DEXIS for Dentrix Ascend

USER'S GUIDE

www.DentrixAscend.com

Publication Information

Publication date

August 2017

Copyright

2017 Henry Schein, Inc. All rights reserved. No part of this publication may be reproduced, transmitted, transcribed, stored in a retrieval system, or translated into any language in any form or by any means without the prior written permission of Henry Schein, Inc.

2017 RealCloud Imaging, Inc. All rights reserved. No part of this publication may be reproduced, transmitted, transcribed, stored in a retrieval system, or translated into any language in any form or by any means without the prior written permission of RealCloud Imaging, Inc.

Software license notice

Your license agreement with Henry Schein, Inc., which is included with the product, specifies the permitted and prohibited uses of the product. Any unauthorized duplication or use of Dentrix Ascend, in whole or in part, in print or in any other storage and retrieval system is forbidden.

Licenses and trademarks

Dentrix Ascend, Henry Schein, and the 'S' logo are registered trademarks of Henry Schein, Inc. The Dexis imaging software, product names, and logo are either trademarks or registered trademarks of Dexis, LLC. The Planmeca imaging software and product names are either trademarks or registered trademarks of Planmeca USA, Inc.

Version

You can find which version of Dentrix Ascend's imaging software you are using by doing the following: on the Developer Tools panel (in Chrome) or on the Web Inspector panel (in Safari), select the Console tab, and then open the imaging software. A line of text similar to "Ascend Imaging version: 1.0.6004.30092 6/9/2016 4:43 PM" appears.


Real Cloud Imaging, Inc.
2625 North Loop Drive
Suite 2130
Ames, IA 50010

Contents

Introduction

Dentrix Ascend's digital imaging solution is a cloud-based 2D and 3D dental imaging software module that interacts seamlessly with the Dentrix Ascend practice management software to provide efficient and versatile image management. Dentrix Ascend's imaging manages intraoral and extraoral X-rays/volumes as well as intraoral and extraoral color images produced by intraoral video and/or consumer digital cameras.

Because Dentrix Ascend's imaging is a browser-based imaging software application, you can use it with Windows, Mac OS, iOS (iPad), and other operating systems in a supported, HTML5-compatible Web browser.

Important Note: The iPad can be used for non-diagnostic purposes only.

You can acquire, import, export, view, and edit 2D images and 3D volumes of dental anatomy. Dentrix Ascend's imaging supports the acquisition of images from many brands of intraoral and extraoral imaging devices, which allows you to mix and match imaging devices and brands of equipment as needed.

All images that you acquire or import are uploaded immediately to the Cloud, so you can access them from multiple locations for any number of users in near real time. Dentrix Ascend's imaging uses world-class storage providers, and images are automatically replicated to multiple servers for disaster recovery.

Dentrix Ascend's imaging has many image processing tools (such as filters and enhancements) that you can use on images to help determine the necessary treatments for patients. Also, you can attach images that you acquire and import to dental e-claims.

Dentrix Ascend's imaging is available as an add-on and must be purchased separately from the Dentrix Ascend practice management software.

Dentrix Ascend's imaging is used for diagnostic purposes in the field of dentistry.

Dentrix Ascend's imaging utilizes lossless compression for all intraoral and extraoral x-ray images and which is 100% reversible and does not result in loss of data. Dentrix Ascend's imaging utilizes lossy compression (JPEG) for all intraoral and extraoral color images.

Contact Customer/Technical Support should you have any questions, difficulties using, experience any anomalies, or have comments regarding the Dentrix Ascend's imaging software. See the "Customer/Technical Support" section of this user's guide for contact information.

Indications for use

Dentrix Ascend's imaging is a web-based Dental Picture Archiving and Communications Systems (PACS), i.e. dental imaging software, that enables dental care facilities to acquire, process, edit, and enhance dental images.

Dentrix Ascend's imaging provides a web-based interface for image acquisition and management of images which are used in the field of Dentistry and when operated by dental professionals who are responsible for providing dental care.

Images can be acquired from dental image acquisition devices and/or consumer imaging devices such as color digital cameras. Previously acquired images or volumes can be selected for upload directly from the user's computer.

Supported images include intraoral and extraoral dental x-rays/volumes and intraoral and extraoral color images produced by intraoral video or consumer digital cameras.

Dentrix Ascend's imaging is used for diagnostic purposes in the field of dentistry.

Dentrix Ascend's imaging is not intended for diagnostic use on a mobile display.

Images can be edited/enhanced (e.g. zoomed, contrast adjusted, inverted, annotated, rotated, filtered, etc...) as well as exported to standard image file formats.

Contraindications

None known

Cautions and warnings

Caution: Federal law restricts this device to sale by or on the order of a dentist.

To effectively use the Dentrix Ascend imaging software, it is Strongly Recommended that all users obtain dedicated training on the use of this software prior to use on any live patients.

Read and understand the User's Guide in its entirety before using the Dentrix Ascend imaging software upon live patients.

Use of this software as a diagnostic aid must be used in combination with other diagnostic aids and clinical experience to form a diagnosis and should not be solely relied upon for diagnosis.

Distance and Angle measurements require calibration by measuring length of a known object in image.

It is the operator's (user) responsibility to properly calibrate prior to clinical measurements and to determine if the accuracy achieved is within the error range required.

Do not operate this software upon live patients if you are feeling ill, fatigued, or if you are experiencing lack of concentration.

Do not leave any computer/device which is operating Dentrix Ascend's imaging unattended as this can create a security risk to patient or practice data. Always close the Dentrix Ascend imaging software when leaving a computer or device unattended.

System requirements

Browser

Note: iPad can be used for non-diagnostic purposes only.

Operating System

Anti-Virus Software

Display

Supported acquisition devices

Legend

Windows
Compatible

Mac
Compatible

Supported Intraoral X-ray Acquisition Devices

Supported Phosphor Plate Devices

Supported Extraoral X-ray Acquisition Devices

Supported Intraoral/Extraoral Color and CAD CAM Acquisition Devices

Important: If you want to use a device other than a DEXIS device, additional costs may be required, such as the purchase of drivers, to integrate that device with Dentrix Ascend's imaging. Before you purchase the Dentrix Ascend's imaging add-on or a particular device that you want to use with Dentrix Ascend's imaging, consult the manufacturer of that device to verify if there will be costs to get that device working with Dentrix Ascend's imaging.

Note: Some, but not all, devices have been testing using a TWAIN driver. Using a TWAIN driver with certain devices might have different results than expected.

Customer/Technical support

Setting up imaging devices

Setting up imaging devices

Because Dentrix Ascend's imaging is a web-based application, it is available immediately for use once you have purchased it and it is enabled by Henry Schein. However, for each computer that you want to acquire images from, you must install the following on that computer:

Note: If you do not perform the necessary setup on a computer that you want to acquire images from before attempting to acquire images, when you attempt to begin acquiring images (see step 2 of "Acquiring Images"), you will be asked to perform the necessary setup and will not be allowed to proceed with the acquisition until the setup is complete.

To install and configure the acquisition agent (Windows only)

Mac users: To install the acquisition agent, please contact our support team at 1-855-232-9493.

Important: Prior to installing the acquisition agent, verify that the Microsoft .NET 4.0 framework is installed. If .NET 4.0 is not installed, you must install it before you attempt to install the acquisition agent.

  1. Run Acquisition Agent Installer.exe.

  2. On the welcome screen, click Next.

  3. On the Choose Components screen, leave Acquisition Agent selected, and then click Next.

  4. On the Choose Install Location screen, leave the default Destination Folder selected, or click Browse to select a different location. Then, click Install.

  5. On the completion screen, click Finish.

  6. If you need to change the default settings of the acquisition agent (even though the defaults should suffice), after you complete the installation, right-click the Acquisition Agent icon in the notification area of the Windows task bar, and then click Preferences.

    The Preferences dialog box appears.

  7. Set up any of the following options as needed:

    • Correction File Path - For Dexis sensors, this is the default location of the calibration files (C:\Dexis\Flashdir). If the calibration files are located elsewhere, click Browse to locate and select the correct folder.

    • Use Binned Acquisition - In the Dexis imaging software (versions 9 and 10), "binned" is the default operating mode for Dexis sensors, so this check box is selected by default for Dentrix Ascend's imaging.

    • Use Buffered TWAIN Transfer - This option is for TWAIN drivers and is selected by default. If there are issues with TWAIN sources delivering images properly to the acquisition agent, clear this check box to use the native transfer mode, which some TWAIN sources require or recommend.

    • Joy Number and Use Joystick with Generic Camera - If you use a "Generic" intraoral camera with a joystick button interface instead of proprietary buttons, select the Use Joystick with Generic Camera check box. The camera button will use a specific joystick number. This is typically zero if no other joysticks are installed on the computer. Enter a number from 0 - 10 for Joy Number.

      If you use a Digital Doc camera, and it has been installed to use a port other than zero, you must specify the appropriate joystick number.

    • Intraoral and Extraoral TWAIN rotation - The Acquisition Agent uses settings in an .ini file to rotate and/or flip an image from TWAIN intraoral or extraoral imaging device prior to being delivered to Dentrix Ascend's imaging. You can modify these settings to correct the rotation/orientation of images from TWAIN devices. The .ini file is located in the Acquisition Agent's folder on the computer. The .ini file lists all the TWAIN devices that have been used by Ascend's imaging. A device will be listed under the category that corresponds to the type of device that it is: PanoramicTwain (for panoramic images) or DigitalSensorTwain (for intraoral images). Refer to the examples below.

      [PanoramicTwain]
      RVG Twain=RotateNoneFlipNone

      [DigitalSensorTwain]
      Planmeca Twain Source=RotateNoneFlipNone

      Next to the device name, you can change the value after the equals sign (=) to one of the following values:

      • RotateNoneFlipNone

      • Rotate90FlipNone

      • Rotate180FlipNone

      • Rotate270FlipNone

      • RotateNoneFlipX

      • Rotate90FlipX

      • Rotate180FlipX

      • Rotate270FlipX

    Note: The acquisition agent logs actions that it performs for debugging, troubleshooting, and performance monitoring. To view the log, click Show Log Files.

  8. Click Done.

Acquiring images

Acquiring images

You can acquire images with a device (such as an X-ray sensor or an intraoral camera) or by importing image files (such as .png or .jpg files). The images will be attached to a patient's record upon acquisition. When you acquire images, you can customize the acquisition settings, and there are options for posting the associated procedure and billing the procedure to insurance.

For the complete list of acquisition devices that are supported by Dentrix Ascend's imaging, see the "Supported Acquisition Devices" section.

To acquire images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, Perio, or Imaging.

  3. On the Chart, Progress Notes, Treatment Planner, Perio, or Imaging tab of a patient's clinical record, from the Imaging tab's menu, clicktap Acquire images.

    Notes:

    • If this computer is not set up to acquire images, a message appears and asks you to perform the necessary setup before you can proceed with an acquisition. ClickTap Done. After you complete the instructions to install the acquisition agent and the drivers for the selected acquisition devices, you can begin acquiring images.

    • If you have not already accepted the diagnostic use policy, a dialog box appears. To begin using the imaging features of Dentrix Ascend, you must select the I accept the above-mentioned policy check box, and then clicktap Accept & Go to Imaging.

    The options for acquiring images become available.

  4. Under Imaging Procedures, select the procedure that you want to perform (each corresponds to a particular acquisition type: individual intraoral X-ray, intraoral X-ray series, extraoral X-ray, or intraoral photo, or extraoral photo).

    The options for the selected procedure become available.

  5. Under Billing Options, set up the following options:

    • Apply charges - To post the fee for the selected procedure (such as D0210 for a full mouth series), select the check box. To post a zero amount for the procedure, clear the check box.

    • Bill to insurance - Specify whether you want to bill or not bill the patient's insurance carrier for the procedure by selecting or clearing the check box, respectively.

    • Provider - Select the provider who you want to associate with the procedure.

  6. Set up the Acquisition Options that apply to the corresponding acquisition type.

    Intraoral X-ray

    Do the following:

    1. From the Tooth chart, select the teeth that apply to the current acquisition session.

      Note: To deselect all selected teeth, clicktap the Clear selected link.

    2. Under Task to Perform, on the Acquire Images tab, the supported devices that have been installed and configured on this computer are available. If the desired device is not selected, select it from the device button menu.

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

    Intraoral X-ray series

    Do the following:

    1. If you are acquiring a full-mouth series, under Acquisition sequence, select FMX 18 or FMX 21; otherwise, skip this step.

    2. Under Acquisition sequence, select "Default sequence" or a custom order (if any).

    3. To change the order of the acquisition sequence, on the graphic with the numbered boxes, clicktap each box in the order that you will acquire the images.

      Tips:

      • To undo the previous selection, clicktap Undo as needed. To undo all selections, clicktap Reset.

      • When you finish specifying the order, to save the custom sequence for future use, type a name for the sequence, and then clicktap Save as ([sequence name]).

      • To delete a custom sequence, with that sequence selected, clicktap the white Delete button , which then turns red, and then clicktap the button again.

    4. Under Task to Perform, on the Acquire Images tab, the supported devices that have been installed and configured on this computer are available. If the desired device is not selected, select it from the device button menu.

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

    Extraoral X-ray

    Do the following:

    1. Under Task to Perform, on the Acquire Images tab, the supported devices that have been installed and configured on this computer are available. If the desired device is not selected, select it from the device button menu.

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

    Intraoral/extraoral photo

    Do the following:

    1. Under Task to Perform, on the Acquire Images tab, the supported devices that have been installed and configured on this computer are available. If the desired device is not selected, select it from the device button menu.

      Notes:

      • For the complete list of acquisition devices that are supported by Dentrix Ascend's imaging, see the "Supported Acquisition Devices" section.

      • The first time you attempt to use an intraoral camera with Dentrix Ascend's imaging on any computer, when a message from the browser appears and asks if you want to allow the browser to have access to the camera, allow it.

  7. ClickTap Proceed with Acquisition to start acquiring images for the corresponding acquisition type.

    Intraoral X-ray

    The selected acquisition device begins initializing.

    Then, the X-ray sensor begins arming.

    Then, the X-ray sensor becomes ready for exposure.

    Do the following:

    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's imaging to verify proper operation prior to use on live patients.

    1. To change the acquisition device, select a device from the Available Devices for Procedure button menu.

    2. From the Automatically 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), or select Not Enhanced to not apply any enhancement.

      Note: When 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 the "Processing images" section.

    3. Position the sensor in the patient's mouth, and align your X-ray source cone to point at the sensor, utilizing the paralleling or bisecting angle techniques. 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, which initiates the capture of the X-ray image. (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 software does not directly control the X-ray source or exposure settings.

      The resulting image is saved to the patient's record, and a preview of the image appears.

    Intraoral X-ray (using a phosphor plate)

    Do the following:

    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's imaging to verify proper operation prior to use on live patients.

    1. Position a phosphor plate in the patient's mouth, and align your X-ray source cone to point at the sensor, utilizing the paralleling or bisecting angle techniques. Make sure that the edge of the phosphor plate with the dot or letter is pointing upward for all vertical placements or pointing toward the back of the mouth for all horizontal placements. 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, which causes the phosphor plate to capture the X-ray image. (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 software does not directly control the X-ray source or exposure settings.

    2. To change the acquisition device, select a device from the Available Devices for Procedure button menu.

    3. From the Automatically Apply Enhancement list, select the type of enhancement that you want to have applied automatically to the image (Entire Image, For Perio, For Endo), or select Not Enhanced to not apply any enhancement.

      Note: When 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 the "Processing images" section.

    4. ClickTap Start Acquisition.

    5. When the scanner is ready, put the phosphor plate, with the edge with the dot or letter pointing up, in the scanner according to the manufacturer's instructions.

      When the scanner finishes scanning the plate, the resulting image is saved to the patient's record, and a preview of the image appears.

    Intraoral X-ray series

    The selected acquisition device begins initializing.

    Then, the X-ray sensor begins arming.

    Then, the X-ray sensor becomes ready for exposure.

    Do the following:

    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's imaging to verify proper operation prior to use on live patients.

    1. To pause acquisition and change the acquisition device, clicktap Pause, and then select a device from the Available Devices for Procedure button menu. ClickTap Continue to resume acquisition.

    2. To skip ahead in the acquisition sequence, clicktap Skip Forward. This button is available only if the current step in the sequence is not the last step.

    3. To go backward in the acquisition sequence, clicktap Skip Backward. This button is available only if the current step in the sequence is not the first step, and if the previous step in the sequence does not have an image.

    4. From the Automatically 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), or select Not Enhanced to not apply any enhancement.

      Note: When 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 the "Processing images" section.

    5. Position the sensor in the patient's mouth, and align your X-ray source cone to point at the sensor, utilizing the paralleling or bisecting angle techniques. 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, which initiates the capture of the X-ray image. (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 software does not directly control the X-ray source or exposure settings.

      Radiation triggers the X-ray sensor.

      The resulting image is saved to the patient's record, and a preview of the image appears.

    6. Wait until the timer counts down to zero to proceed to the next step in the acquisition sequence.

      The current step in the acquisition sequence and the applicable teeth are selected for your reference.

    7. Do any of the following if needed:

      • To stop the acquisition session, clicktap Finish Acquisition.

      • To replace the image that you just acquired, clicktap Recapture.

    8. Repeat steps a - g until you finish acquiring the series.

    Intraoral X-ray series (using phosphor plates)

    Do the following:

    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's imaging to verify proper operation prior to use on live patients.

    1. For each image you want to acquire, position a phosphor plate in the patient's mouth, and align your X-ray source cone to point at the sensor, utilizing the paralleling or bisecting angle techniques. Make sure that the edge of the phosphor plate with the dot or letter is pointing upward for all vertical placements or pointing toward the back of the mouth for all horizontal placements. 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, which causes the phosphor plate to capture the X-ray image. (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 software does not directly control the X-ray source or exposure settings.

    2. To change the acquisition device, select a device from the Available Devices for Procedure button menu.

    3. From the Automatically Apply Enhancement list, select the type of enhancement that you want to have applied automatically to the images (Entire Image, For Perio, For Endo), or select Not Enhanced to not apply any enhancement.

      Note: When 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 the "Processing images" section.

    4. ClickTap Start Scanning.

    5. When the scanner is ready, put the phosphor plates, with the edges with the dot or letter pointing up, in the scanner according to the manufacturer's instructions.

      As the scanner finishes scanning a plate, the resulting image appears as a thumbnail image on the panel at the bottom of Dentrix Ascend's imaging program.

    6. One at a time, drag the thumbnail images from the panel to the appropriate boxes of the template.

      Note: If the orientations the phosphor plates were correct when the radiographs were taken and when inserting them into the scanner, the images will have the correct orientation in the series. When you drop a thumbnail image into a box of the template, the image is rotated automatically as needed for that position in the series.

    7. As needed, do any of the following:

      • To change the orientation of an image in the template, select it to view the toolbar, and then clicktap any of the available buttons as needed: Flip Horizontal, Flip Vertical, Rotate Counterclockwise (90 degrees), and/or Rotate Clockwise (90 degrees).

      • To swap two images in the template, drag one of the images to the box with another image.

      • To remove an image from the template, drag it back to the panel at the bottom.

    Extraoral X-ray

    Do the following:

    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's imaging to verify proper operation prior to use on live patients.

    1. To change the acquisition device, select a device from the Available Devices for Procedure button menu.

    2. ClickTap Start Acquisition.

    3. From the Automatically 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), or select Not Enhanced to not apply any enhancement.

      Note: When 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 the "Processing images" section.

    4. Use the options on the TWAIN interface window that appears to get ready to use the X-ray device. Dentrix Ascend's imaging waits to obtain the image from the device.

    5. Position the patient properly for your extraoral X-ray imaging device (for example, place the patient in a stand-up panoramic imaging device). Set the appropriate exposure parameters on your X-ray source's control panel, and then trigger the radiation emission, which initiates the capture of the X-ray image. (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's imaging software does not directly control the X-ray source or exposure settings.

      The resulting image is saved to the patient's record, and a preview of the image appears.

    Extraoral X-ray (using a phosphor plate)

    Do the following:

    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's imaging to verify proper operation prior to use on live patients.

    1. Put a phosphor plate in your extraoral X-ray imaging device. Position the patient properly for your extraoral X-ray imaging device (for example, place the patient in a stand-up panoramic imaging device). Set the appropriate exposure parameters on your X-ray source's control panel, and then trigger the radiation emission, which initiates the capture of the X-ray image on the phosphor plate. (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 software does not directly control the X-ray source or exposure settings.

    2. To change the acquisition device, select a device from the Available Devices for Procedure button menu.

    3. From the Automatically Apply Enhancement list, select the type of enhancement that you want to have applied automatically to the image (Entire Image, For Perio, For Endo), or select Not Enhanced to not apply any enhancement.

      Note: When 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 the "Processing images" section.

    4. ClickTap Start Acquisition.

    5. When the scanner is ready, put the phosphor plate in the scanner according to the manufacturer's instructions.

      When the scanner finishes scanning the plate, the resulting image is saved to the patient's record, and a preview of the image appears.

    Intraoral/extraoral photo

    Do the following:

    1. To change the acquisition device, select a device from the Available Devices for Procedure button menu.

    2. ClickTap Start Acquisition.

      The live video stream from your camera appears.

      Note: To tune your camera's settings, you can clicktap the Tune Camera button .

    3. With the camera properly positioned, use the button on your camera to pause or freeze the live video stream (or clicktap Pause Streaming).

    4. Use the button on your camera to capture the current video frame (or clicktap Take a snapshot).

      The resulting image is added to the snapshot panel, and the video stream automatically becomes live again.

    5. Repeat steps c - d as needed to acquire additional shapshots.

    6. On the snapshot panel, clear the check box of the snapshots that you do not want to save.

    7. ClickTap Assign Images.

    8. Do any of the following:

      • To save a snapshot as an intraoral image and assign tooth numbers, drag it to the Upper Jaw, Lower Jaw, UR, UL, LR, LL, or Teeth box.

        If you drag it to the Teeth box, select the applicable teeth, and then clicktap Assign Teeth.

      • To save a snapshot as an extraoral image, drag it to the Extraoral Photos box.

      • To save the snapshots on the snapshot panel as intraoral images but not assign tooth numbers at this time, leave those snapshots on the snapshot panel.

      Assigned intraoral images appear on the left side of the preview area; extraoral, on the right.

      Note: If you have a mix of intraoral and extraoral images, they map to one procedure (D0350), which will appear in the progress notes with two icons. Also, you can delete or reassign the intraoral or extraoral exam as needed in the future.

  8. ClickTap Finish Acquisition or Begin Uploading (only for an intraoral X-ray series using phosphor plates or for intraoral/extraoral photos).

    Note: For an intraoral X-ray series using phosphor plates, if not all thumbnail images have been mounted into the template when you clicktap Begin Uploading, a confirmation message appears. If you choose to continue, only the mounted images will be saved.

  9. For an intraoral X-ray series using phosphor plates or for intraoral/extraoral photos, when the images are finished being saved to the patient's record, clicktap Continue.

  10. For a set of intraoral photos (or an individual intraoral photo or X-ray), you can assign tooth numbers to a selected snapshot by clicking the Edit button .

    For each snapshot that needs tooth numbers assigned to it, do the following:

    1. Under Image Preview, clicktap an image thumbnail. You can skip this step if there is only one image thumbnail.

      A larger version of the current image appears in the viewing area.

    2. Click the Edit button .

      The Assign Tooth Numbers dialog box appears.

    3. Select the applicable tooth numbers.

    4. ClickTap Assign Teeth.

Acquiring an image for selected teeth

You can quickly acquire an image for the teeth that are selected on a patient's clinical chart.

To acquire an image

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart.

    The patient's clinical record opens with the Chart tab selected.

  3. Select one or more teeth.

  4. Do one of the following:

    • If your location uses DEXIS devices, from the Imaging tab's menu, clicktap PA Quick acquire.

      The options to acquire an image become available. Skip steps 5 - 8.

    • If your location does not use DEXIS devices, from the Imaging tab's menu, clicktap Acquire images.

      The options for acquiring images become available. Proceed to step 5.

  5. Under Imaging Procedures, select the procedure that you want to perform (an intraoral periapical or bitewing X-ray image).

    The options for the selected procedure become available.

  6. Under Billing Options, set up the following options:

    • Apply charges - To post the fee for the selected procedure (such as D0220 for a periapical image), select the check box. To post a zero amount for the procedure, clear the check box.

    • Bill to insurance - Specify whether you want to bill or not bill the patient's insurance carrier for the procedure by selecting or clearing the check box, respectively.

    • Provider - Select the provider who you want to associate with the procedure.

  7. Under Task to Perform, on the Acquire Images tab, the supported devices that have been installed and configured on this computer are available. If the desired device is not selected, select it from the device button menu.

    Notes:

    • For the complete list of acquisition devices that are supported by Dentrix Ascend's imaging, see the "Supported Acquisition Devices" section.

    • The first time you attempt to use an intraoral camera with Dentrix Ascend's imaging on any computer, when a message from the browser appears and asks if you want to allow the browser to have access to the camera, allow it.

  8. ClickTap Proceed with Acquisition to start acquiring an image for the corresponding acquisition type.

    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's imaging to verify proper operation prior to use on live patients.

    The selected acquisition device begins initializing.

    Then, the X-ray sensor begins arming.

    Then, the X-ray sensor becomes ready for exposure.

  9. From the Automatically 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), or select Not Enhanced to not apply any enhancement.

    Note: When 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 the "Processing images" section.

  10. Position the sensor in the patient's mouth, and align your X-ray source cone to point at the sensor, utilizing the paralleling or bisecting angle techniques. 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, which initiates the capture of the X-ray image. (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 software does not directly control the X-ray source or exposure settings.

    Then, the resulting image is saved to the patient's record.

    Then, a preview of the image appears.

  11. ClickTap Finish Acquisition.

Importing images

You can import image files (.bmp, .png, .jpg, and .tiff files) to attach to a patient's record.

To import images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, Perio, or Imaging.

  3. On the Chart, Progress Notes, Treatment Planner, Perio, or Imaging tab of a patient's clinical record, from the Imaging tab's menu, clicktap Acquire images.

    The options for acquiring images become available.

  4. Under Imaging Procedures, select the procedure that you want to perform (each corresponds to a particular acquisition type: individual intraoral X-ray, intraoral X-ray series, extraoral X-ray, or intraoral photo, or extraoral photo).

    The options for the selected procedure become available.

  5. Under Billing Options, set up the following options:

    • Apply charges - To post the fee for the selected procedure (such as D0210 for a full mouth series), select the check box. To post a zero amount for the procedure, clear the check box.

    • Bill to insurance - Specify whether you want to bill or not bill the patient's insurance carrier for the procedure by selecting or clearing the check box, respectively.

    • Provider - Select the provider who you want to associate with the procedure.

  6. If you are importing images for an individual intraoral X-ray, from the Tooth chart, select the teeth that apply to the current importing session; otherwise, skip this step.

    Note: To deselect all selected teeth, clicktap the Clear selected link.

  7. If you are importing images for a full-mouth series, under Acquisition sequence, select FMX 18 or FMX 21; otherwise, skip this step.

  8. Under Task to Perform, clicktap the Import Images tab.

  9. Select one of the following options:

    • Completed Procedure - Use this for a procedure that you are performing. Today's date and time will be associated with the procedure.

    • Existing Procedure - Use this for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

      Note: With this option selected, the Apply charges and Bill to insurance check boxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

  10. ClickTap Proceed with Acquisition.

  11. Do one of the following:

    • If you are importing an individual intraoral or extraoral X-ray image, clicktap Start Acquistion.

    • If you are importing images for an intraoral X-ray series, clicktap Start Importing.

    • If you are importing images for intraoral/extraoral photos, clicktap Start Importing.

    The Import File dialog box appears.

  12. Select the desired image file(s), and then clicktap Open.

    If you are importing images for an intraoral X-ray series or intraoral/extraoral photos, the selected image files appear as thumbnail images on the panel at the bottom of Dentrix Ascend's imaging program.

  13. For an intraoral X-ray series or intraoral/extraoral photos, repeat steps 10 - 11 as needed to import additional images.

  14. For X-ray images, from the Automatically Apply Enhancement list, select the type of enhancement that you want to have applied automatically to the images (Entire Image, For Perio, For Endo), or select Not Enhanced to not apply any enhancement.

    Note: When viewing an image after it has been imported, 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 the "Processing images" section.

  15. For an intraoral X-ray series, do the following:

    1. One at a time, drag the thumbnail images from the panel to the appropriate boxes of the template.

    2. Do any of the following:

      • To change the orientation of an image in the template, select it to view the toolbar, and then clicktap any of the available buttons as needed: Flip Horizontal, Flip Vertical, Rotate Counterclockwise (90 degrees), and/or Rotate Clockwise (90 degrees).

      • To swap two images in the template, drag one of the images to the box with another image.

      • To remove an image from the template, drag it back to the panel at the bottom.

  16. For intraoral/extraoral photos, do the following:

    1. Clear the check box of any thumbnail image on the panel that you do not want to save to the patient's record.

    2. ClickTap Assign Images.

    3. Do any of the following:

      • To save a snapshot as an intraoral image and assign tooth numbers, drag it to the Upper Jaw, Lower Jaw, UR, UL, LR, LL, or Teeth box.

        If you drag it to the Teeth box, select the applicable teeth, and then clicktap Assign Teeth.

      • To save a snapshot as an extraoral image, drag it to the Extraoral Photos box.

      • To save the snapshots on the snapshot panel as intraoral images but not assign tooth numbers at this time, leave those snapshots on the snapshot panel.

      Assigned intraoral images appear on the left side of the preview area; extraoral, on the right.

  17. ClickTap Finish Acquisition (only for an individual intraoral/extraoral X-ray image) or Begin Uploading (only for an intraoral X-ray series or intraoral/extraoral photos).

    Note: For an intraoral X-ray series, if not all thumbnail images have been mounted into the template when you clicktap Begin Uploading, a confirmation message appears. If you choose to continue, only the mounted images will be saved.

  18. For an intraoral X-ray series or intraoral/extraoral photos, when the images are finished being saved to the patient's record, clicktap Continue.

  19. For a set of intraoral photos (or an individual intraoral photo or X-ray), you can assign tooth numbers to a selected snapshot by clicking the Edit button .

    For each snapshot that needs tooth numbers assigned to it, do the following:

    1. Under Image Preview, clicktap an image thumbnail. You can skip this step if there is only one image thumbnail.

      A larger version of the current image appears in the viewing area.

    2. Click the Edit button .

      The Assign Tooth Numbers dialog box appears.

    3. Select the applicable tooth numbers.

    4. ClickTap Assign Teeth.

Resuming incomplete exams

Resuming incomplete exams

If you skipped the acquisition of any images in an exam that uses a set of images or canceled an exam before acquiring all the images, you can return to that exam and complete the image acquisitions as needed.

To resume an incomplete exam

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

    The patient's imaging page opens to the history view, and the most recent image or image set (such as a full mouth series or bitewings) is selected by default on the Images tab.

  3. Select an image set (such as a full mouth series or bitewings).

  4. From the corresponding options menu, clicktap Resume exam. This option is available only if the exam is a set or series and has missing images (the image count is less than the number of spaces in the set).

    The options for acquiring images in the set appear.

  5. Finish acquiring images for the exam.

Viewing images

You can view the recent images and the image history for a patient.

Viewing recent images

You can view a patient's most recent images by category. This is the default view when you initially open a patient's Imaging page.

To view a patient's recent images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. Do one of the following:

    • From the Patient menu, under Clinical, clicktap Imaging.

    • From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio. Then, from the Imaging tab's menu, clicktap Show Most Recent Images.

    The patient's recent images appear.

  3. In any of the boxes, which correspond to categories (intraoral X-rays, intraoral photos, extraoral photos, and extraoral X-rays), do any of the following:

    • ClickTap the Previous button to view an image that was acquired prior to the image being displayed currently. This button is available only if there is an older image.

    • If you have navigated to an older image, clicktap the Next button to view a more recent image.

    • ClickTap the image being displayed currently to view that image larger. The image will open in the image history view. For information about using the image history view, see the "Viewing history" section.

      Note: If you clicktap a specific image of an image set (such as a full mouth series or bitewings), that image appears by itself, and you can easily navigate through the other images in that set from the patient's image history view.

Viewing image history

You can view a patient's entire image history chronologically and quickly navigate between each image. Also, the history view allows you to view individual images larger than you can from the recent images view, and you can process (such as enhance or annotate) an image. For information about using the recent images view, see the "Viewing recent images" section. For information about processing images, see the "Processing images" section.

To view a patient's image history

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

    The patient's imaging page opens to the history view, and the most recent image or image set (such as a full mouth series or bitewings) is selected by default on the Images tab.

  3. If needed, filter the list of images on the Images tab to display only the images that match the filter criteria that you specify.

    Do the following:

    1. Click inTap the Narrow down the results field to view the available filters.

    2. Set up any of the following filters:

      • Date - To view the images according to a different date, select the desired date from the list under Show images taken on. To view all images that have been acquired on and after the selected date, select the All since that day check box. To view the images that were acquired only on the selected date, clear the All since that day check box.

      • Type - To view images in any category (intraoral X-rays, intraoral photos, intraoral photos without tooth numbers assigned, and extraoral X-rays, and/or extraoral photos), select the All types check box. To view images in only certain categories, make sure the check boxes of only those categories are selected; the other check boxes must be cleared.

      • Teeth - If the Intraoral X-ray and/or Intraoral photo check boxes are selected, to view those types of images for specific teeth, select the desired teeth in the Tooth Chart. The tooth filter does not apply to intraoral photos that do not have tooth numbers assigned to them and extraoral X-rays (which apply to all teeth), and extraoral photos (which apply to all teeth). To clear all tooth selections, clicktap the Clear selected link.

      • Show everything - To set the filter options to their default states and display all the patient's images, clicktap the Show everything link.

      The image list displays the images that match your filter criteria.

    3. ClickTap the X in the upper-right corner of or anywhere outside of the Narrowing Down the Results menu to close the menu.

  4. With an image or image set selected, do any of the following:

    • Navigate the image set - If you have selected an image set (such as a full mouth series or bitewings), to navigate between the images of that set, clicktap each image of the set under Image Navigator. A larger version of the current image (highlighted with a yellow box) in the set appears in the viewing area.

      Note: You can also clicktap the Previous and Next buttons to navigate between the images in the set.

    • Zoom in/out - To increase the zoom level, move the Zoom slider to the right. If you increase the zoom level, to decrease the zoom level, move the slider to the left. You can also zoom in and out by positioning the pointer over the image (the pointer will change to cross hairs) and then rotating the scroll wheel of your mouse.

    • View full screen - To view the image full screen, clicktap the Full Screen button . To return to the normal view mode, clicktap the Normal Mode button .

Determining which teeth have images

You can determine which teeth have images associated with them from a patient's clinical chart and progress notes.

To determine which teeth have images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart.

    The patient's clinical record opens with the Chart tab selected.

  3. Do one of the following:

    • Look at a tooth's number. You can tell if a tooth has an image associated with it, and the age of that image, by the background color of the circle around that tooth number: black is 0 - 6 months, dark gray is 7 - 12 months, light gray is 13 - 24 months, and white is 25 or more months (or no image).

    • If your location uses DEXIS devices, select one or more or no teeth, and then clicktap the Progress Notes tab. On the Progress Notes tab, there is an Imaging icon next to any procedure that has images associated with it.

Viewing images for selected teeth

If your location uses DEXIS devices, you can view images for selected teeth from a patient's clinical chart and progress notes.

To view images for selected teeth

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart.

    The patient's clinical record opens with the Chart tab selected.

  3. Do one of the following:

    • Select one or more teeth with associated images, and then clicktap Image Peek.

    • Select one or more or no teeth, and then clicktap the Progress Notes tab. On the Progress Notes tab, clicktap the Imaging icon next to a procedure.

    The Image Peek dialog box appears.

    Tips:

    • If there are multiple images, use the Back and Forward buttons to navigate between the images.

    • To edit the image that is currently being viewed, clicktap Open for Edit.

  4. ClickTap Done.

Comparing images

Comparing images

You can compare two images side by side.

To compare images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. Do one of the following:

    • View an image from the patient's image history list.

      1. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

      2. On the Images tab, select an image or image set (such as a full mouth series or bitewings).

      3. If you have selected an image set, under Image Navigator, clicktap an image of that set.

    • View one of the patient's most recent images.

      1. Do one of the following:

        • From the Patient menu, under Clinical, clicktap Imaging.

        • From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Most Recent Images.

      2. ClickTap any single image (intraoral X-ray, intraoral photo, extraoral photo, or extraoral X-ray) or an image within an image set (such as a full mouth series or bitewings).

    The selected image appears in the viewing area.

  3. ClickTap Compare.

    The images that have tooth numbers in common with the selected image (the "Original") appear on the Images for tooth range panel.

  4. The first image on the Images for tooth range panel is selected by default, but you can select a different image to compare with the original.

  5. To modify how an image is being viewed, clicktap the Original or Compared image, and then do any of the following for the selected image:

    • Use the (yellow or blue) Brightness/Contrast button to change the brightness and/or contrast.

    • Use the (yellow or blue) Zoom slider to zoom in and out.

    • While zoomed in on an image, drag the blue square (on the comparison image on the Images for tooth range panel) or the yellow square (on the image under Image Navigator) to pan to another part of the image.

  6. Linking the images being compared allows the zooming and panning of one image to be synchronized with the other. To link images, do the following:

    1. ClickTap the Original or Compared image (zoomed and panned or not).

    2. ClickTap the (yellow or blue) Link button .

      The images are linked.

      Note: If you alter the zoom and/or pan of an image before linking it to the other, when you link them, the zoom factor and the position of the pan box (yellow or blue box) of the other image is synchronized to be the same as the first.

    Now, as you zoom in and out and pan, both images are affected.

    Note: To unlink the images, clicktap the Link button .

  7. ClickTap Finish Comparison.

Processing images

Processing images

You can perform various processing tasks, such as enhancing and annotating, on images.

Note: Any processing that you perform on an image is permanent (except for colorize, grayscale, and emboss, which are temporary). However, you can view the image in its original state by turning off any processing filters that you have applied.

To process an image

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. Do one of the following:

    • View an image from the patient's image history list.

      1. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

      2. On the Images tab, select an image or image set (such as a full mouth series or bitewings).

      3. If you have selected an image set, under Image Navigator, clicktap an image of that set.

    • View one of the patient's most recent images.

      1. Do one of the following:

        • From the Patient menu, under Clinical, clicktap Imaging.

        • From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Most Recent Images.

      2. ClickTap any single image (intraoral X-ray, intraoral photo, extraoral photo, or extraoral X-ray) or an image within an image set (such as a full mouth series or bitewings).

    The selected image appears in the viewing area.

  3. ClickTap the Tools tab if it is not already selected.

  4. Use any of the following tools as needed:

    One Click Tools

    • Enhance - Select the filter that corresponds to the anatomical structures that you want to enhance in an X-ray:

      • Not Enhanced - The image is not enhanced.

      • Entire Image - Adds a balance of sharpening and contrast levels that affects the overall sharpness and contrast.

      • For Perio - Adds a lower level of sharpening and a gray level adjustment to accentuate the subtle differences in the grayscale values of periodontal conditions.

      • For Endo - Adds a higher level of sharpening and contrast and a gray level adjustment to accentuate endodontic conditions. You may want to use this filter, for example, to help you to see the position of a file in relation to the root of a tooth when doing a root canal.

      Note: To switch between viewing the image with or without an applied enhancement, clicktap the Enhancement button. If the enhancement is turned on, the button is gray . If the enhancement is turned off, the button is orange .

    • Rotate - ClickTap the button that corresponds to how you want to rotate the image: 180 degrees (clockwise), 90 degrees (clockwise), or -90 degrees (counterclockwise).

    • Flip - ClickTap the button that corresponds to how you want to flip the image: Horizontal or Vertical.

    • Invert - To invert the image's colors, select the Invert check box. To remove the filter, clear the check box.

    • Colorize (X-rays only) - To convert the image from grayscale to color, select the Colorize check box. To remove the filter, clear the check box. This option is available only for intraoral and extraoral X-rays.

    • Grayscale (Photos only) - To convert the image from color to grayscale, select the Grayscale check box. To remove the filter, clear the check box. This option is available only for intraoral and extraoral photos.

    • Emboss - To emboss the image, select the Emboss check box. To remove the filter, clear the check box.

    Annotations

    To add a shape, do the following:

    1. Set up the Drawing tools.

      • Select a shape: arrow, rectangle, or circle.

      • Select a color from the Colors menu, or clicktap one of the Last used colors.

      • Select an Outline width: extra thin, thin, standard, wide, or extra wide. A preview of the selected line thickness that will be used for the shape appears.

    2. ClickTap and drag over a specific area of the image to create the shape.

    Notes:

    • To remove the last annotation that you added to the image, clicktap Undo.

    • To remove all annotations from the image, clicktap Clear All.

    • To switch between showing and hiding the annotations, select and clear the Show check box.

    • To switch between showing and hiding annotations and measurements, clicktap the Annotations/Measurements button . The button is available only if an annotation or a measurement has been applied to the image.

    Measurements

    Important: Distance and Angle measurements are calculated from specified points after calibration from an object with a known length. Image resolution, displayed size, inherent image quality, and proper calibration all affect the accuracy of the measurement results. However, the factors that have the greatest effect on the overall precision of a measurement are the accuracy of the calibration and selection of the start and end points of the actual line or angle to be measured. Using the calibration results, you can decide as to whether the overall accuracy achieved is correct for the desired measurement.

    Warning: It is your responsibility to properly calibrate prior to clinical measurements and to determine if the accuracy achieved is within the error range required.

    To add measurements, do the following:

    1. To calibrate distance measurements using an object of known size in the image, clicktap Calibrate. ClickTap the first (starting) point of the known-length object on the image where you want to start measuring, and then drag to another point on the known-length object. Change the length of the Standard for calibration as needed to the correct number of millimeters for the known length.

      Perform the above calibration step until you are comfortable that you can measure the calibration object accurately and that the displayed results have the accuracy needed. Now that you have defined the length of the segment, all dynamic measurements will be calculated respective to that calibration.

    2. ClickTap Dynamic Measure.

    3. ClickTap a point on the image, then another point, and so on until you have created all the necessary lines.

    Notes:

    • To remove the last measurement that you added to the image, clicktap Undo.

    • To remove all measurements from the image, clicktap Clear All.

    • To show the calculated length of each line segment, select the Show segment length (SL) check box.

    • To show the calculated angle where two line segments meet, select the Show angle (A) check box.

    • To switch between showing and hiding the lines and their calculated lengths and angles, select and clear the Show check box.

    • To switch between showing and hiding annotations and measurements, clicktap the Annotations/Measurements button . The button is available only if an annotation or a measurement has been applied to the image.

    Density (Line)

    Important: Density measurements are calculated from specified points on the image and are reported from the actual pixel values selected. Image resolution, displayed size, and inherent image quality can all affect the accuracy of the Density measurement. However, the factor which has the greatest effect on the overall precision of a density measurement is the accuracy of the selected point or points to be measured.

    To get the density (gray level) from one point to another on the image (X-ray images only), do the following:

    1. ClickTap Line.

    2. ClickTap a point on the image, then another point to create a line.

      A graph of the gray levels along the specified line appears, and the Median gray level is indicated.

    Note: To remove the density line, clicktap Clear.

    Density (Rectangle)

    To get the density (gray level) of a rectangular area on the image (X-ray images only), do the following:

    1. ClickTap Rectangle.

    2. ClickTap and drag to create a rectangle.

      The Median gray level is indicated.

    Spotlight

    To add a spotlight, do the following:

    1. Select one of the Effects: Invert, Colorize (for X-ray images only), or Sharpen.

    2. Move the Spot size slider to specify the size of the spotlight.

    3. Suspend the spotlight on the image:

      • Non-touch-enabled device - Position your mouse pointer over a specific area of the image, and then click. Then, click Suspend.

      • Touch-enabled device - Tap a specific area of the image, drag to another area if needed, and then tap Suspend.

    4. Continue adding spotlights as needed.

      Note: To remove all spotlights, clicktap Clear Suspended, or select another processing tool.

  5. Adjust the brightness and/or contrast as needed.

    Do the following:

    1. ClickTap the Brightness/Contrast button.

    2. Do any of the following:

      • Move the Brightness slider to decrease or increase the brightness.

      • Move the Contrast slider to decrease or increase the contrast.

      • To reset the brightness and contrast levels to their default states, clicktap the Reset to default link.

      Note: If you change the brightness or contrast, the corresponding button becomes orange .

Deleting images

Deleting images

You can delete a single image or a series of images from a patient's record. You can delete images only if they are not associated with procedures that are attached to insurance claims.

Notes: The procedures that are associated with the images that you are deleting will also be deleted or voided (if older than 120 days).

To delete images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

    The patient's imaging page opens to the history view, and the most recent image or image set (such as a full mouth series or bitewings) is selected by default on the Images tab.

  3. Select an image or image set (such as a full mouth series or bitewings).

  4. From the corresponding options menu, clicktap Delete exam.

    The Delete Exam confirmation message appears.

  5. ClickTap Delete.

Reassigning images to a different patient

Reassigning images to a different patient

You can move a single image or a series of images from one patient's record to another's. You can move images only if they are not associated with procedures that are attached to insurance claims.

Note: The procedures that are associated with the images that you are moving will be deleted or voided (if older than 120 days) in the original patient's record and posted to the new patient's record.

To process an image

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

    The patient's imaging page opens to the history view, and the most recent image or image set (such as a full mouth series or bitewings) is selected by default on the Images tab.

  3. Select an image or image set (such as a full mouth series or bitewings).

  4. From the corresponding options menu, clicktap Reassign exam.

    The Reassign Exam dialog box appears.

  5. Use the to the following patient search field to search for and select the name of the patient to whom you want to move the images.

  6. ClickTap Reassign Exam.

Sharing images

You can export and print images.

Exporting images

You can export an image, a specific image of an image set, or an entire image set (such as a full mouth series).

To export images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. Do one of the following:

    • View an image or image set from the patient's image history list.

      1. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

      2. On the Images tab, select an image or image set (such as a full mouth series or bitewings).

    • View one of the patient's most recent images.

      1. Do one of the following:

        • From the Patient menu, under Clinical, clicktap Imaging.

        • From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Most Recent Images.

      2. ClickTap any single image (intraoral X-ray, intraoral photo, extraoral photo, or extraoral X-ray) or an image within an image set (such as a full mouth series or bitewings).

    The selected image (or the first of the selected image set) appears in the viewing area.

  3. If you are viewing an image set (such as a full mouth series or bitewings), to view a differrent image of that set, under Image Navigator, clicktap an image. Otherwise, skip this step.

  4. Do one of the following:

    • To export only the image currently being viewed, clicktap Share.

    • To export the selected image or set of images, from the corresponding options menu, clicktap Share exam.

    The Share Exam or Image dialog box appears.

  5. Set up the following options:

    • Include image enhancements - Select this check box to apply an enhancement, which adds a balance of sharpening and contrast levels that affects the overall sharpness and contrast, to any of the images being exported that have enhancement applied to their originals. Any images being exported that do not have enhancement applied to their originals will not be exported with enhancement. Clear this check box to not enhance any of the images being exported even if enhancement has been applied to their originals.

    • Include annotations and measurements - Select this check box to include any annotations or measurements that were added to the images being exported. Clear this check box to export the images without the annotations and measurements.

    • Export as JPEG (Otherwise PNG) - Select this check box to export the images as a .jpg file. Clear this check box to export the images as .png files.

    • Share exam as - These options are available only if you selected the Share exam option from the image set's options menu in step 4. To export the images as one file that contains all the images, select Entire exam in one image. To export each image as an individual file, select Separate individual images.

  6. ClickTap Export.

    The images are downloaded.

Printing images

You can print an image, a specific image of an image set, or an entire image set (such as a full mouth series).

To print images

  1. Use the Patient Search field to access a patient's record.

    Notes:

    • If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search field.

    • You can include inactive patients in the search results by setting the Include inactive patients switch to On.

  2. Do one of the following:

    • View an image or image set from the patient's image history list.

      1. From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Image History.

      2. On the Images tab, select an image or image set (such as a full mouth series or bitewings).

    • View one of the patient's most recent images.

      1. Do one of the following:

        • From the Patient menu, under Clinical, clicktap Imaging.

        • From the Patient menu, under Clinical, clicktap Chart, Progress Notes, Treatment Planner, or Perio, or Imaging. Then, from the Imaging tab's menu, clicktap Show Most Recent Images.

      2. ClickTap any single image (intraoral X-ray, intraoral photo, extraoral photo, or extraoral X-ray) or an image within an image set (such as a full mouth series or bitewings).

    The selected image (or the first of the selected image set) appears in the viewing area.

  3. If you are viewing an image set (such as a full mouth series or bitewings), to view a differrent image of that set, under Image Navigator, clicktap an image. Otherwise, skip this step.

  4. Do one of the following:

    • To print only the image currently being viewed, clicktap Share.

    • To print the selected image or set of images, from the corresponding options menu, clicktap Share exam.

    The Share Exam or Image dialog box appears.

  5. Set up the following options:

    • Include image enhancements - Select this check box to apply an enhancement, which adds a balance of sharpening and contrast levels that affects the overall sharpness and contrast, to any of the images being printed that have enhancement applied to their originals. Any images being printed that do not have enhancement applied to their originals will not be printed with enhancement. Clear this check box to not enhance any of the images being printed even if enhancement has been applied to their originals.

    • Include annotations and measurements - Select this check box to include any annotations or measurements that were added to the images being printed. Clear this check box to export the images without the annotations and measurements.

    • Share exam as - These options are available only if you selected the Share exam option from the image set's options menu in step 4. To print the images on a single page, select Entire exam in one image. To print each image on a separate page, select Separate individual images.

  6. ClickTap Print.

    A .pdf file of the images is created for you to print.

Attaching images to claims

Attaching images to claims

You can attach images that you have acquired using Dentrix Ascend's imaging to a claim.

To attach images to a claim

  1. ClickTap a claim on the Unsent Claims page, the Sent Claims page, a patient's Insurance Claims page, or a patient's ledger.

    The Claim Detail dialog box appears.

    Note: If the patient has images for the same date of service as a procedure on the claim, a warning icon appears. You can click the icon to view the warning and click a link to go to the Attachments tab.

  2. ClickTap the Attachments tab.

  3. Add images from the patient's images:

    1. ClickTap Add Image.

      The Add from Imaging dialog box appears.

    2. ClickTap a procedure with the correct date of service to view the corresponding images. Select the check boxes of the images that you want to attach to the claim. Repeat this process as needed.

    3. ClickTap Add.