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The following is from a press release from Imaging Sciences the folks behind the I-Cat:
 
“A new report was released this week by the New England Journal of Medicine identifying new dangers of medical CT scans. Specifically, the research shows that unnecessary or overused patient CT scans have been found to cause an increased risk of cancer. But what about dental patients who are required to get a CT scan before dental procedures? Do they face the same risks?
In the dental industry, dentists needing to capture 3-D data of a patient’s mouth, face, and jaw prior to treatment planning and surgical procedures can send the patient out to get a medical CT. However, it is important for dental patients and dental practitioners to recognize and understand the differences between a medical CT scan of the chest, which is the one referenced in the latest research report, a maxillofacial CT scan for a dental procedure.
The radiation dose in a dental CT scan is significantly less-about 100 times less-than the levels released in this recent report on medical chest CT scans. Dental patients then, are not facing the same risks as stated in the report.”

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With a direct sensor the digital radiography image can be viewed on the computer screen in as little as four or five seconds after the sensor is exposed. This speed of acquisition with a direct sensor provides a great benefit which is almost never discussed. That is that the user can view the image before the sensor leaves the patient’s mouth.  If you miss the apex, cone cut the distal or overlap the interproximal you can see the error in seconds and make the necessary positioning adjustments to the sensor or the cone to get a perfect image.
With film you would not know about the problem until the film was processed and then you would have no reference point to return to to improve the image.

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I saw this at the ADA in San Francisco. It was one of many new products in the rapidly expanding Cone Beam market. What I liked about this was the clarity of the images.

TeraRecon’s PreXion 3D is a revolutionary X-ray system that provides high-resolution solutions in dental imaging. Powered by TeraRecon’s proprietary image reconstruction and volumetric image rendering technology, PreXion 3D provides sharper images with more information than the traditional dental X-ray unit. It’s the ideal in-office imager for the specialist performing implants.
With TeraRecon’s clear and 1:1 scale images, accurate measurements assure that the optimum implant is placed. Patient treatment is improved with the powerful computed tomography technology and its precise measurement tools. Accurate dental implant planning and placing, orthodontic investigation, and improved general dental imaging are some of the many true benefits PreXion 3D delivers.
In just 19 seconds, TeraRecon’s PreXion 3D acquires 512 initial X-ray views which are ‘reconstructed’ into a 3D dataset of the patient’s anatomy. Conversion to DICOM 3 is built-in and compatible with all major 3rd party software and systems (NobelGuide, Simplant, ILS, I-Dent, Dolphin, and others).
Revolutionary 3D CBCT | PreXion 3D | TERARECON, INC. [1].

[1] http://www.prexion3d.com/3dct.html

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Integration: If the images are integrated as part of the digital patient record that usually means that the image management application is made by the same company as the charting application. The images can be seen within the chart application. The images and chart data share a common data base.
Bridging: Bridging is usually done in order to link applications made by different companies. The images are not visible as part of the chart but can be accessed with a single click.
Integration and bridging are technically different but both work well and provide the user with a similar experience. Dentists should avoid using a stand alone image management system that is not linked to the patient record. A stand alone system will be much harder to use, take more time and is more prone to error or lost images.

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Look here Aribex NOMAD Portable X-Ray [1] for the whole story

True Portability Unlike other “portable” x-ray instruments, the battery powered NOMAD™ offers true portability with cordless operation and freedom from line voltage fluctuation. With more than 100 exposures on one battery charge and a weight of under 4 kg, NOMAD™ is optimal for remote use and confined spaces as well as operatory functions.

Operator Protection The external backscatter shield and internal radiation shielding protect the operator from radiation exposure.
Constant Potential Performance The high-frequency, constant potential x-ray generator provides constant radiation output. This improves image quality while reducing the skin dose to the patient relative to traditional half-wave (AC) generators.
Ease of Operation The lightweight NOMAD™ is designed for simple operation. The only operator input needed is the exposure time, which is entered on the user-friendly digital control panel. NOMAD™ is compatible with both traditional x-ray film and digital sensors, making it easy for you and easy for the patient.
More Convenience – Less Cost Because the NOMAD™ Cordless Handheld X-ray System is completely portable, just one can replace multiple wall-mounted x-ray sources.

[1] http://www.aribex.com/product.htm

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The following table (adapted from a Schick ad) shows the steps required to view an image with a direct corded sensor as opposed to an indirect phosphor sensor.
             Direct                                            Indirect

Insert sensor into barrier (once)PositionExposeView

Erase each PlateInsert into barrier (each plate)PositionExposeTake to Scanner areaClean up hands and platesOpen barriersInsert plates in scannerArrange images in proper order in software.Retrieve used platesReturn to patientView

The fact is there is a considerable difference in ease of use and time required to acquire an image. With a direct system the dentist can be viewing the image in less than 10 seconds. With an indirect system the time from exposure to viewing is virtually the same as film.

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I will be presenting three talks at the ADA meeting next week in San Francisco. I will be doing a round table all day at Technology Day Sept 26. Then I will be speaking the afternoon of the 27th and the morning of the 28th.
See you there.

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Microsoft Vista and Kodak ProductsAs many of you may know Windows Vista was released this year. Windows Vista is a significant upgrade from Windows XP with many changes that impact our products. We are in the process of enabling our products to run under Vista and we are taking the necessary steps to ensure we thoroughly test our products before we can recommend upgrading to Windows Vista.However, at this time our current releases are not compatible with Windows Vista and should not be installed or run under the Vista operating system.Until our products are enabled and tested under Vista, do not upgrade to Windows Vista, or purchase new equipment with Windows Vista until our products are ready. Note that our products are fully compatible with Windows XP and Windows XP is available as option with most equipment vendors.
Important Notice Regarding Microsoft Windows Vista [1].

[1] http://www.kodakdental.com/vista.asp

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A digital radiography sensor (the corded kind) takes the place of the film; but that’s not all, it also takes the place of the processor. (This is not the case for so called wireless sensors which still need a processor.)
Dentists or hygienist are often panicked that if they only have one sensor it might be in use when they need it so they must have several sensors.
That is silly. If an office can function with one automatic processor it can function with one sensor.
Larger offices often ask me how many sensors they need when switching to digital. The simple answer is how many automatic film processors do you need? If they are getting by with one processor they can almost always get by with one sensor.

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Line Pairs per Millimeter (lp/mm). This is a measure of resolution, which refers to pairs of lines pressed tighter and tighter together until they eventually merge into a single line. The more lines that can be pressed into a millimeter and still be seen as individual lines, the higher the resolution. Digital radiography sensors can acquire images ranging from 8 to <20 lp/mm. The unaided human eye can distinguish about 10 to14 lp/mm. Is that extra resolution lost? Not really that’s where the software takes over.
Pixel and Megapixel. Pixel is short for picture element. Basically it is a dot on the computer screen. The dots are arranged in rows and columns and are so close together they appear to be connected. The dot can be a shade of gray or a color. A typical 800 x 600 image has 480,000 pixels. The more dots that make up an image the better the resolution. A megapixel is simply one million pixels.
8 bit or 12 bit. A bit is short for binary digit. In graphics the term refers to the number of different shades or colors a single pixel can display. An 8 bit image is 2 x 2 x 2 x 2 x 2 x2 x 2 x 2 or 2 to the 8th power. If you do the math that comes to 256. Most monitors display an 8 bit image meaning each pixel could be one of 256 different shades of gray. A twelve bit image is 2 to the 12th power or 4,096. True color is 24 bits which allows for 16 million different shades. At most the unaided human eye can distinguish 100 shades of gray. Is the extra detail useless? It depends on the software.

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