full 3D. You can zoom into a single tooth and move through it and look at areas of possible decay. You can see pit and fissure caries better than on a bitewing.

"Other dentists say the images are amazing. More importantly however, patients look at their image and understand it. We put in a large monitor in the consultation room for patients to see and they are very accepting and understand any concerns straight away. That in itself is priceless."