The biggest drawback of DR systems is the lack of a size-4 sensor plate. This typically only presents a problem in large-breed dogs in which the canine and carnassial teeth cannot be completely imaged on a size-2 sensor (
Figure 6). The larger size-4 plate available with the PSP system decreases the amount of exposures needed to take full-mouth radiographs.
Figure 6: Bisecting angle intraoral image of the mandibular canines in a large-breed dog obtained with a size-2 sensor. Note that while the entire sensor was utilized, only the roots were imaged (and not completely).
Distribution, Storage, & Management
The requirements for image distribution, storage, and management are growing in the veterinary practice. This has resulted in the development of picture archiving and communication systems (PACS) to facilitate these procedures. An open standard called DICOM (digital imaging communications in medicine) is the de facto standard for imaging in human medicine and is ubiquitous with veterinary whole-body radiography, ultrasound, MRI, and CT, and is nearly ubiquitous with veterinary practice information management software (PIMS). It makes communication and locating images for both the practice and telemedicine much easier.
Unfortunately, to date, true DICOM compliance is not readily available with digital dental systems; most of them use proprietary bridges. However, most manufacturers are making significant advances in this area; ask your representative about their system’s DICOM compatibility prior to purchasing. While this may not be a deciding factor, it should be taken into consideration.
Economic Impact
The biggest concern when converting to digital dental radiology is the initial set-up cost. However, there are significant cost savings in film and development. Furthermore, the speed of diagnostic image acquisition and a greater compliance of veterinary staff to use this equipment more than compensate for these initial costs. A busy general practice should easily make up the difference between film and a digital system within one year, at which point the digital system becomes less expensive.
Conclusion
Digital dental radiology is the future of veterinary dentistry. It is more efficient, requires less radiation, utilizes no toxic chemicals, allows for easy telemedicine consults and better communication with clients, costs less than standard radiographs over time, and offers permanent image storage.
CT = computed tomography; DICOM = digital imaging communications in medicine; DR = direct; MRI = magnetic resonance imaging; PACS = picture archiving and communication systems; PIMS = practice information management software