Digital panoramic systems

by Jeffrey B. Dalin, DDS, FACD, FAGD, FIGD

Darkroom? What darkroom? I no longer have the need for a darkroom!

Just recently, I have created some much-needed, extra countertop workspace; a storage area; and a new spot for a computer. Bright, open areas now exist in what was once the "darkroom" in my office. (Quite literally.) No processor, no tank, no chemicals, and, most importantly, no more films. I am very excited! It has long been my goal to remodel that darkroom and throw away the processor and tank.

Many of you know about my enthusiasm for taking digital intraoral X-rays. I have written several columns about the different ways in which my practice has been improved by their arrival. Now, I have a wonderful new digital diagnostic tool that I want to share with you: DEXpan — the new panoramic and cephalometric solution from DEXIS.

I am now diagnosing from superb images — both intraoral and panoramic — shot directly into the same software database. I can view, enhance, and compare images from different diagnostic tools, using the same software, with just a few mouse clicks. I have been waiting for this for a long time. My wait is now over!

I selected my digital pan after considering three different types of solutions. For convenience, I will call them "Full Digital," "Digital Retrofit," and "Digital Film."

A Full Digital system (from Planmecca, Instrumentarium, or Sirona) typically will cost $60,000-$70,000 — much too expensive for most practices.

A Digital Retrofit entails modifying and retrofitting your existing film-based panoramic equipment. This is less expensive (approximately $30,000-$35,000), but carries the risk that the retrofit will not work properly and the possibility that the warranty on the panoramic hardware could be invalidated.

In the Digital Film category, you retain your existing film-based pan, but instead of using film, you directly substitute a "phosphor plate" solution. The panoramic (or cephalometric) image is shot in the same way as film, but instead of developing it in a darkroom, you simply load the plate into a special type of rotating reader that projects the image directly onto your computer screen. DEXIS and Denoptix are the primary choices in this category. With my DEXpan system, I store my pan images directly into the existing patient file, so I can switch easily between intraoral X-rays, intra- and extraoral photographs, and panoramic images.

Here are some benefits of the Digital Film solution:

1. Excellent on-screen image quality
2. Ease and simplicity of use (Note to staff: no more cleaning of the processor!)
3. Reduced time for diagnosis
4. Image-enhancement capabilities, such as magnification, contrast, and coloring
5. Easy image sharing with other dentists or third-party payers
6. Improved patient acceptance and education so that they can be involved in treatment decisions
7. An affordable investment of $18,000-$20,000

Sample digital panoramic image

Oh, yes, there is one more thing. Did I mention that you can also demolish your darkroom?!

Jeffrey B. Dalin, DDS, FACD, FAGD, FIGD, practices general dentistry in St. Louis. He also is the editor of St. Louis Dentistry Magazine and spokesman and critical-issue-response-team chairman for the Greater St. Louis Dental Society. His address on the Internet is www.dfdasmiles.com. Contact him by email at [email protected], by phone at (314) 567-5612, or by fax at (314) 567-9047.