Buyers‘ Guide Digital Radiography—Intraoral Sensors

In the dental practice, production lost during the conventional x-ray-developing downtime (5 to 10 minutes) has always been a costly bottom line item. Essentially immediate computer-generated radiographic images, however, eradicate this irritating and expensive problem implant machine. For the dental team, the elimination of the darkroom, developing chemicals, solution replenishment routines, foul odors, and increasingly complicated environmental liabilities are welcome changes.

Today’s digital radiographic systems offer highly accurate and clinically relevant diagnostic information. Their many advantages include: virtually immediate results, clinical accuracy, expanded diagnostic options, decreased patient radiation, convenient data storage and communication, ease of clinical use by auxiliaries, decreased consumable costs, and a more environmentally friendly profile.

As new diagnostic technologies crowd the dental marketplace, practitioners looking to replace their analog silver halide radiographic equipment have many options in a variety of innovative technological directions. In fact, more and more practices are making the switch to digital radiography.

Digital radiography is advantageous for all dental instruments. The significantly decreased exposure to ionizing radiation is much better for the patient’s health. The digital data is far more effective diagnostically (more detailed, more accessible, and more manipulable) and far more practical clinically than conventional techniques and materials. The manipulation of the raw radiographic image to mine additional diagnostic data without re-exposing the patient to additional radiation is increasingly important. The storage and sharing of data is more practical and less cumbersome. Dental digital radiography is simply faster, cleaner, more effective, and better than traditional silver-based film dental implant machine. The ability to actively co-diagnose and co-treatment plan on the chairside screen in conjunction is highly appreciated by patients.

Several categories of dental radiographic imaging technologies have been introduced into the dental marketplace. In general, they can be operated with existing x-ray units, the only major requirement being a significant decrease in radiation emission. Practitioners looking to update and upgrade their existing (silver halide) radiographic systems have excellent clinical options. One of the most important selection criteria is the sensor-to-computer data transfer mode. Some digital chip sensors, such as the CCD (charge coupled device) and CMOS (complementary metal oxide sensor) are either hardwired to the computer through a USB or utilize a Bluetooth connection. The digital PSP (phosphor storage plate) sensors are wireless and are most similar in appearance, diagnostic area, function, and convenience to traditional radiographic film.

The three types of sensors, CMOS, CCD, and PSP, are equivalent in terms of the data that they accumulate per square millimeter during their brief exposure to ionizing radiation and then transfer to a digital image format. PSP diagnostic areas are typically greater, however. Digital phosphor plate sensors are totally wireless and independent, functioning very similarly to analog film; instead of a series of messy chemical baths, the reusable sensor is read by an electronic scanner.

Sensor dimensions are crucial to diagnostic utility. The larger the active surface (or image) area, the greater the amount of information the sensor provides to the practitioner. A traditional size 2 film provides about 1,100 mm2 of diagnostic area. Similarly, a size 2 wireless digital sensor offers 1,080 mm2 of diagnostic area. Digital chip sensors typically have a smaller active area, providing correspondingly less diagnostic information.

A further bitewing complication for the wired chip sensors is that the 4- to 6-mm diameter sensor wire must be placed between the posterior teeth, preventing complete intercuspation. The resulting empty interocclusal space is non-diagnostic, and, in fact, prevents the effective imaging of the gingival areas and the crestal bone, necessitating additional vertical radiographs.

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