Digital dentistry 1

Digital Dentistry

Chloe Benoit & Taylor Maass

Lamar Institute of Technology

Dental Hygiene Program

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Abstract

X-rays have been used for many years to aid dental professionals in detecting bone loss,

caries progression, and to confirm or classify suspected diseases. Being able to connect clinical

and X-ray findings is a significant advantage that is often applied in the development of a clinical

treatment plan in the dental office. There are multiple forms of X-rays and many different

applications that are used. It can be safe and effective with applied principles of protection for

both operators and patients to minimize risks. Digital imagery is being used vastly worldwide

and is growing in popularity as technology advances in our ever-changing world.

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Digital X-ray sensors and their compatible software

“Traditional radiography is being replaced by digital imaging in the dental office and is

one of the most significant advances that has occurred in dentistry.” (Thomson, 2018) The

purpose of this research presentation is to educate and inform local Southeast Texas dental

professionals on various types of digital dentistry. This includes intraoral x-ray sensors and the

compatible software associated with these devices. Our ongoing research on this topic will

benefit those who are unaware of some of the pros and cons of these devices and imaging

software that are available. “This monumental discovery revolutionized the diagnostic

capabilities of the medical and dental professions and, as a result, forever changed the practice of

medicine and dentistry.” (Iannucci, 2017)

As dental professionals, it is our ethical responsibility to produce high-quality

radiographs for the patients with their consent. In order to achieve this, the dental office needs to

be supplied with proper equipment that has the ability to perform such action. The qualities that

dental professionals strive for with direct digital imaging receptors are the density, contrast, and

sharpness of the image. The ideal radiograph has the proper amount of density for a dentist to be

able to interpret to the patient for a genuine diagnosis. Density is the degree of darkness or image

blackening. Contrast refers to the many shades of gray that separate the dark and light areas. The

contrast helps determine the radiolucent and radiopaque tissues in the oral cavity.

Sharpness/definition is a geometric factor that refers to the detail and clarity of the outline of the

structures shown on a radiograph. It can be distorted or blurry when there is movement between

the patient or image receptor during exposure. “The goal of dental radiography is to obtain the
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highest quality radiographs while maintaining the lowest possible radiation exposure risk for the

patient.”(Iannucci, 2017)

This research project highlights comparisons on direct digital sensors used in dentistry.

Information was obtained by contacting multiple local dental offices including the Lamar

Institute of Technology Dental Hygiene Clinic. “ Manufacturers strive to produce image

receptors with the smallest sized crystals/pixel possible to avoid the loss of image sharpness and

yet maintain image density with a maximum reduction in radiation exposure.” (Thomson, 2018)

TABLE: 1-A

Apex Schick 33 Dexis Gendex GXS- 700

Price for #2 $4,495 $13,085 $7,500 $7,400

sensor

Warranty 2 year manufacturers 2 year 1 year 2 year

warranty manufacturers manufacturers manufacturers
warranty warranty warranty

Extended Lifetime protection- Included in Dexcare- $1,995/ Included in support

warranty $495/year support year

Replacement $2,747 $4,495 $3,500 $3,495

cost

Imaging software Apteryx Xray vision Eaglesoft imaging/ Dexis Imaging Vixwin platinum
CDR DICOM

Annual support (1) Year Support $1,778 Included in Dexcare $1,495/ year
Included - $500/Year
After 1st Year

Training Included in support $1,200 Included in dexcare $1,166

plan

Cable Yes, $900 yes No yes

replacement

Sensor sizes 1.0/2.0 0.0/1.0/2.0 1.5 1.0/2.0

available

Line pairs (mm) 25 LP/mm theoretical 33.3 LP/theoretical 25.6 LP/theoretical 25.6 LP/theoretical

Sensor thickness 5.3 mm 7.4 mm 8.3 mm 7. mm

External 29.7 mm x 38.8 mm 31 mm x 42 mm

30.4 mm x 41.9 mm 30 mm x 43 mm
Dimensions

Active imaging 780 square mm 850 square mm

884 square mm 922 square mm
area
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The first thing to be noticed when assessing the differences between the receptors is the

price. There is a drastic difference between the ones compared, however, when considering

going digital you must consider more than the initial cost. There are hidden fees including

extended warranty, replacement cost, annual support, training, and cable replacement. Many of

these characteristics can adjust the outcome of what a dentist may decide to purchase for their

office. Referring to Table: 1-A, notice the initial cost of Schick is $13,085, which is significantly

higher than APEX, Dexis, and Gendex, which range from $4,495-$7,500. Nevertheless, it offers

cable replacement; it is available in various sensor sizes including 0.1, and 2; the extended

warranty is included in annual support of $1,778. Another substantial observation from the table

above is the juxtaposition of line pairs (mm). A standard criterion for evaluating digital

radiography sensors is resolution. The resolution, in this case, is measured in lines pairs (mm).

The term resolution refers to how parallel the lines can be to each other while still being visible.

In other words, the higher the lines pair (mm) greater the visibility. With that being said, another

thing to be noted from the table above is the price of the Apex sensor. In comparison from the

rest may be cheaper, but the resolution is at the lowest of all listed sensors. To be able to

determine the correct diagnosis, resolution is the most important factor; if the dentist cannot

properly visualize the image, it can be an invalid diagnosis. Lastly, thickness is a key factor in

deciding on a sensor to use in private practice. The thinner the image receptor, the lower the

resolution on the image. This can be contradicting because the size of the mouth varies from

patient to patient. Referring to Table 1: A states that APEX has the thinnest receptor, but has the

lowest resolution. Schick has the best resolution but is the second thickest sensor. This decision

can be difficult to decide which factor is more essential for the dental office. “After doing a

thorough check of all the features mentioned here, plus any additional needs your practice may
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have, you will be able to make an informed decision. Before purchasing, see if the company

offers a free trial so you can verify the sensor is up to standard. Once you have the best sensor

for your practice, you can focus on what matters most, taking care of your patients.” (Jaramillo,

2021)

Software is another key component in digital imaging. Sensors and software go hand in

hand when thinking about switching to a paperless office. In the Dental Hygiene Clinic at Lamar

Institute of Technology, Eaglesoft imaging software is currently being used. This is designed for

practices of all sizes. There are many features included in this software including treatment

planning, scheduling, practice growth, patient communication, accounting, patient records, and

digital imaging. Eaglesoft, however, does not offer training for the following features. Meaning,

it is a “learn-as-you-go” type of software. Dentrix, on the other hand, offers a wide variety of

features including front-office tools, improved communication with patients, simplified

scheduling, instant messaging, patient check-in, 3D patient charting, submitting, and monitoring

lab cases digitally, and many more features. Dentrix does offer training to help aid the office to

become self-sufficient in this software. Curve Hero also has many features available including,

dental billing, digital imaging-direct to the cloud, scheduling and appointment management,

credit/debit card processing, billing management, automatic appointment reminders, online

dental forms, ePrescription, and drug management. The previously stated sensors are considered

universal, this means that they are all compatible with the software listed above. Dental practice

management software is designed to help offices be more productive with day-to-day work. The

software and sensors are important for time management, and all around are more beneficial to

the patient and their safety. “In addition, practitioners should remain informed on safety updates
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and the availability of new equipment, supplies, and techniques that could further improve the

diagnostic ability of radiographs and decrease exposure.” (Iannucci, 2017)

Safety regarding radiation dose is important for patients and operators alike. Digital

image receptors can help protect everyone involved in the process of capturing quality

radiographs. “Digital imaging provides an opportunity to further reduce the radiation dose by 40

to 60 percent.” (Iannucci, 2017) “Digital image receptors require a shorter radiation exposure

time than do film receptors.” (Thomson, 2018) As professionals, it should be the goal of the

dental team to strive for quality radiographs at the lowest possible absorbed dose of radiation.

“Absorbed dose- is defined as the amount of energy deposited in any form of matter, such as

tissues of the head and neck of a patient, by any type of radiation.” (Thomson, 2018) We can

ensure that proper protocol is being followed by staying current on new information. This is our

responsibility as dental professionals and is part of giving our patients comprehensive care in the

office.

In conclusion, the following research shows why digital dentistry is becoming more

popular among dental offices around Southeast Texas. Overall, becoming a paperless office is

shown to be beneficial in multiple ways. It is our hope that this paper will direct dental

professionals to do further research on this topic and apply the information to their own offices.
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References:

Apex dental sensors VS Dexis DENTAL SENSORS. (2020, April 08). Retrieved April 19,

2021, from https://dentalsensors.com/apex-dental-sensors-vs-dexis-dental-sensors-2/

Iannucci, J. M., & Howerton, L. J. (2017). Dental Radiography: Principles and

Techniques (5th ed.). St. Louis: Elsevier.

Jaramillo, P. by A. (2021, March 29). 7 Features to Watch for When Purchasing Dental

X-ray Sensors. DentiMax. https://dentimax.com/purchasing-a-dental-sensor/.

Thomson, M., Eevelyn & Johnson, N., Orlen (2018). Essentials of Dental Radiography:

For Dental Assistants and Hygienists (10th ed.) New York, NY: Pearson.

Eaglesoft Reviews: Pricing & Software Features 2020. Financesonline.com. (2021,

February 23). https://reviews.financesonline.com/p/eaglesoft/.

Dentrix Reviews: Pricing & Software Features 2020. Financesonline.com. (2021, March

3). https://reviews.financesonline.com/p/dentrix/.

Curve Hero Reviews: Pricing & Software Features 2020. Financesonline.com. (2020,

December 6). https://reviews.financesonline.com/p/curve-dental-hero.

X-Rays/Radiographs. (n.d.). https://www.ada.org/en/member-center/oral-health-topics/x-

rays.