Could I have some dental xray machine recommendations please?

RE: Could I have some dental xray machine recommendations please?

Joyce Whitehead — Fri, 08 Dec 2023 13:51:31 GMT

Actually that’s an interesting possible solution Evelyn that I hadn’t considered. We have a giant steel RSJ beam in our xray room so could potentially fix to that as a possibility. I’ll definitely mention it when we get a demo arranged. We are still investigating best finance options. Thanks again.

RE: Could I have some dental xray machine recommendations please?

Evelyn Barbour-Hill — Thu, 07 Dec 2023 22:41:22 GMT

I take it you've considered ceiling mount? Always a couple of hundred pounds more, and slightly more work in the installation, but the one that gets in your way least.

Just make sure – I know I said this before – arrange things so that the monitor is right by the surgeon, so that he or she can just glance up, maybe turn head, to see it. With the keyboard equally handy so that the surgeon can do all those useful manipulations should they wish. I've seen a practice where it was fifteen feet away across a busy room – awful.

RE: Could I have some dental xray recommendations please?

Joyce Whitehead — Thu, 30 Nov 2023 18:00:06 GMT

Thank you both. I’ve had a chat with IM 3 today so they are sending some quotes for CR as I think that suits our needs best at present. We do very few rabbits (sadly still seen as “garden pets to many around us” and are a dog heavy practice being quite rural so the larger plates are probably more what we need. We’ve had a look at figures today to work out possible return and I’m hoping we can make it work. It’s been really useful posting here though.

RE: Could I have some dental xray recommendations please?

Rob Davis — Thu, 30 Nov 2023 17:24:11 GMT

Lots of excellent advice from Rob, Evelyn and Rachel. My suggestion would be to go with CR unless you are doing cats only. As Rachel said, the range of sensor sizes makes it much quicker to do full mouth radiographs. I feel that the image quality I get from my CR7 is superior to the images I get from the DR sensors I have used.

I would avoid hand-held unless space precludes anything else, particularly if you are going for CR as this will be much more difficult to learn from (it is more difficult to see the angles you are aiming for when you are having to hold the generator).

I personally hate mobile machines on a trolley - they are always in the way and if at all possible then wall-mounted is much more convenient. I quite like the IM3 4DC revolution with its clever magnetic brake sphere positioning system, but they are quite expensive and I would agree with Rob that it is probably better to spend extra money on the sensor / processing side of things.

The crucial thing is that when you've installed it, you make sure that everyone receives suitable training both in how to take the images and how to interpret them. Radiography will transform your dentistry.

I also agree not to charge too much, otherwise radiographs won't get taken (coz we all know how good vets are at trying to save owners money!). The extra pathology you find and the increased speed of your extractions when you know what you are trying to remove will more than pay for itself very quickly.

Good Luck!

RE: Could I have some dental xray recommendations please?

Evelyn Barbour-Hill — Thu, 30 Nov 2023 15:35:56 GMT

[quote userid="2161" url="~/f/clinical-questions/30834/could-i-have-some-dental-xray-recommendations-please/243087#243087"]You can now get a size 4 DR sensor from iM3 (around £10000 alone), but then you wouldn't be able to use it in cats.[/quote]

I looked into this only last week.

The size 4 DR from iM3 is approx. £6000 if you use it with your existing software (so probably no good for you, Joyce) or £9000 for sensor plus software, or £12000 for a size 4, a size 2 and the software. (Irritatingly, though it would use my software OK, the TWAIN driver is PC only, and no plans for Mac, so no good to me).

Yes of course you can't get away with size 4 DR alone, you'd need size 2 as well. I've managed fine with size 2 for many years. But, and I should have mentioned this, I have size 4 CR sensors that go through my CR35 machine (yes, the old doughnut!) and give excellent images. Essential for rabbits, and for intra-oral views of the nasal chambers; and handy for imaging the TMJ.

[quote userid="2161" url="~/f/clinical-questions/30834/could-i-have-some-dental-xray-recommendations-please/243087#243087"]but if someone drops or knocks the DR sensor,[/quote]

They are pretty robust and that should not damage it. The biggest worry is a dog crunching it – but there are precautions you can take.

Joyce, I'm guessing you're full of uncertainty by now. I'd say that if you presently have no size 4 capability then you should be taliking to iM3 – either taking the plunge on the £12000 DR or following Rachel's suggestion and getting the CR 7with a range of sensors.

Personally I love the DR but there are pros and cons.

Another thought: do you do many rabbits? That would be an argument for CR, because iM3 do some specially-shaped rabbit intra-oral sensors.

[quote userid="7269" url="~/f/clinical-questions/30834/could-i-have-some-dental-xray-recommendations-please/243088#243088"]Husband (vet too, former PSS inspector) is a bit anti hand held for safety reasons [/quote]

That's why you don't buy one on eBay! A properly certified genuine one is OK with HSE. Just remember you need somewhere handy to put it when not using it.. True, for the beginner it's a bit trickier getting your angle right. But the same goes for a mounted generator that doesn't have a very good mounting – I've seen that.

[quote userid="7269" url="~/f/clinical-questions/30834/could-i-have-some-dental-xray-recommendations-please/243088#243088"]have a demo or two to see what’s around and what we can fit in prep/dental room.[/quote]

Certainly. I wouldn't buy from a company that couldn't offer a demo of some kind.

Oh, have a good think about where you are going to use it. I've seen one practice where dental work was done in a sort of annexe of the prep-and-general-stuff room. Whenever they took a radiograph they had to yell "exposing!" and everyone had to rush out. Get your RPA in and make them do some work for their fee, for a change.

PS. Mere anecdote: I'd still be using my Philips Oralix (which some of you might remember from childhood visits to the dentist) if the modern retrofit controller (which the RPA insisted upon) had not failed some ten years ago.

RE: Could I have some dental xray recommendations please?

Joyce Whitehead — Wed, 29 Nov 2023 21:44:49 GMT

Thank you to both Evelyn and Rachel for your excellent comprehensive answers. I do think having a flat radiography fee makes a lot more sense. Husband (vet too, former PSS inspector) is a bit anti hand held for safety reasons but I think we will have to have a demo or two to see what’s around and what we can fit in prep/dental room. Bit of research and some phone calls to come I think.

RE: Could I have some dental xray recommendations please?

Rachel Perry — Wed, 29 Nov 2023 18:33:58 GMT

Hi Joyce,

That's great you want to invest! A DR system is limited by its size- you either buy a size 2, which is great for most cats and small dogs, but as soon as you want to radiograph medium to large sized dogs, it takes much longer as you need many more images. You can now get a size 4 DR sensor from iM3 (around £10000 alone), but then you wouldn't be able to use it in cats. A CR system, such as the CR7 system from iM3 gives you most versatility as you can get a range of sizes so you can acquire full mouth radiographs in any size of patient every quickly- you could have size 0 and 2's for cats and size 2,4 5 for medium to large dogs. You can then perform full mouth radiographs in every patient quickly and cheaply. Evidence-based medicine would support the use of full-mouth radiographs in all dental patients.The sensors themselves are not that expensive, so if they get damaged they are not horrendous to replace, but if someone drops or knocks the DR sensor, you have a much bigger expenditure to replace. (thousands compared to hundreds). DO NOT buy the CR system that goes into a cassette into a scanner as they are a faff and the image quality is dire. If going CR then go CR7. iM3 also produce positioning guides which can only be used with CR system, and not DR, which is helpful when starting out. I have and love my CR7. I am not paid commission, although I should be!

The wheel mounted dental X-ray has a very large wheelbase- which many people do not realise. It is heavy to move around and takes up a LOT of floor space. Talk to RPA before doing anything. A hand-held can be useful, but when starting out it can be tricky to visualise correct angle.

By charging a small-medium amount for each dental patient, then you get a return quite quickly. Do not charge an extortionate amount as then you take less, and it takes much longer to starting making profit. Work out how many dental procedures per week, and how quickly you want to pay back the investment, then do the maths. Most investment is making profit by the end of the first year.

DO also bear in mind the RAM of your computer needs to be enough to manage the system software, and also archiving, so you may need an upgraded PC too, sorry!

RE: Could I have some dental xray recommendations please?

Evelyn Barbour-Hill — Wed, 29 Nov 2023 17:48:16 GMT

DR is certainly handiest because you often want images asap. And you are not constrained waiting for your entire stock of sensors to pass through a reader while you are doing, say, a whole-dentition series. On the other hand many people use CR and find it perfectly satisfactory. CR images are supposed to be better.

You've clearly decided a trolley mount is best in your set-up. The only objection to a trolley is that you have to wheel it about, it can get in the way of personnel around the table and it takes up space when not in use. Have you considered a hand-held generator? Maybe you have. Nomad is the best-known make but iM3 do a more compact one. There are pros and cons. Don't buy one on eBay whatever you do!

Don't be afraid of buying another computer. You might need to, to run the DR system's software. Check that before you order. Do whatever's necessary to make the images available on a screen right by the surgeon. Maybe you could run a second monitor off your laptop. It might in the long run be handiest to get another computer. That could even network to your practice management system if you have one.There are all sorts of possibilities and what's best for you depends upon your set up, so plan carefully.

Charging? I don't charge "per image" or per "full mouth". I cannot see the point or the necessity. I charge for "radiography" regardless. It's included in the estimate and is never optional. If (the minority of cases for me) radiography is not necessary I don't radiograph and don't charge for it.

RE: Could I have some dental xray recommendations please?

Joyce Whitehead — Tue, 28 Nov 2023 19:23:16 GMT

Our dental table is mobile but the room has limited wall space hence wanting a stand. We already have a laptop for the current DR so hopefully could link to that. Good point re the RPA, we will get in touch with him.

RE: Could I have some dental xray recommendations please?

Rob Loxley — Tue, 28 Nov 2023 19:19:17 GMT

I have and like DR (it’s so quick) some prefer CR, I’d suggest trying both. DR don’t necessarily have higher resolution than CR. There are expensive generators eg im3 revolution but I’m not sure that’s where I’d spend big money over a simpler unit

Can you connect it to an existing computer or do you need to buy another

is your dental station fixed table or used in the same location always, if so consider wall mounting but get the right arm length

get your rpa involved early as if you’re not putting it into an existing controlled area, there maybe more to consider shielding warning lights etc

we charge per image or a full mouth, which is cheaper above 4 images, we include it in the estimate