Digital imaging is an advanced form of X-ray that produces a digital radiographic image instantly on a computer. It utilizes wireless or wired phosphor plate sensors or hard sensors known as receptors, rather than a film. During a dental examination, this imaging technique uses X-ray sensitive plates to capture data. The data is then transferred immediately to a computer without the use of an intermediate cassette. Digital imaging enables dentists to make an accurate dental diagnosis. At The Downey Dentist, we use advanced digital imaging techniques while diagnosing our patients to identify the specific dental problem.
Understanding Digital Imaging
Digital imaging technology provides a more comprehensive and clear view of the teeth, oral tissues, nerves, and bones inside the mouth. Digital imaging is a crucial tool for dental health practitioners because the naked eye is often not enough to view a patient’s mouth fully. Digital imaging helps to uncover conditions not visible to the naked eye. Conditions that might be difficult to detect without imaging include impacted teeth, tumors, cysts, bone loss, and tooth decay.
Dentists store and compare images over time to determine changes and improvements in the affected areas. The technological advancements in digital imaging help dentists to provide a proper dental diagnosis. They also help patients to understand their dental health better. With digital images, the dentist displays the images on a screen where a patient can analyze the image.
Before the emergence of digital imaging, dental clinics relied on film-based radiography. Darkroom image processing was necessary with conventional film-based imaging. The modern equipment used in digital imaging helps dentists to save time and resources.
Equipment Used in Digital Imaging
For a digital imaging procedure to be successful, certain equipment is required:
- X-ray unit
- Computer hardware
- Sensors to capture images
- Software for viewing, storing, and transferring images
- A digital system
- A scanner
The X-ray Unit
Dentists can use a standard x-ray unit with digital imaging and radiographic film. For an x-ray machine to be used with digital imaging, its control panel must be convertible into exposure time. The control panel has to use exposure time and not impulses. If an x-ray unit's control panel cannot be converted into exposure time, the device cannot be used in digital imaging.
Advanced x-ray imaging uses digital x-ray sensors as opposed to the conventional photographic x-ray film. This helps to produce enhanced images of the oral structures, gums, and teeth. Using an x-ray film scanner, dentists can also view conventional x-rays as digital images.
Dental experts rely on intra-oral x-rays to obtain excellent details, especially when detecting cavities, monitoring mouth health, and checking the status of developing teeth. For most dental clinics, the standard intraoral x-ray unit consists of a wall-mounted scissor-arm system. However, portable, hand-held x-ray devices have continued to gain popularity over time.
Dentists use extra-oral x-ray units while detecting problems between the teeth and the facial bones or the jaws. Extraoral x-rays also come in handy while monitoring jaw growth and development or when checking for impacted teeth.
Digital Image Sensors
Sensors are also known as digital image receptors. As opposed to using the conventional x-ray film, the sensors are the receptors in digital imaging. The two types,
- Indirect photostimulable phosphor plates and
- Direct solid-state sensors
Solid-state sensors are wireless and are made of fiber optic cables powered by batteries that transmit data through radio waves. With these options, toggling between wireless Wi-Fi and hardwired USB is possible. Dental staff can move between treatment rooms without the need to carry sensors with fiber optic cables.
Computer Hardware and Software
Dental clinics require particular computer hardware and software to effectively carry out digital imaging. Many dental offices have computers in the treatment rooms. At times, the digital imaging software may be added to the existing software in a dental office if the system is compatible with the existing dental software. Even when providing digital images, there might be a need to provide hardcopy images. Therefore, dental clinics work together with their digital imaging manufacturers to find printing systems compatible with their dental imaging systems.
The Basics of Digital Imaging
An X-ray machine is used in digital imaging, but the image is converted from analog to digital. Digital image production undergoes a process called Analog to Digital Conversion (ADC). Digital images are composed of pixels organized in a matrix of columns and rows. There are two steps involved in ADC, which are sampling and quantization. Sampling involves grouping together a small range of voltage values to form a single value. After sampling, each sampled signal is given a value or number. In quantization, the computer puts the pixels in their right locations and displays gray shades corresponding to the value or number provided. This helps the dentist to see the digital images.
The analog image is converted to a digital image when the photons from the X-ray tube head strike the sensor and then transmit it to the digital imaging software. The digital images are composed of columns and rows of pixels of images, aligned to represent the image's gray level or intensity.
A number or value is assigned to every pixel representing the gray level or intensity of every location in the image. The computer's software organizes the pixels and shows the density of the object through several gray shades. Anatomy like lamina dura, dentin-enamel junction DEJ, and bone trabeculation is easier to diagnose due to pixel technology in digital sensors with high contrast in digital imaging.
Elements of Digital Imaging Cycle
There are five key elements of the digital imaging cycle:
- Acquiring a digital image
- Processing the digital image using an ideal image analysis technique
- Image manipulation using the right software
- Image storage for easy access and retrieval
- Communication, image transfer, viewing, or presentation of the image on computer monitors
Digital Image Acquisition
There are several ways of obtaining a digital image. By using a transparency adaptor and a flatbed scanner, the conventional radiograph can be digitized. Two main types of detector or sensor systems are available: semi-direct digital systems and direct digital systems. The image sensor also plays a primary role in image acquisition. CDD sensors are the most common where a wire connects the sensors with the computer to ensure that an image is displayed instantly on the computer monitor. The PSP sensor is also used in the acquisition of digital images.
Digital Image Processing
Digital image processing results in a more visually appealing image, and it entails correcting the image for any known deficiencies. Image processing also entails compensating for defective pixels and removing blur. The common image processing and enhancement techniques in digital imaging include digital subtraction, filtering, and color setting.
Digital Image Storage
When a dental image is available in digital form, it is stored in a computer system. Digital compression comes in handy in reducing digital images' size to make it easy to store the images in the computer system. Even with the current generation of high-speed fiber-optic networks and storage media, it is challenging to manage large imaging files.
Digital Images Communication
Digital images are stored in computers in compressed form to ease communication, access, retrieval, and transfer. Dental experts use file formats that can accommodate all the imaging data and remain scalable and shareable.
Procedures of Intraoral Digital Imaging
Procedures of intraoral digital imaging vary by manufacturer. Quality assurance is vital with digital imaging, as with all aspects of dentistry. The National Council on Radiation Protection and Measurements Report 145 recommends a written protocol for image receptor systems in dental offices. Research shows that most dental offices use wrong exposure settings, leading to higher radiation dosage and lower diagnostic capabilities.
Loss in spatial resolution may occur despite proper handling and care of phosphor plates. Phosphor plates should be cleaned and carefully handled according to manufacturer instructions. It will also help reduce phosphor plate deterioration resulting in surface contamination and damage.
A dental practice is advised to hold regular in-office training with clinical dental providers on digital imaging equipment, computer software, and hardware. Without radiation, the in-office training allows clinical dental providers to troubleshoot placement with different receptors in each other's mouth. The better a clinical dental provider troubleshoots digital imaging techniques, the more time they can dedicate to other dental practice treatments.
The Benefits of Digital Imaging in Dentistry
Some of the leading benefits of digital imaging in dentistry are:
It Enhances Productivity and Saves Time
With digital imaging, the long processing time of conventional radiography is reduced. Using this modern technology, dentists can view X-ray images in seconds and instantly store them on a computer. It eliminates the time dentists take thumbing through files to retrieve an image. All dental images are just a few clicks away from digital imaging.
Dentists don't need to duplicate or deal with shipping when their clinic or hospital needs to send an X-ray to another specialist or insurance company. Digital images are always ready to go, and dental clinics can fully automate the attachment portion of the daily dental claims.
Images are Secure
Digital imaging eliminates the risk of losing essential dental radiographs. Dentists don't have to worry about images separating from their files or becoming loose from their holders because digital imaging safely stores your X-rays. The images are also safe if the drive is lost in floods, file, or stolen when used with a Redundant Backup System.
Digital Imaging Offers High Quantity of Care
Today's patients are concerned about radiation exposure, and the machine dentists use to examine them determines how they will perceive a dental practice. Dental clinics may place themselves at a disadvantage if they use conventional radiography. Digital imaging reduces patients' exposure to radiation by 75% or more due to digital imaging sensors' sensitivity.
Radiation exposure time can be reduced when changing from radiographic film to digital sensors. For instance, an exposure time required to produce a radiographic film is 0.2 seconds, while a digital image would require an exposure time of 0.05 seconds. Standard radiation safety procedures demand that the patient is covered in a lead apron with a thyroid collar, and the dentist should be at least six feet from the X-ray tube head. When a dentist uses a digital X-ray machine, patients will notice a higher level of care.
Digital Imaging is Easier to Operate
Compared to conventional radiography, dentists and their staff can quickly operate digital imaging machines with brief training. Most dentists acknowledge that digital imaging is faster, cleaner, and easier compared to any conventional radiography.
Digital Imaging Enhances Images
A dentist can make images lighter or darker on demand. A digital X-ray system allows dentists to control each image's exposure in real-time. Dentists can also make superimpose textures, enhance the color, and enlarge images. The features help dental experts to identify the dental disease and its current state. They also produce instant visuals for compelling patient education. Digital imaging enhances quick diagnosis and high treatment plan acceptance.
Digital Imaging Facilitates Faster Sharing of Images
Digital imaging enables dental experts to send images to other practitioners in a short time. Dentists may send digital X-rays while treating a patient or talking on the phone. The result is faster, better collaboration between dental colleagues.
It Enhances Quality X-ray Images
In dental imaging, details and clarity are important. Digital X-ray machines provide quality images that reveal tiny fractures, surpasses traditional films, and brings out imperfections missed by conventional films. Unfortunately, not all dental imaging systems are the same. Therefore, a dental practice needs a digital imaging vendor to demonstrate the machine with live X-rays to make performance judgments.
It Eliminates Chemical Developers
No dentist would wish to deal with fixing solutions and harmful chemicals. Digital imaging eliminates automatic film processors, reduces the space they require, wait times, and takes the odor.
Digital Imaging Reduces Cluttering Files in the Office
Storing, organizing, and filing paper charts can be a difficult task. Dentists eliminate the need to store and file hard copy radiographic images with a digital imaging machine. They can access images stored in a database digitally directly from the software you use to view the images or from any networked computer. Dentists can also free up more office space by scanning and storing all your pre-existing X-rays within the same database.
Disadvantages of Digital Imaging
The negative part of digital imaging in dentistry is the cost of the machines. The digital imaging machine requires two separate detector plates, one for each Bucky position. The detectors are expensive, and they need to be positioned at an appropriate angle for imaging. Purchasing computer software, hardware, and digital imaging sensors is also expensive. There are software updates, repairs, maintenance, and equipment replacement that should be considered while changing from radiographic film to digital imaging.
Digital imaging will also need dentists to ensure infection control while taking images. Since the sensors cannot be sterilized, dentists will need to buy disposable barriers and place them over hard sensors and phosphor plates. They can reuse phosphor plates severally before replacing them, but you will need to replace them more often when damaged. The dentist may not make thorough diagnoses if the phosphor plates are damaged since they obscure the image.
Patient comfort is another concern regarding digital imaging equipment. Like films, direct sensors are hard and not flexible. Depending on the manufacturer, they can also be thick. However, few hard sensors with excellent density and contrast allow enhanced diagnoses of incipient lesions.
A disadvantage that prevents some dentists from buying hard sensors is the patient comfort and limited positioning of the sensor intraoral due to patient anatomy. Training is required to show a clinical dentist how to place sensors to cover the whole patient because of the different digital sensors available.
The digital imaging machines also require monitors with high resolution and high luminance to view final digital images. It also requires large volumes of digital storage on the right media. Additionally, a digital imaging machine depends on picture storage and communication systems with high bandwidth so that the high-resolution images can be stored.
Preventing Infection With Digital Imaging
Dentists have to adopt infection control measures to avoid cross-contamination when taking images. They have to place barriers on the sensors during digital imaging. Dentists often use plastic barriers for hard sensors used in direct and indirect phosphor plate digital imaging. The wired direct sensors require barriers over hard sensors and fiber optic cables. Most digital image receptors are autoclavable, but dental experts often consult their colleagues or your dental sales representative on what they recommend with digital imaging systems.
While working with phosphor plates, dentists wrap each sensor in a plastic barrier to avoid contact with saliva. They also check the manufacturer's instructions to see how the sensors can be disinfected if the sensor becomes contaminated. If the sensor is contaminated, the Center for Disease Control (CDC) recommends an EPA registered intermediate-level disinfectant before using the sensor on the next patient and after removing the barrier.
Find the Best Dental Digital Imaging Services Near Me
If you seek an informed and reliable dental diagnosis through advanced digital imaging, The Downey Dentist has the best solution. Our dentists rely on modern digital imaging techniques to diagnose the patient's dental issues. We believe in making an accurate diagnosis the first time. Contact us at 562-746-0350 and speak to one of our dentists.