Introducing Solid State Digital X-Rays
At Bay Area Pediatric Dental Wellness Group, Dr. Jonathon Lee and Dr. Brian Lee have utilized Solid State Digital X-Rays Technology since 2007. By 2007, Dental Digital X-Ray Technology had finally matured to have the diagnostic equivalence of film in terms of reliability, quality, resolution and grayscale.
In November 2007, we upgraded our extra-oral system from the Siemens Panoramic/Cephalometric X-Ray Machine to a Planmeca’s Promax Digital Pan/Ceph Orthodontic X-Ray Machine. This machine also takes Bite-Wing Type Dental X-rays and can be programmed to take 3-D Cone Beam Type X-Rays.
In January 2008, we upgraded our intra-oral system and IT infrastructure. We transitioned from our existing E/F-high speed film to Carestream/Kodak’s Newest Solid State Digital Dental X-Ray Sensor. Carestream/Kodak’s 7th Generation RVG6100 Solid State Digital X-Ray System, is the highest resolution dental sensor on the market today and is comparable to film in terms of quality and resolution and includes the new Pediatric Size 0 Sensor which utilizes at least 1/3 dose of E/F-speed film or 1/6 the dose of D-speed film.
“The innovations built into this new generation of the RVG System leverages Carestream/Kodak’s 20 years of experience in dental digital radiography and listening to what end users want and need,” said Patrik Eriksson of Carestream. “This generation marks a significant step forward in terms of patient comfort, user convenience and sensor reliability.”
The Carestream/Kodak System also incorporates the LOGICON Caries Detector™, a computer-aided-detection tool that provides dentists with an important decision-support instrument for better patient care. Using diagnostic technology developed for the military by Northrop Grumman, LOGICON Caries Detector™ is a unique, patented tool that assists dentists in the difficult task of diagnosing radiographs for cavities by extracting image features and correlating them with a database of known caries problems. In doing so, the software automatically highlights possible carious abnormalities on patients’ digital dental radiographs, signaling the dentist to take a closer look at the tooth involved.
A study investigating LOGICON found dentists’ accuracy was 75.6 percent before using the software and 88.3 percent afterward, with an improvement of 12.7 percent and enabled dentists to better diagnose caries penetrating into dentin than they were able to without it, while not causing them to mistreat any additional healthy teeth. This study: “The Efficacy of a Computerized Caries Detector in Intraoral Digital Radiography” was published in the July 2002 issue of the Journal of the American Dental Association by Dr. David Gakenheimer.
Both the Planmecca and Carestream/Kodak digital systems utilize Solid State technology that Digital Cameras of today use and both systems are DICOM (Digital Imaging and Communications in Medicine standard) compatible. Both these systems have been chosen by the United States Government to be the Digital Dental X-ray Systems for the Army, Navy and Air Force.
Some dental offices have implemented reusable Storage Phosphor Digital X-Ray systems (aka “Soft Sensors” which are similar to film in shape, feel and dose) because they are compatible with older X-Ray machines. However, research has shown that reusable Storage Phosphor Digital X-Ray systems are prone to bite marks, scratches and artifacts and have less resolution than both film and Solid State Digital X-Rays. They also require the same dose as E/F film and 2-3 times the X-Ray dose than Solid State Digital X-Rays.
The goal of dental radiography is to obtain quality diagnostic information while keeping the X-Ray exposure to the patient and dental staff at minimum levels. It is the consensus of dental radiologists and the FDA that the dosage from dental X-Ray exposure is not harmful. Each of us is exposed to radiation from a variety of naturally occurring sources. Most exposure comes from breathing radon in the atmosphere. We’re exposed to cosmic radiation from space and terrestrial radiation from radioactive isotopes in stone and building materials. A routine 4- D-speed film Bitewing Exposure is equivalent to 7 hours (3 ½ hrs for E/F-speed film) of everyday natural exposure. A Panorex is equivalent to 1 day ~Radiation Safety in Dental Radiography © Kodak, 2004. The benefits of dental radiography certainly outweigh the potential risks.
Did you know that Digital Pan/Ceph X-Ray Machines utilize the same X-Ray dose as film based machines? This is because current technology used in conventional film based Pan/Ceph radiography uses green light from intensifying screens/cassettes to expose the film and not X-Rays. The cassette system is much more efficient at producing images versus direct exposure of film by X-Rays. Therefore the dose to the patient is already greatly reduced and collimated for film based Pan/Ceph X-Rays.
For intra-oral filmed based radiographs, it is impossible to utilize intensifying screens/cassettes because there are no cassettes small enough to fit inside the mouth. However, over the years, film manufactures have produced high speed films which require very low doses of X-Rays.
The fastest intra-oral film technology utilizes E/F-speed rated films also known as Ektaspeed Plus/Insight Film. E/F-speed film utilized 50-60% the dose required by the industry standard D-speed film or Ultraspeed. Solid State Digital X-Ray Systems utilized 1/6-1/4 the dose required by industry standard D-speed film. Although claims are made that Storage Phosphor Digital X-Ray Systems utilized 1/5 the dose of D-speed film, according to the System Operating Instructions for Gendex’s Denoptix Storage Phosphor System, the suggested exposure times are the same or similar to Kodak’s E/F-speed film which is about ½ the dose of D-speed film!
-Jonathon Everett Lee, DDS and Team HappyHealthyTeeth