Advantages and Disadvantages of Digital Imaging

One of the biggest advantages of digital imaging is the ability of the operator to post-process the image. Post-processing of the image allows the operator to manipulate the pixel shades to correct image density and contrast, as well as perform other processing functions that could result in improved diagnosis and fewer repeated examinations (Figure 5). With the advent of electronic record systems, images can be stored in the computer memory and easily retrieved on the same computer screen and can be saved indefinitely or be printed on paper or film if necessary. All digital imaging systems can be networked into practice management software programs facilitating integration of data. With networks, the images can be viewed in more than one room and can be used in conjunction with pictures obtained with an optical camera to enhance the patients’ understanding of treatment (Figure 6). Digital imaging allows the electronic transmission of images to third-party providers, referring dentists, consultants, and insurance carriers via a modem. Digital imaging is also environmentally friendly since it does not require chemical processing. It is well known that used film processing chemicals contaminate the water supply system with harmful metals such as the silver found in used fixer solution.5,6 Radiation dose reduction is also a benefit derived from the use of digital systems. Some manufacturers have claimed a 90% decrease in radiation exposure, but the real savings depend on comparisons. For example, the dose savings will be different if Insight film (F speed film) with rectangular collimation is used versus Ultra-Speed film (D speed film) with round collimation. Clearly, a much greater dose reduction will result from the change of Ultra-Speed film with round collimation to Insight film with rectangular collimation.

Disadvantages
There are also disadvantages associated with the use of digital systems. The initial cost can be high depending on the system used, the number of detectors purchased, etc. Competency using the software can take time to master depending on the level of computer literacy of team members. The detectors, as well as the phosphor plates, cannot be sterilized or autoclaved and in some cases CCD/CMOS detectors pose positioning limitations because of their size and rigidity. This is not the case with phosphor plates; however, if a patient has a small mouth, the plates cannot be bent because they will become permanently damaged (Figure 7.) Phosphor plates cost an average of $25 to replace, and CCD/CMOS detectors can cost more than $5,000 per unit. Finally, since digital imaging in dentistry is not standardized, professionals are unable to exchange information without going through an intermediary process. Hopefully, this will change within the next few years as manufacturers of digital equipment become DICOM compliant.