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Chapter 24

Digital Radiography. Chapter 24. Digital Radiography. Invention of digital imaging Fundamentals of digital imaging & equipment Radiation exposure Advantages/disadvantages Infection Control Legal Issues. Digital Radiography.

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Chapter 24

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  1. Digital Radiography Chapter 24

  2. Digital Radiography • Invention of digital imaging • Fundamentals of digital imaging & equipment • Radiation exposure • Advantages/disadvantages • Infection Control • Legal Issues

  3. Digital Radiography • 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

  4. Digital Radiography • 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

  5. Digital Image • 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 8th power • Equals 256 shades of gray

  6. DIGITAL IMAGE • 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

  7. Storage Phosphor Imaging 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

  8. Charge Coupled Devices (CCD) • 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

  9. Complimentary Metal Oxide Semiconductor/Active Pixel Sensor • 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

  10. Charge Injection Device (CID) • 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

  11. Digital Subtraction • 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

  12. Advantages of Digital Images • 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)

  13. Disadvantages of Digital Images • 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

  14. Infection Control • 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

  15. Legal Issues • 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

  16. Safety • Continue placing lead apron with thyroid collar on patients • Handle equipment with care • Careful not to accidently toss a sensor in the garbage • Approximately $47-60.00 per plate • Do not trip over wired sensors

  17. Digital Radiography • 15-25% of dentists use Digital Radiography according to the ADA • Approximately, $11,700 to $15,500 per operatoryfor 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 3000.00 (wireless handheld)

  18. The End! • Any questions?

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