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Intermediate Diagnostic Imaging Studies 1

Dental Equipment- Overview
Marc Griffiths
Types of dental equipment
Dental Panoramic
Tomography (DPT)
Lateral Cephalometry
Intra-oral
Dedicated skull
equipment
? CT MPR
Reconstruction
DPT - Design Features
Demonstration of a slice of the patients head
rather than its whole
X-ray tube and cassette are linked simultaneous
movement around a moving pivot.
During exposure, cassette moves around the face
of patient & X-ray tube swings around the head
posteriorly
Only the structures within the focal plane (focal
trough) are projected sharply onto the film
everything else is blurred out
Focal plane
Film moves in front of collimating slit so
exposure of film occurs in a band from one
side to the other
Only a narrow band of film is exposed as
machine rotates.
Dental Panoramic Tomography
Positioning important to
ensure optimum image
quality
Head should not be rotated
(causes asymmetry in
image)
Frankfurt plane horizontal
Important to remove
earrings and necklaces,
braces and dentures
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Panoramic tomography
equipment
Specialised units capable
of panoramic views of the
whole jaw or parts of jaw
Some systems can
perform localised
coronal/sagittal
tomograms through the
dental arch and some
can be converted for use
in cephalometry
OPG/Lat Ceph Equipment- Design Features
Power supply/tube design
kVp range 60 -90 kVp
Tube Current Low (10-15 mA)
preferably a selection should be available
Usually Stationary Anode
Low weight > stress on units drive mechanism
Interlock mechanisms
Cassette in position
Tube at start position
Positioning aids
Cross Lights
Mirror
Flat cassette utilised in modern units
Dual function or dedicated to either DPT or
Ceph
Slit beam
emerges from
tube housing
Further slit
collimation
before hitting
film/sensor
Features
Moveable up/down
Handles aid
immobilisation
Cephalometry
Cephalometric lateral - a lateral radiograph of
the whole face to show the relationship of the
upper and lower jaws, the soft tissue profile of
the face, and various bony landmarks
Assessment and follow-up of facial deformity
Multiple serial radiographs taken, often over
years as treatment progresses, therefore
reproducibility important
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Lateral Cephalometry Equipment
Head Grip
Immobilisation
Reproducibility
Long FFD for cephs to reduce magnification
Specialised features
Filtration (Duralmin)/Facial Contouring (> dose)
AED
Digital Images
Measurement tools (Radiopaque slide)
Emergency stop switches
Intra-oral Equipment
Dental x-ray sets
Dedicated units with low
power stationary anode tube
Tube is deployed on an
extendable arm for easier
positioning
kVp of 60-70 is normally
used (not less than 60kVp)
Tube current usually fixed -
7.5-10 mA
Exposure is normally varied
by altering the exposure time
Usual range 0.1-0.5 sec but
over 1sec possible
Intra-oral Equipment - Design Features
Power supply/tube design
Basic design
Short FFD
minimum focus-skin distance of
200mm (NRPB)
Self-Rectified / full wave
rectification - old equipment
New equipment - constant
potential generator preferable
Rectangular collimation should
be an option
Long cable for exposure
switch
Dental x-ray
unit
Flexi-arm design
Angle indication
Device
Patient stability aids
Head rest
Accessory Features
Positioning aids
Self- Rectified (Half-wave) dental units
Full-wave / Two Pulse dental units
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Constant potential generators
High frequency generators offer effectively constant
potential
Less than 1% voltage ripple
Cross infection control
Essential that equipment easily cleaned
Bite block should have disposable plastic
sheath
Sanitiser should be available to clean ceph
ear pieces
Digital dental equipment
Advantages:
No chemical processing of films
Almost instantaneous image display
Instantaneous positioning errors can be spotted
Digital images may be windowed.
Optimisation of individual patient dose
DICOM 3.0 compliant
Digital images can be sent anywhere in the world!
Example of digital intra-oral unit
Digital sensor may reduce patient exposure by up to 95 percent
(Ref: http://www.planmeca.com/pdf/DXIflyen_0203.pdf )
Charged Coupled Devices (CCD)
Various sizes
Planmeca Dixi2 Digital Intraoral
system
Resolution
Normal
13 lp/mm,
Pixel size 38 m
Enhanced
26 lp/mm
Pixel size 19 m
Dynamic range
14bit (16384 grey tones)
File sizes
26x37mm
1.3MB/5.3MB
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Example of software used/ images obtained
Digital OPG units
Planmeca Dimax2
Digital DPT and
Cephalometric
system
Direct digital CCD
(charge coupled
device)
Resolution 6 lp/mm
Pixel size 33 m
File size 4.5-7.7 MB
for DPT
Lateral Cephalostat
Digital manipulation of data
CT Equipment
Multi-Slice CT scanners
Fast image acquisition
Exquisite isotropic resolution
Multi Planar Reconstruction
Excellent planning for Facial Injury /
cancer patients (prosthesis)
Examples of CT
reconstruction
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References & further
information
http://www.xograph.com
http://www.planmeca.com
http://www.ctscan.co.uk/dent_frames_images.html
Carter p., (1994) Chesneys Equipment for Student Radiographers, 4
TH
Edition, London, Blackwell Scientific Publications
Stockley S., (1992) A Manual of Radiographic Equipment, London,
Churchill Livingstone
Essentials of Dental Radiography and Radiology Eric Whaites
Churchill Livingstone
A Guide to Dental Radiography (Fourth Edition) Mason and
Bourne Oxford University Press
Guidance Notes for Dental Practitioners on the Safe Use of X-
ray Equipment NRPB 2001