Introduction to Scanningfor Cranial Remolding Helmets

• Orientation to hardware and software• Cranial Helmet Applications

– Remolding Helmets: Shape Capture & Modification

– Protective Helmets

Course TopicsCourse Topics

OMEGA Tracer

Fabrication

Modification

Shape Capture

Fabrication

Fabrication Partner

BeckerContourMed

DanmarOrthomerica

Orientation toHardware and Software

• Turning computer on • Opening software

• SecurityKey

• Internetconnection

Computer BasicsComputer Basics

Security Key Maintenance

• Allow the software to shut completely down prior to removing the security key

• Premature removal can cause the key to have a fatal error

• Replacement is the only option if this occurs

• Email

• Software updates

• Checking In

• Importing/Exporting

• Sending to a carver

File ManagementFile Management

• Opening a file– Open sample file John Doe

• Saving files / general file management • Screen Areas

– Start, Modify and Assistant screens

• Menus• Rotating the model• Right and Left mouse controls

Software BasicsSoftware Basics

Tracer Menus

Tabs

Status Area

Notes Area

Orientation Indicator

Unit of Measurements

Current Mouse Controls

Left/Right

Model Area

Assistant Screen

Modify Screen

Modify vs. Assistant ScreenModify vs. Assistant Screen

• Smoothing Options

• Build & Carve

• Undo

• Preferences

Introduction to Basic Tools Introduction to Basic Tools and Functionsand Functions

• Fill– Only fills the lows

• Sand – Only sands the

peaks

• Blend– Averages highs &

lows

Smoothing ModesSmoothing Modes

Smoothing functions are applied using the Right mouse button

Blend

Maximum Blend

Maximum Sand

Sand

Too Much of a Good Thing…Too Much of a Good Thing…

1”

Standard

2”

Large

½”

Small

Size of Work AreaSize of Work Area

• How they work• Speed dependent• Fixed amount• The differences between the

two

• Work path size• How wide is the “bit” being

used • Predefined and Custom

Sized

Build & CarveBuild & CarveBuild & Carve functions are applied using the Left mouse button

Build

Carve

Build & CarveBuild & Carve

Fixed Amount Speed Dependent

Work Path of 2”

1”.5” .5”2”

Fill

Build

Sand

Carve

Smoothing vs. Build/CarveSmoothing vs. Build/Carve

• Most Modification Tools can be turned ‘OFF’ by:– pressing Esc on the keyboard– pressing Stop on the Assistant

Screen– Opening or starting another tool

Turning ‘Off’ ToolsTurning ‘Off’ Tools

• Units of measurement• Print options• Leave Distal End Open

when appropriate• Cranial Measurement

Method Options• Smart blend shortcut set

to B

Set Up Preferences and Tool OptionsSet Up Preferences and Tool Options

Introduction to Shape Capture with the OMEGA Scanner

• No eye protection necessary

• Patient movement accommodated during cranial scanning

• Child can stay in parent’s lap during scanning

OMEGA Scanner OfficiallyOMEGA Scanner OfficiallyApproved as a Class 1 Laser DeviceApproved as a Class 1 Laser Device

• LEDs illuminate reflective targets on the surface

• Lasers are used to determine the contours for the surface

• High resolution digital cameras “see” the lasers

and record the position of the reflective targets

OMEGA ScannerOMEGA Scanner

• Capable of scanning directly over skin, sock, liner, plaster, or foam

• Able to scan complex and intricate or detailed shapes and surfaces

• Can merge two scans to create a shape• Can pause and resume during scanning session

OMEGA Scanner FeaturesOMEGA Scanner Features

Completely Portable!Completely Portable!

• Hold the Scanner approximately 12” from the surface to be scanned

• Aim toward the center of the area to be scanned & press the trigger

• Move the Scanner to follow the contours of the surface

Using the ScannerUsing the Scanner

Green light = OK

Red lights = too close or too far

• Optimizing should be performed whenever the scanner has been shipped or transported or if there is difficulty scanning in a surface.

• If the scanner does not ‘travel’, optimizing once a month is sufficient.

• Each scanner has it’s own specific optimizing plate that is located in the base of the scanner case.–Make sure the serial number on the scanner and the optimizing plate match before optimizing

Calibration/Optimizing the scannerCalibration/Optimizing the scanner

Cranial Remolding Helmets

• Select the measurement method you will be using

– Custom Measurements

– Loveday / Tracer Searched

Measurement Methods and PreferencesMeasurement Methods and Preferences

• OMEGA Scanner provides quick, non-contact shape capture

Scanning for Cranial Remolding HelmetsScanning for Cranial Remolding Helmets

• Apply scanning cap

• Identify landmarks

Preparation for ScanningPreparation for Scanning

LandmarkBasic

ComparisonFull Reporting Becker

Glabella Anterior Midline

Lt. & Rt. Frontozygomaticus

Lt. & Rt. Eurion Lt. & Rt. Top of Ears

Lt. & Rt. Tragion Nasal & Subnasale

Opisthocranion

Landmark GuideLandmark Guide

Cranial LandmarksCranial Landmarks

• Eurion [eu]: The most lateral point on the head (identified in opposition)

• Frontozygomaticus [fz]: The most lateral point on the frontozygomatic suture (temporal crest of the frontal bone).

• Glabella [g]: The most prominent point in the medial sagittal plane between the supraorbital ridges

• Nasion [n]: The midpoint of the nasofrontal suture

• Opisthocranion [op]: The most prominent point on the occiput

• Subnasale [sn]: In the midline, the junction between the lower border of the nasal septum and the cutaneous portion of the upper lip.

• Tragion [t]: At the notch above the tragus of the ear where the upper edge of the cartilage disappears into the skin of the face.

• Vertex [v]: The highest point on the head with the head in the Frankfort horizontal plane

Cranial Landmarks DefinedCranial Landmarks Defined

• Capture the shape

• Modify• Prepare for

fabrication• Do not use

training rod on patients when scanning for cranials.

Cranial PracticeCranial Practice

• Relief Pad• Symmetry: Copy Region

Left/Right• Shift Area• Build & Carve• Trimline

Most Commonly used Most Commonly used Tools for Cranial Tools for Cranial

ModificationsModifications

Relief PadsRelief Pads

•What are Relief Pads?

•How to create them?

•How to save them for repeated use?

•When to use them?

Creating and Saving Relief PadsCreating and Saving Relief Pads

• Relief Pads: Custom and Predefined

−Provides the ability to create and save a specific region in a desired shape, size and amount of change.

−A Relief Pad can be a build up or an excavation

−Relief Pads can be created then saved for repeated use on future shapes.

−Predefined or ‘saved’ relief pads can be edited for shape, size and amount of change.

Anatomy of a Relief PadAnatomy of a Relief Pad

1st: Identify Apex First

Area of maximum amount of Build up or excavation.

2nd: Identify Outer Perimeter of Region

The area the build up or excavation will be blending or the ‘skived’ edge of the total area to be affected.

APEX

Perimeter of region

Assigning a Build UpAssigning a Build Up

3rd:

Determine the amount of build up

Using the slider, select the maximum amount of build up at the Apex

4th:

Save Relief Pad for future use

Relief Pads can be saved for repeated use by selecting the Save button on the Raise/Lower screen

When to use Relief Pads?When to use Relief Pads?

• Relief Pads: Custom and Predefined

−Excellent modification tool option for:

−Plagiocephalic deformities

−Scaphocephalic deformities

−Brachycephalic deformities

Symmetry: Copy RegionSymmetry: Copy Region

•What is Symmetry: Copy Region?

•How to use Symmetry: Copy Region?

•When to use Symmetry: Copy Region?

What is Symmetry: Copy Region?What is Symmetry: Copy Region?

• Symmetry: Copy Region Left/Right

−Provides the ability to identify a region to be mirrored to the corresponding opposite side of the model.

How to use Symmetry: Copy Region?How to use Symmetry: Copy Region?

1st: Identify Region

Identify the area to either be copied To or From. This example displays area to be copied From.

2nd: A mirror image of the region is created

A corresponding region is created in the mirror image of the original region on the opposite side of the model. Note: For best results, select Copy Surface Contour Only.

3rd:

Determine the copy percentage

Using the slider, select the amount of mirroring to take place, 0-100%.

How to use Symmetry: Copy Region?How to use Symmetry: Copy Region?

When to use Symmetry by Region?When to use Symmetry by Region?

• Symmetry : Copy Region Left/Right

−Excellent modification tool option for:

−Plagiocephalic deformities

−Scaphocephalic deformities, ONCE side of head is modified to the desired shape and contour.

−Contraindicated for Symmetrical Brachycephalic deformities

Shift AreaShift Area

•What is Shift Area?•How to use Shift Area?

•When to use Shift Area?

What is Shift Area?What is Shift Area?

•Shift Area: − Works like a ‘heat gun’ tool to shift or move an area−The defined area can be edited −The greatest amount of changed is confined to single point apex−Can shift or move an area in more than one direction

How to use Shift Area?How to use Shift Area?

1st: Identify Center of Shift

Area of maximum amount of Build up or excavation.

2nd: Identify Distance from Center

The area the build up or excavation will be blending or the ‘skived’ edge of the total area to be affected.

How to use Shift Area?How to use Shift Area?

3rd:

Edit the shape of the region or area

To further define or edit the shape of the area selected, pull and drag the blue lines using the left mouse button

4th:

Shifting the Area

Use the cursor or the arrows on the keyboard to shift the area as needed. Note: This is a ‘View Dependent’ tool, orientate the model as needed to pull and drag the surface of the model

When to use Shift Area?When to use Shift Area?

• Shift Area:

−Excellent modification tool option for any area that does not require an apex sustained over a large area.

• Extend

• Skeletal Fit

• Adjust

• Tool Pages

• Modification Wizards

Other tools to considerOther tools to consider

Length Changing OptionsLength Changing Options

• Extend or shorten the model using these methods:

−By Amount−By Set Height Interval− By Pulling Tissue

Using the Extend Options?Using the Extend Options?

• Extend or shorten the model−By Amount: Provides the ability to change the length between two points by a specified amount. Ex: Increase length by .5”

−Set Height Interval: Provides the ability to specify a length between two points. Ex: Distance from Glabella to Opisthocranion equals 15cm

− By Pulling Tissue: Allows you to “pull” the distal end of the model by an amount entered while locking the model at the level indicated by Top of Section and maintaining the volume constant.−Ex: Elongation of socket by .5”

What is the Adjust tool?What is the Adjust tool?

•Adjust:− Provides the ability to adjust a model’s circumference, volume, A/P and M/L at specified levels.

Adjust ‘Modes’Adjust ‘Modes’

1st:

Select an Adjustment Mode

AdjustAdjust

2nd:

Identify level to be adjusted.

Select from the list of landmarks provided

AdjustAdjust

2nd continued :Identify level to be

adjusted

Click directly on the model to create custom

landmarks

AdjustAdjust3rd : Specify new measurement or amount of change.

Enter the desired amount, or the amount you wish the measurement to change by with the use of a + or – sign.

To prevent a specific level from being adjusted enter +0 or click on the ‘Current’ measurement being displayed

AdjustAdjust

4th : Preview

Select Preview to view the desired changes.

5th : Lock

Select Lock to keep the desired changes.

What is Skeletal Fit?What is Skeletal Fit?

•Skeletal Fit: − Provides the ability to set a caliper distance or measurement between two points on a shape

Skeletal FitSkeletal Fit

1st:Place Arrows

These arrows will always be opposing each other.

Arrows can be placed by selecting a landmark from the list or by using the left and right mouse buttons as indicated.

Skeletal FitSkeletal Fit

2nd: Determine movement of arrows.

Three options provided:

• Move each arrow equally

• Move Red Arrow Only

• Move Green Arrow Only

3rd: Determine Desired Measurement

The Current Measurement will be displayed.

Enter the Desired Measurement

Skeletal FitSkeletal Fit

4th: Applying Lock Points

Lock points provide the ability to isolate an area for modification and ‘lock’ or prevent the rest of the model from changing.

Add Lock Points to apply.

These white arrows essentially build a fence around the area to be modified.

Select Done with Lock Points once finished.

Skeletal FitSkeletal Fit

5th : Preview

Select Preview to view the desired changes.

6th : Lock

Select Lock to keep the desired changes.

Skeletal FitSkeletal Fit

3rd : Determine Desired Measurement

The Current Measurement will be displayed.

Enter the Desired Measurement

What are Tool Pages?What are Tool Pages?

•Tool Pages:−Model specific tool screens that display the useful tools for a specific type of model on one easy to use page.

Areas to considerAreas to consider

•Asymmetrically sloping crown or forehead•Neck Extensors•Mastoid processes•Occipital condyles•Over-modifying or 100% mirroring

• Modification for– Plagiocephaly:

• Consider using Relief Pad and/or Copy Region

– Symmetrical Brachycephaly:• Consider using Relief Pad

– Asymmetrical Brachycephaly:• Consider using Relief Pad and/or Copy Region

– Scaphocephaly:• Consider using Relief Pad to create the contour of one

side, then use Copy Region Left/Right to mirror the contour to the opposite side.

– Craniosynostosis:• Consider using the Adjust tool modification models

for changing circumference, M/L or A/P

Modification Options by DeformityModification Options by Deformity

Cranial Comparison ToolCranial Comparison Tool

Access through the tools menu > cranial comparison

Current Model will be shown

Browse or use drop down list to select comparison model to superimpose on this model

Create Report using the ‘report’ button

• Allows you to track the progress of a patient by comparing two scans to each other

Cranial Comparison ToolCranial Comparison Tool

Cranial Asymmetry ReportCranial Asymmetry Report

Ordering From

Becker, Danmar or Orthomerica

• Must be certified or licensed orthotist

• Must have cranial remolding orthosis experience

• Must be current on OMEGA account status

• Must have OMEGA Tracer Version 10.5 or greater

• Prior to placing first order, must obtain pre-approval as follows…

Requirements for UsingRequirements for UsingCranial Fabrication Services Cranial Fabrication Services

• Cranial Shape File size must not exceed 10MB

• Large photo files attached can stop the file from going through

• Confirm with fabricator that file was received

Limits to Cranial File SizeLimits to Cranial File Size

• Review the series of patient care steps that will now be part of your routine

• How to get help

• Additional functional capabilities with the hardware & software

• Next steps

Review/Summary Review/Summary

• Manuals

– Available in PDF form

– Click on any item in Table of Contents or Index to go to desired page

Resource Materials Resource Materials

• Any questions?

• Thank You

Introduction to Scanningfor Cranial Remolding Helmets