1. Scanning the Patient (as provided by NewTom)

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1 Using NewTom VGi, with NNT2.17 software or above, and Materialise SimPlant for implant planning.. Note: Users of NewTom VG (not VGi), produced in 2007 and 2008, should contact the manufacturer s Technical Service for deviations from the procedure below. 1. Scanning the Patient (as provided by NewTom) 1.1. Select the FOV. For implantology, select Zoom (recommended) or HiRes Zoom mode. (Note: HiRes Zoom will result into datasets 4 times larger (file size) than regular Zoom, and correspondingly longer reconstruction, transmission, and processing times, and slightly more noisy images, but with a slightly better spatial resolution.) 1.2. Positioning the patient Position the patient so that he/she is properly symmetrical and the volume of interest is centred in the Field of View. This is achieved by finely adjusting the motorised chin support and checking via scout flash images. When a scan prosthesis is applied during the scan, make sure it is separated from the opposing arch by a radiologically-transparent bite-block. Note that impression material (silicon-based) and rolls of gauze may not always offer enough radiolucency, and may thus show up in the images. 2. Taking the scan and processing the dataset Perform the scan. That ultimately results into a Volumetric dataset, with isometric voxels (0.24 mm from the Zoom scanning, 0.15 mm from HiRes Zoom scanning) Creating a Study By creating the study, you can crop portions that you deem unnecessary and limit to the volume of interest. In the process, the patient s head orientation can also be finely re-adjusted for symmetry and orthogonality. Select ISO (isometric voxel) (this is the default). Normally this result into approximately 300 slices for Zoom scans and 500 slices for HiRes Zoom scans (depending upon the cropped volume height) Scanning the prosthesis When the prosthesis has to be scanned separately, select the same FOV and settings as for the patient scan, and perform the scan by selecting the denture mode. Then proceed in the same way and the same settings as for a patient scan.

2 3. Exporting Dicom to a folder and importing into SimPlant Exporting the Study in Dicom format to a folder will save the dicom dataset into a specified folder. Within SimPlant the dicom images can be imported from that specified folder 3.1. Procedure exporting to Dicom Setting up DICOM settings in NNT Setting your dicom settings can be achieved by selecting in the File menu - Save in Dicom Format Sequence of Axial images Dicom Settings. Here you select multiple files. This setting needs to be configured only once and will remain until you configure it differently Exporting Dicom The data has to be exported as a Sequence of Axial Images, and you can choose either Free Matrix or 512x512 Matrix. Free Matrix is recommended if the scan was in HiRes Zoom mode. You will be prompted to select the destination file path. Exporting in DICOM format can be done by selecting in the FILE menu - Save in Dicom Format Sequence of Axial images and then choose the matrix you desire. You will be prompted to selecting the destination folder.

3 3.2. Importing DICOM in SimPlant Start SimPlant and click on import Images in the Task Panel In the Import Images dialog box browse to the folder where you saved the images and click Next In the check Images dialog SimPlant provides you an overview of the scan parameters. Click on the convert button to proceed.

4 The Image Selector dialog is prompted to the user. In this dialog, user selects the corresponding anatomy of the frame set, and selects required frames for importing. In order to reduce software load, you can skip image frames by selecting the skipped image count from Skip Images drop down list. Skip 1 images selects second image, skip 2 images selects every 3 rd image.

5 In order to further reduce unnecessary load, you can REMOVE UNNECESSARY IMAGES from the beginning or end of the frame set. Browse to the first frame of the sequence of needed frames, right click on the frame thumbnail and choose Unselect before this. All the frames before the respective one will be removed. Do the same thing for the frames at the end of the frame set. Choose the appropriate frame, right click on it and select Unselect after this. When ready, press OK and the software imports the selected frame set to SimPlant.

6 4. Exporting to DICOM and automatically import into SimPlant, versions prior to SimPlant Crystal. From SimPlant Crystal on this functionality is automatically installed and configured with the English version. This feature can only be configured when SimPlant and NNT are installed on the same physical computer and will allow NNT to export the dicom into the SimPlant import module. Therefore there is no need to specify a folder where the DICOM images need to be exported and there is no need to look for that folder in SimPlant to import them. We advice that this feature is installed and configured by a technical person of Materialise Dental or NewTom. The exact steps for configuring this functionality can be found in Appendix A Send data to SimPlant Once this feature is installed and configured you can access it from the NNT software, in the File menu. The preparation of the scan remains the same so please follow steps 1 to as described in the prior chapter. When you want to export DICOM images you now only need to select Send data to in the File menu of NNT and click on SimPlant. SimPlant will start and will automatically import the DICOM data. The image selector screen as described in 3.2 step 4 is shown and from here on you can follow the same procedure to finish the import.