Digital radiograph system
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PRODUCT NAME (DATE OF ADA ACCEPTANCE)
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CDR (received ADA Seal of Acceptance in September 2002)
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MANUFACTURER
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Schick Technologies Inc., 31-00 47th Ave., Long Island City, N.Y. 11101, 1-718-937-5765, "www.schicktech.com"; distributed by Patterson Dental Supply Inc., 1-800-873-7683, "www.pattersondental.com"
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SUMMARY
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CDR is a computerized imaging system. Digital images are relayed to a personal computer, or PC, via an electronic sensor that replaces film. The sensor is more sensitive to X-rays than is film, which allows for a reduction in the radiation dose that the patient receives. The CDR sensor is available in three sizes: 0 for pediatric periapical radiographs, 1 for anterior periapical or pediatric bitewing radiographs, and 2 for adult bitewing and periapical radiographs (Table).
The CDR system comes with one sensor and disposable plastic sheaths for infection control. The Active Pixel Sensor, or APS, attaches to a remote module via a thin, flexible cord. The module connects to the computer through a universal serial bus, or USB, interface. The sensor works with X-ray tubes that can be set to 0.04 seconds or less. The sensor can be used with a variety of film holders (for example, Snap-A-Ray, Dentsply Rinn, York, Pa.).1
The CDR software allows for manipulation of images and the addition of annotations and patient information. The software allows for image enlargement and contrast and color enhancements.
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CONSIDERATIONS FOR ACCEPTANCE
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Schick submitted studies published in peer-reviewed journals demonstrating that the diagnostic quality of the CDR system is substantially equivalent to that of conventional dental film. These included studies evaluating detection of proximal caries,2,3 detection of periapical bony lesions4 and determination of endodontic file length.5,6
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SAFETY AND EFFICACY DATA
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The CDR sensor was shown to be safe for use in the oral cavity. The sensor is watertight so that it can be disinfected between patients. The sensor cannot be autoclaved and should not be soaked in disinfectant solution. The sensor should be wiped with disinfectant and used with the sterile plastic sheaths that are included with the system. It was demonstrated that a plastic sheath placed over the X-ray sensor and the modified bitewing bite block (XCP, Dentsply Rinn) or a sheath that covers the sensor in a Snap-A-Ray holder were the least likely to result in cross contamination.7 These disinfection practices meet the Centers for Disease Control and Prevention’s recommendations for infection-control practices in dentistry.8
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SYSTEM REQUIREMENTS
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The CDR system runs on PC-compatible computers with Pentium-based central processing units running Windows 98, Me or 2000 (Microsoft Corp., Redmond, Wash.).
- – Supported USB controllers: Intel (Intel Corp. Santa Clara, Calif.) 82371 AB/EB PCI to USB Universal Controller, Intel 82801 AA USB Universal Host Controller, Intel 82440 MX PCI to USB Controller, Intel 82801 BA/BAM, USB Universal Host Controller-2442.
- – Minimum 64 megabytes of random access memory, or RAM, and 20 MB of hard disk space (not including images).
- – Minimum 20 gigabytes hard disk space (including images—approximately 40,000 images).
- – Minimum display requirement is 800 x 600 x 256 colors. Minimum display requirement for video images is 800 x 600 x 24-bit color.
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REFERENCES
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- 56-22 Schick Computed Dental Radiography (CDR) kit (project 97-42). U.S. Air Force Dental Invest Serv Newsletter 1999;56. Available at: "www.brooks.af.mil/DIS/DIS56/sec6f.htm". Accessed Sept. 27, 2002.
- White SC, Yoon DC. Comparative performance of digital and conventional images for detecting proximal surface caries. Dentomaxillofac Radiol 1997;26:32–8.[Abstract]
- Nair MK, Nair UP. An in-vitro evaluation of Kodak Insight and Ektaspeed Plus film with a CMOS detector for natural proximal caries: ROC analysis. Caries Res 2001;35:354–9.[Medline]
- Paurazas SB, Geist JR, Pink FE, Hoen MM, Steiman HR. Comparison of diagnostic accuracy of digital imaging by using CCD and CMOS-APS sensors with E-speed film in the detection of periapical bony lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:356–62.[Medline]
- Melius B, Jiang J, Zhu Q. Measurement of the distance between the minor foramen and the anatomic apex by digital and conventional radiography. J Endod 2002;28:125–6.[Medline]
- Vandre RH, Pajak JC, Abdel-Nabi H, Farman TT, Farman AG. Comparison of observer performance in determining the position of endodontic files with physical measures in the evaluation of dental X-ray imaging systems. Dentomaxillofac Radiol 2000;29:216–22.[Abstract]
- Hubar JS, Gardiner DM. Infection control procedures used in conjunction with computed dental radiography. Int J Comput Dent 2000;3:259–67.[Medline]
- Centers for Disease Control and Prevention. Recommended infection-control practices for dentistry. MMWR Morb Mortal Wkly Rep 1993;5:28.
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