Chapter 9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental...

Chapter 9

Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson

• Define the key words.• Explain the fundamental concept of digital

radiography.• Differentiate between direct and indirect digital

imaging.• List the equipment used in digital imaging.• List and describe three types of digital image

receptors.

• Discuss digital radiography’s effect on radiation exposure.

• List and describe five software features used to enhance digital image interpretation.

• Identify advantages and limitations of digital radiography.

• Digital radiographs, or filmless imaging, are rapidly becoming an integral part of the paperless oral health care practice.

• A computer approach to x-rays will improve the quality of oral health care while reducing radiation exposure for the patient.

• The dental assistant and dental hygienist must understand basic concepts of digital radiography to use digital technology.

• Digital imaging systems used in dentistry replace film with a solid state (no moving parts) image receptor called a sensor or a polyester plate covered with phosphor crystals called a photostimulable phosphor (PSP) plate.

• Detect, confirm, and classify oral diseases and lesions

• Detect and evaluate trauma• Evaluate growth and development• Provide information during dental procedures (i.e.,

root canal therapy and surgery)

• The main difference between film-based radiography and digital imaging is that the film is replaced with a digital image receptor.

• Direct digital imaging — charged-couple device (CCD) and complementary metal oxide semiconductor (CMOS) technologies work equally well at converting x-rays into an electronic signal that is sent to the computer.

• Indirect digital imaging — uses photostimuable phosphor (PSP) plate sensor technology

• X-ray machine• Image receptors• Computer• Software

• Software: software programs allow the operator to manipulate programs. Features include:• Side-by-side displays of images• Magnification• Density and contrast• Measurement tools

• Software: software programs allow the operator to manipulate programs. Features include:• Charting• Digital subtraction• Artificial intelligence• Other features

• Spatial resolution — number and size of pixels• Gray scale — number of shades of gray visible on

an image• The goal of digital imaging systems is to produce

high-quality diagnostic images. The combination of pixels, spatial resolution, and gray scale determines the quality of the final image.

• Allows different digital systems to interface with each other.

• The American Dental Association Informatics Task Group has recommended that the DICOM standard be used for dental imaging systems.

• Oral health care practice of the near future will most likely see a decreased use of film-based radiography.

• Digital radiography is a method of capturing a radiographic image and displaying it on a computer screen.

• Film-based radiographs may be digitized by scanning or photographing to convert these analog images to digital files.

• Direct digital imaging — replaces film with a solid state sensor, that contains an electronic chip based on either CCD technology or CMOS technology.

• Indirect digital imaging — replaces film with a photostimuable phosphor (PSP) plate covered with a storage phosphor that captures the analog image similar to the action of film.

Digital imaging requires the use of a conventional dental x-ray unit, CCD or CMOS sensor or PSP plate, computer, and special software.

Special software is required and allows for manipulation of the image. Features include multiple views, magnification, measuring, charting tools, digital subtraction, and artificial intelligence.

• Digital radiography advantages include radiation dose reduction, instant images, elimination of the darkroom and chemicals and hazardous wastes, potential for improved interpretation through image manipulation, ability to transmit the images electronically, and effective patient education.

• Digital radiography limitations include retakes which could lead to excess radiation exposure, adherence to DICOM for transferring images between different systems, increased sensor width, decreased recording area, initial costs to convert to digital imaging, infection control, memory storage, computer crashes, and interrupted access to the data.

• General• Chapter Review

• The oral health care practice where you are employed is considering purchasing a digital radiography system. Using the Internet, search for companies that manufacture and sell dental digital imaging products. From your research, choose two companies and compare their two products.

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.A. What are the names of the companies that

manufacture the products you chose to compare?

B. What are the names of the digital radiography systems they manufacture/sell?

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.C. Do these digital systems have special computer

requirements, or can they be used with the computer currently in use at your practice?

D. What type of sensor does each offer? How are they alike? How are they different?

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.E. What size sensors are available?F. Are special sensor holding devices required

for positioning the sensor intraorally? Where can these be purchased?

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.G. What are the infection control guidelines for

the sensor? Does the company make custom-sized plastic barriers that fit the sensor?

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.H. Does software come with the purchase of the

digital radiography system? What features are included that will allow the operator to enhance the image for interpretation?

I. Are the companies adhering to DICOM standards?

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.J. Does the company offer training for your oral

health care team to learn to operate the system? Is there training in digital radiographic interpretation? Is there a fee for service and/or maintenance to the system after purchase?

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.K. Does the company offer articles or reviews of

their products by outside agencies that support their marketing claims?

L. Based on what you learned in this chapter, prepare a list of advantages and limitations of each of these products.

• Prepare an analysis to help your practice decide what digital radiography system will be the best choice. Contact the company for literature or additional information as needed to answer the following questions about each of the products.M. Based on your research, which product would

you recommend your practice purchase, and why?

• Proceed to Chapter 9, Laboratory Application, to complete this activity.

Chapter 9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental...

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