Dr. Raed Kamal D.M.D

Dental Care For The Whole Family

Winnipeg Family Dentist | Dr. Raed Kamal

Something you may not be aware of, or think to ask, but is good to know is, Are all digital x-rays the same? The answer to this is no. Just like one digital camera can be very different to the next, so are the various digital x-ray systems. On this page you will find information on the different types of systems, comparisons in the amount of radiation used, as well as comparison of image quality. All of which are important for you to know as it can affect your treatment, and ultimately, you should know what you are paying for.

Direct Digital vs Scanned Digital

There are two main systems for taking digital x-rays, direct or scanned. Direct would be equivalent to taking a picture with a digital camera and having it go straight into your computer with no processing.

Scanned digital systems would be comparable to taking a picture with a film-based camera and then scanning in the image to the computer. Anyone who has ever done this will know that an image acquired directly with a good digital camera will yield a better image than once scanned in from a negative.

With scanned digital x-ray systems, a film is used similar to traditional x-ray film. This film collects the information, and then is put through a special scanner to read the information and convert it into a digital image in the computer. Along the way, the data is degraded and overall image quality compromised. The films themselves degrade over time and are easily damaged.

This results in images that are washed out or filled with artefacts. In many cases, the resulting image is of poorer quality than a conventional x-ray, and although it requires less radiation than a conventional x-ray, these systems often require more radiation than direct digital systems.

Similarly, a good quality direct digital x-ray system will produce higher quality images than a system that uses films and scanners, and there are a couple reasons why. With scanned digital x-ray systems, a film is used similar to traditional x-ray film. This film collects the information, and then is put through a special scanner to read the information and convert it into a digital image in the computer. Along the way, the data is degraded and overall image quality compromised. The films themselves degrade over time and are easily damaged. This results in images that are washed out or filled with artefacts. In many cases, the resulting image is of poorer quality than a conventional x-ray, and although it requires less radiation than a conventional x-ray, these systems often require more radiation than direct digital systems.

To the right you will see some x-rays done with scanner based systems, which demonstrate the poorer image quality and artefacts from scratches on the films. When compared to the image above of x-rays done with the direct digital system used at My Family Dentist, or comparing the panoramic x-ray to the ones below, you will likely agree that direct digital x-ray systems produce a better quality image that will be more diagnostic.

So why use scanner based systems? Many offices see the benefits of going digital, but are hesitant to put a lot of money into the upgrade, or are persuaded to buy a cheaper system by sales people looking to get a sale at any cost. Direct digital systems are more expensive, but provide the best quality, which is why we chose to incorporate a top of the line direct digital x-ray system into our office.

Winnipeg Dental Direct-Digital-X-Ray
Winnipeg Dentist Film-Based-Digital-X-Ray-Old-Films
Winnipeg Dentist Film-Based-Digital-X-Ray-Washed-Out
Winnipeg Dental Filmed-based-panoramic-x-ray

2-D Digital X-ray vs 3-D Digital X-Ray

Recent advancements in technology have brought 3-D digital x-ray machines into some dental offices. These have huge benefits, particularly for oral surgeons who are planning surgeries to place dental implants, perform bone grafting, remove cysts or tumours, etc. In the past, patients had to be sent for CT scans with high doses of radiation and added costs and hassles. With the 3-D technology for dental offices, the amount of radiation used is significantly less than that of a conventional CT scanner. This makes it safer for dental use, but at the same time, is less diagnostic for analyzing the images for possible lesions in the soft tissue (many radiologists refuse to analyze these images due to this fact, and some provinces do not allow general dentists to have these machines in their office).

3-D technology is very expensive, so offices that purchase such a unit will not also purchase a standard panoramic machine (for taking 2-D panoramic x-rays). As a result, they have to use the 3-D machine to take the panoramic x-ray. With the majority of machines on the market, especially the early ones, a full scan is done and then converted into a 2-D panoramic image. Due to this process, image quality can be severely compromised, and the patient is exposed to extra radiation (each bit of tissue is exposed to very little radiation, but more tissues are being exposed). Further, areas of the head and neck are being scanned, but not necessarily being analyzed for any abnormalities.

The image above is one taken with the 2-D unit at My Family Dentist. The image below was done at another office by a general dentist using a 3-D scanner to produce a 2-D image. Note the difference in image quality and ability to see detail, especially when comparing the level of artefacts over the teeth in the
image below. Although the image below may show some structures a bit better, in the teeth area it definitely falls short, and gives an overall poorer quality image.

Future advances in technology are bringing smaller scanning fields for these 3-D scanners which will decrease the extra radiation, and some are even being developed with a dedicated panoramic x-ray mode to prevent a full scan and allow switching between 3-D and 2-D mode.

Due to the poorer image quality for panoramic x-rays (staple for general dentist), the added radiation exposure when doing scans, and lack of ability to adequately analyze all the acquired data, Dr. Kamal has opted to stick with a standard direct digital panoramic x-ray unit. When a 3-D scan is required, he works closely with an oral surgeon nearby, who has the facilities and training to take the required scans.

Winnipeg Dentists Dedicated-Panoramic-X-Ray1

The image above is one taken with the 2-D unit at My Family Dentist. The image below was done at another office by a general dentist using a 3-D scanner to produce a 2-D image. Note the difference in image quality and ability to see detail, especially when comparing the level of artifacts over the teeth in the image below. Although the image below may show some structures a bit better, in the teeth area it definitely falls short, and gives an overall poorer quality image.

Winnipeg Dentists Panoramic-X-Ray-From-3-D-Image

In Conclusion

If you are having x-rays taken, know your options. Not all systems produce the same results, and not all systems are intended for purposes for which they are being used. And when it comes to pricing for your x-rays, general dentists with 3-D scanners will often charge more, for what may very well be a poorer quality
image. So when you have x-rays taken, make sure you know what you are getting, and that you are getting what you are paying for.

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