It's logical

28 June 2013
Volume 29 · Issue 6

Tobias Kuntze sheds lights on the bits and bytes behind success.

Digital technology is constantly evolving. Ten years ago, analogue technology was still in the lead, but now mobile phones have replaced our compact film and even digital cameras. The same applies to digital imaging in dentistry: it’s a logical step forward because of the quality, the convenience and instant availability of the images, and the ability to easily share the images. At a time when most practices use digital patient records, why would you want to have physical copies of the radiographs with all the space requirements?’

I centre my entire practice set-up around the patient and patient comfort during treatment is paramount; that’s why I have chosen to use phosphor plates as they are as flexible as film in their usage and much more comfortable in the mouth than imaging sensors. A big talking point is the fact that digital radiography is less harmful to the patient. Thanks to the digital processing, developing errors are an issue of the past and, despite HTM 01-05, digital imaging creates less waste than conventional film, so it’s good for the environment.

Pictures say more than words so I let the pictures do the talking: the decay in a bitewing on the screen takes out any argument whether or not treatment is required. And a nice portfolio or gallery of ‘before and after’ images creates confidence about the capabilities of their dentist.

What I like about digital imaging is that it integrates so seamlessly into my workflow. Pictures are quickly taken and instantly form part of the patient record with no physical storage requirements. I can integrate digital photographs and radiographs into case reports, prepare lectures or articles and send images to referring dentists or the patients. This efficient way to communicate with the patient has improved treatment uptake.

I recommend anyone who wants to become a good dentist to learn to take good digital photographs. This way you can build up a portfolio and it helps to review the treatment and identify areas where you can benefit from some continuing professional development.

For digital intraoral radiography, I use Durr phosphor plates and the VistaScan Mini Plus scanner. These phosphor plates come in the same formats as traditional X-ray film and there is no learning curve as intraoral it handles exactly the same. Image sensors can be very uncomfortable for the patient and often I had to use a film to get a radiograph of a child or a narrow palate. This problem does not occur with phosphor plates as they are flexible. Obviously the phosphor plates still require a development process: the new small VistaScan Mini handles all intraoral sizes in about 16 seconds without the need for any adapter, pulling the phosphor plate straight out of the sleeve. I also use the format 3, which is the adult bitewing format and delivers an excellent overview over all posterior teeth including wisdom teeth. With a resolution of 22 lp/mm, I can see more detail than in analogue films with the convenience to calibrate and measure on screen. With its small footprint, the VistaScan Mini Plus fits anywhere in the surgery and the USB and ethernet connectivity allows quick and easy deployment anywhere in the surgery.

For intraoral images, I have a VistaCam incorporated into my Planmeca dental unit; this way I can use the footswitch to freeze the image and can keep the camera more stable. My VistaCam is now four years old and images are still very good and more than adequate for my purposes.