Digital Radiography

 Invention of digital imaging  Fundamentals of digital imaging & equipment  Radiation exposure  Advantages/disadvantages  Infection Control  Legal Issues

 In 1987, Dr. Francis Mouyen invented the first digital radiography system in Europe.  “Filmless imaging system”  No Film or processing chemistry is used  Less radiation exposure ( from 50-80% less)  Electronic sensor, scanner, and computerized imaging system

 Direct Digital Imaging (wired)-intraoral sensor is exposed to x-rays to capture an image viewed immediately on computer  Wired sensors can be bulky  In-Direct Digital Imaging (wireless)- intraoral wireless plate is used to capture image, then scanned and converted to digital form  Wireless sensors are similar in size to traditional film - slightly larger

 Analog image-radiographic image produced by conventional film (x-ray photons strike a film)  Bit-depth image- number of possible gray scale combinations for each pixel  8 bit-depth image has gray-scale combination of 2 to the 8 th power  Equals 256 shades of gray

 Array of picture elements called pixels  Discrete gray values for each pixel  Electronic charge is produced on the sensor  This electronic signal is digitized or converted to “digital form” when scanned to the computer  Line pairs/millimeter (lp/ml)- measurement use to evaluate the ability of the computer to capture the resolution (detail) of a radiographic image

 Image is recorded on phosphor-coated plates and placed into an electronic processor  Laser then scans the plate and produces an image on computer screen  Concorde’s Digital System  “Wireless” plate or sensor  Carrousel holds the plates

 Solid state detector used in many devices (video camera, fax machine)  Image receptor found in the intraoral sensor  Immediate viewing  Wired sensors  Must work around the wires  Direct digital image

 Another sensor technology is (CMOS/APS)  When APS was developed the CMOS became a useful sensor  Schick Technologies uses CMOS/APS instead of CCD and claims 25% better resolution  The CMOS/APS is also less expensive than CCDs  Durable

 Another Sensor technology  Silicon based solid state imaging receptor similar to CCD  No computer is required to process images  Intraoral video camera platform  CID x-ray sensor, cord, and plug inserted into the Reveal light source on the camera platform  Digital images are seen on the system monitor in seconds and stored in computer

 Another image enhance method to produce two radiographs in the same area of the mouth at different time intervals  The first image can be subtracted from the second to identify changes during a specific time period  Minimal changes of hard tissue & bone loss can be detected  Done by reversing the gray scale as an image is viewed  Cephalostat – head stabilizing device

 Images viewed almost instantly (less time)  Less radiation exposure to the patient  Saving on disposable costs for film and chemicals  Environmentally friendly  Ability to enhance images  Data storage  Communication with other Dentists (teleradiology)

 Upfront cost of equipment & software  Upgrading equipment  Cost of converting previous records to digital  Computers for each operatory  Must work around wired sensors  Loss or breakage of sensors/ or plates  Learning to use the software and equipment

 Digital sensor is a reusable device that cannot withstand the heat of the autoclave  Disposable barriers must be sealed over sensors to maintain asepsis  Barriers can be placed incorrectly, causing cross-contamination  Sensors must be tossed out if contaminated with saliva

 Digital images can be altered to show an apparent need for treatment that is not actually necessary  Although, there is upgraded software to protect from fraud and HIPPA regulations now on the market

 Continue placing lead apron with thyroid collar on patients  Handle equipment with care  Careful not to accidently toss a sensor in the garbage  Approximately $ per plate  Do not trip over wired sensors

 15-25% of dentists use Digital Radiography according to the ADA  Approximately, $11,700 to $15,500 per operatory for a wired system and $20,000 to $22,000 for a wireless system  Technology is continuing to improve  The Latest in Digital is the X pod is about (wireless handheld)

 Any questions?