Digital Radiography: Diagnostic Information Compared to Conventional Systems?

Dr. C. asks:

digitalradiography.gifI am considering buying a digital x–ray system for my dental practice. Many of the dentists in my area have implemented digital radiography into their practice. I understand there are many benefits to having a digital system, but I am still concerned about how well the digital x–ray machines work. Is the contrast and density clear enough for me to be able to see caries well? Am I going to lose any diagnostic information with a digital system compared to a conventional one? I would like to hear from general practitioners using these systems. Was it worth the investment? Which digital radiography systems do you recommend?

7 thoughts on “Digital Radiography: Diagnostic Information Compared to Conventional Systems?

  1. Good topic for discussion! I believe there are many studies that compare digital radiography to conventional systems, when it comes to diagnostic information. There are also studies evaluating different systems.

    One study that comes quickly to mind is the one that appeared in Oper Dent. 2007 Sep-Oct;32(5):504-9. It was called: In vitro comparison of four different dental X-ray films and direct digital radiography for proximal caries detection. The study investigated the efficiency of different speeds of conventional intraoral films and a direct digital system for proximal caries detection. The study showed that the diagnostic performance of E- and F-speed films and direct digital radiography are similar for proximal caries detection.

    In general, though, I think the main benefits for digital radiography systems are straightforward:
    No more film, chemicals, or disposal fees, Instant images allow significant time savings, Increased treatment plan acceptance, to name a few…

  2. I have used Dexis and Trophy visioradiography for ten yrs.I feel that it was a huge investment in time and money and I was 90% satisfied.
    In the las few months we switched over to Kodak it is a big improvement in quality and since we have their software,we can use it to comunicate better with patients.It is almost tridimentional.
    The storage and time we save is superb.The quality is far better than conventional radiography.

  3. Let me put it simply:
    a- remember in Dental School when they tried to teach us the difference between 7Ma/10/MA/15ma machines?? and the 70kvp v. 90 kvp machines.
    That is the analogy I will use
    Analog emulsion film essentially gives you a GREAT restorative diagnostic image. The digital takes a learning curve to read because so much information is in the picture that it is like a 90 KVP radiograph with many different “shades of grey”” the stuff the periodontists and oral surgeons like.
    You will find yourself missing stuff because it does NOT stand out like emulsion film

    Now technical notes:
    a- you could not pay me to go back to film
    b- essentially only two companies make the sensors but MANY make software
    c- The differences in the sensors are few and far between, but the software does vary. BTW- DO NOT get cordless sensors, they get lost quick
    d- sensors have proprietary firmware in them that prevent them from working with other companies software [dexis will not work with Schick and vica versa]
    e- emulsion film is 14K dpi. Your screen is 8K dpi. Does not matter, the human eye is NOT so great. But the printing on ALL SYSTEMS universally stinks because cheapo dentists buy cheap printers and use plain paper to print out the copies.

    I have the PRO IMAGE EVA from Dent-x [people who took over for the phillips 810 developer] great bargain and great system BUT their software is simplistic and not as sophisticated like Schick or Dexis. But Schick for a one sensor system is double the price.
    I can take a FMS, my bitewings and all of that and print them. I DO NOT have an easy interface for emailing xrays [so I invested 200 dollars in Adobe Professional, print the xrays to Adobe and send them out as a .pdf.] so I worked around that problem.

  4. Two years ago we invited the chairman of the radiology department of one of the best german universities. After several glasses of our marvelous wines he told us that they had compared a lot of digital systems and couldn´t believe how good the scanner from Duerr was working. The even hesitated to publish in order not to receive legal acts from other producers.

    Having this in mind we installed the Perioscan from Duerr last year.

    It is very easy to use! Our personel didn´t have to change their routine.

    It is a lot slower then sensors where you get the result in a second. But you have all small film formats and they work very smooth in the mouth.

    The quality of the X-Ray is amazing and phantastic! I would say that it is as good as the best developped standard film but you can work on it, making different analysis and storing it easily in your server.

    If you see a small X-Ray in HD quality on a big PC screen then you would never want to go back to the former methods.

  5. I love Adobe, but you can also use CutePDF for free.
    I recently saw the new Kodak software, it has some very nice features for locating caries & even fracture lines you might normally miss.
    We’ve used Dexis for several years now & love not feeding the developer film, solutions, etc. Dr. can be in another office (in another city, even), treatment room, or private office & see the x-ray instantly. The ability to enlarge an image beyond what normal loupes can do, modify brightness & contrast, add other enhancements, instantly duplicate,lower exposure times, developer & biohazard costs, etc. make digital better than film (IMHO). Only problem is when computer power is lost you don’t have a fallback. We’ve had good luck with only one warranty replacement due to damage in about 4 years, 3 offices, 4 sensors.

  6. I’m just deciding if to buy or not Durr-Perioscan to improve the Radiology of my office.Hard to decide after 30 years of conventional radiology!

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