Newsletter #7

Two Years of iCAM -Thoughts and Lessons

Happy Summer!

Hopefully everyone is getting some nice R&R but also staying busy. Sorry for the click baity title lol, but the info is true and helpful (so sorry, not sorry).

It just hit me recently that I've been using the iCam almost exclusively for the past two years and throughout that time had some successes and roadblocks that I thought would be worth sharing. I'll start with the most important and then work my way down the list.
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As always, this is anecdotal and may or may not be what the manufacturer suggests but it is 100% what I do in my day to day. AKA, your mileage may vary but just know that all this comes from stressful moments and a lot of DIY /figure it out sessions.

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​Dose of gratitude: "No duty if more urgent than that of returning thanks." - James Allen (I had to look this up, but James Allen was an English philosopher for the 1900s and wrote a book called As a Man Thinketh, which was one of the first books in the self-improvement genre)

iCAM Thoughts and Lessons

1.Update your shizzz.

Nothing worse than getting to surgery and then having an update or having a software not work because of a pending update. It seems like sometimes the software will let you know that an update is ready, and other times you will have to manually update or have support update. But either case I've definitely been in the middle of scanning or setting up a case and have been locked out of the software or have had errors due to a pending update. Then you're in that scramble of connecting to wifi and calling customer service while people are asking you how much longer. Talking about getting major sweats!!!

So what I do is, the morning of get to the office, plug everything in and then I check to make sure all four cameras are being picked up. And then I will set up a case and just do a calibration. So there's no need to actually bring out the scan bodies because as long as you can get to the calibration part you should be good. So I calibrate, I make sure all four cameras are operating and then if that's good then I go ahead and pack everything up.

Make sure all four cameras are on during the calibration. You can check by clicking on the screen during the calibration which will minimize the live view window but show you all four cameras in purple. I've had situations where all four cameras are being picked up via USB but when I calibrate only two cameras are actually working. There are a couple reasons why that could happen, but as long as you can pick this up ahead of time it's usually a pretty quick fix from there.

Second option, which I have to do when I'm on the road and can't check it in the hotel for whatever reason, is as soon as I get to surgery I plug everything in and then do a quick calibration. Again, don't need the scan bodies as long as you can get to the calibration screen and verify all four cameras are working then you should not have any problems during the actual scan body measurement scan.

That's covering a software update but there's also a component hardware update which is the speed box that comes with the scanner. This is basically an adapter that will take the USB input from the iCam and then turn it into a USB-C that goes into your laptop. Now the one that comes with the iCAM is actually several years older and isn't made any longer. I updated to a newer one and we've made substantial improvements in my scanning time. This has been verified by several other users I recommended the same item too. Here's the link to the Amazon product: https://www.amazon.com/StarTech-com-Port-USB-3-0-Hub/dp/B004DVEWH4/ref=sr_1_2_sspa?crid=LZ47W4685B1P&dib=eyJ2IjoiMSJ9.Be8E4puXb5P7xHhqtkTD-6E8Loo28DNON9_Hjmn_rvby2vyH23r9AFbvo_NruCiVQDaLdfvuUM9LLxX7PHM1pCPOvO5J8PZe6laV8XyvdLEvj4Ut8KuAjMgzoQaR6Dhx_fPoOdkONMwsaojHu9gBEiVz39YgkRFrbUrs-EkE83Hbfza93MCG3IQ5EPBxtTrdLJtSr6FdMCqcXGoo-MecfXmhje7R1ka4cN63eIb8PGA.GZBimRjLlH-5Z0ElnGVHIbdTqcsz1MXvdEOLjUgpi5Y&dib_tag=se&keywords=speedbox%2Busb&qid=1786122221&sprefix=speedbox%2Busb%2Caps%2C192&sr=8-2-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&th=1​

2. Always check the data before you remove the scan bodies.

There have been two instances where I completed the scans perfectly, achieved at least 50 scans with a green status, came back to the lab, and the data was corrupt when I imported the iCAM bodies into the scan software. Now after the scan, before removing the scan bodies, I will always drag and drop the iCam bodies into the scan software and make sure they load correctly before we move on to the next step. This may never happen to you but when it does it is the absolute worst because now you have no way of delivering a temporary and the patient has already left. This step takes maybe 20 seconds and it's a lifesaver.

3. For more than four scan bodies, or crowded positioning, plan for two scans at the beginning.

For cases involving five to six implants, or maybe an FP1 with seven or eight implants, or for a crowded situation where the iCAM bodies are very close to each other, my recommendation would be to not bother trying to capture them all in the first scan. It can be a little bit frustrating and take a little bit of time. So in these cases, I will from the get-go plan to capture the data in two scans. When you set up the case, mark all implants that you're intending to scan. The protocol is to keep the most terminal posterior scan bodies and then I will remove the next anterior ones bilaterally, keeping one to two scan bodies in the middle. Once those scan bodies are captured, I will go ahead and then add the missing ones to complete the scan. I find this to be most efficient and also just shows people that you know what you're doing versus having a failed first scan and then resorting to the dual scan.

4. Did you take geometry in the last three years? Me neither, do this instead.

It can be a funny exercise to describe to someone how to orient the scan bodies who has never done it before. Do you tell them to put the edge to the facial? Do you call it a corner? Do you call it a vertex? Do you just tell them to put it towards the front? As they say, a picture is worth a thousand words. So I carry this picture laminated inside our iCAM case. I just pull it out and just say, "make them look like this!" And they say, "you got it, boss!" JK, they usually say, "Okay, small Asian man with the perm."

5. Bring your own retraction device.

The goal is make every case as predictable as possible. In order words, remove as many variables as possible. That's why I don't like to rely on other people retracting for me because we all do things differently with different instrumentation. I bring my own Optragate from Ivoclar and have had great results. There are a lot of retraction device options out there, just bring one that works for you. I've had surgical offices ask me to give them the wrapper from the Optragate so that they can order more for themselves.

6. Don't use any of the blue lining paper underneath your laptop.

Most commonly in the surgery office, I will use the instrument table from the adjacent room to set up all of my equipment and then roll it in when it's time to scan. Often they would try to be helpful and line the table with the blue sterile wrapping paper. However, the fan on my computer is on the bottom. So what we found was that the paper would block the fan and then the computer would overheat during the iCam scan causing it to time out because the graphics card wasn't operating. Best to let the bottom have plenty of space.

That's your five minute boost! Actually, that was more like 10 minutes, my bad. As always, written by my little fingers and not AI (hence, the typos to keep it geniune). Will repost another entry from the last six months later this week as part of our catch up!

-Charles