Technical Comparison between Vatech / Sirona / Planmeca / Instrumentarium RX SOLUCIONES DE IMAGENOLOGÍA S.A. de C.V. www.rxdigitalschick.com radiografiadigitalschickgdl@gmail.com contacto@rxdigitalschick.com Guadalajara, Jal. MÉXICO TEL (33) 3499-7095 / (33) 1300-5813 @RxDigitalDental

1. Pixel Size and Image Quality 1-1. Factors of effecting Image Quality Sensor Sensitivity, Sensor Pixel Size, Screen Resolution, Image Processing SW, X-Ray Quality, Accuracy of Focal Layer, Patient positioning, ect. 1-2. Comparison Chart of Pixel Size Company Model Pixel Size **Pixel Size After Binning Theoretical Line Pair Sirona Orthophos XG 28㎛ (?) Planmeca Promax 33㎛ Pano 66 / Ceph 99 ㎛ 7.6 / 5.05 lp Instrumentarium OP200D 48㎛ 96 ㎛ 5.2 lp VATECH PaX-Series 22 / 48㎛ 44 / 96 ㎛ 11.4 / 5.2 lp ** Pixel Size After Binning

1-3. If Image Pixel Size is 96㎛, The Resolution is O.K.? Monitor Resolution Image Resolution Normal Monitor : 1024 x 768 Super High Resolution Monitor : 2048 x 1536 2840 x 1536 pixels - Conclusion As you see our image resolution, it is more than the resolution of Super High Resolution Monitor. It means our image resolution is good enough.

1-4. Sensor Structure and Image Quality 1) General Recognition : Small Pixel Size -> Good Sensor -> Good Image ??? 2) Structure of Image Sensor Module X-ray -- CsI (transferring X-ray to Visible Light) -- FOP -- Detector The important thing in the sensor design is for increasing the life time of the sensor module and reducing the scattered light The sensor module which has smaller pixel is not better sensor. The most important thing is the optimized design for life time of the sensor module and reducing the scattered light.

2. Sensor Resolution 2-1. Line Pair 2-2. Line Phantom - Unit of sensor resolution : Line Pair Per mm (lp/mm) - Theoretical formula = 1mm / (2 x Pixel Size) - e.g. Pixel Size 25㎛: 1000 / (2 x 25) = 20 lp/mm 2-2. Line Phantom Real Measurement by Line Phantom 구조 Pixel size ( 이미지용 / 센서용) Resolution 타사에서는 10 ip도 얘기하나 이것은 이론상의 수치. 실직적으로는 최대 5 ip가 최대이다. 실질적은 인트라오랄센서에서 10ip 이상만 되어도 아주 좋은 이미지를 회득할 수 가 있다. 팬텀은 유관상으로 측정해야 되는 것인지 현미경으로 해야 되는 것인지 기준이 정해 진 것은 없다 따라서 업체들이 얘기하는 lp는 자체 기준을 설정 사용 2-3. Difference between theoretical Line Pair and real Line Pair - The other factors are not perfect : Focal Trough, Scattering, Noise, Image processing, etc. - Manufacturers do not calculate the effect of Pixel Binning on purpose - Have no Standard Method to evaluate Line Pair by using Line Phantom (Under discussion at American Radiology Association)

3. Number of “bit” (Gray scale) and Image Quality ☞ 12 bit (212 = 4,096 ) data provides 16 times higher image quality than that of 8 bit data(256). A B 1) 16 bit data = Header(4bit) + Tail(12bit) Header(4 bit): positioning & addressing the data Tail (12 bit): the data 2) The Resolution of the Monitor The white-and-black on the monitor is expressed by 8bit apart from the medical monitoring equipment. Red: 8bit Green: 8bit ----- > express the white-and-black part Blue: 8bit A B Image quality of A is different from that of B in 12 bit data, But same in 8 bit data

4. CCD & CMOS Image Sensor 4-1. Structure CCD Charge Coupled Device Each pixel can transfer its electric charge to one or other of its neighbors. The last pixel converts the accumulated electronic charge so that the chip outputs digital bits. CMOS Complementary Metal Oxide Semiconductor Each pixel has its own charge-to-voltage conversion so that the chip outputs digital bits. Intra oral sensor, CT = CMOS (area sensor) Panoramic X-ray = CCD (liner sensor)

4-2. Which is better ? CCD or CMOS “Old-fashioned Issue” CCD CMOS Past - Particular Process - High Quality & High Cost General Process Noise Problem Now Fit to TDI System (Time Delay Integration) Fit to Panoramic X-ray High Quality & Low Cost (By the advance in technology) e.g. Canon 12Milion pixels Digital Camera (No.1 company in digital camera) - e.g. Schick : Intra-Oral Sensor

5. Wireless Intra Oral Sensor “ Do you have a plan to release the wireless intra-oral sensor? ” 1) Common Technology - The wireless communication is already commercialized - e.g. Mobile, Intra Oral Camera, etc. 2) The Problems & The Issues - Insufficient Power Supply Only few shots on full charge (Charge time is around 3 hours) - Unstable Telecommunication 3) The Failure of Example : “Schick”

Micro Electro Mechanical 6. Manufacturing Facilities for Sensor 6-1. Have our own Technology of Sensor Design & Manufacturing - Semi-conductor Production Technology & Industry of Korea (e.g. Samsung) - Vatech’s Know-how (located in the Samsung industrial cluster) 6-2. Manufacturing process of sensor & X-ray Wafer Die Bonding Machine Post-processing Micro Electro Mechanical System Processing Tube processing

7. Life time of Sensor 1) Life time (Experimental Data in our R&D Center) - 40,000 times continuative photographing for Panoramic sensor - 70,000 times continuative photographing for AnySensor (on going) 2) Term of Guarantee - Guaranteed for 1 year. - In case that customer wants longer terms of guarantee, the price condition could be variable. 3) How to operate the sensor for using longer time? - Prevent from the shock. - Sensor is designed to withstand high temperature and sudden changed in temperature. However we strongly recommend to keep our sensor from -5° to 25°.

8. Focal Spot 8-1. Comparison Chart of Focal Spot VATECH “S” “I” “P” Tube model D-051S SR90/15 D-054S Maker Toshiba OPX (Italy) Spot Size(mm) 0.35*0.5 0.5*0.5 We use one of the best products from Toshiba which has the highest quality. 8-2. Effect of Small Focal Spot Focal sopt size는 튜브에 따라 결정되는 요소로 현재 바텍은 도시바의 D-051S를 사용한다. 이것은 아주 작게 될 결우, 이미지 획득을 위한 충분한 X-ray 조사량을 얻지 못하기 때문에 적정 사이즈를 필요로 한다. 이러한 포컬 사이즈는 그 외의 X-ray tube 설계시 적정한 조합이 필요하다 참고로 바텍을 X-ray Generator Design을 자체적으로 하고 있다.

9. Exposure Time 9-1. Comparison Chart of Exposure Time Panoramic Standard Cephalometric sec kVp / mA Vatech 12.9 / 9.8 68kVp / 08mA 12.9 / 1.9 72kVp / 08mA P Co. Ltd 18 / 9~10 68kVp / 12mA S Co. Ltd 12~16 70kVp / 10mA I Co. Ltd 14 72kVp / 12mA 시간을 줄임으로써 데이타 량을 적게 받고 이미지 프로세싱을 통해 질을 높였다 => 환자에게는 좋은 효과 피폭량은 스캐닝 타임과 kVp/mA 중요 Ceph: 2.3초는 두개의 센서를 빨리 0.3초는 Orthomaster

10. DC & AC 10-1. What is DC? What is AC 10-2. Merit & Demerit of DC ☞ AC type : Kvp ☞ DC type : Kv AC, DC 10-2. Merit & Demerit of DC Merit : Stable waveform (stable exposure of X-ray) & Lower noise - Demerit : High Cost

☞ FM (Frequency Modulation) ; ☞ PWM (Pulse With Modulation) ; 11. FM & PWM 11-1. What is FM? What is PWM ☞ FM (Frequency Modulation) ; Power increasing through changing the frequency ☞ PWM (Pulse With Modulation) ; Power increasing through changing the Pulse Timing 11-2. Technology of PWM There is no special core technology. The difference is just the electric parts The price of parts was high, but it is just the same as that of FM parts at the moment

12. How much X-ray patient be exposed Natural (1 Day) Intra Oral Panorama CT Amount 6.6 μSv 22 μSv (3 Film) 26 μSv 50 μSv Ratio 1 3.33 3.93 7.58 ** The source of this information is from “Korea Institute of Nuclear Safety” Originally, since the amount of X-ray exposure is 4 times as much as natural radioactivity. Almost no hazard for human body. 질문하는 아그들 >> 그 나라에 바텍 제품을 등록하거나 설치할 때 검사 자료로 사용하기 위해 질문하는 것이다.

13. What is Calibration ? 1) Reason for Sensor calibration - Every sensor consists of many pixels. - Each Pixel has different sensitivity against the same X-ray signal. - If there is no process of calibration, the pixels do not show the same reaction against a certain X-ray signal. - In this condition the X-ray image can not be good. 2) What is the process of calibration - Adjust all the pixels on the sensor to show the same reaction against a certain X-ray signal. - It needs very special technology of HW & SW. - Not only in hardware but in SW algorithm is very important. - Calibration technology is the main factor for qualified image.

(Flat-Field Correction) (pre-image porcessing) (post-image processing) 14-1. Image Processing Procedure Offset correction Gain correction FFC (Flat-Field Correction) Image enhancement Data gaining (12bit, raw data) Pre – image (pre-image porcessing) Post - image (post-image processing) Final image capture.

14-2. FFC (Flat Field Correction)

Pre-post processed Image 14-3. Post Image Processing (Image Enhancement) Sharpen Pre-post processed Image Contrast

15. What is PACS 15-1. Diagram of Picture Archiving Communication System

15-2. Do you need PACS ? DICOM Format is supported. Case 1. So as to install our equipment on the place that PACS is already operating. Case 2. So as to set up PACS in some place. DICOM Format is supported. If PACS was already installed, we can link it with any equipment.

15-3. DICOM (Digital Image Communication on Medicine) Format

16. Data Back up in Digital System 16-1. Is it essential ? - Data back-up is very important in digital system. - EasyDent is designed to back up your digital data very easily. 16-2. How to back up the digital data ? - Back-up media will be changed so fast according to the development of technology (e.g. Floppy disk) - In case of CD : possible to use. But, not everlasting - Able to recommend method : Back up system using exterior type hard disk and raid card (Mirror식 저장: 이미지를 평상시대로 저장하면 자동으로 PC에 저장되는 데이터와 똑같이 외장형 Hard Disk로도 저장되는 방식으로 번거로움 없음) (추천 외장형 하드 소개 : 인지도 있는 업체 제품) Be able to back up all the information without any delay like a mirror

17. Solution for Eliminating blurred image of Incisor 17-1. Cause and Current solution ? - Cause : Because of spine X-ray signal is too weak to transfer enough signal to the detector - Current Solutions Scanning spine, increase the x-ray power or electronic frequency Scanning spine, decrease the speed of rotator’s movement  not a good solution - GAC Technology (New Projection Geometry Avoiding Cervix) will be the real solution 현재 우리는 1번 방식(kvp증가) 이용 -> 몸에 남아있는 잔존량 적다 2번 방식 -> 몸에 남아있는 잔존량 많다 Pax 500부터는 3번 방식 이용

17-2. GAC Technology (New Projection Geometry Avoiding Cervix) [X-ray ] OFF [X-ray] ON spine ON

www.rxdigitalschick.com @RxDigitalDental RX SOLUCIONES DE IMAGENOLOGÍA S.A. de C.V. www.rxdigitalschick.com radiografiadigitalschickgdl@gmail.com contacto@rxdigitalschick.com Guadalajara, Jal. MÉXICO TEL (33) 3499-7095 / (33) 1300-5813 @RxDigitalDental