Thinking digital?

Thinking digital?

Consider goals as a practice; weigh merits of each system

Intraoral radiographs are essential to perform quality dental therapy. Teeth can be cleaned and polished without seeing radiographic images below the gingiva, but "dentistry" cannot be performed properly.

How can a diagnostic film be obtained? Intraoral film is exposed with a standard veterinary whole-body system or a dedicated dental unit and processed either manually in hand tanks or by an automatic film processor.

Alternately, a digital sensor instead of film may be exposed, allowing the images to be captured and viewed directly on a computer screen. This way is easier, economic and in many ways more diagnostic compared to the "analog" film methodology.

Digital radiography sensors are positioned using parallel and bisecting-angle technique.
Making a conversion to digital is up to each practice owner. However, my experience is that it makes sense. It's rewarding to see enlarged images within seconds on a 17-inch monitor. Electronic processing and enhancement allow more diagnostic information to be extracted from the image. Digital images are easily saved in a variety of formats for insertion into the client file, to be e-mailed or used in a report given to the client. Archive image storage on the computer's hard drive is automatic and takes up no physical space or a technician's film-sorting time compared to film storage.

•Understanding digital formats Digital technologies available for dental imaging fall into two basic categories: photo sensitive phosphor (PSP) plates and digital imaging sensors. PSP technology uses an X-ray sensitive plate that replaces film. It is exposed by the X-ray unit, and placed into a scanning device, which records the latent image and converts it to a digital file in a computer within 45 seconds. While the plate is relatively rugged with less size restrictions, it must be handled in light-safe conditions similar to film. The plates need replacing after 50-500 exposures depending on the manufacturer at a cost of about $25.

Digital imaging sensors are wired directly or employ wireless (Schick) technology to communicate with the computer. The image can be viewed on-screen within seconds without additional handling or processing. The original sensors used a charge-coupled device (CCD) combined with a scintillator to produce an instant image. The process was termed RadioVisioGraphy (RVG). RVG was designed for "operative radiology" in human dentistry rather than to replace the full-mouth series of film images. During the past two decades, there have been five additional versions of the RVG — the most recent (Kodak RVG 6000 digital radiography system) is based upon a complementary metal oxide semiconductor (CMOS). With CMOS, high-efficiency, low-noise images are produced, which then are digitized and transmitted to a computer via a standard USB port. AFP Imaging, Bio-Ray, Kodak Dental Systems, Progeny, and Schick represent popular system manufacturers on the market.

This oral survey helps the clinician assess the dental health of this patient. This survey depicts the maxillary teeth above mandibular teeth.
•Digital essentials If you decide to go digital, what will you need to get started?

A dental X-ray unit is required to expose the sensor. Traditional AC units are adequate, but if the veterinarian is purchasing all new equipment, DC generators produce a homogeneous X-ray beam that works best with the sensor. Because the amount of radiation necessary to produce digital images are less than traditional film, old dental X-ray units might need to be replaced.