Digital Imaging in DentistryDigital Imaging in DentistryApplications and ChallengesApplications and Challenges

S. Brent Dove, DDS, MSS. Brent Dove, DDS, MSUniversity of Texas Health Science CenterUniversity of Texas Health Science Center

San Antonio, TexasSan Antonio, Texas

“A picture is worth a thousand words”

“Knowledge is valuable”

“Don’t waste it”

Digital Dental RadiologyDigital Dental Radiology

Intra-oral Panoramic Cephalometric Sinus and Skull Tomography CT MRI

Advantages of Digital RadiologyAdvantages of Digital Radiology

No Darkroom No Chemical Processing Lower Cost Per Image Instant Viewing of Images Less Radiation to Patient Image Processing and Analysis Transmission of Images for Consultation

CCD/CMOS-based SensorCCD/CMOS-based Sensor

X-rayBeam

ScintillatorFiber OpticsCCD

#2 #1 #0#2 #1 #0

Standard&

High Resolution

High Standard

High Resolution = 22.5 Standard = 45

CCD/CMOS - 45CCD/CMOS - 45

CCD/CMOS - 22CCD/CMOS - 22

Storage PhosphorStorage Phosphor

X-rayBeam

Imaging Plate

Storage PhosphorStorage Phosphor

Helium-NeonLaser

Imaging Plate

Photoreceptor

Storage PhosphorStorage Phosphor

Storage PhosphorStorage Phosphor

Diagnostic AccuracyDiagnostic Accuracy

Primary Dental Caries

Recurrent Dental Caries

Periodontal Disease

Periapical Lesions

Endodontic File Length Determination

CCD Extra-oral RadiograpyCCD Extra-oral Radiograpy

TomographyTomography

Panoramic RadiographyPanoramic Radiography

Cephalometric RadiographyCephalometric Radiography

The Next GenerationThe Next GenerationThree Dimensional ImagingThree Dimensional Imaging

TACT

Small Volume CT

TACT™ Methodology TACT™ Methodology

Series of imagestaken fromdifferentangles

Slices of a maxillary molarSlices of a maxillary molar

Small Volume CTSmall Volume CT

Small Volume CTSmall Volume CT

Small Volume CTSmall Volume CT

The Future is Full of PossibilitiesThe Future is Full of Possibilities

Optical Biopsy

Laser Computed Tomography

3D Ultrasound

Laser Fluorescence

Computer-based FOTI

Computer Aided Diagnosis Computer Aided Diagnosis (CAD)(CAD)

Observational Errors

Misinterpretation Errors

Integration of Data Errors

Most Beneficial in Observational Errors

“CAD systems do not necessarily have to be better than the clinician, just help him not miss obvious lesions.”

Computer Aided Diagnosis Computer Aided Diagnosis (CAD)(CAD)

PAP Cytology & Oral Brush Biopsy

Mammography

Chest X-ray Screening

Periodontal Disease

Dental Caries

Digital Subtraction RadiographyDigital Subtraction Radiography

-

Neural Network DetectionNeural Network Detection

Digital Dental ImagingDigital Dental Imaging

Intra-oral Radiography Panoramic Radiography Cephalometric Radiography Tomography Intra-oral Photography Extra-oral Photography Histology & Surgical Microscopy

Interoperability ????????Interoperability ????????

The DICOM StandardThe DICOM Standard

The Digital Imaging and Communications in Medicine (DICOM) Standard is a detailed specification that describes semantics and syntax for exchanging images and associated information. The standard applies to the operation of the interface which is used to transfer data in and out of an imaging device.

DICOM WorkflowDICOM Workflow

DICOMArchive

Storage, Query/Retrieve, Storage, Query/Retrieve, Study ComponentStudy Component

Query/Retrieve, Query/Retrieve, Patient & StudyPatient & Study

Query/RetrieveQuery/RetrieveResults ManagementResults Management

Print ManagementPrint Management

LiteBox

DICOM DisplayWorkstation

Media ExchangeMedia Exchange

DICOMAcquisition

What is DICOMWhat is DICOM

Digital Imaging and Communication in Medicine

Standard for communication of images and image related information between devices

International in scope

All biomedical imaging

Voluntary standard

DICOM is Biomedcial InformaticsDICOM is Biomedcial Informatics

“the storage, retrieval, sharing, and optimal use of biomedical information, data, and knowledge for problem solving and decision making.” Edward Shortliffe

“model formation, implementation of the model, application of implementaion to the real world, evaluation of the implementation” Titus Schleyer

DICOM, Informatics, ResearchDICOM, Informatics, Research

Digital X-ray

Visible Light

Clinical Trials

Structured Reporting

The Future is Full of The Future is Full of PossibilitiesPossibilities