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Ax.CEPH Users Guide Ver. 2.0

1. Visible Name Element on layer Visible Name Element on layer v Radiograph v Radiograph All Elements All Elements Analysis m v Analysis y Report oO Report Mandibula Mandibula Maksila El Maksila a b Image 106 On image a no element is selected on image b an element is selected 6 9 1 3 Export layer content in vector format The window enables you to export layer or in other words all currently visible elements in vector format which you can later process or import in documents such as documents containing possible solutions bids etc Right clicking the desired layer opens a context menu where you can select a Export all elements on canvas b Export selected layer Using the Superimposition panel you can export all elements contained in the selected layer For example exporting the Mandible layer exports all elements which are contained in all Mandible layers across all superposed analyses Y Radiograph All Elements Y Analysis H mp Mandib E Export Analysis to EMF E Export Selected Layerto EMF Image 107 Export to Windows meta file WMF The Windows meta file format is used for storing files composed of vector graphics which enables resizing and print out of curves without causing a fuzzy or broken curve line You can Ax CEPH Users Guide Copyright 2011 Page 86 of 141 import it in most text editors slideshow presentation editors and you can edit it usi
2. AX LEPH Cephalometric X ray Analysis Software www axceph com AX CEPH CEPHALOMETRY SOFTWARE DOCUMENTATION Ax CEPH Ver 2 0 Users Guide Audax d o o Tehnoloski park 18 Ljubljana SI 1000 Telephone 00 386 1 200 40 50 Fax 00 386 1 423 47 00 www axceph com Ax CEPH Users Guide Copyright 2011 Page 2 of 141 Table of Contents 1 ABOUT THIS GUIDE REERRTTNRUNENRE EERTMS 6 1 1 MFO SI WU NS Eliane ota 7 1 2 TY POGRAPHICAL lt GONVENTIONS xcedixetiltcndtuedtitedis iui o llo ar eed 7 2 MINTO DWC TOON RR ROTE 8 2 1 PURPOSE A o E ML do e do MM dt 8 2 2 Ex A O P trist EAE UM 9 2 3 POCO EPENVVINDOWIUAYOLJLT 2 cotes e eode pe toit de te ld de tdeo duce t etal 10 2 4 PXXGEPHOPERATINO MODE suites pda t Mec evi vo doe Vor ect puede alcala Cain 12 3 MAKING ANALYSES BASED ON PREDEFINED ANALYSIS TYPE tmm 13 3 1 VM OPRIKEBROW O ele ie EE a ELLA m LN eut E 14 3 2 PREPARING DATA FOR THE ANALYSIS cccsceccececcececcececcececcecuccccecececuececuececeeaecucaeuecauaecsuaeceuaeees 15 3 3 PRINTING AND SAVING ccccceccececcececceccccecsccececcececsucecsucecseausseausecucecsucecsucessuessccusecausecsuaecsuaesas 38 4 DIGITAL FILTERS IN IMAGE PROCESSING eere nnnm menn nenne 40 4 1 IMAGE MANIPULATIONS AND DISPLAYING cccsceccececcececcececcccuccccuccccecueaucueaececaececuececauaeceuaeseuaeees 41 4 2 A epu EIE C MM erence aden M RM LM IUE MM LE IM E Mt 44 4 3 STON ERR 49 4 4
3. Shift F11 Insert Delete Move or Copy Gel View Code EE Protect Sheet Tab Color d Hide Select All Sheets Jatient Shee Image 113 Inserting a new list when creating template renaming worksheet to Analysis optional Right click on a new sheet tab and rename it to Analysis Drag the Analysis worksheet to the first position you may leave it where it is as well 6 12 1 3 Image To display the patient s radiograph and print layer in the Analysis worksheet do the following Select cells of the image in the Image worksheet or delete the image to make selecting easier The radiograph covers cells from A1 top left corner to D14 bottom right corner Mark them Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 93 of 141 Calibri l1 A y a wy E B 7 Hi Ar Ara E JU Ii d Cut Paste Ea coy 1 Formulas i Paste Paste Values Paste Special No Borders Insert Transpose Delete I Paste Link Clear Contents i Paste Special Filter d Sort k Copy as Picture 3 Y Insert Comment A m Format Cells Pick From Drop down List Paste as Picture Mame a Range a Hyperlink Image 114 Copy the radiograph to the Analysis worksheet Right click outside the image and somewhere inside the marked fields area for example on the red x point in the Image 115 Use Copy from the pop down
4. chler 2 Silhouettes Cabinet B chler 2 Silhouettes acxT _ Downs Downs acxT L European Board of Orthodontists European Board of Orthodontists acxT L LJ shiza Ljubljana Shiza acxT L L3 splo na Ljubljana_Splosna acxT L Ricketts Ricketts_1 acxT L Soft tissue Soft_tissue acxT __ Verband sterreichischer Kieferorthop den V K VOEK_1 acxT L Zagreb 82 MOD Zagreb_82_MOD acxT Zuerich Zuerich_1 acxT Image 118 Using already stored analysis type to create a new one New analysis type will be a copy of the chosen one from the list Ax CEPH Users Guide Copyright 2011 Page 98 of 141 8 Creating Analysis Type Using Predefined Elements 8 1 Using Predefined elements Use predefined elements to create analysis types more easily Here you can use geometric features defined in the Ax CEPH library ls 4 Point Plane Teeth Group Predefined reposition Cognitive features Click the Predefined button to open a window offering predefined elements Measurements Points Planes Measurements Points Planes Tag ID SNB d Filter s ar Lua ee eee SNA SNA Name Kot SNB SNB ES wa Kot SNB Desc Premica Premica _ Element shown m Show text iv Basis element Image 119 Window with predefined elements The window is divided into three sections In the middle section you can find predefined elem
5. chler a Cabinet B chler 1 Silhouette Cabi Analysis type LJ Cabinet B chler 2 Silhouettes Cab E Downs Downs acxT Patient type adults 2 European Board of Orthodontists E Date 19 8 2011 2 LJ shiza Ljubljana S5Shiza acxT LJ splo na Ljubljana 5plosna acxT Status LJ LJ 2 acxT Ricketts Ricketts 1 acxT Soft tissue Soft tissue acxT Soft tissue Soft tissue 1 acxT Verband sterreichischer Kieferorth Zagreb 82 MOD Zagreb 82 MOD a Zagreb 82 MOD Zagreb 82 MOD 1 Zuerich Zuerich_1 acxT Description 3 Cancel Image 10 Selecting analysis type In the analysis type selection dialog check the analysis type based on which you wish to make the analysis Click the OK button Unplaced geometric elements that are used in the analysis appear on the image This state is called raw analysis 3 2 4 Correctly Placing Offered Landmark Points onto the Radiograph After identifying reference points and defining outlines the analysis is ready to be printed exported saved or sent by e mail 3 2 5 Selecting Elements Elements can be in one of three states Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 17 of 141 a Set a set element is placed onto the canvas and designates a point plane etc b Highlighted an element is highlighted when the mouse pointer green crosshairs is placed on it the element turns light blue An element can be highlighted by moving the mouse po
6. pom 4 Ill x Show measurement tag Font ip Arial Unicode B Font preview Info Box Font 3 Cancel Image 38 Dialog box for defining Infobox settings 3 2 13 5 Align InfoBox After selecting the element Infobox you can select Align Infobox option from the context menu Click the point and the information about the selected point is immediately dispayed in Infobox Leading point lt gt y OK 3 Cancel Image 39 Dialog box for displaying information about the point s location in Infobox If the location isn t suitable you can move Infobox by pressing the Ctrl key and moving the pointer while holding down left mouse key to a new relative position in relation to the point of reference On the other hand if you delete the point the Infobox becomes a floating element which cannot be deleted Ax CEPH Users Guide Copyright 2011 Page 34 of 141 3 2 13 6 Align Silhouette Ax CEPH comes with predefined silhouettes see 3 2 10 Creating and Editing Outlines hard and soft tissue The silhouette is aligned according to the previously entered points Right clicking the silhouette opens a menu where you can select the Align silhouette option Show Hide Align silhuette Delete Image 40 Silhouette context menu The corresponding alignment tool is opened depending on the type of the selected silhouette oee follow up for interfaces concerning silhouette alignment Tooth alignment
7. type xs string minOccurs 0 lt xs element name PatientFileName type xs string minOccurs 0 gt lt xs element ref Patients gt lt xs element name ResultStatus minOccurs 0 gt lt xs annotation gt lt xs documentation gt Id of result negative error code positive or zero successful operation xs documentation lt xs annotation gt lt xs element gt lt xs element name ResultMessage minOccurs 0 gt lt xs annotation gt lt xs documentation gt Confirmation Error message xs documentation lt xs annotation gt lt xs element gt xs sequence lt xs complexType gt lt xs element gt lt xs element name Patients gt lt xs annotation gt lt xs documentation gt Patient attributes in database lt xs documentation gt lt xs annotation gt lt xs complexType gt Xs sequence lt xs element name Patient minOccurs 0 maxOccurs unbounded gt lt xs annotation gt lt xs documentation gt Patient attributes in database lt xs documentation gt lt xs annotation gt lt xs complexType gt lt xs sequence gt lt xs element name PIDOutside type xs string minOccurs 0 gt lt xs element name PGUID type xs string minOccursz 0 lt xs element name NameOfPatient type xs string minOccurs 0 gt lt xs annotation gt lt xs documentation gt Surname and name of patient lt xs documentation gt lt xs annotation gt Ax CEPH Users Guide Copyright 2011 Page 140 of 141 lt x
8. 4 1390 13 17 3 11 VERTIKALNI RELATIONS ML NSL incl of mandible 30 32 2 487 30 05 9 4 12 VERTIKALNI RELATIONS ML NLinterbasal angle 17 24 7 1780 16 88 4 13 VERTIKALNI RELATIONS Facial axis 87 90 3 840 86 64 4 14 VERTIKALNI RELATIONS PFH AFH 67 63 4 1087 67 35 96 96 4 15 VERTIKALNI RELATIONS Bj rk 390 396 6 1487 390 05 4 16 VERTIKALNI RELATIONS Gonial angle 122 120 2 54612218 4 17 DENTAL ANALYSIS Angle 1 NL 119 109 10 4862 118 72 2 18 DENTAL ANALYSIS Angle 1 NA 31 22 9 4669 31 34 2 19 DENTAL ANALYSIS Distance 1 NA 4 4 0 342 3 66 mm mm 1 20 DENTAL ANALYSIS Angle 1 ML 107 90 17 16681 106 68 1 21 DENTAL ANALYSIS Angle 1 NB 28 25 3 1488 27 98 2 22 DENTAL ANALYSIS Distance 1 NB 5 1 6594 66mm mm 1 23 DENTAL ANALYSIS Angle 1 A Pg 29 22 7 6616 28 62 1 24 DENTAL ANALYSIS Distance 1 APg 1 1 0 396 1 40 1 1 25 DENTAL ANALYSIS Interinc angle 118 135 17 3457 117 21 5 26 SOFT TISSUE ANALYSIS Upper lip E line 5 4 1 715 5 43 mm mm 2 27 SOFT TISSUE ANALYSIS Lower lip E line 2 2 0 318250426 159 2 32 mm mm 2 28 Image 112 Worksheets image top left patient top right and measurements in the bottom Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 91 of 141 6 12 Create an Excel Template To create a template click the export button Excel opens displaying the following three worksheets Measurement Image an
9. 500 70 20 lt Telephonel gt Telephone2 Telephone2 lt Email gt john novak audax si lt Email gt lt Address gt Nova Pot 1 1000 Ljubljana Slovenija lt Address gt lt Active gt 1 lt Active gt lt Description gt sample patient lt Description gt lt DateOfInsert gt 19 8 2011 12 11 42 DateOfInsert lt Patient gt lt Patients gt lt Command gt OpenPatient lt Command gt ResultXMLFileName result xml ResultXMLFileName ResultStatus ResultStatus lt ResultMessage gt 0 lt ResultMessage gt AxCephComData GetPatientDir Returns a directory of selected patient Directory is written in result file in node lt ResultStatus gt lle GetPatientDir xml Sample XML file lt xml version 1 0 encoding utf 8 lt AxCephComData gt lt Patients gt lt Patient gt PIDOutside 1024 PIDOutside NameOfPatient John Novak Edited lt NameOfPatient gt DateOfBirth 19670409 DateOfBirth lt Sex gt M lt Sex gt lt Telephone1 gt 386 500 70 20 lt Telephonel gt lt Telephone2 gt lt Telephone2 gt lt Email gt john novak audax si lt Email gt lt Address gt Nova Pot 1 1000 Ljubljana Slovenija lt Address gt lt Active gt 1 lt Active gt Description sample patient lt Description gt DateOfInsert 19 8 2011 12 11 42 DateOfInsert lt Patient gt lt Patients gt lt Command gt GetPatientDir lt Command gt lt ResultXMLFileName gt resultPatientDir xml lt
10. Click Plane and set it in direction of the occlusal plane as shown on the image Image 94 Wits appraisal Enter the name Ocp 3 Click Point and set it on the occlusal plane Image 95 Wits appraisal added 4 Enter the name PntWits 5 Set planes perpendicular to the plane Ocp through given points A and B Image 96 Added A Pln Wits and B Pln Wits Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 77 of 141 6 Enter names A PIn Wits and B Pln Wits 7 Then create two distance measurements a from point PntWits to plane A Pln Wits and enter the name wa b from point PntWits to plane B Pln Wits and enter the name wb Image 97 distance measurements 8 Enter the following calculation Wits wa wb Calculation Meritev wa A Pln Wits PntWits wb B Pln Wits PntWits Image 98 wits calculation 9 Proceed by entering a name label unit of measurement and equation as stated below a Select wa Ax CEPH Users Guide Copyright 2011 Page 78 of 141 Double click it or click gt to move it to the right hand side box Click the operator minus Select wb Double click it or click gt to move it to the right hand side box 7 Oo mo s Confirm the result by clicking Ok 6 Geometry 2 s Pick N Pick Y SN S N 2 A Pick 2 B Pick NB N B O Pick Pick 7 A Pin Wits Perp OcP A PntWits Plane OcP 7 B Pln Wits Perp OcP B Y NA
11. Destination Location Select Start Menu Folder Where should AxCeph be installed Where should Setup place the program s shortcuts O Setup will install AxCeph into the following folder Setup will create the program s shortcuts in the following Start Menu folder To continue click Next If you would like to select a different folder dick Browse To continue click Next If you would like to select a different folder click Browse C Program Files AxCeph AxCeph At least 27 5 MB of free disk space is required Don t create a Start Menu folder Image 142 Setting application folder and group name in Start menu Proceed by specifying the application folder and group name in Start menu You can also create a shortcut view setup summary and finally click Install to begin installing Note It is recommended that you don t install the application in the Program Files folder Failure to do so could result in the license not working properly 11 2 Unlocking Application Features On first running the application the 30 day trial period starts It offers a fully functional application Each time when you run the application a message appears informing you about the remaining days of the trial period Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 115 of 141 Welcome to AxCeph You can obtain the full version by contacting Buy a Serial Number us To get a valid Serial Number you have to buy the prod
12. E Mail in your dipboard Start your E Mail application Send the E Mail to smtp axlicensing amp audax si and paste the content of the dipboard using CTRL V into the E Mail You have to add a subject line manually Image 150 activation step 7 When you send the message the first part of the E Mail Activation procedure is finished Clicking Next will close the application Re opening the application appears the activation key window After some minutes you receive an e mail reply on request for activation containing the activation key Example of an activation key gr41k H9197 f4lq5 7BOCo Qd8hg 6V8S3 Enter the activation key in designated fields and click Next Apply Activation Key Enter all received keys to unlock the product If you have received information to unlock AxCeph please enter the Unlock Key s If there is more than one key enter one key after another in the correct order Make sure to enter keys in a case sensitive manner l Apply Key You requested an Unlock Key on 29 8 2011 09 59 for the Serial Number nOFUS 53j9D 8ZcaG Aop84 ciTCf D3T9G Activation Method Activation by E Mail Activate again End Image 151 activation step 8 Ax CEPH Users Guide Copyright 2011 Page 120 of 141 If it is a valid activation key you receive a message about successful activation and the activation process finishes Activation completed We hope you enjoy working with this product You have successfully activa
13. N A ZEN Measurements 1 PA TEA ama Wi Wi V Ra Gg M ox ma 278 80 pix wa A Pin Wits PntWits AT x i pi d 287 78 pix wb B Pln Wits PntWits DA TEC DE us ros 8 98 mm wits wa wb A y ELJ 8 1 03 7 SNA SN 2 NA A 1 1 Fi 7 Y 7 y m EP 79 55 SNB SN NB L PT HADA NINE E D G A J a i UY 2 1 48 9 ANB SNA SNB ie Image 99 Analysis type including all elements Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 79 of 141 6 6 Colors Settings point point parallel perpendicular vertical horizontal Split angle Point edge Point filling Point on plane edge Point on plane filling Point on crossection edge Point on crossection filling Silhouette Teeth Wrapping edge Wrapping filing Measurements Calibration Info Box Inside 1 std dev Inside 2 std dev Inside 3 std dev Inside outside 3 std dev Wiggle Chart Image background Unmoved elements 1st analysis in superimposition 2nd analysis in superimposition 3rd analysis in superimposition 4th analysis in superimposition 5th analysis in superimposition A E Image 100 color settings window You can change the color of individual elements in an analysis type consequently also color of the element in the analysis In addition you can also change default colors of individual elements To do this click Col
14. Preview to check the printout Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 89 of 141 Status Beginning Patient Bernice Haus F 32 Date of Birth 1 5 1977 Date of image 12 4 2010 Date of analysis 14 4 2010 SAGITALNI RELATIONS Angle SNA iW 74m ao 779b Andes S 7124 890 876b ange aNE 29 29 O97 S Wis Imm i74 Oo5 i20 SNB aa o coc A al a Fix RUNS nn VERTIKALNI RELATIONS Upper lip E lineSN FH NL NSL incl of maxilla ML NSL incl of mandible ML NL interbasal angle PFH AFH Be E e 3em sese ees anges SSCS o or Angle UNAS 3134 220 yy Distance 1 NA mij 35 E meam O O oss Soo 1659 hy ES OO t 2798 250 298 a Distance 1 NE mj 4s 49 969 Ye Angle 1 4 Pg 388 3229 gt PIE m Distance 1 AP9 immi 140 io 049 M Interinc angle 117 1 135 00 1729 wN pers Upper ip E line mm OO X1 Lower lip E line nmn 232 200 932 o Moree Image 110 Example of printout radiograph on the left elements on print layer on the right measurement groups in the bottom section Ax CEPH Users Guide Copyright 2011 Page 90 of 141 6 11 Export to MS Excel Print Export Image 111 Export button Click Excel button to export measurements patient information the radiograph and pr
15. ResultXMLFileName gt lt ResultStatus gt lt ResultStatus gt lt ResultMessage gt lt ResultMessage gt lt AxCephComData gt Sample result lt xml version 1 0 gt gt lt AxCephComData gt lt Patients gt Ax CEPH Users Guide Copyright 2011 Page 138 of 141 Patient lt PIDOutside gt 1024 lt PIDOutside gt lt PGUID gt F5D FQ1 1EA8 44D6 9159 A4328C8BF63A lt PGUID gt NameOfPatient John Novak Edited2 lt NameOfPatient gt DateOfBirth 19670409 DateOfBirth lt Sex gt M lt Sex gt lt Telephone1 gt 386 500 70 20 Telephone1 lt Telephone2 gt lt Telephone2 gt lt Email gt john novak audax si lt Email gt lt Address gt Nova Pot 1 1000 Ljubljana Slovenija lt Address gt lt Active gt lt Active gt lt Description gt sample patient lt Description gt lt DateOfInsert gt 8 16 2011 10 55 05 AM DateOfInsert lt Patient gt lt Patients gt lt Command gt result lt Command gt lt ResultStatus gt heureka2 DENT BackupsNMAxCephNSkupnaBazaN 0F5DOFO1 1EA8 44D6 9159 A4328C8BF63A lt ResultStatus gt lt ResultMessage gt 0 lt ResultMessage gt AxCephComData Result This denotes an XML that is a result set from an operation ResultMessage describes what happened You can also read error codes in ResultStatus 0 command processed OK 1 patient not found 100 exception at processing input XML file Check if input XML file is composed correctly L Result xml
16. Select SNA Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 75 of 141 Double click it or click gt to move it to the right hand side box Click the operator minus Select SNB Double click it or click gt to move it to the right hand side box poo SU ew ico D Confirm the result by clicking Ok IJ Active picture C Users AxCEPH Res t0 1 jpa H E Data O Calibration Geometry SP S Pick N Pick SP A Pick 22 B Pick Fa Plane S N Pa Plane N A Y Plane N B amp Measurements 79 94 7 SNB Plane Plane S 81 73 SNA Plane Plane 2 1 78 ANB SNA SNB j JAS A jf LS bt f A J HY E j i Jl j C Image 93 Tree and analysis type for determining angles SNA SNB and ANB 6 5 An example of how to measure WITS appraisal For example let us add WITS APPRAISAL to the previously created analysis type Image 94 Wits appraisal Ax CEPH Users Guide Copyright 2011 Page 76 of 141 Wits appraisal is the distance between two planes perpendicular to the occlusal plane One of the perpendicular planes goes through a given point A the other through point B The appraisal can be assigned positive or negative value In case that can be observed above the value is negative Should the plane going through point A go through point B which is to the right the value would be positive Follow steps 1 The analysis includes points A and B 2
17. analysis or to start a new analysis Also you can t open or start new superimposition New analysis can be started directly from radiograph in Ax PRS You have to 1 Select a patient or insert new patient 2 Select a radiograph or insert new radiograph 3 Start new analysis AC Audax Patient Record System E 2 a E gt Edit Delete Open folder Patient Selected object Create Radiographs Analyses Superimpositions Date of birth 1 2 1922 Y Gender 7 Male C Female Telephone 01 200 40 60 GSM 386700700 Email alex audax si Image 161 Add radiograph to patient If you right click on the radiograph on which you want to perform Analysis pop up menu is shown and you can select New Analysis Ax CEPH Users Guide Copyright 2011 Page 128 of 141 AC Audax Patient Record System E 33 G el Y amp ly B4 New Edit Delete Open ancel Open Add Delete Email Analysis folder Patient Selected object Create Radiographs Analyses Superimpositions Patient Krakovski Alex y E Date of birth 1 2 1922 v Gender 7 Male C Female Telephone 01 200 40 60 GSM 4386700700 Email alex amp audax si Address Description X Delete Email GUID 32603FD9 F516 44AE A4FC 52 Image 162 Start new analysis from radiograph Ax PRS form will close and you can start working on new Analysis After clicking Save analysis will be saved to Ax PRS You can always edit it by double clicking on it oimilarly ne
18. click Point and set it anywhere you want in the image Later you can move it around at will 2 Click Point bottom part select Point on plane and place the point on the desired line Move the point along the line Ax CEPH Users Guide Copyright 2011 Page 64 of 141 3 Click the Point bottom part icon and select Point on cross section Place the point on the cross section of two lines Change the color of a point border of the point and label and fill color point surface at will The default color changes according to the type of point that is whether it is a point on plane or a point on cross section Note Ax CEPH stores the last element that was inserted in the analysis type Pressing lt F4 gt creates a new element of the same type Hence you can use this shortcut in stead of continuously clicking the same button in the command ribbon 6 2 2 Plane P a Parallel plane Y Perpendicular plane Horizontal plane Vertical plane Use one of the following types of planes 1 independent simply click any two points on the canvas 2 child of a point click an existing point and then anywhere on the canvas 3 child of two points click two existing points on the canvas Create a parallel line in one of the following two ways 1 Parallel plane through a point First select a plane parallel to the existing plane and then just select a point through which the parallel plane should go 2 Parallel plane First
19. differently according to the relation of a point to other geometric elements 3 2 7 1 Single point Eg Eg Eg Image 12 Selecting a point A single point is one that is not bound to any other geometric element like a line It can be moved freely in any direction First select the point place the mouse pointer on it to highlight it then left click then drag it to the desired position Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 19 of 141 Image 13 Moving a point to a new position Select a point by clicking it directly see Image 13a or alternatively and often more practical click the point s label see Image 13b then drag it to the desired position 3 2 7 2 Point on a Line Plane piani Point Image 14 Moving a point on a line to a new position A point that is on a line is distinguished by its color It is good practice to give elements of the same type but with different characteristics different colors By default a point on a line is cream colored its label and outline are olive green Existence of such point depends on the existence of the line it is on If the line which is in that case a parent is deleted the point is also deleted because it is the line s child If the line is moved the point on it is moved also Settings piane pia Point Image 15 Point on a line dialog box Double clicking the point on a line opens a dialog box see Image 15 which enables
20. given analysis This User Manual is structured in a way that those completely new to the program can become productive as soon as possible Advanced users should see follow up for detailed treatment of designing their own analysis types Ax CEPH Users Guide Copyright 2011 Page 8 of 141 2 2 Glossary This User Manual uses some terms that are specific for the program This glossary explains those terms Plane Radiographic cephalometry often refers to straight lines from the two dimensional world of x ray images as planes Planes are represented as lines because they are perpendicular to the radiograph and viewing them from the side makes one of their dimensions invisible Both terms plane and line will be used in this Manual Point Setting cephalometric points landmarks is the basic task of an analysis Measurement A measurement is any determined property be it a distance angle or calculated value Layer Layers are used to group elements as required for example by properties For example when printing only elements included on a certain layer are printed Analysis An analysis is the concrete processing of a patient s radiograph Results of analyses are measurements of correlations between hard and soft tissue and their comparison with standard values Results can be displayed on screen printed out or exported to an Excel spreadsheet Analysis type An analysis type is the computerized correlations between cephal
21. how to shorten a new analysis type development by using predefined measurements from the database Chapter 9 Superimposition explains how to place analysis over analysis or photography over analysis Chapter 10 About panel explains additional features for software setup Chapter 11 Ax CEPH setup explains how to install the Ax CEPH software and enter the key to unlock additional functionalities Chapter 12 Ax CEPH patient record system Ax PRS explains what is Ax PRS and how to use it Appendix Ax CEPH Users Guide Copyright 2011 Page 6 of 141 1 1 Who Should Use lt This guide is intended for users of different degrees of knowledge and experience with the Ax CEPH software Users The users who will use Ax CEPH as a routine too Advanced users The users who will develop their own analysis types Researches The developers who will use Ax CEPH as a research tool This guide assumes that you have some knowledge of the Windows operating system 1 2 Typographical Conventions This document uses the following typographical conventions Command and option names appear in bold type in definitions and examples The names of directories files machines partitions and volumes also appear in bold Variable information appears in italic type This includes user supplied information on command lines In addition the following symbols appear in command syntax definitions Square brackets surround
22. is displayed Place the mouse pointer over the box the pointer changes to a crosshairs left click and drag the box to quickly navigate the image Close the Navigator by clicking the cross X icon It is closed automatically when displaying the whole image You can also use the sliders on the right and at the bottom to move around the image Or simply click in the image hold and move in the desired direction In the bottom section you can find a toolbar Use it to modify brightness and contrast levels Initially the values are by default set to O zero That is contrast and brightness are set at neutral levels Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 43 of 141 Note CONTRAST AND BRIGHTNESS LEVELS ARE GENERALLY BEST LEFT AT THEIR DEFAULT VALUES OTHERWISE SOME INFORMATION IN THE IMAGE MIGHT BE LOST 4 2 Filters The Filters section contains a selection of digital image processing tools Apply them to the whole image or just to a selected area To only change a selected area click ROI region of interest in the Show menu that is place the pointer in the top left corner of the selected area and drag it to the bottom right corner and release the button You can resize and move the selected area after applying specific filters The filters and area get recorded in the History table in consecutive order s nm Negative Median F2 Softening F3 Sharpening F4 Emboss F5 Gray level F6 Soft
23. klo H cB T y 98 90 CW Layout of the derived image Two image layout The original image is displayed on top the derived image at the bottom This option is especially useful for digital panoramic dental x rays that is comparing the derived image with the original Two image layout The original image on the left the derived image on the right This option is useful for intra oral x ray images comparing the same area in the derived image and the original Resize image to fit window Show full sized image Flip image horizontally Flip image vertically Rotate image 90 degrees counterclockwise Rotate image 90 degrees clockwise Set custom zoom Preset values available are 50 7096 100 20096 and 50096 You can type in any value Image 49 Description of image manipulation and displaying Use the editor to view and edit derived and original images The name of the currently open image is displayed in the title bar Ax CEPH Users Guide 141 Copyright 2011 Page 42 of Image 50 Various layout options Use the mouse wheel to zoom the image in or out Turn the mouse wheel towards you to zoom in or away from you to zoom out lf the image is zoomed in to a level where it no longer fits the screen the Navigator window appears for easier orientation around the image Image 51 Navigator A dashed bounding box borders appear in the Navigator window marking which area of the image
24. level po M SS O Sa as Note Gray level correction is one of the most important operations 4 2 6 Soft Tissue Cephalometric images are usually quite bright due to transillumination of the head Use the Gray level filter to make them darker This way you lose the information on soft tissues which may be crucial in diagnostics planning etc Hence determine the area in the nose let us say it covers a fifth of the image on the right hand side where the soft tissue filter will be applied Then select Soft tissue to apply it in the selected Ax CEPH Users Guide Copyright 2011 Page 48 of 141 area You can repeat the procedure until you get the right results normally repeating it twice should do it Step by step preparation of cephalometric image 1 Use Gray level for darker sections of the image to display hard tissue properly 2 Then mark the area see the next section to apply the filter 3 Select the Soft tissue filter or press lt F7 gt Repeat the procedure until you get a suitable result Image 58 Using soft tissue filter in grayscale from black to white Set the ROI area to apply Soft tissue operation between the two lines see above 4 3 Show The Show menu offers two functions Use them to specify the area where an operation will be used or for highlighting grays with a different color ROI Pseudo color Image 59 Show menu Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Co
25. menu Select the Analysis layer and choose appropriate field for pasting Paste the copy by using Paste As Picture Paste Picture Link Changing anything inside A1 to D14 area will reflect in this linked copy This is more like dynamically changing snapshot of A1 to D14 area You may do the same with analysis image 6 12 1 4 Measurements You can copy other measurement values that is standard values names plus patient information and examination data date the radiograph was made analysis date Copy exported values in the following way Select a cell in the Analysis worksheet and enter the equals 2 sign Then select for example the Patient worksheet select the desired data and press Enter The cell value in the Analysis worksheet is Patient A2 if you copied the patient s name Edit the exported values at will That is change font use them in calculations etc This is beyond the scope of these instructions Ax CEPH Users Guide Copyright 2011 Page 94 of 141 Image 116 Copying patient s name to the Analysis worksheet Do the same to copy for example names of measurements measurement values etc Elena Patient Bernice Haus Patient H At this point it is wise to save the template That is why you should delete all data in Measurements Images and Patient worksheets Leave the Analysis worksheet as is Proceed by saving the template Click a button to select template and save analysis
26. new patient with unique PGUID will be added Returns message and patient data in resulting XML update xml Sample XML file lt xml version 1 0 encoding utf 8 lt AxCephComData gt lt Patients gt lt Patient gt PIDOutside 1024 PIDOutside NameOfPatient John Novak NameOfPatient DateOfBirth 19670409 DateOfBirth Sex M Sex Telephone1 386 500 70 20 lt Telephonel gt Telephone2 Telephone2 lt Email gt john novak audax si lt Email gt lt Address gt Nova Pot 1 1000 Ljubljana Slovenija lt Address gt lt Active gt 1 lt Active gt lt Description gt sample patient lt Description gt lt DateOfInsert gt 19 8 2011 12 11 42 DateOfInsert lt Patient gt lt Patients gt Command UpdateOrInsertPatient Command ResultXMLFileName result xml ResultXMLFileName ResultStatus ResultStatus lt ResultMessage gt 0 lt ResultMessage gt AxCephComData You can also add file like patient image or report to patient if you include node PatientrileName lle add xml Sample XML file lt xml version 1 0 encoding utf 8 lt AxCephComData gt lt Patients gt lt Patient gt lt PIDOutside gt 999 999 lt PIDOutside gt NameOfPatient Miha Datotecnik lt NameOfPatient gt DateOfBirth 19690202 DateOfBirth lt Sex gt M lt Sex gt Telephone1 999 999 lt Telephonel gt lt Telephone2 gt lt Telephone2 gt lt Email gt datofMaudax si lt Email g
27. outline to any other element But you can connect all other elements to the points in the outline Point 1 Point 2 Image 82 Line is connected to the apical point and incision inferius line 1 with analysis type MF UNI LJ Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 67 of 141 6 3 Measurements Use the application to measure distances and angles between geometric features included in the analysis Inserting measurements in an analysis type creates predefined sets of analysis types The measurement functions like a geometric feature that is you can change its name label add a description and image Plus you can determine the layers of visibility and change colors On the other hand you can also hide measurement and only use it in calculation or printout l Distance A Angle fa Calculated va Measurements Image 83 Entering a new measurement Every measurement that is distance or angle measurement can have two statuses Each measurement is undefined when newly added E The measurement was inserted in the structure and has undefined status H A Loto Lund The measurement was inserted in the structure and has defined status 6 3 1 Distance Distance measurement can be determined as existing between two points between a point and plane and between two planes 1 Distance between two points Click Distance and measure the distance between two points on the canvas 2 Distance between a
28. part d a e lee Image 18 Moving a single line A single line can be moved in two ways a By moving one of the two green endpoints The other endpoint remains in place the line is resized and rotated to follow the moving endpoint b Selecting a line anywhere in between the endpoints moves the whole line without resizing it 3 2 8 2 Line Through One Point Paint Image 19 Moving a line that runs through one point If a line is the child of a point it can be moved in two ways a By moving the green endpoint The point remains in place the line is resized and rotated to follow the moving endpoint Ax CEPH Users Guide Copyright 2011 Page 22 of 141 b By moving the line s parent point Select and move the point as described above The green endpoint remains in place the line is resized and rotated to follow the moving point Such lines cannot be selected as a whole and moved around 3 2 8 3 Line through two points Point Image 20 A line that runs through two points A line that is the child of two points can only be moved by moving one of the two points Such lines are colored blue Paint Image 21 Moving a line s endpoint causes the line s child elements to move accordingly It may happen that a point is moved indirectly because its parents are moved With proper positioning you can construct a complex mechanism analysis type Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Pag
29. patient and his her date of birth Entering the rest of patient data is optional New patient is active by default You can deactivate hide it later by un checking the Active checkbox 12 3 3 Adding files to patient After clicking Save you can add patient files by drag amp drop operation e g from windows explorer to this form Another way is to click add to add a patient file analysis superimposition output file to selected patient You can add files from any location network Ax CEPH Users Guide Copyright 2011 Page 130 of 141 USB drive They will be added to Ax PRS thumbnail of added file will appear and copied to patient directory 12 3 4 Working with patient files If you need access to patient physical files click on button Open folder That will open wndows explorer on a patient directory and all this files will be shown We greatly discourage manipulating patient files directly on file system if you delete or rename a file directly on file system the Ax PRS will know nothing about that until you rebuild the database Better way to work with files is to manipulate them through Ax PRS If you right click on a file thumbnail several options appear e open file e start new analysis superimposition e duplicate file e delete file e email file When you delete a file thumbnail disappears but file is not physically deleted It is renamed to deleted extension It can be restored back to
30. point and a plane Click Distance and measure the distance between a plane and point on the canvas The order of selection does not matter You have obtained a perpendicular distance that is the shortest distance between the point and line 3 Distance between two planes Click Distance and measure the distance between two planes on the canvas Ax CEPH Users Guide Copyright 2011 Page 68 of 141 aged eke o Point n qu 7 Point Point Image 84 Distance between point and plane distance between two points distance between parallel planes 6 3 2 Angle Angle measurement can be determined between three points or between two planes 1 Angles are determined by three points Here the order of selection is important The first point determines the first ray the second point determines the apex and the third determines the second ray eG ey qa Apex Apex K2 K2 Image 85 Order of setting points must be observed On the left hand side we selected K1 Apex K2 and on the right hand side we selected K2 Apex K1 2 The angle can be determined by two planes p1 p2 That is first click plane 1 p1 and then the second one p2 Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 69 of 141 ge Y 9 ON gr Image 86 Setting adjacent angle The lines intersect each other so that two adjacent angles a and f exist The following calculation a 180 8 can be used You need not recalculate by
31. resulting XML lle deactivate xm Sample XML file lt xml version 1 0 encoding utf 8 lt AxCephComData gt lt Patients gt lt Patient gt PIDOutside 1024 PIDOutside NameOfPatient John Novak Ed NameOfPatient DateOfBirth 19670409 DateOfBirth lt Sex gt M lt Sex gt lt Telephone1 gt 386 500 70 20 lt Telephonel gt lt Telephone2 gt lt Telephone2 gt lt Email gt john novak audax si lt Email gt lt Address gt Nova Pot 1 1000 Ljubljana Slovenija lt Address gt lt Active gt 1 lt Active gt Description sample patient lt Description gt DateOfInsert 19 8 2011 12 11 42 DateOfInsert Patient Patients Command DeactivatePatient Command ResultXMLFileName result xml ResultXMLFileName PatientFileName PatientFileName ResultStatus ResultStatus lt ResultMessage gt 0 lt ResultMessage gt AxCephComData OpenPatient Opens Patient Record System in Ax CEPH with patient Ax CEPH searches Patient by PGUID or by PIDOutside node Returns message in resulting XML lle Sample XML file 9P9 m Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 137 of 141 lt xml version 1 0 encoding utf 8 lt AxCephComData gt lt Patients gt lt Patient gt PIDOutside 1024 PIDOutside NameOfPatient John Novak Edited NameOfPatient DateOfBirth 19670409 DateOfBirth lt Sex gt M lt Sex gt Telephone1 386
32. select a plane parallel to the existing plane and click anywhere on the canvas Create a perpendicular plane in one of the following two ways 1 Perpendicular plane through a given point First select a plane perpendicular to the existing plane and then just select a point through which the perpendicular plane should go Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 65 of 141 2 Custom perpendicular First select an existing plane and then click anywhere on the canvas to add the perpendicular In addition there are two special planes that is the horizontal and vertical plane You can move these two planes only translationally and their direction remains fixed That is regardless of the image rotation used You can use them in measurement and calculations like all other types of planes 6 2 3 Outline Silhouette Insert outlines to analysis types like any other feature Define outlines by selecting it in the tree clicking in the canvas and start creating the outline Additional clicks create new nodes of the outline Finish by double clicking You cannot connect outlines to other elements Change the shape of the created outline by dragging and dropping individual points or by deleting them delete any point by pressing CTRL click outline deleting an endpoint deletes the outline To move the outline translationally click anywhere between the endpoints and move it Change the label name descr
33. simply selecting the corresponding adjacent angle holding down lt CTRL gt and clicking the adjacent angle Regardless of how you defined the angle it always consists of child elements that define it Deleting them results in deleting the measurement 6 3 3 Calculated values Clicking Calculated values opens a window for creating calculations Calculated value Measure unit Measurements in analysis Measurements in calculation Angle Perp to NA and APg APg Perp to NA Downs angle of convexity 90 Angle Perp to NA and APg Angle Perp to NPg APg AB plane angle 90 Angle Mandibular plane angle FH Downs mandibular plane Y Axis FH Plane Cant of Ocdusal plane OcP FH Interincisal angle 1 1 Angle 1 Occ dummy 1 OcP Angle Downs mandibular plane 1 Incisor Mandibular plane angle 90 Angle Distance w1 1i Point Distance w2 Point APg Protrusion of Maxillary Incisors w1 w2 Angle 1 Occ 80 Angle 1 Occ dummy Distance 90 Angle 1 Occ dummy Distance N A JE EE E bk Calculation 9 _ Current value Image 87 Calculation window Ax CEPH Users Guide Copyright 2011 Page 70 of 141 The above window section offers options that can be found in the dashboard Here you can enter name of the calculation tag label description comment and set a unit of mea
34. that have been applied The Region column displays whether the operation was performed on the entire image or only on a particular area If the operation is checked this means it was performed You can check the boxes or leave them unchecked The derived image is changed accordingly In order not to perform a certain operation uncheck it so that it will not be applied To completely remove a specific operation mark it so that it is selected blue and click Delete filter or press lt Delete gt History Region Operation Y Picture Sharpen 4 Picture Median Picture Gray level Image 71 Operations history list 4 6 2 Storing History Recipe CTRL R After having entered all modifications and you would like to store operations history you can store it as a prescription Press the key combination lt CTRL gt lt R gt A new window is opened where you click Save history as recipe Then enter the name of the recipe and confirm it In the next step assign any of the function keys F9 to lt F12 gt to the recipe To assign a function key drag and drop the recipe on it Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 55 of 141 Recipe Short Operation Paramaters A Sharpen Radius 3 Factor 2 5 Median Gray level Gamma 100 Min 0 Max 4080 uis Save filter history as recipe Run selected recipe w Delete selected recipe Image 72 Assigning key to recipe The operations are displayed tog
35. the Print amp button Printed are analysis information x ray image analysis elements on the print layer and the measurements table The analysis is saved automatically before printing 3 3 2 Export to Excel x Export the analysis to Excel by clicking the Excel button Excel uses the template that comes with an analysis type The analysis is saved automatically before printing Ax CEPH Users Guide Copyright 2011 Page 38 of 141 3 3 3 Send by E Mail E Send an analysis by e mail by clicking the e mail button The analysis is sent as a single file containing all information for the recipient to view and edit it 3 3 4 Saving lal Shrani Save an analysis by clicking the Save Analysis ss button The created file s name contains key information for example the file Jane Doe 2 4 2008 1 acx tells us Jane Doe the patient s name is Jane Doe 2 4 2008 the analysis was done on April 2 2008 1 this is the patient s first analysis on that day Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 39 of 141 4 Digital Filters in Image Processing At any time during the analysis you can use digital filters to process the image and improve its diagnostic value That is make it darker lighter use specially designed filters for highlighting soft tissue etc Use Ax CEPH to store images as derived images Click the Edit button in the Image group of the command ribbon to run the editor Zoom window Pic
36. the following meaning Save table db Add a standard value Delete a standard value i Add a new patient type for example mixed dentition adult E Export to Excel Import from Excel 6 8 Linking Standard Values and Standard Deviations with Angles and Measurements Click Link button to open a window for linking standard values and standard deviations with measurements Ax CEPH Users Guide Copyright 2011 Page 82 of 141 Image 103 Window for linking measurements with standard values and deviations On the left hand side you can see all measurements included in the analysis type On the right you can on the other hand see all standard values which were added using the edit button To open the window for editing mean values click To link measurement with standard value you first have to select it in the left box and select standard value from the right box In the end click to link them up You can remove a link by selecting it and clicking 4 You can also export linked standard values by selecting Export to Excel button on bottom side 6 9 Layers and elements visualization Set layers in order to group elements The following layers have been predefined 1 The Radiograph layer contains a radiograph image When switched off the radiograph image is not visible 10096 transparency 2 The All Elements contains all geometric features including measurements When switched on all
37. type as xlt file Note You need to save a template as template file format xlt Leave Excel and load the saved excel template using Choose template button Note In order to make the template file smaller and faster to load you should delete both images from Image worksheet before saving Note We recommend choosing Analysis worksheet before saving so that it will open on export Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 95 of 141 J AnalysisTemplatel Compatibility Mode Microsoft Excel o ae Page Layout Formulas Data Review View Add Ins x A la zE A a General T E Conditional Formatting gt g Insert gt E AF dA ER memet l mg 9 4 Format as Table gt E Delete s gt cx 7 BIU ES Jr gt a a to E Cell Styles gt E Format PL TL ue El Number Cipooard PO 2 9 gnmen 0 Number Styles Cells Ii Editing F51 T IF ISBLANK D51 IF AND D51 C51 1 D51 C51 1 NORMAL INCLINATION IF AND D51 C51 2 D51 lt C51 SLIGHT RETRUSION IF AND D517 C51 0 5 D51 C51 3 SLIGHT PROTRUSION IF D51 gt 051 3 PROTRUSION RETRUSION 1 Patient name sex age Bernice Haus F 32 analysis date 14 4 2010 2 status Beginning x ray date 12 4 2010 3 a 5 6 Mrd B g 10 Ai 12 13 14 15 16 17 y 18 19 21 23 3 24 J 25 26 3 28 r l PARAMETER c
38. with this product You have successfully activated AxCeph If you got multiple Activation Keys you can now enter these keys A key can also be pasted using the clipboard CTRL V Apply Key Next Image 149 activation step 6 Click Next to finish activation process On the other hand in case you select E Mail Activation the procedure takes longer but it offers activation without the need of Internet connection Click Next on the screen displaying activation data to open default e mail client and compose a message and send it to the activation server The message contains the recipient s address subject and content Please do NOT CHANGE THE MESSAGE CONTENT If no e mail client is available the message content is stored on the Clipboard This way you can save the text in a text file and copy it on computer with Internet connection Here you can then generate a new message using your favorite e mail client For message recipient enter axlicensing audax si under subject Activation Request for AxCEPH and for message content copy the text from the text file Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 119 of 141 The activation is in process We hope you enjoy working with this product Your E Mail application will open now Send the E Mail which was automatically created You will get an Unlock Key within a few business days In case your E Mail application did not open you will find the content of the
39. you to position the point on the line by percentage value between the first and second endpoint The Ax CEPH Users Guide Copyright 2011 Page 20 of 141 maximum percentage value you can set is 200 which basically means that the point will be placed two times further from the initial point and endpoint with respect to the line 3 2 7 3 Point at the Intersection of Lines art Image 16 A point at the intersection of two lines A point that is on a line is distinguished by its color By default a point at the intersection of lines is cream colored its label and outline are dark grey Existence of such a point depends on the existence of two intersecting lines If the intersecting lines which are in that case parents are deleted the point is also deleted because it is the lines child Moving any of the lines moves the point to the new intersection Note Lines are infinite in length in both directions But they are displayed as line segments with small extensions at both endpoints The intersection of two lines can therefore be outside the displayed line segments E y Mg Plane Point Image 17 A point at the implied intersection of two lines Plane 1 and Plane 2 Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 21 of 141 3 2 8 Moving a Line Plane Moving a line behaves differently according to the relation of a point to other geometric elements 3 2 8 1 Single Line Plane Plane a oma a
40. 3 SAVING ANALYSIS TYPES ccccccecececececececececececucucucccccccueeuaeceauuauauauaunenenenenenenenenenenenenensnensneneners 96 7 CREATING ANALYSIS TYPE FROM PREVIOUSLY STORED TYPE rte 97 8 CREATING ANALYSIS TYPE USING PREDEFINED ELEMENTS tmm 98 8 1 USING PREDEFINED EEEMENTO e DOLO cA PO D cre EOS 98 8 2 HOW TO STORE ELEMENTS TO THE PREDEFINED DATABASE 2ccscecececcecececcececcececcecaceececaecesacees 99 GS 3SUPERINMPOSITION sua tne doit tates veo facct tester ded dec E bec aed Sam at dedo ee cts 101 9 1 SUPERIMPOSING ANALYSIS OVER ANALYSIS sceccccecececcccececccccecececaccccecsceeacausecscauaeserstareenens 102 9 2 SUPERIMPOSING PHOTO IMAGE OVER ANALYSIS ccccececcecececccecececueaecececueaeaececusueaeaecuseraeaees 105 9 3 LISING DISPEAY TOOLS T T 107 9 4 TOOLS FOR SETTING POINTS MANUALLY cccececececececccecccecececccececececauauauauauauauauususeneneenenenes 107 9 5 EXPORT TR ee ects alt de anios 108 9 6 ANALYSIS AND SUPERIMPOSITION RELATION 2ceccecececceccceccccececcecuccececcececccucacueceeaeceuaecesaeees 108 10 ABOUT PANEG ra ica en E er M ni a eee LEN CE LUE ee 110 10 LANGUAGE zarate di lt Lo o LE TIE E EE TNTA on e el de eo eos 110 10 2 DISPLAYING APPLICATION DATA oi 110 10 9 TENTERINGA PRODUCT KEY uranio 111 11 NO a A O Oh cute ucc tatu cl tasas S deal 112 qc APPLCANON SETUP aena e cmi cei I eu ene Oe bs Lar Emu 112 11 2 UNLOCKING AP
41. ANNOTATIONS SYMBOLS xac tutu e e D UM I T MER ol 51 4 5 INTERACHON Soria aro eens Dc EE 54 4 6 O AS 55 4 7 CHANGING BACKGROUND COLORS cada 56 4 8 STORING DERIVED IMAGE ci as desea e trs os loe dene taa esL eap od 56 5 VIEWING ANALYSES PERFORMED ccccceccececcececcceccceccccecuccecucuececuucucueueceeaeceeaeeeeacsecaees 57 5 1 OO O E LLLA E E E e TEL Aci A E 57 5 2 PARME OP naaa tano 58 6 CREATING A CUSTOM ANALYSIS TYPE 0 cccccccccceccecsccecsccececcecaccccucaucecuccecsccasecsesacceaneass 60 6 1 mig EON od RE ER do arte HR RERO 61 6 2 GEOMETRIC FEATURES a o leon Ae 62 6 3 ITE NS WIENS atn datis secte robado lenin cda ta ed tail lacra 68 6 4 AN EXAMPLE OF CREATING CUSTOM ANALYSIS TYPE FROM SCRATCH ececcececececcececececaccececes 71 6 5 AN EXAMPLE OF HOW TO MEASURE WITS APPRAISAL 2 c2secccececcececceccccececcececcececeececceueaceeceees 76 Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 3 of 141 6 6 Po nn REPE 79 6 7 EDITING STANDARD VALUES AND STANDARD DEVIATIONS oocococcncnoconnncnnnnconnnnnnnnnnnnnnnnnnnnnnnnnnnnnons 80 6 8 LINKING STANDARD VALUES AND STANDARD DEVIATIONS WITH ANGLES AND MEASUREMENTS 81 6 9 LAYERS AND ELEMENTS VISUALIZATION esse do oux veas av uou eoa Evae deer Ova deux odo sage re Uo Eva ca Da EE Eds 82 6 10 PRINTOUT GUS TOMIZATION ici ic cie 86 Bel EXPORT TOM SEACE idi taii Ua iMi mnc Mas Eu E ee tae 90 6 12 CREATE AN EXOEE TEMPERATE iioc e eoa oec E O a 91 6 1
42. Ax PRS if you rename it back and add it again to Ax PRS 12 4 Rebuilding the database You can always rebuild database from existing files if you click on Delete and rebuild Ax PRS database button Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 131 of 141 Settings zs Colors Settings Files Image Formats Licence options Licence file AxCeph lic Default save paths X Save files to database Database file neureka2 DENT_Backups AxCeph SkupnaBaza AxPRS6_7 mdb A Analysis type D yazvoj Delphi2009 AxCephTRUNK2 Ceph AxCeph Bin AnalysisT ypes Az Delete and rebuild AXPRS database gt Load Defaults Save as Defaults ndi v OK 3 Cancel Image 165 Delete and rebuild Ax PRS database button Ax PRS will 1 delete current database file 2 copy blank database file from template 3 add data and files to database by rebuild algorithm 12 4 1 Rebuild algorithm 1 Gather all files Start on database file dir and also search all subdirs 2 For each Patient xml file a Add patient and his her data to database 3 Foreach Analysis file a checkif patient already exists in database Checking is performed by patient identifier ID If there s no ID patients with same name and date of birth are treated as one patient i YES add analysis to existing patient li NO add patient and then add analysis to him her 4 For each Superimposition file a checkif all analyses on superimposition e
43. B Angle ANB Angle SN Ba Angle SN Pg Wits Facial convexity y Image 108 Print customization and groups windows The Groups box is empty when creating the analysis type Clicking opens a window for editing groups Add a new group by clicking 3 and delete a group by clicking Change the existing group with gt Before printing do the following First click to add a group Then add measurements to the group Proceed by entering a new group and add measurements Ax CEPH Users Guide Copyright 2011 Page 88 of 141 V Printout customisation Measurements Group 0 SAGITALNI RELATIONS Angle SNA 82 00 Angle SNB 80 00 Angle ANB 2 00 Wits 0 50 Angle SN Ba 33 130 00 Angle SN Pg 81 00 Facial convexity 2 00 El Group 1 VERTIKALNI RELATIONS Upper lip E line amp M FH 6 00 NL NSL ind of maxilla 9 00 ML NSL ind of mandible 32 00 ML NL interbasal angle 24 00 Facial axis l 30 00 PFH AFH 63 00 Bj rk 396 00 Gonial angle 120 00 Group 2 DENTAL ANALYSIS Angle 1 NL 109 00 Angle 1 NA 22 00 Distance 1 NA 4 00 Angle 1 ML 90 00 Angle 1 NB 25 00 Distance 1 NB 4 00 Angle 1 A Pg 22 00 Distance 1 APg 1 00 Interinc angle 135 00 El Group 3 SOFT TISSUE ANALYSIS Upper lip E line 4 00 Lower lip E line 2 32 2 00 El Group Other Export to Excel _ x K C__ _ gt lt lt Image 109 Final printout customization Click
44. CEPH Users Guide Copyright 2011 Page 52 of 141 Here you can edit annotation the same options are available as when editing text Add any text to the field and click OK Image 67 Line with annotation Whenever you want to make changes to annotation or symbols you have to select it first Hover with the pointer over the item 2 and right click it Then select Settings A window for modifying settings is opened Set the parameters accordingly and click OK To move the line you first have to select it Place the pointer on item 1 and left click it and hold down Drag it to the desired position Do the same with item 2 To move the entire object place the pointer on one of the items so that the pointer changes to a crosshairs Then left click hold down and move it to the desired location Delete the line the same way as the text 4 4 3 Memo This option is different from the Annotation option because it lets you enter multiple lines to the note Plus by default the color of the frame is different than the color of the text Otherwise all the operations are like the ones mentioned above see Annotation The only difference is in how you insert or change text 4 Audax v OK Image 68 Window for editing memo Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 53 of 141 4 4 4 Line The Line tool is available for marking crucial spots The line can be added as any other element from this section Plus i
45. E bd Active picture C A4xCephiResit01 jpg Calibration B Geometry Measurements Layer LJ E ou f e 32 goa 22 Ga sh f T ES f 2 we J Visible Mame Element on layer w Radiograph L Al Elements iv Analysis mj L Report m Analysis type saved to file C 14xCephiAnalysisTypesichanged_1 acxT Transparency E E ai ausi a tg 4 10095 Fit Image 78 Basic analysis type window 6 2 Geometric Features Geometric features consist of primitives such as points planes and outlines They appear as independent elements or are related to other geometric features e g a point lies on the line Add these features to the analysis type using the following commands that can be found in the Tools group in the command ribbon Ax CEPH Users Guide Copyright 2011 Page 62 of 141 Da mi T Silhoue Point Plane Teeth gt Cognitive features Image 79 Inserting geometric features Some buttons consist of two parts Click the upper part to add individual features On the other hand clicking the bottom part opens a dropdown menu from which you can select the method for connecting a feature to other elements in the analysis type The features in the analysis type can have two statuses colored differently in the tree The newly inserted component is always undefined In contrast to the analysis the features cannot be colored green when creating analysis type because you cannot determine thei
46. Guide Copyright 2011 Page 84 of 141 en Toggle button to show hide all info boxes Trying to use the existing analysis type with a new analysis all elements that are visible in the analysis type will be visible here also That is why certain elements e g outline are visible but you cannot see it after setting it and opening for example the analysis layer a m d gt i wi JE j f EN j y PA ae A j s EN jj Tas fx VLL yY Mya ANA y WG A War Ca UY E f Y Image 105 All elements used in analysis type elements required to create analysis elements on print layer 6 9 1 1 Layer visibility Checking the Visible column in front of the selected layer makes it visible All elements included in this layer are made visible Multiple layers can be visible simultaneously 6 9 1 2 Adding removing elements to from a layer The window layout is modified depending on whether any element is selected on the canvas or not After selecting an element boxes in the Element on layer section are ticked for layers which contain the selected element Note Add an element to the layer by a first selecting it then b ticking the box in Ele ment on layer section of the layer where you want to place the element Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 85 of 141 7 A 2 a we Sz 7 A aa u e Sz C dE gasa Ta 2 unu sn x ip di gua 2t 2 2 mmm sn a PD 2 728 PD gt TD
47. H You can do that manually A more convenient option is to click Delete and rebuild AxPRS database and Ax PRS will scan all files in Database file directory and its subdirectories and add them to database 12 2 1 Database file Patient data is stored in a database file This is a MS Access file which must have a mdb extension In a database file are also thumbnails some data and links to patient files which are stored in patient directories Database file can be at any time completely rebuilt from filesystem because all patient data is physically stored in filesystem 12 2 2 Patient directory All patient files are stored in patient directory which is always created on database file path Each patient has a unique directory created from Patient GUID field Here is a real example of file structure c AxCeph Analysis AxPRS mdb database file path c AxCeph Analysis 00D4DE23 62A3 490B 9823 819A1237D0FC patient directory path Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 127 of 141 c AxCeph Analysis 00D4DE23 62A3 490B 9823 819A1237D0FC Patient acx patient file path analysis c AxCeph Analysis 00D4DE23 62A3 490B 9823 819A1237D0FC Patient dcm patient file path radiograph c AxCeph Analysis 00 D4DE23 62A3 490B 9823 819A1237D0FC Patient xml xml file with patient data which is needed when rebuilding database 12 3 Working in Ax PRS mode After Ax PRS is enabled there s no icon to open
48. PLICATION FEATURES vets one eee ee desee a 114 11 3 POSTAVITEV VECUPORABNISKE MRE NE LICENCE ccccececcececcececceccccececcccucuccucuccecaeueceuaecauaeeas 121 tA INFORMACIE O LICENC La ed rte P cec EE 122 12 AX CEPH PATIENT RECORD SYSTEM AX PRS scatet Ve xa diia 124 W221 AS O AE nN 125 12 2 ENABLING AX O RO od 126 12 3 WORKING IN AX PRS MODE ccccccececececececececacceceaeneneneneneneneneneneneneuenetececatetauauatacscanecenenanas 128 124 REBUILDING THE DATABASE o s DE 131 Ax CEPH Users Guide Copyright 2011 Page 4 of 141 125 AX CEPH COMMUNICATION INTERFACE 13 APPENDIX os ia Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 5 of 141 1 About this guide This document is divided into the following chapters Chapter 1 About this guide Chapter 2 Introduction introduces our Ax CEPH software Chapter 3 Making analyses based on predefined analysis types explains how to get started Chapter 4 Digital filters in image processing describes filters and methods for digitally enhancing x ray images Chapter 5 Viewing analyses performed Chapter 6 Creating a custom analysis type introduces tools to make any analysis type Chapter 7 Creating analysis type from previously stored type explains how to shorten a new analysis type development by using existing type and changing it Chapter 8 Creating analysis type using predefined elements explains
49. Sample XML file lt xml version 1 0 gt lt AxCephComData gt lt Command gt Result lt Command gt ResultStatus 0 ResultStatus ResultMessage Patient found lt ResultMessage gt AxCephComData Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 139 of 141 13 Appendix AxCephCom xsd lt xml version 1 0 encoding UTF 8 gt lt xs schema xmlns xsz http www w3 0rg 2001 XMLSchema elementFormDefault qualified attributeFormDe fault z unqualified lt xs element name AxCephComData gt lt xs complexType gt Xs sequence lt xs element name Command type xs string gt lt xs annotation gt lt xs documentation gt GetListOfActivePatients Returns a list of all active patients in the resulting XML if any patient elements inserted in request XML only data for those patients is returned GetListOfAllPatients Returns a list of all patients in the resulting XML UpdateOrInsertPatient Updates Inserts a patient into DB Returns patient data in resulting XML AddFileToPatient Add patient file to DB File could be image report DeactivatePatient Deactivates a given patient in a Patient element OpenPatient Opens AxCeph and tries to find the given patient in the AxPRS module GetPatientDir Returns patient directory Result this denotes an XML that is a result set from an operation xs documentation lt xs annotation gt lt xs element gt lt xs element name ResultXMLFileName
50. Y PD lt gt a ecc Y ee E b PA point TEC PRipoint PEpoint e v OK 3 Cancel y Of 3 Cancel Tooth alignment pa lt gt El PA point PB lt gt PC lt gt PB point PA point PD lt gt articulare PE lt gt e PG point PCpoint L Pres PF point PG lt gt T ePE point I PD point T ERES pem Image 43 Silhouette alignment for a Pterygomaxillary fissure b Nasal spine c Mandible For alignment you first have to enter points which will then be aligned When the alignment interface is opened you have to select the points Set them manually by left clicking The points PA PB which will be aligned are displayed in the interface Selecting the point for silhouette alignment displays it on the list All points must be entered You can remove any point from the alignment list by clicking the adjacent dash sign PA point EAS dm PB point 23 Point 1 lt gt Point 4 Point 2 lt gt Tooth alignment PA point Wane A N PB point Point 1 lt gt Point 4 Point 2 lt gt Point B v Image 44 Silhouette alignment selected points a one point b two points Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 OK 3 Cancel El El Page 37 of 141 3 3 Printing and Saving 3 3 1 Printing Start printing by clicking
51. aAxPRS6 mdb Image 158 First run Check Save files to database Then select database or leave the default database You can select an existing database file or start working on a new empty database file You can also change this setup later if you wish Click Settings in the Ax CEPH main menu A new form will be opened Analysis Superimposition Analysis type About r Prepare Pointy Tissue v Edit EN v mm Print Plane Data Save E mail Zoom wind ae Calibration Settings Excel eem ves Silhouette eo Analysis Picture Cognitive features Measurements Standard values ustomizatio Layout Image 159 Settings button in main menu oelect tab Files and check Save files to database Then enter Database file You can select an existing database file or start working on a new empty database file which will be created from template after Ax CEPH is restarted Ax CEPH Users Guide Copyright 2011 Page 126 of 141 Settings Colors all age Formats Default save paths y Save files to database Database file heureka2 DENT Backups AxCeph SkupnaBaza AxPRS6_4 mdb de Analysis type D yazvoj Delphi2009 AxCephTRUNK2 Ceph AxCeph Bin AnalysisTypes A Delete and rebuild AxPRS database dp Load Defaults y Save as Defaults OK 3 Cancel Image 160 Enabling Ax PRS New database is empty so you have to add existing files to database if you already worked with previous version of Ax CEP
52. acas NORM VAL VALUE ar CEPHALOMETRIC ANALYSIS oee 30 7 SAGITALRELATIONS ie 31 2 SNAP 825 ee 82 0RTHOGNATIC MAXILLA uud 32 e SNB 809 71 79 ORTHOGNATIC MANDIBLE 33 j ANB 0 49 3 IRI 34 Witsi 1 mm 0 35 SN Ba 36 SN Pg 37 bo Facial convexity 2 1 caian NORMAL RELATION F 38 VERTICAL RELATIONS nn 39 SN FH NL NSL incl max Al ML NSL incl mand 42 ML NL interbasal 43 facial axis m 44 i Image 117 A part of a final Excel template Ax CEPH Users Guide Copyright 2011 Page 96 of 141 6 13 Saving analysis types al Save type Analysis type Save as Click Save type button to save the analysis type under the name you specified before creating it Of course you can click Save as button to change name at will Clicking Save as opens a window where you can enter the name of new analysis type Click Ok to save it Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 97 of 141 7 Creating Analysis Type from Previously Stored Type When creating analysis type you can add existing types This way you can use predefined types and create new analysis types more easily New type of analysis Type name Types of analysis L 6 6 1 acxT L ABO American Board of Orthodontics ABO American Board of Orthodon Burstone Burstone acxT L Cabinet B chler 1 Silhouette Cabinet B chler 1 Sihouette acxT L Cabinet B
53. alyses analysis types and superimpose images and analyses you need to have a licensed product key The latter is computer specific and cannot be transferred You can receive a time restricted or no restriction key For detailed treatment of the setup process see the follow up chapter on how to install the application Ax CEPH Users Guide Copyright 2011 Page 112 of 141 11 Ax CEPH Setup Ax CEPH application setup can be done in two steps First you have to install the application on the computer from CD or by running a setup file that can be downloaded from the website www axceph com Then you have to unlock the application to make it fully functional The application is fully functional during the trial period It switches to the Viewer Only Mode after expiry To make it fully functional again you have to reactivate it 11 1 Application Setup You can download the setup file from the website www axceph com There are two versions available the demo and full version The Viewer Only Mode lets you open and work on the existing documents but you aren t able to Save or create new ones The full version offers all features First you have to unlock it by supplying the product key For more information on how to unlock the application see follow up 11 1 1 Start Setup i ECCSEELISETI Select an appropriate file version demo or full version and run it by double clicking it Select Setup Language Select the language to use dur
54. alysis type includes data about 1 2 3 4 geometry landmarks and planes and measurements measurements and their correlations to standard values printout and template for exporting to Excel When making an analysis these are applied to concrete radiographs Making an analysis based on a predefined analysis type is simple and involves the following steps L Preparing Data for the Analysis a selecting x ray image b entering data about the patient his or her status analysis and x ray procedures c selecting analysis type Identifying landmark points and outlines a correctly placing offered landmark points onto the radiograph b calibrating the image c creating or editing outlines teeth hard and soft tissue Printing and saving a printing out b exporting to Excel c sending by e mail d saving 3 2 Preparing Data for the Analysis 3 2 1 Selecting an X ray Image Start a new analysis by clicking the New analysis button A dialog box opens where you locate and select the desired image Most standard image file types are supported BMP JPG TIF GIF as well as single image DICOM files In the case of DICOM files the dialog offers you the option for extracting metadata the name of the patient when the x ray was taken so you don t need to enter it manually Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 15 of 141 in sikeRTG Baxs demoD1COM de
55. choice The windows which you do not need currently can be put in the docking storage This way you can display only windows that are required Ax CEPH Users Guide Copyright 2011 Page 10 of 141 Ax Ceph allows you to save individual layout settings making analysis superimposition The user defined window layout is saved for later usage open windows size and position 2 3 1 1 Choose layout Default Defaut Layout Layout Image 2 Choosing layout Choose a layout from the ribbon Every application has its preset layout Default which cannot be deleted To select a layout form pick it from the dropdown menu in the ribbon and Ax CEPH window layout will be changed accordingly 2 3 1 2 Customizing layout You can create floating windows and move them between docking panels That is they can be visible or hidden in the docking panel Inside the docking panel you can shift them around resize them and group them in tabbed view Name Tag Vidna Description Color E S d ek Print Color md Fill Color NT Es Print Fill Color 7 e Normal Value NV Image 3 Moving a window To move a window click and hold the top bar and place it anywhere you want The floating window appears when you place it outside the docking panel In addition you can move the window between docking panels Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 11 of 141 Element Settings ots E
56. d Patient The Measurements worksheet lists the following measurements in the order you defined in the Printout customization window Group Name Value Normal value Difference Bias ValueS Measure unit Std deviation The Patient worksheet lists the following columns in the order you defined in the Printout customization window Patient s name Patient s birthday Date of image Sex Status Age Date of analysis The Image worksheet includes the following the radiograph and image of analysis Finally save the template taking care to set correct template file type that is format xlt format xItx is not supported Quit MS Excel Now you can use all the available options the template offers Let us take a closer look at the following example 6 12 1 Example 1 6 12 1 1 Starting a new template Open an analysis in the selected type and export data into the template The open Excel file has three worksheets containing exported data 1 Measurements where all measurements are exported according to the print customization Image where the X ray image and analysis image are exported Patient where the patient data is exported Ax CEPH Users Guide Copyright 2011 Page 92 of 141 6 12 1 2 Adding a new worksheet Add a new worksheet Shift F11 and rename it to Analysis You may use the Insert Worksheet button to insert a new worksheet Measurements Image Patient 3 4 si Lock E Insert Worksheet
57. e 23 of 141 3 2 8 4 Perpendicular Lines E e aor Image 22 Moving a perpendicular line A perpendicular line is colored brown The perpendicular of a selected line turns purple Move it by clicking anywhere between the endpoints and drag it around In the special case when the position of a perpendicular is limited with a point you can move the perpendicular by moving the point 3 2 8 5 Parallel lines Image 23 Moving a parallel line A parallel line is colored brown The parallel of a selected line turns purple Move it by clicking anywhere between the endpoints and drag it around In the special case when the position of a parallel line is defined with a point you can move the parallel by moving the point Ax CEPH Users Guide Copyright 2011 Page 24 of 141 3 2 8 6 Split angle line To make a line which runs under a certain angle together with its parent line or intersects the angle in a set percentage ratio use the Split angle line option from the menu n Plz ne VA Parallel plane Y Perpendicular plane Horizontal plane Vertical plane B Spit angle m ane 2 2 Image 24 Split angle The above image shows a plane which intersects the angle Two planes a are required between which you place an angle Select the dividing line and angle Settings ES PRA Angle portion 1 Exact anale vw OK X Cancel Image 25 Split angle dialog box Double clicking the d
58. e precision Image 134 Moving analysis or photo image Ax CEPH Users Guide Copyright 2011 Page 108 of 141 9 4 1 Translation First select the analysis or photo image on the canvas and move it anywhere on the screen holding down the left mouse button 9 4 2 Rotation Or move it by clicking the green crosshairs by the First point all the time holding down the left mouse key The analysis or image will be rotated around the First point To reset values of the analysis or image click the Reset button which can be found in the Link box in the dashboard 9 5 Export Picture 2 a Export picture Print You can export the superimposed image by clicking the Export picture button 9 6 Analysis and Superimposition Relation Any changes made to the analysis can be observed in the corresponding superimposed image This means were you to move the linking points the interrelated positions of the superimposed analysis will change as well You can make changes to the analysis in these two ways Change analysis in the Analysis panel save it to disk and then open the corresponding superimposition containing the analysis Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 109 of 141 Mu E Change analysis Image 135 Change analysis button You can also change analysis by clicking the Change analysis button in the Superimposition panel A window is opened where you can make according changes to the analysi
59. ed the text press Enter Image 63 Inserting annotation To change the size color or font of the text you first have to select it if the field is not selected use the command Choose object in the Interactions menu Then right click the text box to open the menu where you can select Settings Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 51 of 141 rot Al Audax Line width i E Text REALLY PROBLEMATIC Image 64 Window for editing annotation A new window opens where you can set the style font color size etc The line width is the width of the frame Here you can also change the text at will Image 65 Content does not fit frame When the text does not fit the frame or the frame is too big resize the frame accordingly That is select it left click the annotation having first selected Choose object in the Interactions menu and move the squares to fit accordingly You can also move the selected frame Image 66 Expanded frame To remove annotation you have to select it first Then right click it and select the Delete option You can also delete it by pressing lt Delete gt 4 4 2 Line with annotation To insert a line with annotation in the derived image select Line with annotation from the menu Left click the image and hold down see item 1 in the Image 67 and then drag the line to the designated position see item 2 On releasing the mouse button a new window is opened Ax
60. ents There are three panels from which you can select Measurement Points and Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 99 of 141 Planes Use the filter to narrow down your search Or click to display predefined elements in panels see above or in rows See the left hand side to view a specific element s details You can change them but take care since the actions cannot be undone See the right hand side to view elements included in the analysis type They are displayed in separate panels To insert a new feature into the analysis type first select it in the predefined elements window and click to add it On the other hand click to remove it from the analysis type Adding more complex features or measurements adds its constituent elements as well That is why when for example adding Wits appraisal three points an occlusal plane and two auxiliary planes get added as well TZ Add elements Image 120 Add predefined element button Click the Add elements button to add all selected elements into the analysis type These elements can be applied in the same way as the ones added manually The only difference is that their values are preset name label picture description You can repeat the procedure of adding as many times you need 8 2 How to store elements to the Predefined database Each newly created element can be stored into the Predefined database by using IS button which is
61. ether with the parameters in the right hand side window You can delete it by marking it and selecting Delete selected recipe Selecting the assigned recipe key deletes only key association But having selected recipe then both the assigned key and the recipe are deleted 4 7 Changing Background Colors Change background color in the editor by pressing lt CTRL gt lt B gt A color scheme is displayed where you can make appropriate changes Confirm it by clicking Ok 4 8 Storing Derived Image Having finished operations and you are satisfied with the way the derived image turned out you can store it The following options are available 1 Click Save 90 quality which is suitable for sending by e mail due to its small size 2 Or click Save lossless which is suitable for later printing Regardless of the option you use the image quality is sufficient for performing analyses Ax CEPH Users Guide Copyright 2011 Page 56 of 141 5 Viewing Analyses Performed 5 1 Soft copy 3e 3 Save as New Open Save E mail analysis analysis analysis Analysis 5 1 1 Opening an Analysis To open an existing analysis click the Open analysis button and select the analysis 71x Look in E Analyses ex E3 BF210FF6 47C9 4E42 B557 66C3E0SFEEFD FE73F2CD 0447 4184 B844 1885679912FB My Recent Documents Desktop My Documents 1000x832 My Computer LY NET Fiename Sample acx Places Files of t
62. he outline s parents if either point is deleted so is the whole outline Delete an element by selecting it and pressing the lt Delete gt key Point 1 c Geometry Point 1 Point 2 3 Upper incisor Point 2 Image 29 A tooth in the tree and on the canvas The newly added tooth has a blue dashed bounding box around it Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 27 of 141 Point 2 Point 2 Point 2 Image 30 Resizing and moving a tooth Point 2 Width It can be changed by clicking a tooth s outline it turns red from pink and the bounding box appears and dragging the resize handle on the bounding box to the desired position PA point c Y PB oint e PA point l 1 f b j m z L PB point 9 poin PB point PA point PS f PB point PA point bi _PC point E uin PD point x 9 e 3 PB point Se E PR n AN PA point PB point PE point PA p oi nt PA point PA point L e j EN TEST f i f 1 f i EN uU f E a 7 IJI M PN H r 4 int 7 2 poin PB point PB point Image 31 All predefined tissue outlines PA point s El o PB point Position a tooth can be moved around by dragging its two points to the desired position Read more about tooth positioning in the follow up in chapters about creating analysis types 3 2 10 2 Hard and soft ti
63. ht click Select Rotate to Horizontal from the context menu This makes the selected line horizontal and the whole image is rotated to match Ax CEPH Users Guide Copyright 2011 Page 32 of 141 Show Hide Show text Tag Value Rotate to Horizontal Add to print layer Remove from print layer Add to analysis layer Delete from analysis layer Delete Image 37 Image rotation 3 2 13 4 Settings InfoBox After selecting the element InfoBox you can select the Settings InfoBox option from the context menu Consequently a dialog box appears where you can select settings for Infobox select measure for display font and set whether the name of the selected measure will be visible Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 33 of 141 Info Box Settings Measures in analysis Measures in Info Box Measure Measure Kot SN Ba SBa SN Kot SNA SN NA wa A Pln Wits Pntwits Kot SNB SN NB wb B Pln Wits PntWits Kot ANB SNA 5NB Wits wa wb Kot SN Pg SN NPg Konv APntKonv PntKonv A konw NPg NPg PntKonv Obrazna konveksnost KonvA KonvNPg ML NL interbazalni kot NL ML ML NSL inkl mandibule SN ML Obrazna os MBa PtGn Paneli ZOW 5 tGo SOV N Me ZOV SOV zov sov Bj rk ML NSL 360 Kot 1 NA 1 NA Kot 1 NL 1 NL Gonialni kot ArtGo ML Kot 1 ML 1 ML Kot 1 NB 1 NB Razdalja 1i pom Razdalja APg
64. ight 2011 Page 105 of 141 Click the Assemble button to superimpose analysis over analysis You can rename the new superimposed image at will The default name is set according to the constraints names You can create any number of superimposed images AC Analysis Superimpasition Analysis type About q Ul uj d dar a XU Mefa De X 4 alm E p pa Add Export Settings E JL Mew Open Save Save Add Change as analysis analysis picture Print Add Remove link link picture Customization Layout Superimposition Image 130 Adding links Click the Add link button to return to the panel for linking analyses Just repeat the above procedure 9 1 4 1 Superimposition types There are three different superimposition types available see Image 129 Setting up linking constraints 1 Point Point 2 Point Plane 3 Point Rotation 9 2 Superimposing Photo Image over Analysis Photo images can be viewed in profile that is as one dimensional lateral radiograph Hence it is impossible to expect that they will be a 10096 match AC Analysis Superimposition Analysis type About T UJ gg gj 51M le aul ODP ME X uw wu E p pr Mew Open Save Save Add Change Add Remove Export Settings E JL as analysis analysis link link picture Print Customization Layout Superimposition Image 131 Adding picture i e lateral photography Ax CEPH Users Guide Copyright 2011 Page 106 of 141 To add an image c
65. in Ax CEPH File could be image report Ax CEPH searches patient by PGUID or by PlDOutside node If patient is found patient file is added If you want to add new patient with file use InsertOrUpdatePatient command instead Also use InsertOrUpdatePatient when you want to update patient data and add file Returns message in resulting XML lle addfile xml Sample XML file lt xml version 1 0 encoding utf 8 lt AxCephComData gt lt Patients gt lt Patient gt lt PIDOutside gt 129 lt PIDOutside gt lt NameOfPatient gt Sample patient 3 lt NameOfPatient gt DateOfBirth 19670409 DateOfBirth lt Sex gt M lt Sex gt Telephone1 386 500 70 20 lt Telephonel gt Telephone2 Telephone2 lt Email gt john novak audax si lt Email gt Address Nova Pot 1 1000 Ljubljana Slovenija lt Address gt Ax CEPH Users Guide Copyright 2011 Page 136 of 141 lt Active gt 1 lt Active gt Description sample patient lt Description gt DateOfInsert 19 8 2011 12 11 42 DateOfInsert lt Patient gt lt Patients gt Command AddFileToPatient Command ResultXMLFileName result xml ResultXMLFileName lt PatientFileName gt d bernice haus jpg PatientFileName ResultStatus ResultStatus lt ResultMessage gt 0 lt ResultMessage gt AxCephComData DeactivatePatient Deactivates a given patient Ax CEPH searches Patient by PGUID or by PIDOutside node Returns message in
66. ing the installation TE E Image 139 Selecting setup language Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 113 of 141 A window is opened where you can select setup language To continue click the Ok button Welcome to the AxCeph Setup Wizard This will install AxCeph 1 0 on your computer It is recommended that you cose all other applications before continuing Click Next to continue or Cancel to exit Setup Image 140 Setup wizard Please read the warning and after reading it proceed by clicking the Next button You can terminate the process by clicking Cancel anytime during the setup T Setup AxCeph License Agreement Please read the following important information before continuing Please read the following License Agreement You must accept the terms of this agreement before continuing with the installation AUDAX Customer End User License Agreement 2010 AUDAX d o o IMPORTANT NOTICE The Ax CEPH Software is the copyright of AUDAX d o o Audax whose principal place of business is 1 accept the agreement 2 1 do not accept the agreement Image 141 Customer End User License Agreement for Ax CEPH A Licensing Agreement is displayed Please read the agreement carefully If you agree with what you have read select accept the agreement and click the Next button Ax CEPH Users Guide Copyright 2011 Page 114 of 141 js Setup AxCeph fo Setup AxCeph Select
67. int layer to MS Excel Click the upper part to automatically export data in the predefined template On the other hand click the bottom part to select a template if more than one is available A template can be included in each analysis type Analysis data get exported to three Excel worksheets that is Measurements Image and Patient The Measurements worksheet includes measurements together with calculations set in the Print customization window Here are also included additional and standard data on measurements The Image worksheet includes the radiograph and print layer The Patient worksheet includes patient information Patient s name Patient s birthday Date ofimage Sex Status Age Date of analysis 2 2 Bernice Haus 1 5 1977 12 4 2010 F Beginning 32 14 4 2010 3 A B G D E F G H 1 Group Name Value Normal value Difference Bias Values Measure unit Std deviation 2 SAGITALNI RELATIONS Angle SNA 74 82 8 3892 74 22 2 3 SAGITALNI RELATIONS Angle SNB ral 80 9 4378 71 24 2 4 SAGITALNIRELATIONS Angle ANB 3 2 1 4872 97 2 5 SAGITALNI RELATIONS Wits 2 0 5 1 2482 1 74mm mm 0 5 6 SAGITALNI RELATIONS Angle SN Ba 139 130 9 2332 139 33 4 7 SAGITALNI RELATIONS Angle SN Pg 73 81 8 2579 73 26 3 8 SAGITALNI RELATIONS Facial convexity 1 2 1 503 0 99 mm mm 2 9 VERTIKALNI RELATIONS Upper lip E lineSN FH 15 6 9 4466 14 93 2 10 VERTIKALNI RELATIONS NL NSL incl of maxilla 13 9
68. inter near it or its label c Selected an element is selected after left clicking on a highlighted element The element turns red Elements can also be selected in the tree This comes in particularly handy for elements that are hidden OcP Pick Pick i7 A Pln Wits Perp OcP 2 PntWits Plane OcP i7 B Pln wits Perp OF Pa Ravnina Perp MFg a PntKonv Plane Ravnil E PNS Pick e ANS Pick A NI ENS ANS Image 11 The selected element is highlighted in the tree and colored red on the canvas If an element depends on other elements parent child relationship and is selected all parents of that elements turn purple see Image 14 Moving a point on a line to a new position 3 2 6 Element Icons in the Tree The icons of elements in the tree come in different shapes and sizes each with its own meaning Ax CEPH Users Guide Copyright 2011 Page 18 of 141 Colors r A red element is included in the structure and is completely undefined r s A yellow element is included in the structure it identifies a feature but it is in the initial position A green element is defined and moved to the designated position Icons i pa t th e point m measurement leng 1 eL 4 line x measurement angle 2 outline 4 measurement calculation A grey icon background e g T means that the element is currently hidden 3 2 7 Moving a Point Moving a point behaves
69. ion Remove Calibration Original image size 3028 x 2947 Original image size 3028 x 2947 Current image size 3028 x 2947 Current image size 3028 x 2947 Preset found for image size Preset found for image size Done Save to preset Done Image 27 Image calibration window empty calibrated The calibration dialog box can be empty in this case the button was colored red or the calibration has been performed and fields display values on the other hand the button was colored red Click two points on the radiograph ruler and enter their distance in millimeters If you want to change the points press Delete or the Calibrate again button and repeat the procedure Note The calibration is executed only in the Analysis panel not in the Analysis Type panel That is the analysis type cannot be calibrated Ax CEPH Users Guide Copyright 2011 Page 26 of 141 3 2 10 Creating and Editing Outlines hard and soft tissue Outlines can be predefined teeth or created manually by placing points around an area 3 2 10 1 Teeth z Or T d ig Silhoue El Fort Pare fome E Vide bio Gou Teeth Upper incisor Lower incisor Upper first molar Lower first molar Other tissue Sphenoid Orbit Nasal Bone Acoustic Meatus Pterygomaxillary Fissure Nasal Spine Mandible Image 28 The Teeth menu Selecting a predefined tooth adds three interdependent elements to the canvas and the tree two points and the outline of a tooth The points are t
70. iption color or layer the same way as with other elements An existing point cannot be an outline s node 6 2 4 Teeth Outline Teeth E Upper incisor Lower incisor Upper first molar Lower first molar To add a tooth outline into an analysis type select it from the Teeth dropdown There are four predefined teeth outlines available that is upper and lower incisor and upper first and lower first molar Ax CEPH Users Guide Copyright 2011 Page 66 of 141 In contrast to other features these outlines are predefined and are set in the default position Plus a tooth outline consists of three components that is two points and outline The outline is in child relation to the two points thus deleting a point deletes the outline as well Point 1 Pay P x E ver 2 Point 1 wf S amp Ni 2 Point 2 6 7 2 Upper incisor A a P E S x N 5 de e t Ed aus i E Te da e o e pd 2 Y f TO Ye i Qm p Point 2 Image 81 of tooth outline tooth in default position in analysis interactive points of tooth outline Change the position of a tooth outline by moving point 1 and point 2 the top and bottom arrows in image 64 image on the right Change the width by moving the blue squares which are displayed after you click the outline Change the name label description color and layers of visibility of a tooth as for all the other elements You cannot connect a tooth
71. ividing line opens a dialog box where you can more precisely define the line properties You can set a half angle angle portion in percentage value or exact angle value it comes in handy for example when defining a horizontal plane in the Burstone analysis type 3 2 8 7 Verticals and horizontals Verticals and horizontals are special lines that are always vertical or horizontal respectively no matter how the image is rotated Move such lines by clicking anywhere between their endpoints and drag them to the desired position Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 25 of 141 3 2 9 Image Calibration Image calibration is a procedure whereby the length of and distance between objects is determined based on the known length of any element An x ray image usually contains a ruler next to the forehead Calibrate the image by clicking the Calibration button on the ribbon The button is colored red if the image hasn t been calibrated Otherwise it is colored yellow IP il Calibration Calibration Image 26 Calibration button The Calibration element has a circle icon in the tree Image calibration starts by selecting the Calibration button The calibration window appears Calibration 3 Calibration pa First point First point X 1638 00 Y 555 00 Second point Second point X 1685 00 Y 976 00 Distance 423 62 pixels Distance mm Distance mm 23 Manual Calibration Remove Calibration Manual Calibrat
72. lement Settings o g Bement Image oo Element ID 7200964B AE92 D04 867F ASA91E993FA HA Element ID 7200964 E92 004 8B7F ASAQIEISFA fA de mu Name Nason Name Nason Tag N Y Vidna Tag N Y Viens Description Najbol sprednja toca nosno elminega a Description Najbol sprednja tia nosno Celn nega a anteriorna toda suture nasofrontalis anteriorna toda sAture nasofrontalis Color BEN Print Color MN gt Fil Color E Pnnt Fil Color wj Fil Color Pont Fil Color Element ID 7200964 AE92 4004 887F ASA91E995FA Name Nasion Tag N Y Vidna Description Najoolj sprednja toca nosno lt elni nega iva anteriora toa suture nasofrontals Color MEN gt Print Color MINNS Fl Color 7 Print Fil Color a HARSH Na Radiograph Image 4 Moving a window inside docking panel To move two windows inside the panel pull one over another as shown in the above image 2 3 1 3 Saving deleting a layout You can update layout form add a new one or delete it by using the ribbon buttons Updates and saves the currently selected layout settings di Saves the selected layout under a new name Deletes the currently selected layout 2 4 Ax CEPH operating mode A Ceph works in one of two modes e Without a database e With a database oelect one of the modes from the Settings in the Files panel Ax CEPH Users Guide Copyright 2011 141 Page 12 of Settings ES Set
73. les Ax CEPH exports Ax CEPH Users Guide Copyright 2011 Page 124 of 141 AC Audax Patient Record System 9 amp Es Ea amp Q E New Edit Delete Open Save ance Jpen Add folder Patient Selected object Create Radiographs Analyses Superimpositions a Patient Bernice Haus y Date of birth 1 1 1977 M Gender Male Female Telephone 01 200 40 60 GSM Email bernice audax si Address Tehnoloski park 18 1000 Ljubljana Slovenija Description Standard patient 24 11 2010 3000 x 2343 14 4 2010 Beginning 12 8 2011 first sup GUID 34475A23 9A32 4E0D 8218 CO ID 22 Outside ID Active Image 157 Selected patient and his her files 12 1 Workflow When we enable Ax PRS we have several options We can 1 start working on a new empty database file or 2 select existing database file After database file is selected we can 3 add data manually a enter new patient and his her data b add patient files radiographs analyses superimpositions output files 4 rebuild database from existing files Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 125 of 141 12 2 Enabling Ax PRS On first run of Ax CEPH this dialog is showed Very first run Defaults Setup Please select if AxCeph wil be used with database support NOTE This dialog will be displayed only on the very first run of AxCeph You can change this setup later in the Settings Wheureka2DENT_Backups AxCephSkupnaBaz
74. lick the Add picture button The window for adding image is opened Select it and then click Ok The image is then opened in a special window There you can observe two points First point and Second point Move the First point to the position Subnasale and the Second point to the position under the chin asa tp 757 anon ne Image 132 Moving the First and Second point After having set the points click the Save analysis and return button to return to the window for superimposing Repeat the procedure to superimpose photo image over analysis Then select any two points in the patient s soft tissue Note In case the first analysis does not include points otherwise included in the superim posed photo image select it from the tree and click the Change analysis button A window is opened where you can change elements at will They can be added and deleted All changes can be viewed in the Superimposition window Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 107 of 141 9 3 Using Display Tools You can set specific settings for each analysis individually To do this use the Settings section of the dashboard Image 133 Moving the First and Second point Here you can set color transparency levels and check whether the analysis will be shown or not 9 4 Tools for Setting Points Manually The analysis or photo image can be positioned manually This way you can match them with mor
75. lt file input xml Ax CEPH result xml Input XML file must be created by XSD XML schema definition defined in appendix Ax CEPH then processes input file and executes one of demanded commands from this list Command node e GetListOfActivePatients GetListOfAllPatients get list of active patients from Ax CEPH Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 133 of 141 e UpdateOrinsertPatient update patient or insert new if not found e AddFileToPatient add file image or report to patient in Ax CEPH e DeactivatePatient deactivate hide patient in Ax CEPH e OpenPatient open patient in Ax CEPH e GetPatientDir open patient s Windows folder e AddPatientFile add a file to the selected patient in AX CEPH If AxCeph exe is already running and you start it again with parameter another instance of Ax CEPH is started just for the time to send this parameter to first instance After execution Ax CEPH generates result XML file which is specified by parameter ResultXMLFileName If it is not specified result file is not generated The result file has same structure as input file but shows different values lts node Command has always value Result Nodes ResultStatus and ResultMessage show if execution of input file was successful Result XML file is written in default UTF 8 encoding Below are command descriptions Look at the end of this document for detailed input XML description file AxCephCom
76. lysis can on the other hand be found top right The bottom section displays analysis results organized in columns Click Prepare report to edit displayed results and order them into lists For more information on editing printouts see follow up topic on how to create analysis type Ax CEPH Users Guide Copyright 2011 Page 58 of 141 Status Beginning Patient Bernice Haus F 32 Date of Birth 1 5 1977 Date of image 12 4 2010 Date ofanalysis 14 4 2010 Measure Value Normal value Difference Bias SAGITALNI RELATIONS maesa o AR 778 poate sg taal 3 ed il a os iac r3 a se gt gt a c LL mmi Image 75 Analysis printout Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 59 of 141 6 Creating a Custom Analysis Type Create an analysis type in one of the following three ways 1 by modifying an existing type 2 using predefined elements 3 from scratch Analysis type made from Putting together a mechanism Naming and description of elements Equiping elements with thumbnails Defining layers analysis print Defining printouts Defining exports Connecting measurements with standard values Image 76 Ways of creating a new analysis type Ax CEPH Users Guide Copyright 2011 Page 60 of 141 6 1 How to start To create a new analysis type first select the Analysis type tab above the tools banner and click New type A new window is opened where yo
77. m at j fantomXrayLat jpg v Use DICOM data 2272x2045 File name demoDICOM dem Files of type At Image 8 Opening an x ray image for the analysis 3 2 2 Entering Data about the Patient His or Her Status Analysis and X ray Procedures Data about the patient and the analysis are entered into the Patient Type window Patient Type o gp Name John Smith Date of Birth 1 1 1977 34 years x Gender o Male C Female Image date 8 8 2011 Analysis type LJ P Patient type adults z Date 9 8 2011 z status Description Image 9 Patient Type window Data can be entered and changed anytime during the analysis 3 2 3 Selecting an Analysis Type Having selected the image to use for making analysis the elements of the last analysis type will be placed there automatically Thus you needn t select the type of analysis over and over again Ax CEPH Users Guide Copyright 2011 Page 16 of 141 To select a different type of analysis simply click the Add button as shown on the image below The mask for selecting type of analysis is opened Patient Type En Name John Smith ame John Smi Palieniktyne Date of Birth 1 1 1977 34 years hi aaaaaaaaaaaaa aaaaaaaaaaaaa 1 mixed dentition E l ABO American Board of Orthodonti adults Gender 0 Male Female Burstone Burstone acxT Image date 8 8 2011 m Cabinet_B chler Cabinet _B
78. ng freeware software available via the Internet 6 9 2 Analysis layer The analysis layer enables you to join all required elements of the analysis When creating analyses the group is visible but all the other elements are hidden By default no component in the analysis type is included in the analysis layer Hence it is recommended to add all elements that must be visible during the analysis to the analysis layer 6 9 3 Print Layer The print layer enables you to join all elements required for printing an analysis To subsequently print the element it has to be included in the print layer To make elements visible add them on the print layer when creating the analysis type Outlines are by default included on the print layer 6 10 Printout customization Ei Prep Print Export Click the Print customize button to open the Print customization window On the left you can view all the measurements included in the analysis type and on the right there is a box for editing groups In the bottom section there is a box with data which will be grouped together Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 87 of 141 m Printout customisation ft Groups Measurements a Measurement name Group name Upper lip E lineSN FH DENTAL ANALYSIS Zg gr Upper pE e VERTIKALNI RELATIONS DENTAL ANALYSIS Sp ustnica E linija Lower lip E line SOFT TISSUE ANALYSIS SOFT TISSUE ANALYSIS Angle SNA SAGITALNI RELATIONS Angle SN
79. ng network licences users currently using network licence and period of licence validity Note The Installation codes section contains codes for use in system identification where licensed Ax CEPH application is located Installation codes are required when trying to solve issues relating to licensing Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 123 of 141 12 Ax CEPH Patient Record System Ax PRS Ax CEPH Patient Record System Ax PRS is a database system built for storing and organizing patient data and files from Ax CEPH and also from external applications Ax PRS is a part of Ax CEPH application If it is enabled all Ax CEPH data is organized on a patient basis When patient is selected his her data and files are shown By patient data we mean Surname and name Date of birth Gender Telephone GSM Email Address Description Patient database identificators GUID ID Outside ID Active if checked patient is visible for searching By patient files we mean Patient xml stored patient data in file Radiographs X ray images in standard image types BMP JPG TIF GIF and sin gle image DICOM files Analyses ACX files contain patient data Superimpositions ACXS files Ax CEPH output files Below is a picture of Ax PRS form Selected patient and his her data are displayed on the left His files are in columns Radiographs Analyses Superimpositions and at the bottom are output fi
80. o display the vicinity of the crosshairs in negative or click one of the magnification buttons on the upper right to change magnification 3 2 12 Info Window The Info window can be opened or closed if it is open by pressing the F3 key It can be moved around and the program remembers the last used position The Info window displays information about the currently selected element name image and note Element Ez Tangent gonion ML peste posteriorne krivine ramusa in linije ramusa ascendensa mandibule Image 35 The Info window 3 2 13 Element Commands Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 31 of 141 Elements offer a number of advanced options Select an element in the tree or on the canvas Right click to open the context menu with a number of options Show Show Show Show Hide Hide Hide Hide Show text Show text Show text Align silhuette Settings InfoBox Eu Rotate to Horizontal l Delete Delete Align Into Box Delete Delete Image 36 An element s context menu a Info Box b Point c Plane d Silhouette 3 2 13 1 Hide Show Elements can be hidden and revealed as necessary The element s icon in the tree changes accordingly 3 2 13 2 Show text All elements have labels that can be visible or hidden on the canvas Use this command to toggle a label s visibility 3 2 13 3 Rotate to Horizontal The image can be arbitrarily rotated Select a line and rig
81. ometric points and planes cephalometric measurements in comparison with standard values and a specific method of displaying results Examples are Downs Analysis Ricketts Analysis Steiner Analysis etc Analysis superimposition Superimposition of analyses and or photographs is used to compare the state of hard and soft tissue during orthodontic and surgical treatment Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 9 of 141 2 3 Ax CEPH Window Layout The program screen is divided into a number of areas EZ uu B 3 m la n w yga ano s tUe ji a ey EE NM LN em Fort Pee Teme Wage fo Gwp P 4 A Cn Pfu sa Date of Brfh 21 7 1957 53 years e Gende Ma D Fem T 1 1 2011 PATIENT mm Patent type red denthon WINDOW Status VIEW MONDO x DOCKING STORAGE DOCKING STORAGE CANVAS Image 1 A typical Ax CEPH program window layout The Command Ribbon changes according to the type of task making analyses designing analysis types superposing images View Window allows hiding or revealing single types of primitives and layers in the image The Model Tree provides easy browsing of the primitives in the analysis The Splitter allows resizing the canvas at the expense of the docking windows and vice versa The Canvas contains the image and the analysis primitives The Docking storage contains hidden windows 2 3 1 Docking Docking option allows you to customize window layout by
82. on for phantom pictures in Ax CEPH is in the setup folder lt Ax CEPH gt Res The default installation folder is C AxCeph The phantom pictures are automatically assigned names t01 t02 If a new picture is added then you have to reopen Ax CEPH to display it 6 4 2 Position landmarks First set four single points UserGuideVer2 0 docx Copyright 2011 Page 73 of 141 Image 90 Setting points S N A and B Then rename them to S N A and B To do so use the Dashboard 6 4 3 Create planes Connect points SN NA and NB to create planes _ PEZ S Area N i ei y N LEES ENS ge UES x Image 91 Setting angles SNA and SNB Page 74 of Copyright 2011 CEPH Users Guide 141 Ax 6 4 4 Create dimensions Set two angles between the created planes that is between SN and NA and between SN and NB To select adjacent angles use Ctrl and click the corresponding adjacent angle Enter names for measurements SNA and ZSNB 6 4 5 Calculated dimensions Enter a mathematical expression to calculate a new measurement which equals the difference between angle measurements ANB SNA SNB Measurements in calculation SNA SN NA SNB SN NB Calculation SNA SNB Current value 1 14 Image 92 Angle measurement ANB First enter a name and label plus the unit of measurement Calculate in the following way 1
83. optional items Angle brackets lt gt surround keyboard user supplied values Pipe symbol separates mutually exclusive values for an argument Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 7 of 141 2 Introduction 2 1 Purpose Analyzing a cephalometric x ray image is a part of diagnostic procedures in jaw and dental orthopedics In addition dentists can use it to determine a toothless patient s occlusal plane lt is based on a transilluminated radiograph of the head onto which landmark points and lines planes are placed Based on the measurement between landmark points in hard and soft tissue are prepared tables and diagrams containing deviations from values that are normal for teeth in a given age or race There are several analyses and analysis interpretations available by authors like Ricketts Downs Steiner Segner and others Besides standard analyses dentists orthodontists or surgeons can make additional ones This makes it easier for them to formalize irregularities define virtual planes or set a course of treatment Considering the diversity of cases and the time used computer software can greatly aid specialists in making routine but critical calculations in analyses Ax CEPH is a program that enables you to integrate your specialist knowledge into the computer and reuse it in cephalometric X ray image analysis The program allows users to make their own analysis types or make additional measurements in a
84. ors tab in settings window A window is opened listing all elements used in the analysis type see Image 100 color settings window Click color by the element Clicking LX opens a dropdown menu where you can set new default color On the other hand clicking me opens Colors window Ax CEPH Users Guide Copyright 2011 Page 80 of 141 JENMENME EEEE miii m Image 101 colors window In the top section you have basic colors 48 colors and the bottom section offers custom colors and the button Define Custom Colors Clicking it opens a new window where you can set a new color and you can add it to custom colors by clicking Add to Custom Colors To set new default color select a custom or basic color and confirm it by clicking Ok Having finished setting default colors click Ok to quit the Color window To discard the new settings click Cancel 6 7 Editing standard values and standard deviations Standard values Click Edit std val to open the window for editing standard values and deviations Set standard values for each analysis separately Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 81 of 141 Gonialni kot 1 NL 1 NA 1 NA razdalja l 1 1 NB 1 NB razdalja 1 A Pg 1 A Pg razdalja interinc kot Zg ustnica E lin Sp ustnica E lin MON OO 4 24 NO Ny Image 102 Window for editing standard values There is a number of buttons with
85. oth cases after clicking Next the activation form will be displayed where you can enter required data Activation data consist of Serial Number and user s personal information The fields which must be filled out are marked with red Please enter the activation data Serial Number rirun 53590 8zcas A0p84 erTCf DgTOS Please enter all required information for the activation process M EE a Company Ffomiecomay SSCS Salutation FS First Name IE Last Name pe Country 5m y E Mail Address Fonn doelzaudax s Image 146 activation step 3 Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 117 of 141 If you select the Online Activation option you receive a warning on clicking Next informing you that the Internet connection must be ensured for activation to initiate Online Activation AxCeph will now be activated by online activation To process the activation data has Please make sure that an Internet connection is available to be sent to the Activation Service Back Next End Image 147 activation step 4 Click Next to start activation During transaction the animated screen is displayed showing computer communication with the activation server Activation in process Image 148 activation step 5 After the process has finished a message about successful activation is returned Ax CEPH Users Guide Copyright 2011 Page 118 of 141 Activation completed We hope you enjoy working
86. p Tooth alignment ES Point 1 lt gt Point 1 lt gt PA point Point 2 lt gt Point 2 lt gt Po E PA point E El j i ot N N SU a eC e PB point PB point v X 1D X Cancel Lov ox E X Cancel y Tooth alignment Sz Tooth alignment 3 Point 1 lt gt Point 1 lt gt PA point Point 2 lt gt ic aa Point 2 lt gt ri A f rm PA e n S ef A i M pn F Y E u X wW e PB point PB point mp m PEERS eem AA Image 41 Tooth alignment for a Upper incisor b Lower incisor c Upper first molar d Lower first molar Ce eden Copyright 2011 Page 35 of 141 UserGuideVer2 0 docx Tooth alignment eS Tooth alignment PA lt gt YL PB lt gt poi e PB point Poesccccssencccscscnsneccsonsnees PA point PF PB point Tooth alignment pa Tooth alignment PA lt gt PE lt gt LULU poccccocccccsoveccsccansccvonecees Pow OK 3 Cancel PA point PB point PA lt gt PB lt gt ceeccccecececcccceccececcesseceen 3 Cancel Image 42 Silhouette alignment for a Sphenoid b Orbit c Nasal bone d Acoustic Meatus Ax CEPH Users Guide 141 Copyright 2011 Page 36 of Tooth alignment SS Tooth alignment SS PA lt gt PA lt gt mes mes El PC lt gt _PC point PA point PD point S
87. placed by Element ID in the element settings Ax CEPH Users Guide Copyright 2011 Page 100 of 141 Element Settings Element ID Name Upper incisor apex Tag Point 1 Visible Description Color E Y aud Print Color BN L2 ug Fill Color da Print Fill Color we Image 121 A new predefined element The element from the above image Image 121 A new predefined element hasn t been saved to predefined elements yet This is why the Element ID field is empty Element Settings Element ID 55EFBFC4 2861 447B 83D5 5ABF 1C2DF 5 Bm Name Upper incisor apex Tag Point 1 Visible Description Color BN L2 3 Print Color BN A uid Fill Color we Print Fill Color we Image 122 A saved predefined element Whenever an element is saved to a predefined group it is assigned a unique Element ID Click l after manually specifying the element that is after placing it in the image entering description name label and image Should you choose to save a more complex element or measurement also all its constituent elements that have not been saved as predefined will be saved After saving predefined element you can also update it Change data of predefined element and again select E New dialog will need user confirmation on changing predefined elements Image 123 update predefined element Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 101 of 141 9 Superimposition Superimposition tools allo
88. pyright 2011 Page 49 of 141 4 3 1 ROI region of interest Set an area by clicking the top left corner of the area and drag the pointer to the bottom right corner Then release the button Image 60 Area ROI Region Of Interest You can modify the area when black squares are displayed in corners and in the middle Drag and drop the squares to resize it at will 4 3 2 Pseudo color Use this function to display any grayscale image using red green and blue Start using function by selecting Pseudo color button Image 61 Window for setting pseudo colors Ax CEPH Users Guide Copyright 2011 Page 50 of 141 Changing the amount of red green and blue in turn changes the color scheme of the derived image on screen After finishing and closing the window the image is changed back to grayscale that is it is returned to the original version before having used Pseudo color function Images where pseudo colors have been applied cannot be stored as derived images 4 4 Annotations symbols You can insert annotations to the image That is graphical symbols text or their combination Line with annotation Line Square Memo Image 62 Annotations and symbols 4 4 1 Annotation Select Annotation from the Annot symbols menu Hover over the image and left click thus selecting the area where you can enter text You can change the annotation at any time that is change the content font color positioning Having enter
89. r precise position You can only set their initial position A red element is included in the structure and is completely undefined 2e The feature is inserted in the image status identified and it is in initial position To define the status and determine the initial element position select it in the tree and place it in the image Change the name and label of the element make the label visible or hide it by checking or un checking Show in the Dashboard In addition you can enter a text description Desc of the element change its color and filling color and set layers You can also add a drawing of its position in the image All settings can be viewed in the editor which is by default on right hand side Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 63 of 141 Element Settings o p Element ID 367215D5 B45E 4BA4 A7A0 65 H Name Anterior Nasal Spine Tag ANS Visible Description Spina nasalis anterior Color MN Print Color BE Fill Color v jee Print Fill Color BAUL Element Image EIE da om aye o A F aa u G Ra Visible Name Element on layer v Radiograph All Elements Y Analysis y Report Image 80 Geometric features Dashboard where you change various properties 6 2 1 Point aan aog ug A Point on plane X Point on crossection Click Point on the ribbon to add a point in the analysis type which you can then define as needed 1 To add a point
90. s E x Save analysis Cancel and return Analysis superimposition Image 136 Save and return button To accept the changes you made and return to the previous window click the Save analysis and return button Otherwise click Cancel Having deleted the linking points by mistake the original analysis version will be kept Ax CEPH Users Guide Copyright 2011 Page 110 of 141 10 About panel In this panel you can set and view the following language application data and license data 10 1 Language Set language using a dropdown menu Set language and the menu and reports will be changed accordingly Language can be set through About gt Language menu Once the Language button is selected a new window is opened where you can select appropriate language Select Language Image 137 Select language window After selecting new language a window will inform user to restart Ax CEPH Information Image 138 information on changes 10 2 Displaying Application Data Ax CEPH is the copyright of AUDAX d o o the head office of which is located at Tehnoloski park 18 SI 1000 Ljubljana Slovenia Audax d o o Tehnoloski park 18 Ljubljana SI 1000 Telephone 00 386 1 200 40 50 Fax 00 386 1 423 47 00 www axceph com Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 111 of 141 10 3 Entering a Product Key Use Ax CEPH to view the out of the box analyses or create new ones To create new an
91. s element gt lt xs element name Description type xs string minOccurs 0 gt lt xs element name DateOfBirth type xs string minOccurs 0 gt lt xs element name Sex type xs string minOccurs 0 gt lt xs annotation gt lt xs documentation gt M male F female lt xs documentation gt lt xs annotation gt lt xs element gt lt xs element name Telephonei type xs string minOccurs 0 gt lt xs element name Telephone2 type xs string minOccurs 0 gt lt xs annotation gt xs documentation GSM number xs documentation lt xs annotation gt lt xs element gt lt xs element name Email type xs string minOccursz 0 lt xs element name Address type xs string minOccurs 0 gt lt xs element name DateOfInsert type xs string minOccurs 0 gt lt xs annotation gt xs documentation Date when record was inserted in data base xs documentation lt xs annotation gt lt xs element gt lt xs element name Active type xs string default 1 minOccurs 0 gt xs annotation xs documentation 1 is default If 0 then patient is not shown in list of patients xs documentation lt xs annotation gt lt xs element gt lt xs sequence gt lt xs complexType gt lt xs element gt xs sequence lt xs complexType gt lt xs element gt lt xs schema gt Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 141 of 141
92. se Load Defaults y Save as Defaults ay OK 3 Cancel Image 154 Settings window You receive the message if the licence file has been successfully changed In case of an unsuccessful attempt the client uses the previously set licence Information Image 155 License information box 11 4 Licence information Click the About tab in Ax CEPH application Proceed by clicking the Licence Data button A window containing licence information will appear Ax CEPH Users Guide Copyright 2011 Page 122 of 141 Licence Information Author Audax d o o Licence Owner Sample Company Version 1 0 Info Additional Keys El Modules EbAxCeph GF Er Update Subscription i Activated i Valid until 08 08 2012 Installation Codes Code 1 899C0E47 Code 2 47FD9147 Code 3 55453F13 Code 4 33645F9E Code 5 DESA1288 X Code 6 17CB1E7E Code 7 E29A7398 Code 8 1BAOBSBS bs Code 9 3188F37F Code 10 77297238 Code 11 Code 12 83365429 a Close Image 156 Complete license information The aforementioned window contains data on author and licence owner as well as application version for which the licence is issued The bottom window section of the Info panel contains detailed licence information Here are displayed AxCeph module Update subscription and corresponding properties such as licence type Floating Licence activation status available floati
93. serGuideVer2 0 docx Copyright 2011 Page 103 of 141 9 1 3 Selecting Additional Analyses Change analysis To add new analyses click the Add analysis button A window is opened Proceed by selecting an analysis and superimpose it over the one which is being currently opened X E Ve Image 127 Selecting an analysis The two analyses are displayed side by side The first one is on the left the last one on the right Analyses are added one by one It is recommended that you superimpose each added analysis as you go along to keep things organized The colors are preset But you can change them at will The first analysis is red the next one green sky blue purple etc Ax CEPH Users Guide Copyright 2011 Page 104 of 141 9 1 4 Linking up Analyses Select an analysis in tree structure view to superimpose it over the first analysis Image 128 Linking up analyses Click the Define elements button in the floating Link Settings dialog box and the linked fields will color yellow Name Link 1 Desc Point Point Point Plane Point Rotation First analysis Dependend analysis Sella turcica lt gt Sella turcica Nasion lt gt Nasion Assemble Cancel Flip Reset Use calibration Image 129 Setting up linking constraints The elements of the first analysis are linked up with the elements of the dependent analysis Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyr
94. sliders to set the factor and radius and focus the image as best as possible lt is recommended that you take care in setting these two parameters Warning Do not change the parameter Stand Dev By default it is set to values between 0 1 and O 8 The radius is used to determine the size of the area for sharpening the greater the radius the greater the area calculated for sharpening Proceed by setting the factor to determine the sharpening magnitude To reset default values that is radius 3 and factor 300 click Reset After setting the values click Ok They are saved as default and will be applied when running Sharpening again 4 2 4 Emboss A relief can be generated based on the color information in the image Increasing the radius raises the embossing height Apply emboss with F5 or Emboss button n B bemessen 53 D i y OK Drecten cancel Radius po z Image 54 Window for emboss setting Ax CEPH Users Guide Copyright 2011 Page 46 of 141 4 2 5 Gray Level Correction Use gray level correction to set brightness and contrast of images without diminishing the quality of the original image The human eye can perceive around 40 different shades of gray On the other hand the computer can display 256 shades of gray 8 bits 25 256 In addition you can print them onto transparencies The medical image is comprised of 12 bit pieces of information Hence the image contains 4096 shades of grey 2 4096 The compu
95. ssue Other structures can be marked by manually creating outlines with the Outline 20 tool Ax CEPH Users Guide 141 Copyright 2011 Page 28 of Image 32 Click to place the outline s nodes Right click where you want to start the outline then click around the structure you wish to outline Double click to finish the outline DESELECTED OUTLINE Image 33 Selected and deselected outline Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 29 of 141 An outline can be edited 1 by clicking and dragging nodes or 2 by deleting nodes hold the lt Ctrl gt key and click a node Deleting any of the two end nodes will delete the whole outline All outlines are by default on the print layer and therefore appear on the printout Remove them by using the editing tools 3 2 11 Zoom Window The Zoom window can be opened or closed if it is open by pressing the F2 key It can be resized and moved around The program remembers the last used size and position of the Zoom window The Zoom window displays a magnified view around the mouse pointer No elements are displayed in the zoom view Zoom window Negative ea371 mm 4 20 mm e 1 56 mm Ax CEPH Users Guide Copyright 2011 Page 30 of 141 Image 34 The Zoom window when moving a point When moving a point the Zoom window displays a crosshairs marking the center of a point even if the label was selected Click the Negative button t
96. surement Select between millimeters mm degrees percentage or leave blank On the left hand side of the bottom section are displayed all measurements plus calculations included in the analysis type The right hand side displays measurements used in creating calculations The Add number field can be found under the Measures in calculation box Use it to add number constant to the calculation There are six buttons in the section between the two boxes Use the upper two in order to move measurements to be included or excluded from calculation The other four are operators In the bottom section you can see the field Calculation which displays the formula used in calculation 6 4 An Example of Creating Custom Analysis Type from Scratch Below you can see the process used in creating an analysis type Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 71 of 141 picture Se type Image 88 Analysis type after entering occlusal plane points A and B Do the following to create analysis type for calculating ZANB First open Analysis type panel Click New type and enter name of analysis type Ax CEPH Users Guide Copyright 2011 Page 72 of 141 6 4 1 Choose phantom picture phantom picture Image 89 Choose phantom p cture To display a lateral view of the phantom image click Choose phantom picture Note A phantom picture can be added at will or you can change the existing one The storing locati
97. t lt Address gt Nova 999 1000 Ljubljana Slovenija lt Address gt lt Active gt 1 lt Active gt lt Description gt sfajlom lt Description gt Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 135 of 141 DateOfInsert 19 8 2011 12 11 42 DateOfInsert lt Patient gt lt Patients gt Command UpdateOrInsertPatient Command ResultXMLFileName result xml ResultXMLFileName ResultStatus ResultStatus ResultMessage 0 ResultMessage lt PatientFileName gt d SamplePatientFile bmp lt PatientFileName gt lt AxCephComData gt Sample results lt xml version 1 0 gt lt AxCephComData gt lt Command gt Result lt Command gt lt ResultStatus gt 0 lt ResultStatus gt lt ResultMessage gt Patient updated OK lt ResultMessage gt lt Patients gt lt Patient gt lt PIDOutside gt 999 999 lt PIDOutside gt lt PGUID gt 1D4A225FE 05B4 4926 BF87 63A0821EBBC3 j lt PGUID gt NameOfPatient Miha Datotecnik NameOfPatient DateOfBirth 19690202 DateOfBirth lt Sex gt M lt Sex gt lt Telephone1 gt 999 999 Telephone1 lt Telephone2 gt lt Telephone2 gt Email dato jaudax si Email Address Nova 999 1000 Ljubljana Slovenija Address lt Active gt 1 lt Active gt lt Description gt sfajlom lt Description gt lt DateOfInsert gt 9 2 2011 12 04 48 PM DateOfInsert lt Patient gt lt Patients gt AxCephComData AddFileToPatient Add patient file to patient
98. t can also be removed in the same way as the others Settings EI Calor E Red Line width n E I Image 69 Window for editing line and square 4 4 5 Square To mark the area more easily use rectangles They can be used like all other objects Plus you can change color and line width as also for lines 4 5 Interactions We have already dealt with some of the options offered in the Interactions menu Mi Move Zoom to selection Choose object Image 70 Line with annotation 4 5 1 Move Having resized the image so that it does not fit the window in such a case the Navigator is displayed you can move in it by left clicking the image holding down the button and moving to the desired position 4 5 2 Zoom to selection Selecting Zoom to selection maximizes the selected section of the image to screen size Mark the section you want to view with a dotted rectangle and the rest is done automatically Ax CEPH Users Guide Copyright 2011 Page 54 of 141 4 5 3 Choose object We have already dealt with the Choose object option but we have always selected only one object Sometimes you want to select multiple objects for example to delete them Place the pointer on the edge of the last object and left click it hold down the button and select all the other objects The selection is confirmed with black squares displayed on the edges 4 6 History 4 6 1 The history table The History table records all the filters
99. ted AxCeph If you got multiple Activation Keys you can now enter these keys A key can also be pasted using the clipboard CTRL V Apply Key Next Image 152 activation step 9 11 3 Setting up multi user network licence Ax CEPH offers a multi user floating licence option This licence allows multiple network users Setting up the network licence environment requires basic knowledge about network systems that is why it is recommended that a network administrator performs this job Store the Ax Ceph lic licence file which you have received via e mail on a network location with available access for all clients who will be using this licence That is the read and write access must be enabled Then open Ax CEPH on one of the clients and click the Settings icon uw E io ad settings Image 153 Settings icon Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 121 of 141 Open Files panel The Licence File input field is located in the Licence options box where you set the licence file Clicking button right side of Database file opens a dialog box in which you can look up the licence file network location and then click OK Settings eS Colors Settings Files Image Formats Licence options Licence file MUCILNICA2 SRVAxCEPHAxCeph lic Default save paths Save files to database Database file C AxCeph Analyses AxPRS mdb e A Analysis type C AxCeph AnalysisTypes A Delete and rebuild AxPRS databa
100. ter displays batches of 16 bit grayscale data as one Internally the image is still 12 bit That is why you can retrieve the quality of the original image by additional transformation of the derived image fors E zoom woseecion gt lt o ES er Gray level ru Gamma 1 1 Left border gt a E Right border CE poem l e E 255 Image 55 Preview window for gray level correction Clicking Gray level or pressing lt F6 gt displays a window where you can change parameters accordingly The bottom section displays two charts The left hand side chart represents the gray level of the input image The right hand one represents the output image Move the slider under the input image chart to set the desired gray level Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 47 of 141 Gray level Gamma 2 13 E j Left border 0 ES 3 Right border a W 773 Image 56 Parameters for correcting gray levels Move the red handle to the left to make the image brighter and move it to the right to make it darker Move the green handle to expand or shrink the range Only the range between the green and blue handle will be used Note Moving these handles to the middle range results in the loss of information however it will result in changing contrast and brightness of an image Gamma Left border 54 Image 57 Example of setting contrast Gray
101. the elements are shown The Analysis layer which includes elements used in creating analysis The Print layer which is used to print the result of analysis Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 83 of 141 The window for layers and displaying elements is located both in the Analysis panel as well as the Sumperimposition panel The Superimposition panel also contains a checkbox which enables you to hide or display elements or layers across all analyses included in the superposed image This way you can for example hide all planes across all combined analyses by checking Apply to all analysis and clicking the Hide Show button Layers o A MA 2 a Jag Adr D vi Visible Name Element on layer Y Radiograph All Elements Y Analysis Image 104 Window for layers and displaying elements To show or hide elements and making use of group save function use the top window icons Otherwise the window can like any other floating window be stored or hidden in the docking panel ZF Two options a save all the visible elements to selected layer or b show elements on the selected layer Add a new layer with a default name Rename layer with a doubleclick and entering anew name Delete the selected layer Toggle button to show hide all points Nan Toggle button to show hide all planes amp 3 Toggle button to show hide all silhouettes m Toggle button to show hide all measurements Ax CEPH Users
102. tings eS Colors Settings Files Image Formats Colors Settings Files Image Formats Default save paths Default save paths v Save files to database MN I Save files to database ingAxCeph Analyses AxPRS_6 mdb Analysis type C dockingAxCeph Ana Analysis dir C dockingAxCeph Analyses Analysis type C dockingAxCeph AnalysisTypes D Delete and rebuild AxPRS database Load Defaults Save as Defaults mm v OK 3 Cancel Load Defaults ay Save as Defaults wy OK 3 Cancel Image 5 Setting up modes Consequently the ribbon changes accordingly offering one of the following options AC Analysis Superimposition A AC Analysis Superimposition A Analysis Image 6 Ribbon layout a without a database and layout b with a database The user guide deals with both functionalities in separate sections respectively Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 13 of 141 3 Making Analyses Based on Predefined Analysis Type Making an analysis applies the knowledge that is contained in analysis type Most users will be using only this feature of Ax CEPH 3 1 Workflow AREY Patient Choose picture data analysis type Raw PEAK Locating landmarks Finished SHEETS Image 7 Flowchart for making an analysis Ax CEPH Users Guide Copyright 2011 141 Saved analysis types LEE ave analysis Page 14 of A given an
103. tissue F7 Image 52 Filters The data contained in the History table is important since filters are applied consecutively The filter commands are assigned the following function keys except for the Negative option from F2 to F7 Ax CEPH Users Guide Copyright 2011 Page 44 of 141 4 2 1 Median Deletes irregular points which deviate from the image lf a bright dot appears inside a dark field an error during image capture must have occurred Using the filter removes such errors Median is applied with lt F2 gt or by Median button in filter list 4 2 2 Softening Use Softening to remove blurred edges between objects in the image by selecting lt F3 gt or by Softening button in filters list 4 2 3 Sharpening Use Sharpening to emphasize borders between bright and dark areas in the image For example sharpen the image in order to highlight the bone structure Apply sharpening by selecting lt F4 gt or Sharpening button Image 53 Window for setting parameters for sharpening Selecting this filter opens a new window According to how you set display options you can simultaneously view the original image marked with Before and the resulting image marked Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 45 of 141 with After Of course you can display only the image which is the result of sharpening The same imaging functions are available as in the editor zoom move and navigator Use
104. ture Image 45 Edit button owitch between displaying derived and original images at will To do so select them in the tree The Active image element shows the currently displayed image Ez 15 4 2010 gt E kd Active picture deriv 2 jpc E Bernice Haus jpg 15 deriv 1 jpg 15 4 201 M deriv 2 jpg 15 4 201 E ez Data a Image 46 Active image in the tree Ax CEPH Users Guide Copyright 2011 Page 40 of 141 E Cephalometry UE 00r IHE E 1 1 Horizontal mirror j Vertical mirror 90 CCW y 90 CW 100 v Negative Derivate Median F2 Softening F3 Sharpening F4 Emboss F5 Gray level F6 Soft tissue F7 ROI Pseudo color Anotation Line with annotation Line Square Memo History Region Operation Delete filter iw Enable filters lr Save 90 quality cz Save loosles 7 y v X Cancel Brightness 0 11 Reset brightness Contrast 0 2 E Reset Contrast NER 944459 y Image 47 Editor window for editing diagnostic values 4 1 Image manipulations and displaying The Editor provides tools for resizing flipping and rotating images _ al Tt Em ls j 1 1 Horizontal mirror Vertical mirror on 90 CCW E 90 CW 100 x Image 48 Display editing tools Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 41 of 141 Ld e l
105. u can enter the name of the new analysis type fW New type of analysis TeName 0 0 0 0 000 0 0 Types af analysis O LJUBLJANSKA ANALIZA LIUBLIANSKA ANALIZA acx OP TA KEFALOMETRIJSKA ANALIZA OP TA KEFALOMETRIJSKA ANALIZA C Soft tissue Soft tissue 1 acx Zagreb 82 MOD Zagreb 82 MOD 1 acx k HE Cancel ad Image 77 Entering name of new analysis type Enter the name of the new analysis and confirm it by clicking Ok A generic window for creating new analysis and phantom picture is opened Switch views by clicking Choose phantom picture Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 61 of 141 AC Cephalometry New type of analysis Licenced to Marko Trebovsek Audax j Analysis Superimposition Analysis type About gt m E E LI Prep X XE 9t Silhoue 86 n oe nia if ME ye T Default id i A Angle New Open Close Save Save v Excel Point Plane Tissue v Wiggle Info Group Predefined Calibration oa Lane Settings Choose qb type type type as v v v Chart Box reposition fo Calculated va ES phantom picture Analysis type Cognitive features Measurements Standard values Customization Layout Patient Type T m Element Settings ud Type Mame Mew test analysis Element ID a Date 9 5 2011 d Name Status Tag Visible Description Description Color ig Print Color uu Fill Color Ma Print Fill Color MA Element Image Lud z A Tree Uu 9 5 2011
106. uct You can This is an evaluation version You can evaluate AxCeph for another 22 activate it any time day s If you don t have a Serial Number you can continue witn the evaluation version Image 143 Message about the remaining trial period days Purchasing the application you receive a unique personal license file and serial activation number by e mail Then replace the Ax Ceph lic file contained in the Ax CEPH application setup folder with the one you received by e mail In addition on running the application again you receive notification that the application has to be activated Welcome to AxCeph To use this product you have to activate it by Buy a Serial Number entering a Serial Number o get a valid Serial Number you have to buy the product Yo activate it any time If you don t have a Serial Number you can continue with the evaluation version Image 144 activation step 1 Click Next On the screen which appears select the type of activation One of two options can be selected That is Online Activation and E Mail Activation Ax CEPH Users Guide Copyright 2011 Page 116 of 141 How do you want to activate the product Select the preferred activation method o Online Activation An Internet connection from this computer is required to do this E Mail Activation An E Mail application should be available on this computer to do this Back Next End Image 145 activation step 2 In b
107. w superimposition can be started from existing analysis Existing analysis or superimposition can be opened by double clicking it If you click the Data button Ax PRS form will be opened ephalometr o Analysis Superimposition Analysis type About Tissue eV rib b nt v ES y PRA Ve Ef Ef alibratio Settings Edo eo 3 Analysis Picture Cognitive features Measurements Standard values Customization Layout Image 163 Data button in main menu 12 3 1 Selecting patient Click on the Patient field and patient search will be opened Start writing patient name and or surname into this field and all active patients with entered name surname will be shown You can UserGuideVer2 0 docx Copyright 2011 Page 129 of 141 also enter just a part of name surname When you click on one of displayed patients his her data and files will be shown Date of birth Bernice Haus 1 1 1977 Gender Telephone GSM Email Address Description GUID 34475423 9432 4E0D 8218 C0 ID 22 Outside ID Active Image 164 Patient search Click Show all patients if you want to see deactivated patients also If you started working on an empty database patient search will be empty You can enter new patient or rebuild database from existing materials see chapter 12 4 12 3 2 Entering new patient and its data You can click New to enter new patient It is mandatory to enter patient name and surname field
108. w you to place one analysis over another analysis or a photograph over an analysis Any number of analyses and patient photographs may be used Analysis Analysis Analysis Photo 1 2 e n 1 Assembly RULES SN e ML e NL Export picture ave superpos Image 124 Superimposition process in Ax CEPH To superimpose analysis over analysis you have to set cephalometric landmarks For example by setting both landmarks S Sella turcica and N Nasion both analyses are superimposed according to the interrelation and location of the two points The size of images and image rotation are adjusted accordingly Ax CEPH Users Guide Copyright 2011 Page 102 of 141 9 1 Superimposing Analysis over Analysis 9 1 1 Selecting the Superimposition Panel First you have to open the Superimposition panel You can work in the Analysis and Analysis Type panels simultaneously But you can only work with a stored analysis AC Analysis Superimposition Analysis type About DO at Mew Open Save Save Ade change Add Remove Adc Export Settings Superimposition Print Customization Layout Image 125 Selecting the Superimposition panel 9 1 2 Selecting an Analysis Clicking the New superimposition button opens the window where you can select an analysis For example let us open the oldest analysis version and click Ok e ef Be Image 126 Selecting analysis for superimposition Ax CEPH Eng AxCEPH U
109. xist Checking is performed in the patient directory All analyses files must exist here i YES add superimposition to existing patient li NO skip this superimposition 5 Foreach file in patient directory a check file type Checking is performed by file extension File could be bitmap image bmp dcm gif ico jpg jpeg png tif tiff or Ax CEPH output file doc docx xls xlsx pdf ppt emf wmf i Add bitmap image to patient radiographs li Add output file to patient output files Ax CEPH Users Guide Copyright 2011 Page 132 of 141 12 5 Ax CEPH communication interface You can integrate Ax CEPH with external software if you need to Ax CEPH communication with other Patient Management Software can be done with the use of xml files Through its communication interface we can perform e Reading data from Ax CEPH Get list of active patients in AX CEPH Get list of all patients in AX CEPH e Sending data to Ax CEPH Insert new patient to Ax CEPH Update patient data Add image to patient Deactivate hide patient Open patient in AXPRS Communication is possible only when AxPRS mode is enabled Any Patient Management Software can communicate with Ax CEPH by sending input XML file to Ax CEPH as a parameter to AxCeph exe execution file e g AxCeph exe input xml Input XML file tells Ax CEPH what to do one of commands below Ax CEPH then executes demanded command and optionally generates XML resu
110. xsd is also in Ax CEPH installation directory GetListOfActivePatients Returns a list of all active patients in the resulting XML input xml Sample XML file xml version 1 0 encoding utf 8 AxCephComData xsi noNamespaceSchemaLocation AxCephCom xsd xmlns xsi http www w3 org 2001 XMLSchema instance gt Command GetListOfActivePatients Command ResultXMLFileName Result xml ResultXMLFileName AxCephComData GetListOfAllPatients Returns a list of all patients in the resulting XML input xml Sample XML file xml version 1 0 encoding utf 8 AxCephComData xsi noNamespaceSchemaLocation AxCephCom xsd xmlns xsiz http www w3 0rg 2001 XMLSchema instance Command GetListOfAllPatients Command ResultXMLFileName Result xml ResultXMLFileName AxCephComData Ax CEPH Users Guide Copyright 2011 Page 134 of 141 UpdateOrlnsertPatient Updates Inserts a patient into Ax CEPH XML file must have exactly one entry with patient and its data Fields NameOfPatient and DateOfBirth are mandatory Ax CEPH searches Patient by PGUID or by PlDOutside node PGUID is internal Ax CEPH ID which is returned when you call GetListOfActivePatients or GetListOfAllPatients command PIDOutside is ID of your Patient Management Software integer or string with max 255 characters All patients should be inserted with PlDOutside If both IDs are empty or patient is not found
111. ype AxCeph Analysis acx M Cancel Image 73 Open analysis window The Open analysis window displays a preview of the opened analysis that is x ray image which was used in performing analysis 5 1 2 Changing an Analysis In an open analysis the positioning of points and planes can be changed elements and measurements added and removed To save the analysis under the old the existing name click Save analysis But should you want to save the modified analysis under a new name or to keep it before applying changes click Save as and save the analysis under a different name The patient s name is offered by default Ax CEPH Eng AxCEPH UserGuideVer2 0 docx Copyright 2011 Page 57 of 141 ae OK f E Cancel Image 74 Save as window 5 1 3 Send Analysis by E Mail Click to send the analysis by e mail An e mail message is opened Here you have to enter a recipient the subject and body of the message A file containing the analysis with all the required data is attached to the message 5 2 Hard copy E Prep mh Print Frint Export 5 2 1 Print Click the Print button to print an analysis A preview window is opened where you click IS in the top left corner to print the analysis Note The Print button will only be availabe if measurements have been performed in the analysis The patient s radiograph can be found on the left hand side of the printout Any additional graphical elements of the ana

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