Acquiring extraoral X-rays

You can acquire extraoral X-rays (panorexes and cephalograms) with digital equipment, phosphor plates, and third-party programs.

Note: For the complete list of acquisition devices that are supported by Dentrix Ascend Imaging, see "Supported Acquisition Devices."

To acquire an extraoral X-ray

If the correct patient is not already selected in Dentrix Ascend, use the Patient Search box to access the patient's record.

Note: You can include inactive patients in the search results by setting the Include inactive patients switch to On.
On the Patient menu, under Clinical, click (or tap) Chart, Progress Notes, Quick Exam, Perio, Tx Planner, or Imaging.
On the Chart, Progress Notes, Perio, Tx Planner, or Imaging tab of a patient's clinical record, on the Imaging tab's menu, click (or tap) Acquire images.

Notes:
- If the acquisition agent is not installed, the Acquisition Activation dialog box appears. Click (or tap) the Click here link to download the acquisition agent installer. Then, click (or tap) Done. After you install the acquisition agent and the drivers for your acquisition devices, you can begin acquiring images.
- If you have not already accepted the diagnostic use policy, the Diagnostic Use Warning dialog box appears. To begin using the imaging features of Dentrix Ascend, you must select the I accept the above-mentioned policy checkbox, and then click (or tap) Accept & Go to Imaging.
The options for acquiring images become available.
Under Imaging Procedures, select one of the following tabs:
- Favorites - This tab contains the imaging procedures for the current location that have been marked as favorites. This tab is available only if there are favorite imaging procedures for the current location. If there are favorite imaging procedures for the current location, this tab is selected by default.
- Standard - This tab contains the standard imaging procedures that come with Dentrix Ascend Imaging. This tab is available for all locations. If there are not any favorite imaging procedures for the current location, this tab is selected by default.
Note: The Custom tab, even if it is available, does not contain imaging procedures for extraoral X-rays.
Select an imaging procedure that corresponds to the acquisition type for an extraoral X-ray: Panoramic Image or Cephalometric Image.

The options for the selected procedure become available.
Under Billing Options, set up the following options:
- Apply charges - To post the fee for the selected procedure (such as D0330), select the checkbox. To post a zero amount for the procedure, clear the checkbox.
- Bill to insurance - To bill the patient's insurance carrier for the procedure, select the checkbox. To not bill the patient's insurance carrier for the procedure, clear the checkbox.
- Select provider - From the list, select the provider who you want to associate with the procedure.
  
  Note: Only providers who have access to the current location and who are flagged as charting providers are available for selection. Also, the provider who is selected by default is determined by the current location's Default procedure provider setting.
Set up the Acquisition Options for extraoral X-rays.
Do the following:
1. If no interpretation or analysis of the acquired image will be done in your office, to use an alternative procedure code, do one of the following:
  - For a panorex, select the Without interpretation/analysis using code D0701 checkbox.
  - For a cephalogram, select the Without interpretation/analysis using code D0702 checkbox.
2. Under Task to Perform, on the Acquire Images tab, select the correct device on the Available Devices menu if it is not already selected.
  
  Note: For the complete list of acquisition devices that are supported by Dentrix Ascend Imaging, see "Supported Acquisition Devices."
Acquire the extraoral X-ray with the specified device.

With a digital panoramic or cephalometric unit
Do the following:
1. Position the patient properly for your extraoral X-ray imaging device (for example, place the patient in a stand-up panoramic imaging device).
  
  Note: A phantom, test target, and/or another non-human object should be X-rayed when installing or using any image acquisition device for the first time in Dentrix Ascend Imaging to verify proper operation prior to use on live patients.
2. Click (or tap) Proceed with Acquisition.
  
  Dentrix Ascend Imaging waits to obtain the image from the device.
  
  Note: If the acquisition stops because of a device error, fix the issue, and then click (or tap) Start to proceed with the acquisition.
3. Set the appropriate exposure parameters on your X-ray source's control panel, and then trigger the radiation emission. (Refer to the documentation provided by the manufacturer of your X-ray source for details about changing settings and usage.)
  
  Note: Radiation from an X-ray source initiates the imaging device to capture an image, and this is controlled by someone triggering the X-ray source. The Dentrix Ascend Imaging program does not directly control the X-ray source or exposure settings.
  
  The image is saved to the patient's record.
With a phosphor plate scanner
Do the following:
1. Put a phosphor plate in your extraoral X-ray imaging device according to the manufacturer's instructions.
2. Position the patient properly for your extraoral X-ray imaging device (for example, place the patient in a stand-up panoramic imaging device).
  
  Note: A phantom, test target, and/or another non-human object should be X-rayed when installing or using any image acquisition device for the first time in Dentrix Ascend Imaging to verify proper operation prior to use on live patients.
3. Set the appropriate exposure time on your X-ray source's control panel for the specific imaging device in use, and then trigger the radiation emission. (Refer to the documentation provided by the manufacturer of your X-ray source for details about changing settings and usage.)
  
  Note: Radiation from an X-ray source causes the phosphor plate to capture the image, and this is controlled by someone triggering the X-ray source. The Dentrix Ascend Imaging program does not directly control the X-ray source or exposure settings.
4. Click (or tap) Proceed with Acquisition.
  
  The scanner is initialized.
  
  Then, the scanner continues preparing to scan.
  
  Then, the scanner becomes ready.
  
  Note: If the acquisition stops because of a device error, fix the issue, and then click (or tap) Start to proceed with the acquisition.
5. From the Apply Enhancement list, select the type of enhancement that you want to have applied automatically to the image that will be acquired (Entire Image, For Perio, For Endo), select Custom to apply the default custom sharpness level, or select Not Enhanced to not apply any enhancement.
  
  Note: While viewing an image after it has been acquired, you can turn the enhancement off and on. The original, raw image is preserved. For more information about enhancements and turning them on and off, see "Processing images."
6. Put the phosphor plate, with the edge with the dot or letter pointing up, in the scanner according to the manufacturer's instructions.
  
  The scanner begins scanning the plate.
  
  When the scanner finishes scanning the plate, the resulting image is saved to the patient's record.
With a third-party program (TWAIN or bridge)
Do the following:
1. Position the patient properly for your extraoral X-ray imaging device (for example, place the patient in a stand-up panoramic imaging device).
  
  Note: A phantom, test target, and/or another non-human object should be X-rayed when installing or using any image acquisition device for the first time in Dentrix Ascend Imaging to verify proper operation prior to use on live patients.
2. Click (or tap) Proceed with Acquisition.
3. Use the options in the third-party TWAIN interface or imaging program that opens to get ready to acquire the image.
4. Set the appropriate exposure time on your X-ray source's control panel for the specific imaging device in use, and then trigger the radiation emission. (Refer to the documentation provided by the manufacturer of your X-ray source for details about changing settings and usage.)
  
  Note: Radiation from an X-ray source initiates the imaging device (sensor) to capture an image, and this is controlled by someone triggering the X-ray source. The Dentrix Ascend Imaging program does not directly control the X-ray source or exposure settings.
5. Close the third-party TWAIN interface or imaging program.
  
  The image is saved to the patient's record in the Dentrix Ascend Imaging program automatically.