DIGITAL IMAGING

(RADIO VISIO GRAPHY)

• 1895: Wilhelm Conrad Roentgen  X-rays

• Two weeks after: Otto Walkoff: First dental x-ray

• ALARA principle
“As low as reasonably achievable”

• 1987: First digital x-ray sensor for use in dentistry by

Dr Francis Mouyen ( Later Marketed by Kodak).

• 2006: End of the film-base radiology??

“Sharpen your diagnostic ability.”

“...immediately enhance your

diagnostic capabilities.”
“You may simply let the patients
know that they’ll be getting about
90% less radiation than they would
from a standard x-ray.”
“The images come up instantly as
patients are in the chair; the images
are so large that patients can’t help
but become involved in the diagnosis.”
“Most patients are amazed at how
quickly the image comes up on the
screen and are impressed by its
size.”
“Don’t have to spend a lot of time
trying to sell the technology.
Simply let patients know what it is
and let them see the images.”
“Requires much lower exposure-
times than film thus reducing the
patient’s radiation consumption
dose.”
“Patients will view the the doctor
as making a more accurate
diagnosis by using improved
technology.”
... The images can be immediately
brought up on the screen for the
patient to view and it can be
magnified from 100% to 300%.”
“It combines superior design with
outstanding performance,
resulting in perfect quality x-rays.”
 “It’s been more than 100 years
since X-rays were invented.”

• Radiographic imaging process has not been

changed much.
 Standard Radiographs

• Image receptor: film

• Image processing: photochemical
(developing, fixing, washing/rinsing, drying)
• Viewing: radiograph on illuminator
• Storage: radiograph
 Digital Images

• Image receptor: CCD or screen

• Image processing: cpu and software or laser,
cpu and software
• Viewing: image on screen or print-out
• Storage: on disk or paper hard copy
 Advantages/Disadvantages
Radiographs vs. Digital Images
• portable • not portable
• familiar • new technology
• can be viewed by all • must have
hardware/software
• initially inexpensive • inexpensive after
initial investment
• must send by mail • transmissible by wire*
• one viewer • viewed
simultaneously
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
Advantages/Disadvantages
 Advantages/Disadvantages
Radiographs vs. Digital Images

• film size similar to beam • receptor size smaller than

size beam size

• film covers larger area • receptor covers smaller

area
 Advantages/Disadvantages
Radiographs vs. Digital Images
• film disposal • no film disposal
• chemical/silver • no chemicals
disposal
• film placement is easy • cable connection
interferes with
placement
Digital Imaging:

Most significant advantages:

- Computer-aided image interpretation

- Image enhancement
- Image archiving
- Image retrieval
 Digital Imaging

More Advantages

-No Chemical processing

-No Hazardous wastes
-Images can be transferred electronically
-Patient Education
-Time
-Less Radiation
Radiovisiographic image with contrast effect of the upper right
canine after root canal obturation made by the manual lateral-
vertical technique of gutta-percha compaction
A marked area of the apical
portion of the root for
zooming in ‘window’ format
Three-dimensional analysis showed
overfilled obturation mass as mild bulging
at the very end of the root canal
Digital Imaging

Disadvantages

-Cost
-new technology = uncertainty
-rigidity and thickness of the sensor
-System crash
-Infection Control a challenge :-
(sensor cant be sterilized)
-unknown sensor lifespan
 Available
Intraoral
Digital Systems
 Intraoral Systems

•RVG 6100 / 5100

Kodak Dental System Group www.kodak.com/dental

•Computed Digital Radiography: CDR

Schick Technologies

•SIDEXIS IO2
Sirona Dental Systems
•DEXIS
DEXIS Digital X-Ray
•ImageRAYi
Dentrix
• Lightyear (Light Year Technology)
 Intraoral Systems

•Sigma
Sigma Instrumentarium
•MDX Digital Sensor
MediaDent
•VisualiX eHD
Gendex Imaging
•Dixi-3
Planmeca
•Cleartooth
Cleartooth Electronics
 Intraoral Systems
PSP Systems

• OpTimeA
Soredex USA,
• DenOptix QST
Gendex Imaging
• ScanX
Air Techniques
Factors that might influence your purchasing decision:

•Sensors: Size
Shape
Positioning devices

•Software features

•Computer equipment: Processor

System memory (RAM)
Hard disk space
 ADA in 2006 evaluated 7* direct digital system:

•DIXI 3 Planmeca
•CDR Schick Technologies
•Image RAYi Dentrix Dental System
•RVG 6000 Kodak Dental Systems
•Sigma Instrumentarium Dental, Inc.
•VisualiX eHD GENDEX Dental Systems
•DEXIS * Dexis LCC

19 clinicians under standard conditions for interpretation

 Perceptibility Test
Accuracy, Sensitivity, and Specificity of Evaluated Systems

Accuracy Sensitivity Specificity

CDR 93.2 88.9 98.9

DIXI 86.3 80.0 98.9

ImageRAYi 93.7 91.1 98.9

RVG 94.0 91.1 100

Sigma 88.6 82.9 100

VisualiX 86 81.1 95.8
 “I” Sensor Configurations

•RadioVisioGraphy: RVG 6100

•Computed Digital Radiography: CDR
•SIDEXIS IO2
•Lightyear (lightyear technology)
 “Q” Sensor Configurations

•DEXIS
 RVG 5100

Cost 1.35 Lac

Warranty 3 years

Sensor size # 0 # 1 and # 2

Clinician guide to Dental Products and Technology

CDR Plus Wire ®
Planmeca Dixi ® Receptors
 So, what
should one
look for?
 So what should one look for...?
• Do I need this now?
• How many operatories are equipped
with tubeheads?
• Are you & your staff willing to learn
new techniques?
• Can I communicate with other
practitioners (or other offices)?
 So what should one look for...?
• How easy is it to back up the images?
• Can I get upgraded software and if so,
what would it cost?
• How is servicing handled? Cost,
availability, time to arrive?
Both Happy Families But you have to
keep on be upgrading yourself
(As and When BUDGET allows!!)