CAT Scan Imaging for Dental Implants

CAT Scan Imaging for Dental Implants
Yoni Goldstein, The Jerusalem Report
OsseoNews
Getting a dental implant is a pain, in more ways than one. Aside from the cutting and scraping, stitching and swelling, there are the thousands of dollars that it costs to get each titanium screw into your jawbone and silicon screw into your gums.
Now, a fledgling Israeli company plans to make life easier for both the dentally challenged and their dentists, using a combination of CAT scan imaging, computer programming and a personalized stencil for improved precision in placing the implant. The classic implant process involves a technique called "flapping," where the patient's gums are sliced open so that the dentist can see the correct path to drill the screw through the gum line and into the jaw. Once the screw is in place, the gums are stitched together again. Recovery can take a week or longer.
I-Dent, based northeast of Tel Aviv in Hod Hasharon, has come up with ImplantMaster, a computer program that can make flapping unnecessary. The program decodes the CAT scan image of a patient's mouth, creating a computerized version of the mouth that the company calls a "virtual patient." This mapping technology helps dentists plot the path of the screw in relation to the jawbone, essentially allowing dentists to plan ahead and avoid flapping. I-Dent CEO Joseph Kowen says dentists use flapping for risk-management: "They don't want to risk drilling in the wrong place, so they cause their patients a great deal of unnecessary trauma just to be extra careful."
The I-Dent method does away with that painful step. Once the dentist maps out a plan on the computer, the information is sent to the company via the Internet. I-Dent then uses the mapped image to produce what it calls an I-Guide, a personalized template that fits snugly on top of a patient's teeth during the implant procedure. At the spot set for drilling, the I-Guide contains a small opening - just large enough for the dentist to drill a hole straight through the gums into an optimal point in the jawbone. There's no need to slice up the gums to find the sweet spot and the implant can be completed in a third of the time conventional methods would take.
I-Dent was founded in 2002 - just as the bubble burst on the tech boom of the late 90s - by the South Africa-born Kowen, who came to Israel in the 1970s, studied law and worked for Rehovot startup Objet Geometrics, which designed a method of printing three- dimensional models. He was joined by two partners: Romanian-born Andrei Feldman, the company's chief technology officer, and vice president Mark Hamburger, who lives in England. "Basically, we started the company at the worst possible time," a sheepish Kowen admits, "and we couldn't even scrape together a $1-million investment."
Kowen and Feldman went ahead with the project anyway, with about $800,000 from private investors. The gamble paid off: I-Dent received U.S. Food and Drug Administration approval in October 2004 as a medical device and followed that up with an official U.S. launch in March 2005.
They're ready to tap into a market that is growing at an astounding rate. To illustrate just how big the dental implant industry is, the tall and well-groomed Kowen notes the stats: $1 billion per year in sales of titanium screws and the more than 3 million implants installed worldwide during 2004 in a market that is growing by 15 percent a year.
"It's about vanity," says Kowen. "People who wouldn't spend $30,000 on a new car are willing to spend it to see a mouth they're happy with every morning in the mirror."
But I-Dent isn't just looking to capitalize on people who don't want to wear dentures. It's looking to the dentists as well. Currently, the implant process is generally performed by specialists - a periodontist, for example - and not general dentists. "But, in truth, there's no such thing as an 'implant specialist,'" says Kowen. "There's no reason general practitioners shouldn't be doing implants."
The problem, Kowen explains, is that because the implant process is in fact an invasive, surgical procedure, many general dentists are hesitant to get involved. But with ImplantMaster and the I- Guide, Kowen predicts general dentists will no longer be scared off.
I-Dent isn't the only Israeli company out to revolutionize the dental implant industry. According to Kowen, the local industry "has gone gangbusters over the last few years." At least five dental implant manufacturers have arrived on the scene and another five are geared specifically to developing CAT-scan technology for the mouth.
Kowen suggests the interest has a lot to do with Israeli dentists. "General dentists in Israel are far more confident than their counterparts around the world," he explains. "They're willing to take the risk of doing an implant. They're willing to just go for it."
And more dentists performing the surgery means the price of an implant in this country is far lower than the international norm: Where a single implant can cost upwards of $3,000 in North America, Kowen estimates the price in Israel currently stands at less than $1,000.
I-Dent expects its computer software and implant templates to both be sources of profit. Kowen suggests that the ImplantMaster software will be priced at about $2,500 for an initial licensing fee, with an additional annual maintenance and upgrade fee. But he sees the I-Guide templates as a more significant source of recurring profit.
"Every implant patient has a unique map in their mouth," he explains, "and that means that each one needs an I-Guide when they decide to go the I-Dent route." Additional implants at a later date, naturally, mean new templates - at a cost of up to $450.
I-Dent's technology already has market competition from another Israeli firm. DenX, based in Moshav Orah, near Jerusalem (see "Dentist's Helpers," May 7, 2001), has developed a drill with an imbedded probe that allows the dentist to see the path of the titanium screw in real time.
Hebrew University computer science and engineering Prof. Leo Joskowicz sees the merit of both products: "I-Dent's idea gives dentists a more accurate and customizable tool but the DenX method can be considered a more flexible technology because it doesn't require a specific template that needs to be customized for each patient." Still, he thinks there may be enough room in the market for the two to coexist.
"It's just like cars," he says. "Some people like the ease of automatic transmission, others like the control of a manual stick shift."