Buyers Guide: Digital Intraoral X-ray Systems

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What I Need to Know
The Questions to Ask
Definitions

Dentalcompare

Clinical Director

Why Digital X-rays?

Before considering what digital intraoral x-ray system to purchase for your practice, it is important to understand how much more powerful every digital system is over traditional film x-rays.

Less Radiation – Perhaps one of the most important features of digital x-rays is the sensors themselves require less radiation from the x-ray generator to “expose” the image. Compared to dental film, you can expect to need up to 90% less radiation depending on your exposure settings.

Digital X-Ray Highlights

Save time with faster image captures and no image processing
Improved quality with higher resolution images
Better communication with larger images to show patients
Reduced radation exposure for patients
Easier storage and sharing of images
Enhanced diagnositc capabilities with image processing

Exposure – Digital x-rays provide instant exposure. You do not have to mess around with chemicals, and you don’t have to spend time waiting for—or maintaining—the developer. Plus, there is no wasted time mounting the x-rays into holders.
Storage – Film x-rays must be stored in a patient’s chart, and this takes up physical space. Additionally, they degrade as time goes on. With digital x-rays, you have nearly unlimited storage on a hard drive. Because they are digital files, the x-rays themselves will never yellow or degrade over time.
Access – Because the x-rays are stored as files on a computer, you can have multiple people accessing the same image at one time. For example, while an assistant is capturing the x-rays in the operatory, the dentist could be reviewing the images from another room.
Patients – Patients are more aware than ever of the amount of radiation they are exposed to. They encounter it everywhere from hospital CT scans to airport screening systems. Besides limiting their radiation exposure, patients also benefit from improved communication. It is much easier for a patient to see an image on a screen than it is to squint at a tiny film x-ray.
Diagnostics – Digital x-rays can provide more image resolution than film. With most systems, you also can adjust the contrast to optimize the image for hard or soft tissue features, or to clarify the possible presence of decay.
Return on Investment – With digital x-rays, you no longer have to worry about paying for film, the cost of maintaining the developer machine or buying chemicals. Plus, if you add up the amount billed each month for x-rays, ROI calculations often show an investment in digital equipment paying for itself in just a few months.

Type of Sensor – Digital x-rays feature sensors very similar to those in digital cameras, using either CMOS or CCD detectors. The quality of the image usually is not affected by which type of sensor technology you choose.
Image Processing – The software that comes with the sensor should have some basic image processing that further enhances or clarifies the image. Many come with this feature at a click of a button, without you having to mess with contrast or brightness on your own.
Practice Management Software – The imaging software should be compatible with your current practice management software. Some integrate directly into the software modules themselves. Others require a “bridge” that looks for the patient’s name in the practice management software and automatically pull that patient up on the imaging side.
Resolution – Most sensors display images twice the resolution of film. You may see the resolution of different digital x-ray sensors expressed in terms of shades of gray, megapixels or line pairs per millimeter.
Connection – The connection of the sensor should be simple and straightforward, such as utilizing a USB port to plug into a computer. Some digital sensors have a direct wired connection to the USB port. Others require a capture box the sensor plugs into first, and the box then plugs into the computer. In these cases, you only need to purchase one box per sensor. Some of the latest systems also have either Ethernet or wireless connections available.
Positioner Type – Most systems have several different types of positioners that all resemble the Rinn style. Make sure you have options available that your staff are already used to working with.
Image Storage – Most systems store images in a proprietary format, but allow for easy export as common file types such as .jpg. The software also may allow you to export in DICOM format for transferring records to another office.
Size – The size of the sensor will be important depending on the type of patient pool in your practice. For example, a practice that sees younger children would benefit from a system that has pedo-sized sensors, similar to size zero film.

What sizes of sensors are available to me?
What is the warranty on the system?
Is it compatible with the operating system of the computers in my office?
Is it compatible with the practice management system used by my office?
Do I need a dedicated server for image storage?
What type of training is available?
What if I need help down the road? How is the customer support set up?
What type of positioner/holder devices does the system work with?
What is the resolution of the sensor?
What type of connection is required from the sensor to the computer? If wireless or Ethernet, do I have the hardware infrastructure to support that?
Is the layout of my operatories physically set up to allow me to take digital x-rays considering connection and computer requirements?

CMOS – Complimentary metal-oxide semiconductor. A type of digital x-ray sensor.

APS-CMOS – Active pixel sensor type of CMOS sensor. A type of digital x-ray sensor.

CCD – Charge coupled device. A type of digital x-ray sensor.

.jpg – Common image file format. This format is often used with point-and-shoot digital cameras.

DICOM – Digital Imaging and Communications in Medicine. An image file format that allows the file to carry additional information such as patient name, date image was taken and more.

Line Pairs Per Millimeter – A measure of resolution of the sensor. This refers to a diagnostic test in which a microscope is used to determine how many lines of the image can clearly be seen in the space of a millimeter.

Megapixel – The term used to express the number of image sensor elements in a device. Each megapixel of resolution captures 1 million individual dots, or pixels, of image information.