RADIO VISIO GRAPHY, Dr Anirudh Singh Chauhan

DIGITAL IMAGING (RADIO VISIO GRAPHY)

Dr. Anirudh Singh Chauhan

• 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/DisadvantagesRadiographs vs. Digital Images

• portable • not portable• familiar• can be viewed by all

• initially inexpensive

• must send by mail• one viewer

• new technology• must have

hardware/software• inexpensive after

initial investment• transmissible by wire*

• 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/DisadvantagesRadiographs vs. Digital Images

• film size similar to beam size

• film covers larger area

• receptor size smaller than beam size

• receptor covers smaller area

Advantages/DisadvantagesRadiographs vs. Digital Images

• film disposal • no film disposal• chemical/silver

disposal• film placement is easy

• no chemicals

• 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 forzooming 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 / 5100Kodak Dental System Group www.kodak.com/dental

• Computed Digital Radiography: CDRSchick Technologies

• SIDEXIS IO2Sirona Dental Systems

• DEXISDEXIS Digital X-Ray

• ImageRAYiDentrix

• Lightyear (Light Year Technology)

Intraoral Systems

• SigmaSigma Instrumentarium

• VisualiX eHDGendex Imaging

• Dixi-3Planmeca

• MDX Digital SensorMediaDent

• CleartoothCleartooth Electronics

• OpTimeA Soredex USA,

• DenOptix QSTGendex Imaging

• ScanX Air Techniques

Intraoral SystemsPSP Systems

Factors that might influence your purchasing decision:

• Sensors: Size ShapePositioning devices

• Software features

• Computer equipment: ProcessorSystem 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 eHDGENDEX Dental Systems• DEXIS * Dexis LCC

19 clinicians under standard conditions for interpretation

Perceptibility TestAccuracy, Sensitivity, and Specificity of Evaluated Systems

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

Accuracy Sensitivity Specificity

“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)?

• 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?

So what should one look for...?

Both Happy Families But you have to keep on be upgrading yourself

(As and When BUDGET allows!!)