DICOM WG 22 (Dentistry) Past, Present, and Future Past, Present, and Future Allan G. Farman, Founding Co-Chair DICOM WG 22 President, AAOMR

Orthodontist OralSurgeon Endodontist Images referred to specialists Practice management data base archive 2y Admin Uses SateliteDentalOffice Patient Alternative Digital System in Same Office Hospital or Physician Forensics GeneralDentist

You are a Dental Practitioner without a digital system. You make a photograph of the radiograph on your viewbox, or use a transparency adaptor to your flatbed scanner. You refer the images to a second dentist and they are transferred efficiently. PROBLEM: The JPEG images have no image file attributes to indicate patient unique identifier, date of exposure, or even R-L orientation. The radiograph could be misidentified as belonging to the wrong patient or incorrectly orientated. SCENARIO #1

You are a Dentist with digital X-ray system “A” You make a dental Io image using System “A” and refer the patient to an Endodontist with System “B”. The image from system “A’ is displayed with System “B”. The Endodontist makes Endo completed images with System “B” and sends them to The GP. The GP sends images from Systems “A” and “B” to a Prosthodontist with System “C”. Images from “X,” “Y” and “Z” can be interoperable because all can use the DICOM file format. SCENARIO #2

DICOM IN DENTISTRY 1983: ACR-NEMA => 1992: DICOM => 1994: DICOM demonstrated by 25 vendors at RSNA infoRad 1996: DICOM Standards Committee “re-formed”: ADA was the first representative of organized Dentistry (Summer): Six dental vendors meet at CAR/CMI San Francisco to investigate cooperation on digital interoperability/DICOM (Fall): ADA House of Delegates Resolutions supports DICOM for image interoperability in Dentistry.

B-164. Resolved, that the ADA adopt the Digital Imaging and Communication Standard (DICOM) as its standard for communication of digital dental images; and be it further Resolved, that the appropriate agencies of the ADA develop and communicate a definition of compliance with the DICOM and other relevant standards that can be used by the members to ensure vendor's compliance and be it further Resolved, that the appropriate agencies of the ADA develop a mechanism for recognizing vendors in compliance with the ADA definition of the DICOM and other appropriate standards. American Dental Association Board Resolution B

DICOM IN DENTISTRY 2001 (Feb): Vendors meet before Chicago MidWinter Dental Congress. ADA Standards Committee on Dental Informatics WG 12.1 (Interoperability) formed. 2003: DICOM WG22 (Dentistry) formed. Initially membership similar to that of SCDI WG : DICOM WG22 Task Groups formed in Japan and Europe as well as the USA. Membership evolves. 2010: AAOMR and AAO apply for DICOM Standards Committee Membership.

Efficiency: Integration of different modalities in one dental office. Portability: Exchange of images between dental practitioners needed when patients move or require specialist care. Integrity: Attributes uniquely identify the patient, procedure, procedure date and protect image integrity. Why DICOM in Dentistry?

Demonstration projects at ADA Annual Sessions CD x4 Years Education in the Round Live Operatory x2 Years

(1)Supplement 92 – Dental Grayscale Images (2)Supplement 113 – Transport (3)Supplement 116 (with WG 2 # ) – 3D X-Ray (4)Supplement 123 – Structured Display (5)Supplement 132 (with WG 24*) – Endosseous Implants (6)Future Work (with WG 24) – Optical Surface Scans (7)Future Work (with WG 24) – Prosthetic Chain [Europe] (8)Future Work – Dental Query/Retrieve [Japan] # Dx *Surgery WG 22 Work

 There is a story about four people named Everybody, Somebody, Anybody, and Nobody.  There was an important job to be done and Everybody was sure that Somebody would do it. Anybody could have done it, but Nobody did it.  Somebody got angry about that, because it was Everybody's job.  Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn't do it.  It ended up that Everybody blamed Somebody when Nobody did what Anyone could have. author unknown