Frequently Asked Questions
Is GALILEOS difficult to use? Can my staff operate it?
The scan is easier to take than a panoramic image. GALILEOS isn't an intimidating sit-down steel structure that was designed for use on unique patients with special dental issues. It was designed to accommodate virtually every patient and clinical situation. Patient positioning is easy and unencumbered: The patient is positioned within the unit, standing or seated. In 14 seconds, the scan is complete.
The software has many proprietary features like pan navigation and built-in implant planning that the staff can use. Advanced tools are available for clinicians. Sirona provides two levels of in-office training and a two-day CE course with every GALILEOS system. At the two-day course, a board-certified maxillofacial radiologist teaches day one, and an implantologist teaches day two.
Sirona covers the hotel and meal expenses for this course. With an easy scanning process, intuitive software, and advanced training, clinicians and staff can feel very comfortable with the integration of GALILEOS into their offices.
Can I use it as a pan? What is the normal protocol for new patient exams?
Almost every GALILEOS unit in use today has replaced the panoramic. This is possible because the image is available in about two minutes on any computer in the office network. Also, images are more consistent because the pan can be adjusted for abnormal patient morphology or mis-positioning. The 2D pan image can be extracted and integrated into virtually any practice management program. The most common general practice new patient protocol is a GALILEOS scan and four bitewings. Some clinicians take GALILEOS and seven bitewings, and every practice should follow what they believe to be best, taking into account patient history, lifestyle, and other clinical considerations.
Will insurance pay for these scans? How do I pay for this?
This is a great question when making such a large investment in the practice and your patients. Several options are available to you. First, you can simply bill your patients for the scans. The usual cost is $350 per scan. For some practices, this simplifies ownership, but for others this is difficult to present to patients. The second option is billing 2D images to dental insurance. Many practices bill a panoramic image, cephalometric image, and /or TMJ images from the GALILEOS. Remember that just about any image you can create with 2D can be pulled from the 3D scan. Many owners pay for GALILEOS simply by billing panoramic images to dental insurance.
Another option is to bill the entire 3D volume. Some dental insurers are paying for the complete 3D scan, but most opt for billing medical insurance. With regards to the complete 3D scan, medical insurance pays more ($300-$500 per scan), they pay more often, and it doesn’t take such a big bite out of the limited annual dental benefits. If you go the medical route, there are software programs that can assist a general practice as they delve into medical. Many clinicians supplement their own GALILEOS images by charging for others to use the system. GALILEOS includes a Wrap-and-Go function that exports a patient scan and software to a single CD, making it easy to share. The more important elements to consider, though, are expansion of the practice. GALILEOS owners report much higher case acceptance after implementing 3D technology. Patients understand their options, their oral health, and understand your opinion more clearly. That leads to acceptance. Also, this represents a marketable feature of the practice. Patients haven’t seen this before, and are more likely to refer friends and family when they are excited about this technology.
What can I use this for in a general dentistry practice? Can I diagnose caries?
This is a tricky question. The true answer today is no. Several studies have concluded that cone beam imaging is equal to or better than intraoral digital imaging for detecting caries, but those studies were done with virgin, unrestored teeth. Cone beam images produce a slight halo effect around very dense objects, such as previous fillings. This “beam hardening artifact” makes it impossible to distinguish caries around previous restorations. However, there are many diagnostic benefits. Dentists are responsible for oral health at a minimum, and many would claim maxillofacial general health.
Dentists take a very proactive approach today, and GALILEOS provides the means to allow dental clinicians to potentially diagnose more pathology, and do so earlier. Studies from the University of Southern California and the University of Texas at Houston Health Science Center have confirmed this, and GALILEOS owners will anecdotally tell you that they find new pathology on at least one out of four patients. This is a great benefit, and common findings include periapical lesions, bony lesions, cysts, calcifications, and sinus and airway issues. Other benefits to general practices are tied to the fact that most GPs do more than drill-and-fill procedures. GPs that provide ortho treatment will be able to see impactions clearly and be able to choose the best path of exposure and attachment, will be able to see root tipping issues prior to fenestration, and will be able to communicate better with both patients and their parents. GPs that provide endodontic therapy can scroll through a tooth from top to bottom and see if there is an MB2 canal prior to starting or distinguish whether a tooth needs retreatment and which canal is causing the issues.
GPs interested in sleep apnea can use GALILEOS to test and demonstrate whether or not oral appliances are opening the patient’s airway. GPs that extract third molars can see the exact location of the nerve compared to the roots. GPs that are interested in periodontics can visualize bone levels and show it to patients more effectively. GPs that treat children can follow development more accurately. For GPs that place implants or provide surgical services, GALILEOS provides value as a surgical treatment planning system.
What is my liability for missing pathology? Will I see brain tumors?
With GALILEOS (and all cone beam systems) you will not see tumors within soft tissue. See the CT explanation in the answer to question #9 for more information. Any abnormal growth needs to be in airspace or hard tissue for it to be visible. The high-definition scans produced by GALILEOS can potentially raise the level of patient care by uncovering pathology that may not have been distinguishable via 2D radiographs. To answer the concerns of reading the scan, Sirona provides multiple levels of training that include a full day with a maxillofacial radiologist. The radiologist will teach you how to evaluate scans, how 3D imaging differs from 2D, normal versus abnormal pathology, and how to diagnose lesions and cysts, and much more.
The same radiologist and many others around the country are available to provide over-reads and radiology reports if you are ever unsure or simply want a second opinion. Years ago, radiologists provided services to read panoramic images, and it is a natural part of the transition to this new technology. For most clinicians, learning to interpret 3D proves much easier than learning how to understand the distorted shadow images that 2D provides. 3D imaging is becoming the standard of care in some communities, and proper training can make implantology more predictable. As the technology becomes more prevalent, it will be integral in providing ways to manage difficult diagnoses, oral pain, or other undiagnosed pathology.
How much more radiation is it than a pan?
GALILEOS is the equivalent of approximately 3 digital pans or 1 to 2 film pans. It is less than a full-mouth series, and in line with other dental imaging modalities.
What is the patient benefit? How do I communicate the benefits to my patients?
GALILEOS provides a quick scan that improves the opportunity to catch issues early, makes the health of the maxillofacial complex easier to understand, and provides very reliable results. The real connection occurs when the patient sees their own scan and understands what you are describing in a way never before possible. It’s easy to describe: “The scanning process only takes 14 seconds The doctor will review the scan with you, and you will be able to see your teeth, upper and lower jaws, sinuses, etc.,—in 3D. If something is going on, the images will provide a means to see it earlier and help to provide a more accurate diagnosis.”
What is the workflow like? Can I use this on everyday patients?
GALILEOS was designed from the ground up to be used on nearly every patient, every day. To begin with, it looks like a pan to staff and patients. Patients can just stand in the machine or be seated. There is no difficult positioning, and the process is less involved and less time-consuming than taking a pan. The patient scan is 14 seconds, and the patient is in the machine for less than a minute. You can use any computer on your network to view the resultant images. This is important, because clinicians generally want the scan to come up wherever the patient is located.
The software opens and automatically has a 3D pan, a 3D skull, and cross-sectional images. Additionally, there is an option to have the software identify the location of the arch and create a 2D pan that gets placed into 2D software automatically. The software features many functions such as panoramic navigation that makes it easy to learn and use on a daily basis.
If this is so inexpensive and easy, why do hospitals still buy CTs? What is the difference between this and a CT
The ideal option would be our ORTHOPHOS XG 3D-ready unit. It is essentially a 2D version of the ORTHOPHOS XG 3D system that is readily upgradable to 3D when you are ready.
What does CEREC® Integration mean?
The merger of GALILEOS and CEREC is complex and multifaceted, as well as exciting. Sirona patented the merger of 3D cone beam and CAD/CAM for implant planning and surgical guide years ago, and the research is now coming to fruition. GCI (GALILEOS CEREC Integration) will take place in multiple phases, each with its own benefits to clinicians. The first phase is being rolled out now, and it allows clinicians to take an optical scan with CEREC, plan an ideal restoration in an edentulous space, and import that data into GALILEOS imaging. The CEREC 3D data (scan and restorations) are registered to the GALILEOS 3D scan, meaning it is accurately aligned in three dimensions.
With GALILEOS, the implantologist has always been able to see the bone in accurate undistorted 3D, and place virtual implants for the manufacturer of their choice. Now they can verify that the implant is aligned to the restoration, ensuring a good esthetic result with good margins. GCI allows us to make the process of fabricating guides easier, because CEREC provides a virtual wax-up. Guided implant cases can now be a two-visit process for standard cases. On the first visit, the GALILEOS and CEREC scans will be taken and virtual implant planning completed. The second visit will be the actual implant placement though a surgical guide. The next phases are in development now. The development process, field testing, and FDA approvals are complicated processes that vary with each project. However, we are working towards virtual implant indexing, complete abutment libraries, the ability to mill custom abutments in CEREC, and the ability to mill surgical guides for less complex cases in CEREC.