Digital Imaging in Dentistry Applications and Challenges

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Digital Imaging in DentistryApplications and
Challenges
S. Brent Dove, DDS, MS University of Texas Health
Science Center San Antonio, Texas
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• A picture is worth a thousand words
• Knowledge is valuable
• Dont waste it

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Digital Dental Radiology

• Intra-oral
• Panoramic
• Cephalometric
• Sinus and Skull
• Tomography
• CT
• MRI

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Advantages of Digital Radiology

• No Darkroom
• No Chemical Processing
• Lower Cost Per Image
• Instant Viewing of Images
• Less Radiation to Patient
• Image Processing and Analysis
• Transmission of Images for Consultation

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CCD/CMOS-based Sensor
X-ray Beam
Scintillator
Fiber Optics
CCD
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High Resolution 22.5? Standard 45?
Standard
Standard High Resolution
High
2 1 0
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CCD/CMOS - 45?
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CCD/CMOS - 22?
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Storage Phosphor
X-ray Beam
Imaging Plate
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Storage Phosphor
Helium-Neon Laser
Photoreceptor
Imaging Plate
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Storage Phosphor
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Storage Phosphor
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Diagnostic Accuracy

• Primary Dental Caries
• Recurrent Dental Caries
• Periodontal Disease
• Periapical Lesions
• Endodontic File Length Determination

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CCD Extra-oral Radiograpy
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Tomography
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Panoramic Radiography
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Cephalometric Radiography
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The Next GenerationThree Dimensional Imaging

• TACT
• Small Volume CT

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TACT Methodology
Series of images taken from different angles
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Slices of a maxillary molar
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Small Volume CT
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Small Volume CT
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Small Volume CT
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The Future is Full of Possibilities

• Optical Biopsy
• Laser Computed Tomography
• 3D Ultrasound
• Laser Fluorescence
• Computer-based FOTI

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Computer Aided Diagnosis (CAD)

• Observational Errors
• Misinterpretation Errors
• Integration of Data Errors
• Most Beneficial in Observational Errors

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CAD systems do not necessarily have to be better
than the clinician, just help him not miss
obvious lesions.
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Computer Aided Diagnosis (CAD)

• PAP Cytology Oral Brush Biopsy
• Mammography
• Chest X-ray Screening
• Periodontal Disease
• Dental Caries

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Digital Subtraction Radiography
-
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Neural Network Detection
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Digital Dental Imaging

• Intra-oral Radiography
• Panoramic Radiography
• Cephalometric Radiography
• Tomography
• Intra-oral Photography
• Extra-oral Photography
• Histology Surgical Microscopy

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Interoperability ????????
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The DICOM Standard

• The Digital Imaging and Communications in
  Medicine (DICOM) Standard is a detailed
  specification that describes semantics and syntax
  for exchanging images and associated information.
  The standard applies to the operation of the
  interface which is used to transfer data in and
  out of an imaging device.

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DICOM Workflow
DICOM Display Workstation
Storage, Query/Retrieve, Study Component
Query/Retrieve Results Management
DICOM Acquisition
Media Exchange
Print Management
Query/Retrieve, Patient Study
DICOM Archive
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What is DICOM

• Digital Imaging and Communication in Medicine
• Standard for communication of images and image
  related information between devices
• International in scope
• All biomedical imaging
• Voluntary standard

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DICOM is Biomedcial Informatics

• the storage, retrieval, sharing, and optimal use
  of biomedical information, data, and knowledge
  for problem solving and decision making. Edward
  Shortliffe
• model formation, implementation of the model,
  application of implementaion to the real world,
  evaluation of the implementation Titus Schleyer

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DICOM, Informatics, Research

• Digital X-ray
• Visible Light
• Clinical Trials
• Structured Reporting

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The Future is Full of Possibilities