Dental X-rays in Veterinary Medicine: Sensor vs. Imaging plate

Digital X-ray analysis is now standard practice in veterinary dental diagnostics, for example in the detection of periodontitis, tooth fractures, root changes, or non-visible tooth resorption. The high image quality ensures precise diagnostics, which enables targeted treatment planning and thus helps improve the prognosis for the animal. Since animals are often anesthetized or sedated for the examination, the rapid availability of images is a decisive advantage: anesthesia time can be shortened and stress for the animal minimized. Two digital X-ray methods are currently available: an indirect method, in which image plates are digitally read in a separate scanner after exposure (computerized radiography, X-CR), and the direct method, which uses a sensor to capture the X-ray image and immediately provides it as a digital image (digital radiography, X-DR). Both methods thus differ in technology and handling and are prioritized by users for different reasons.

High flexibility thanks to imaging plates

The X-CR uses imaging plates (phosphorescent plates) instead of traditional X-ray film, making the workflow simpler and more environmentally friendly than with traditional film radiography. After the image is taken, the films are removed, read in a separate digital scanner, and digitized, a process that can take anywhere from a few seconds to several minutes, depending on the type of scanner used and the image resolution.¹

The imaging plates are available in various formats for different dentition sizes and regions. This allows for flexible use depending on the animal and the clinical question. Which plate formats can be read depends on the scanner.

Imaging films can be easily bent and thus readily adapted to the interior of the mouth. They are wireless and therefore easy to position. Additionally, they are relatively resistant to impacts and pressure, though they can become scratched.² The imaging films can be reused, theoretically up to 100 times. However, their lifespan is limited due to wear and tear.

Efficient Workflow with Dental Sensors

Unlike the X-CR method, the newer dental sensors are digital detectors that convert X-rays directly into electrical signals and transmit them to the computer without any intermediate steps. The X-DR method thus reduces the time required to produce X-ray images, minimizes the number of steps, and thereby ensures greater efficiency in the workflow. Because the images are available immediately, they can be evaluated right after they are taken.

Dental sensors are placed directly in the animal’s mouth. Since the new generation of dental sensors has higher radiation sensitivity, the radiation exposure for the animal is lower. Because modern dental sensors are rigid, they can sometimes be more difficult to position in very small or sensitive animals.³ Multiple dental sensors of different sizes are required to achieve the same flexibility offered by film formats.
Dental sensors can be used an unlimited number of times but may be damaged by mechanical stress.

Comparison of Image Quality and Costs

Both methods ensure high image quality, although the additional digitization step in the X-CR method can result in some loss of quality.^{4, 5} The initial cost of X-DR sensors is higher than that of the X-CR method, but there are no additional costs for consumables such as film or plates.

Conclusion

In addition to slightly better image quality, the main advantage of the X-DR method is the rapid availability of the digital X-ray image. This makes it particularly suitable for high-volume practices that perform numerous X-ray analyses and follow-up examinations on a daily basis. The X-CR method, on the other hand, is a better option for practices that prioritize flexibility in image formats or lower initial costs.

Sources

¹Berkhout WE, et al. A comparison of digital and film radiography in Dutch dental practices assessed by questionnaire. Dentomaxillofac Radiol 2002,31, 93-9.

²Roberts MW, et al. Clinical techniques to reduce sensor plate damage in PSP digital radiography. J Dent Child (Chic) 2004,71, 169-70.

³Coffman CR, et al. Oral and dental imaging equipment and techniques for small animals. Vet Clin North Am Small Anim Pract 2013,43, 489-506.

⁴Buske N. Digitales Röntgen: Vorteile und Nachteile. Online availiable: https://medizinio.de/blog/digitales-roentgen.

⁵Elkhateeb SM, et al. Analysis of photostimulable phosphor image plate artifacts and their prevalence. World J Clin Cases 2022,10, 437-47.

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