Júní 8, 2016

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X ray machine –The big Advantages of Digital Radiography —

Digital radiography may represent the greatest technological advance in medical imaging over the last decade. The use of photographic films for X ray imaging will be obsolete in a few years. An appropriate analogy that is easy to understand is the replacement of typical film cameras with digital cameras. Images can be taken, immediately examined, deleted, corrected, and subsequently sent to a network of computers. However, the majority of practitioners in the United States have not abandoned conventional radiography, and many question the need to change to digital radiography. Is it finally time to move to this form of recording radiographic images?
Here I will present a candid view of this technology and make a few personal conclusions about the state of the art in digital radiography.
The following list of advantages is prioritized in order of my personal conclusions on digital radiography. They are based on clinical usage and research, and they may or may not be the same conclusions as those reached by other clinicians.
1. Immediate observation of radiographic images. If this were the only positive aspect of digital radiography, I still would choose it over conventional radiography. Keep in mind that only some digital radiography devices provide immediate viewing. Charge-coupled devices, or CCDs, provide immediate viewing. However, phosphorous-plate technology requires placement of the irradiated sensor in a processing device to scan it and put the information into a computer so that the image can be viewed.
In conventional radiographic techniques, the delay in reading the image usually forces the clinician to change gloves and do something else as the radiograph undergoes development. On returning to the patient, the clinician must wash his or her hands, don new gloves and reorient himself or herself to the clinical procedure at hand.
Immediacy of viewing the image is a significant clinical advantage in accomplishing many oral procedures. It is especially important in endodontic therapy, implant surgery, evaluation of crown fit, placement of posts in endodontically treated teeth, evaluation of potential overhangs or open margins in newly placed restorations, detection of radiopaque foreign objects in soft tissue, patient education and innumerable other situations. When accomplishing implant placement, using conventional radiography is a major inconvenience, as the entire aseptic procedure is disrupted and time is wasted while the clinician awaits the development of the films several times during the implant placement procedure.
I have used both conventional and digital radiography for several years, but I easily can conclude that because of its advantage of immediate image viewing, digital radiography is highly desirable.
2. Ability to enhance images. How many times have you looked at a radiographic image and thought that it needed to be lighter or darker, or that you would like the image to be somewhat larger? Digital radiography allows the clinician to change contrast (to lighter or darker), enlarge images, place color enhancements or superimpose various textures on images. All of these changes of the original image facilitate easier detection of any pathosis that is present, and they also allow immediate and effective patient education.
3. Data storage. Pulling up specific stored radiographic images from a computer database is easy because of the highly organized nature of computer file storage. When using conventional radiography, all of us have had times when we have looked unsuccessfully for the paper chart and radiographs of a patient treated some years ago. With similar frustration, we have misplaced active patients’ charts and radiographs, sometimes never finding them.
Patients who have been in any specific practice for many years have charts that are enormous because of the accumulation of bulky panoramic and full-mouth conventional radiographs organized in their plastic or cardboard holders. Conversely, it is amazing to observe how much data can be stored in the relatively miniscule space occupied by a computer, and how easily and rapidly the data can be retrieved. Of course, there is the obviously time-consuming challenge of placing previously made conventional radiographic images into digital form for storage in the computer. I will discuss this subject later.
4. Developing solutions and conventional film developers. One of the less desirable tasks in dental practice is maintaining and changing the radiographic developing and fixing solutions and keeping the often unreliable developing devices in a functional state. In digital radiography, those tasks are eliminated, along with the dark-room that still is present in some offices that do not use automatic film processors. The problems of odors and stains from the developing and fixing solutions and the space occupied by the developing devices are eliminated when digital radiography is incorporated into a practice.
One of the most useful advantages of digital radiography is the ability it gives clinicians to send images to other practitioners in a matter of minutes.
5. Communication with other practitioners. One of the most useful advantages of digital radiography is the ability it gives clinicians to send images to other practitioners in a matter of minutes, even while talking on the telephone. I have used that advantage numerous times as I have been consulted about a specific technique or have been required to send images to another practitioner while the patient in question was being treated. There are various ways to send an image, but the commonly used e-mail method is one of the easiest.
6. Less radiation. When using conventional radiography, I often have been hesitant to make a radiograph because it exposes the patient to radiation. The reduction in radiation offered by digital radiography—usually 70 to 80 percent, and at times even more—allows multiple periapical images for the same radiation exposure involved in a single periapical image obtained via conventional radiography. This reduction in radiation is especially important in implant placement or difficult endodontic therapy, in which multiple images frequently are needed.
7. Loss of conventional films. Most practices have relatively efficient ways to store conventional radiographs in their respective patient charts, but occasionally a critical film comes loose from its holder, and it is lost without the possibility of retrieval. Assuming adequate back-up procedures are observed, there is no reason to lose stored digital radiographic images.
8. Ease of use. Some practitioners who are not comfortable with computers may debate this point. However, after a short learning period, accompanied with frequent use, the simple software necessary for use of digital radiography is easily mastered. The new wireless digital radiography concept (currently available only as the Schick CDR2000 Cam, Patterson Dental Supply, St. Paul, Minn.) has simplified the clinical procedure even more. In my opinion, the digital concept is easier, cleaner and certainly faster than conventional radiography.

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