That is an OPG?

An Orthopantomograth or OPG is a panoramic dental x-ray that produces a 2 dimensional view of the maxilla, mandible, maxillary sinus and surrounding structures. It demonstrates the number, position and growth of all the teeth including those that have not yet surfaced or erupted. An OPG may be requested for the planning of orthodontic treatment, for assessment of wisdom teeth or for a general overview of the teeth and the bone which supports the teeth.

OPG image programs

Imaging programs available on OPG’s vary significantly between machines and manufacturers. Some are supplied with only limited programs such as standard OPG, paediatric & TMJ. Others include a wide range of imaging programs including standard OPG, paediatric, Bitewing, Maxillary Sinus, PA & Sagittal TMJ, Orthogonal, Interproximal, Ortho, Wide Arch and many more. Units with a Cephalostat, can also include imaging programs such as Lateral Ceph, PA & AP Skull and hand/wrist imaging.

Software Considerations?

There are number of software considerations to take into account when looking at integrating an OPG. Firstly does the practice already have an existing imaging software in place for their intra oral imaging? If yes, can this software be used for capturing and viewing OPG’s?

Practices that already have phosphor plate systems or digital direct sensors will already have imaging software in place, most of these software can be used to view OPG & Ceph images as well. If the software is supplied from the manufacturer images will automatically appear, alternatively a TWAIN driver is often used to communicate with 3rd party imaging software.

One of the biggest considerations today is in the area of digital dentistry and future plans within the practice. Practices looking at integrating CBCT, intra-oral scanners, 3D printers and/or CAD/CAM will need a more comprehensive imaging software that is suitable for virtual implant placement, crown design, surgical guide fabrication etc. These software’s generally allow much more flexibility for practice growth and new technology investments, as they’re often modular and can be added too as the practice grows. Whereas a practice that’s only looking at I/O imaging & OPG can get away with a more basic software designed for viewing and saving x-rays.

Other considerations include the level of support the distributor or manufacturers offer for their software including training. Given the importance of Dental x-rays to patient diagnosis & treatment, it’s extremely important you have the support behind you to limit downtime.

Planning for the future

All OPG rooms require shielding to comply with local state radiation bodies. Therefore it’s always advisable when designing a surgery to make plans to include an OPG room, even if you may not start out with one initially. Designing and shielding the room from the beginning is always significantly cheaper than trying to do it at a later stage. It also advisable to check with your equipment provider to get the correct measurements and requirements so these can be factored into the design and build as well. Also if you plan to be doing Orthodontics in the future you will need to make sure the room is designed with this in mind, allowing enough room to add a Ceph arm at a later stage. Again it’s always cheaper to make these allowances and provisions from the outset and design stage.

How OPG can improve your practice?

Diagnostics

An OPG is one of the fastest and easiest ways to get an overall assessment of a patient’s dental health. Diagnosis is crucial to providing successful treatment outcomes, OPG’s play a key role in patient diagnosis as does intra oral imaging, 3D Imaging & clinical evaluations.

Patient retention & Convenience

Today’s modern lifestyle is fast past and patients are busier than in years past, as such convenience is increasingly becoming such an important aspect when patients are deciding where to go for their dental treatment. Having digital imaging in-house means an initial consultation and treatment plan can be provided in 1 appointment vs 3 when the patient is referred out for their imaging. Referring patients out for imaging also increases the risk they may not actual have the scan taken or worse they don’t return to the practice. Offering in house imaging ensures you’re offering the convenience patients are seeking and helps significantly with patient retention and case acceptance as a treatment plan can be provided in a single appointment.

Differentiation

Dentistry and in particular running a successful dental practice today is increasingly becoming very competitive with approx.150 new dental practices opening each year along with over 500 new graduates coming into the industry. Therefore differentiating your practice and the services offered to those around you is crucial to building a successful practice. Offering in-house imaging is one such way to differentiate your practice, providing patients with the convenience they’re seeking and helping to retain those patients in-house. Patient care, treatment outcomes and convenience are by far the main reasons dentist choose to offer in-house imaging, however increasing practice revenue is also a by-product of having an OPG in house. Most practices find they’ve paid their investment off after 6-24 months, just on the revenue from the scans not to mention the additional revenue from increased case acceptance and patient retention.

The path to 3D

CBCT or Cone Beam 3D imaging is a rapidly expanding technology in Australia, and is increasing being seen as the preferred choice in imaging for many dental procedures & diagnosis today. 3D images provide dentists with views & information previously not available from plain film imaging. Recent technology advancements and introduction of new low dose CBCT systems, is allowing dentists to provide better treatment outcomes, greater surgical predictability, reduced surgical time, increased patient communication, whilst minimising patient dose. This development with CBCT and other technologies means practice growth and future plans are key considerations when looking at purchasing an OPG. Practices looking to integrate 3D CBCT in the future are choosing to purchase an upgradeable OPG, as it offers greater flexibility in the future without having to change units completely. Upgradeable OPG’s are becoming the main choice for most dentists when looking at an OPG due to this increased flexibility, as it offers them an easy path to 3D in the future. However not all upgradeable machines are the same, with some only offering limited upgrade options vs others that offer a much wider choice in 3D fields of view, along with other variable such as image quality, resolution, patient dose, file size, workflow, service & support. Importantly the decisions made today can impact our future positions, going down the wrong path now can lead to added costs or expenses in the future or having to stick with a system that isn’t ideal for the practices needs.

Purchasing an OPG

• Company experience/Reputation – Is the manufacturer a well-known and experienced imaging provider.
• Image quality – Is the clarity and overall quality of the image suitable for the intended use?
• Patient positioning – does the system provide stable patient positioning – is there sufficient training to ensure all users have a strong grasp of correct and efficient positioning?
• After-sales Service & Support – Is there the availability of ongoing training and support? In the event of an issue, can you rely on the provider to provide timely support?
• Clear & flexible upgrade path – Are you looking to upgrade to 3D imaging in the future? Will the model in question enable you to upgrade sufficiently to meet your requirements (namely volume size).