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1. EN JE 1774 4 s Set 3D Rendering Cutoff Threshold Moving the slider determines the threshold for which gray scale values are shown in the A 3D rendered view sg Adjust 3D Rendering Transparency Moving the slider to the top increases the transparency of the 3D rendered view Adjust Levels If the adjustment of the 3D volume rendering is not satisfactory the adjustments can be done manually by using the Adjust Levels window The gamma curve can be adjusted by moving the green line in the histogram The value can be seen in the box in the middle of User s Manual Planmeca Romexis D 23 3D EXPLORER the window The histogram can also be cut from both sides by moving the red lines which effects the Adjustment of the Contrast and Brightness see 2 3 1 Adjust on page 21 Input Values R Overlay result histogram E Linear scale 247 Avg 2656 92 3460 StdDev 424 36 OK Cancel Scale histogram By pressing the arrows in the middle the histogram can be scaled up or down The button 43 restores the original scale of the histogram Threshold The black line increases or decreases the threshold and consequently has the same function than the slider Set 3D Hendering Cutoff Threshold Pseudo Colour modification The buttons left and right of the gamma value named F and H modify the pseudo colours Pressing the button alters and allocates the colour selection for different tiss
2. IMAGING OK Cancel In the Panoramic tab you can make adjustments to the image quality settings of the panoramic images Resolution Bits Per Pixel and Image Format define how the images are stored in the database after the image has been taken Autoenhancements include settings that affect the visualization of images in Romexis Resolution e Normal With normal resolution the pixel size is 0 132 mm e Enhanced Decreases the pixel size to 0 099 mm and improves the image quality e High High resolution sets the pixel size to 0 066 mm and is the mode for a best resolution Note The size of the image is much larger and the handling of the image slower when the pixel size is smaller NOTE The resolution selected in the Romexis Configuration panorami settings does not affect the image size pixel size is always 127um Other RomexisConfig settings BitsPerPixel ImageFormat Gamma Sharpening Median are same as the settings for other 2D images acquired with Dimax sensor User s Manual Planmeca Romexis H 7 IMAGING Bits Per Pixel This field defines whether the images are captured as 8 bit or 16 bit The best dymaic contrast range is reached by using 16 bit per pixel but the images will be twice the size of 8 bit images Image Format The format in which the images are stored in the database The options are TIFF and JPEG JPEG Quality The JPEG Quality can be set to be Low Medium High or
3. V Vol 1 L 125 Size 250 x 250 x 250 voxels 80 x 80 x 80mm Figure 1 Volume Stitching dialog after the first volume is added Volume Stitching To combine multiple volumes into one first Agathe source volumes Then arrange the volumes to an approximately correct orientation and click on Stitch la 3 12 2007 16 30 52 ial Add Remove Mode Horizontal Background Black Stitching Mode Auto Adjust Slices p 125 p 125 v Vol 3 p 125 size 488 x 2 4 x 250 voxels 159 87 x 80 mm Figure 2 Volume Stitching dialog after all three volumes have been added to the work area and perfectly aligned Note that the volume size is 15 9 x 8 7 x 8 cm User s Manual Planmeca Romexis D 11 3D EXPLORER Volume Stitching To combine multiple volumes into one first 4da the source volumes Then arrange the volumes to an approximately correct orientation and click on Stich 13 12 2007 16 30 52 Add Remove Made Horizontal Background Black stitching Mode Auto Adjust Slices Vol 1 p 125 Vol 2 p 125 Vol 3 P 125 Size 528 x 258 x 250 voxels 168x82 x80 mm Figure 3 Volume Stitching dialog Example of inadequate alignment Zoom Mode When the Zoom Mode button is activated the sliced views can be scaled up and down Move the mouse pointer over the desired view and turn the mouse wheel into the appropriate direction up to zoom in down to zoom out NOTE When the Zoom Mode button is deactivated tur
4. e Send Images with annotations applied Enable this option to have annotations made in Romexis to be merged into the image that is sent to DICOM storage e Storage Commitment enabled Enables Storage Commitments that will be shown in Image Properties once received e Two association mode for commitment When Two Association mode is enabled a dedicated association socket will be opened for establishing Storage Commitment Otherwise the original Storage associa tion socket is reused to establish Storage Commitment e Listening port for commitment Specify port where Romexis server listens for Storage Commitments when Two Asso ciation mode is used e Timeout for commitment s Specify Romexis Server timeout for receiving Storage Commitments when Two Associ ation mode is used F 12 Planmeca Romexis User s Manual 2 2 2 User s Manual IMAGING Dicom Printer Setup The DICOM Printer settings can be checked and changed in the opening DICOM Printer Setup window x DICOM Printer Setup AE Title MERGE PRINT SCP Film Box Orientation Default Film Size Default Magnification Type Default smoothing Type Magnification Factor Header Text Height Footer Text Height Annotation Text Height OK Cancel Under Film Box the following settings can be made Orientation Default Portrait Landscape Default will let the printer choose the print orientation while Portrait or Landscape will force the
5. Com pact i Quick Reference Card and Compact i maintenance and hygiene instructions are currently available E 12 Planmeca Romexis User s Manual Chapter F ADMIN MODULE The Admin module is divided into the following tab sheets 1 Resource Dental record Imaging Device alerts qu A un Local settings 1 RESOURCE Under the Resource tab you can create user groups and define user names passwords and clinic names 1 1 Groups Tab Sheet The existing user groups are shown in the list To define the new user group click the Add button In the opening dialog type in a name and description of the new user group and define permissions for the new group Update Group Group Group Name Pmbridge Users Description Permissions Toolbars Available Current Administrative Add All permissions gt Manage global settings Remove Patient Management Manage users Help View patients Manage materials Configure clinic Patient Queries Edit Toolbars layout edit Cl nic Management Reporting operatories update Clinical Information View reports device firmware View clinical info Configure reports remove alerts in Imaging Patient Management Clinic Module Clinic je apture X Rays Add patients Monitoring tab Capture X Rays without approval Assign patients Deny Module Access Manage template patients Appointment Update patients Dental Record Inactivate patients 3D Imagina View all patients Clinic Monitoring Upda
6. LJ Romexis Service E E3 Server Parameters Lj Server LJ Database LJ External Communication set Defaults Romexis Server is running User s Manual Romexis Database The database that is used with Romexis can be selected from among the three alternatives shown in this field Romexis uses JDBC driver to connect to the database If you plan to use a different database from the one provided in the Romexis installation you must acquire JDBC driver for the alternative database e JDBC Connect URL is the connection string which JDBC driver uses to locate the data source An example URL can be seen beside the database names but because it is defined by the provider of the driver it can differ from the example URL In such cases contact the provider of the JDBC driver e UserlD and Password are the login information to the Romexis Database Planmeca Romexis H 27 SERVER PARAMETERS Test Connection The database connection can be tested by clicking the Test Connection button Set Defaults Default settings can be restored by clicking the Set Defaults button in the bottom right corner of the tab 5 3 External Communication Im Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis 3 General Settings Datagate External Patient Management System E 3 Resources Solid Example URL jdbc jtds sqlserver sserver paort sdatabase propertys z value General Oracle Person S
7. e User Guidance Visit For cases where there is no technical problem but a visit is required to instruct the user in proper use or maintenance of the dental unit e Remote Service Recorded when a technical problem can be solved without visiting the chair for example by adjusting service modes remotely e Remote User Guidance Used for example when the user can be remotely instructed on the phone on the proper use of the dental unit by referring to the recorded history information e User Name The maintenance person who was logged in at the time of recording the entry e Comment To provide more details and to assist in later maintenance visits service History Entry ID Date Entry Type User Mame Comment 23 2 2008 17 43 Service Visit Default Provider Changed delight lamp 2 23 2 2008 18 07 Service Visit Default Provider Annual maintenance The existing entries can be viewed by selecting them from the Service History list which automatically updates the recorded values onto the form To record a new entry click on New Entry to start recording a new maintenance operation To edit an existing record click the Edit button The following information can be recorded for maintenance visits Planmeca Romexis E 11 CLINIC MODULE VIEWS e Username of the person who provided the service automatically records the user cur rently logged in e Ent
8. siis Exp w Study dci WwIPSP Cam setup Capture Image Import DIR Imp Toolbars Hide All Reset Toolbars to Defaults show All X ray Input Layout Output Planmeca Romexis F 3 RESOURCE 1 2 Users Tab Sheet The existing users are shown in the list To add a new user click the Add button In the opening dialog fill in or define User s personal information Username and password Address Contact information Role provider type doctor student hygienist Group s that the user belongs to Whether the user is also a patient Whether the user should receive device alerts User profile can have a photo added to it using the Photo tab The photo will be shown in the user interface where remote user identification is relevant Planmeca Romexis x Add User User Personal Liser Lisername Inewstudent Password esseess Retype Password leeesees Member of Groups Administrators Students 2008 Students 2006 Teachers Students 2007 Roles Useris a provider Provider Type Student useris a patient Properties E Listens to Device Alerts OK Cancel Use the Update button to modify a user s information Use the nactivate button to inactivate the user in Romexis F 4 Planmeca Romexis User s Manual 1 3 Device Alerts Configure Device Alerts A Planmeca Romexis 2 0 0 12 B 24 10 2008 Default Provider sysadm Licensed to Planmeca PLANMECA File Bomex
9. 12 E1 12 Output Valve Aux short circuit on MCB Assistant syringe water valve sh UNIT TYPE 1 1 13 E1 13 Output Valve Aux short circuit on MCB Separator alarm reset signal sh UNIT TYPE 1 1 14 E1 14 Output Valve Aux short circuit on MCB PLANET output ELMP short cir UNIT TYPE 1 2 01 E2 01 Output Valve Aux open circuit on MCB Incoming water valve open circuit UNIT TYPE 1 2 02 E2 02 Output Valve Aux open circuit on MCB Incoming air valve open circuit UNIT TYPE 1 2 03 E2 03 Output Valve Aux open circuit on MCB Bowl rinse valve open circuit UNIT TYPE 1 2 04 E2 04 Output Valve Aux open circuit on MCB Cup filling valve open circuit UNIT TYPE 1 2 06 E2 06 Output Valve Aux open circuit on MCB Separator pulse valve open circ UNIT TYPE 1 UNIT TYPE 1 12 07 E2 07 Output Valve Aux open circuit on MCB reserved E2 12 Output Valve Aux open circuit on MCB Assistant syringe water valve op UNIT TYPE 1 E213 Output Valve Aux open circuit on MCB Separator alarm reset signal op UNIT TYPE 1 E3 1 General pressure problem Incoming air pressure compared to the water UNIT TYPE 1 E3 4 General pressure problem Internal air pressure after pressure regulato UNIT TYPE 1 E3 5 General pressure problem Internal air pressure after
10. D 20 Planmeca Romexis User s Manual 3D EXPLORER 2 2 1 3D Volume Orientation The 3D Volume Orientation buttons provide a 180 rotation of a specific view Changing orientation in one of the views also changes the orientation of the rendered volume Anterior view of the plane Posterior view of the plane Lateral view of the plane Contralateral view of the plane Upper view of the plane Exterior view of the plane 2 2 2 Layer Slide Bar and Maximize button NOTE Pressing the Maximize 1 button at the top right corner of a viewport opens the corresponding view into a full size window showing the image in large A Layer Slide Bar is located at the right border of the coronal sagittal and axial view In each case the slide bar can be moved to scroll through the image layers of the corresponding view For example scrolling the slide bar of the coronal view up and down moves the view inside the layers forward and backwards The corresponding orientation lines in the two other views as well as the auxiliary plane in the 3D rendered view automatically move to the appropriate position to reflect the change It is also possible to scroll through the image layers using the mouse wheel when the Zoom Mode is deactivated see 2 3 1 Adjust on page 21 2 3 Volume Adjustments Volume Adjustments at the far right contain Explorer specific image processing tools Adjust 2 3DRend 32 2 3 1 Adjust Thickness 1
11. Defines the language file used with Romexis Client e Main Window Size X and Main Window Size Y These parameters can be used to force the Client s main window to a certain size Set Defaults The default settings can be restored by clicking the Set Defaults button in the bottom right corner User s Manual Planmeca Romexis H 23 START UP 4 2 Romexis Service Fl Planmeca Romexis Configuration 2 2 0 15 8 5 25 09 Romexis General Settings E gt Resources LJ General LJ Person LJ Security Regional E Imaging LJ Panoramic Lj Cephalometric LJ Intraoral 3 CBVT Lj Display LJ Dental Record LJ PlanLink amp Diagnostics LJ Print gt Image amp Data Management Lj Data Falders LJ Trash LJ Long Term Archive 3 Start up LJ Client Parameters Romexis Service El 3 Server Parameters LJ Server E Database Romexis Service is running Connected to server localhost PLANMECA L External Communication show Help Romexis Service Windows Service Name Romexisservice Executable Name Romexisservice Startup Delay min O Java Vil Parameters JVM Path C Program FilesVava jre6ibiniclientjyvm dll Classpath arclibwrapper_jio jarjai_codecjarjai_corejarjai_imageio jarmlibwrapper_jaijar Main Class romexis_server_appimainfRomexisSever OpionalAppaas nn SEA Optional JVM Args l Max Heap Size MB 600 AgdaressivelMulti care G
12. E1 12 Assistant syringe water valve short circuit E1 13 Separator alarm reset signal short circuit E1 14 PLANET output ELMP short circuit El E2 nn Output Valve Aux open circuit on MCB E2 01 Incoming water valve open circuit E2 02 Incoming air valve open circuit E2 03 Bowl rinse valve open circuit E2 04 Cup filling valve open circuit E2 06 Separator pulse valve open circuit only with Micravac s E2 11 Separator start signal open circuit Microvac valve open circuit E2 12 Assistant syringe water valve open circuit E2 13 Separator alarm reset signal open circuit E E3 n General pressure problem F 6 Planmeca Romexis User s Manual PLANMECA r omexis File Resource Device Alerts imaging Local Settings RESOURCE Configure Usage Data Alerts I Planmeca Romexis 2 0 0 12 B 24 10 2008 Default Provider sysadm Licensed to Planmeca Configure Device Alerts Usage Alert Name Delight Close Patient Marshall Nelly X y Type Usage Alert Parameters Maintenance Annual Maintenance Maintenance Name Delight Panic El Ez User s Manual Message Delight lamp must be replaced Type Maintenance Y Instrument Operation Light M 9 Used more than 12000 h Selected more than times in seconds Activated more than times in seconds Remove Save Settings The Configure Usage Data Alerts tab is used to configure triggers that allow custom events on Unit compo
13. Export DICOMDIR Export allows you to export a set of multiple patients with their patient information and images into a DICOMDIR file structure A DICOMDIR Directory information file is saved as specified in the Export To dialog and all exported DICOM image files are stored into its adjacent subfolder titled images To start exporting patient information and images from a DICOMDIR open the Import dialog by clicking the DICOMDIR Export tamm button or if no patient is selected use the File DICOMDIR Export menu option a C 8 Planmeca Homexis User s Manual User s Manual IMAGING MODULE MM Planmeca Romexis DICOMDIR Export First specify a DICOMDIR filename with the Export 7o button and then add patients Export To Add Patient ns 3 13 sx 502 Tap E Patient Patient Test 2 E V Study E Series O DX Image 0 CT Image 1 CTI Image 2 CT Image 3 CT Image 4 ICT image 5 ICT Save Processed Image Save Annotations Anonymize File s 6images selected Export with Romexis Viewer Burn DICOMDIR and Romexis Viewer to SD Export Cancel First define the DICOMDIR file to be created and exported into using the Export To button In the opening Export To dialog you can browse to the correct folder and define a filename for the new DICOMDIR file After you have defined the DICOMDIR file add patients into the tree list at the top left by using the Add Patient button In the dialog that opens you c
14. LJ Client Parameters LJ Romexis Service E gt Server Parameters LJ Server Lj Database LJ External Communication Romexis Server is running In the CBVT tab you can make adjustments to the image quality settings for the CBVT images Default Settings and Auto Enhancements affect the visualization of the CBVT images when they are opened in Romexis Default Settings e Window Defines the amount of grey shades in the image The window range is O 4095 shades of gray and it is typically set to 2000 e Level Defines the midpoint for the shades of gray 0 4095 If level is set to 2000 and window is 2000 the shades of gray that are in use include values from 1000 to 3000 Auto Enhancements e Gamma Correction Defines the default gamma value for the Auto Enhancement e Auto Levels Min Pct Defines the percentage of cumulatives shades of gray that is left out of the contrast range from the lower end of the contrast range e Auto Levels Max Pct 6 Defines the percentage of the cumulative shades of gray that is left out of the contrast range from the upper end of the histogram H 12 Planmeca Homexis User s Manual IMAGING 2 5 Display ki Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis Show Help gt General Settings Background Colors E Resources Background for X Rays NEN LJ General D Parson Background for Photos E LJ security L Regional Default GUI Font SansSerif m E E3 Imagi
15. Maximum Auto Enhancements The Auto Enhancements group includes settings that affect the visualization of the images in Romexis They do affect the original images in the database When a new image is captured the Adjust Levels operation is automatically performed to the image with the Auto Enhancement group adjustments If the automatic adjustment is not satisfactory it can be undone by clicking the Undo button in the Imaging Module and the adjustments can be done manually in Romexis through the Adjust Levels function e Gamma Correction Adjusts the gamma curve of the image By adjusting the gamma value the image can be made to look more like a conventional X ray image e Sharpen The image can be sharpened with a specific filter and strength Low Medium or High e Despecle A specific filter can be used to remove noise from the image by selecting Despecle Bitewing Auto Enhancements The Bitewing Auto Enhancements group includes dedicated settings that affect exposures taken with the bitewing programs available in selected Planmeca X ray units They will not affect exposures taken with intraoral sensors The same values as for the Auto Enhancements for panoramic images above apply Save Autofocus Images Save Autofocus images as normal exposures among other X ray images in Romexis Save auto Focus Images function is available only with Dimax sensor as Autofocus is not available with SmartPan H 8 Planmeca Romexis User s
16. NOTE On the bottom there are three drop down lists and the estimated size of the final stitched volume is displayed Additional sliders to adjust the slice shown will appear when the volumes are added into the work area see Fig 1 and Fig for examples The following options are available Mode Select Horizontal or Vertical depending on whether the volumes are to be stitched horizontally side by side or vertically on top of one another Background Select Black or White as the background colour for the work area In some cases it is easier to work against a white background but this option is for user convenience only and will not affect the stitching result Stitching Mode Auto In the Auto mode Romexis will search for the best horizontal alignment for stitching after the user has provided a rough alignment in the work area This mode is most suitable for horizontal stitching and it is the default when the horizontal stitching mode is used in ProMax 3D Auto with Tilt This mode is similar to Auto mode above but Romexis will additionally consider different rotations for the volumes in case the patient has tilted their head between the exposures Tilt recognition is most suitable for vertical stitching and this mode is the default when vertical stitching mode is used in ProMax 3D Manual The Manual mode allows the user to manually perform a final alignment for the volumes in case the two automatic modes explained above do n
17. Password E Imaging Lj Panoramic F Cephalometric Java Yh Parameters JVM Path System Default LJ Intraoral Stack Size kB 500 CBVT D Max Heap Size MB 1200 P Display 3D Rendering Open GL Lj Dental Record F FlanLink amp Diagnostics F Frint So Image amp Data Management P Data Folders 3 Trash P Long Term Archive gt Start up Client Parameters LJ Romexis Service Language English Main Window Size X Main Window Size Y gt Server Parameters Set Defaults Romexis Service is running Connected to server localhost OK Cancel NOTE This tab can be used to configure only the Client that is installed on this current workstation Connection to Romexis Server e Server Address and Server Port define the Romexis Server address into which Romexis Client connects to Host address can be either IP or DNS name e UserlD and Password are login information for the Client and they are optional Java VM Parameters e JVM Path Set the Java Virtual Machine to be used by Romexis client e Stack Size Defines the amount of stack memory in use This parameter is optional and needs to be configured only if certain TWAIN devices are used e Max Heap Size Defines the maximum amount of memory which Romexis Client has in use e 3D Rendering Defines the rendering method for 3D images H 22 Planmeca Homexis User s Manual START UP User Interface e Language
18. a white framed rectangle appears By dragging the mouse on the view the cropped area can be defined The rectangle also appears in the two other sliced views as reference to define an exact area for the cropping In case volume has not been rotated a preview of the cropped volume is shown instantly The cropping operation is finalised with mouse right click The cropped rendering is automatically centered when right mouse button is clicked The cropping can be adjusted by turning on the cropping feature and adjusting the cropping boundary by dragging its corner points You can pan the rendered volume around by dragging it while pressing the middle mouse button or alternatively holding down left and right mouse buttons while dragging To re center the rendering right click on the new center point only available on Surface rendering style D 22 Planmeca Romexis User s Manual 3D EXPLORER 2 3 2 3D Rendering There are two different 3D rendering styles available in Romexis Surface style and X ray style 3D rendering style is selected from Romexis Admin module The default rendering style is Surcafe Style Surface style rendering X ray style rendering The 3D Rendering tools can be applied to manipulate the rendered volume 2 3 2 1 Rendering settings 3135 1600 Adjust Contrast and Brightness Regulates the contrast and brightness of the rendered volume By dragging the sliders the brightness and contrast can be adjusted
19. and move single points in the curve or even the whole curve by grabbing the green line of the curve Change the position by dragging the points or the entire curve with the left mouse button To finish editing click the icon again D 30 Planmeca Romexis User s Manual 3D PANORAMIC MODULE OPTIONAL 3 3 4 Select Panoramic Curve Pressing this button shows a list of all saved panoramic curves All curves you draw are saved and named with the date and time they were created Click on an entry to recall and apply that curve 3 4 Adjusting panoramic images From panoramic view upper right corner adjustment dialog can be opened by clicking the button The number of panoramic images the layer thickness and the distance between panoramic images can be defined in the opening dialog Scale 034 L 1 Scale 0 35 L2 A c am 4 3 E E m nua abonon Mnt dc Pd c a M dn up d dc Doa fr P co o u uud Qn o ao du ao un d 3 Seal ale T KT L 3 EScale 0 35 L 4 ig P P lt T1 E SU X Je 21 LA de i NE 1 E JE TO Imm mn TP PPP TR mom le ol a a a a Scale 0 39 L 5 Scale 0 39 if A i AAA dm ela A Lil Mi prim nim hore FINU 3 5 3D Rendered view adjustment See section 3D Rendering on page 23 User s Manual Planmeca Romexis D 31 3D CROSS SECTIONS MODULE OPTIONAL 4 NOTE 3D CROSS SECTIONS MODULE OPTIONAL In case you have purchased Romexis Implant licens
20. be automatically presented to the user when Romexis viewer is started The user can then select a subset of images from the DICOMDir or open all available images for viewing Please note that no preview is available for 3D images After selecting images and clicking mport the images will be opened in the image browser To view 3D images move to the 3D module using the module browser on the far left For more information on how to view and enhance 2D images please see Romexis manual section 2D IMAGING MODULE Please note that Planmeca Romexis Appendix B 1 OPENING IMAGES some features such as exposure export and DICOM are not available in Romexis Viewer A Planmeca Romexis Viewer 2 0 0 4 B 2 10 2008 MESA Fie Daz n Browser 0 m Planmeca Romexis Viewer Open DICOMDIR First select a DICOMDIR file with the Browse button and then choose the images to import CARomexis Viewendicomdir Patient Marshall Nelly 2 E Study E Series 0 DX Image 0 CT Image 2 CT Image 3 CT v Study E Series 0 DX Image 0 DX Pres Image 1 DX Pres Image 8 IO Pres v Study B Series 0 DX Image 0 IO Pres V Study B Series 0 DX Image 0 IO Pres Tag Browse No preview 19 8 2008 15 08 Value pow InstanceNumber ReferencedFilelD ReferencedSOPClassUIDInFile ReferencedSOPinstanceUIDInFile ReferencedTransferSyntaxUIDInFile SOPInstanceUID 4 Allow Duplicate UIDs Prompt on E
21. beet DLE Died S Ded uL baareo acute pdeaai bci G 2 A E G 2 2 IMAGEVIEW ains G 3 ZA Previous NexXciMade coa taa G 3 222 CODEN CODY estro deseas G 3 A eee ea ithe tee tes G 4 Chapter H ROMEXIS CONFIGURATION APPLICATION 1 GENERAL SETTINGS sonia aa H 1 MEMMIUS H 1 t2 POSON aace EE H 2 WSs DECU ARR TID UT ETE eae H 4 TA eoa rH T H 6 MEMA Pe VICES H 7 2E MEE oc LAO TEE H 7 22 GEDINGIOMEWIC 6o iere deti hia ii sets bce trier sce ace H 9 23 d ttaofaleuteestetottuddesuc ibis e bep cU ipeo bue ud stili bee lee e aePU a ID SLE e Lo ete E Seeds H 10 A BB EE H 12 Zo MISA taa o H 13 Z0 Bl M Ee Ur H 14 2 1 Ianbinmke Dla NOS CS illes H 16 zo El RUN H 18 3 IMAGE amp DATA MANAGEMENT eren nnn H 19 Sell Dala Older UE H 19 4 STARTUP otr a ri H 22 A AGERE Paramore Soon iio H 22 42 MOmexIiS DOIVICO Lotes edocuit ta aise Mte ILI odon ie a E LLEVE H 24 5 SERVER PARAMETERS cc ereea eren anne a ann nu uua ranura ra rn rr aA H 26 O A H 26 52 DS RET A A A sic ia ce cueee ck H 27 5 3 External Communication eeesesesesesee mH Imm nemen nemen metere ne H 28 User s Manual Planmeca Romexis 3 TABLE OF CONTENTS APPENDIX A PLANMECA PROMODEL APPENDIX A 1 1 QUICK GUIDE FOR PLACING PLANMECA PROMODEL ORDERS uidi imis a E cups MAE EM EE DM IE APPENDIX A 1 2 PLACING PLANMECA PROMODEL ORDERS APPENDIX A 2 2 1 3D Mast
22. clicking the Image Browser button from the top toolbar The image browser shows all the images the patient has with different image types in their respective categories The visibility of the images in each category can be controlled with the set of buttons below the navigator CBVT 5 Ceph 1 Photo 13 Other 8 Intra 17 View selected Clear Refresh To clear the image selection click the Clear button The image browser is opened by default in the lower part of the screen when the Imaging The Refresh button can be used to update the image view and recall any new images This function is especially helpful in case the patient file is open in one workstation and images are captured simultaneously to the same patient in another workstation The number in parenthesis indicates the number of images in each category All Dates 21 12 2006 20 11 2006 Overview 29 rur A CUEIS 2 742 1 TT TAT 20 12 2006 16 41 Pe ae eee 141 j d je tar EE gt La w A gt lai a JEU r 4 EG E lt a Periapicals Bitewings Ceph 3 Photo 13 Other 8 Intra 17 View Selected i Clear Retresn Refresh The intraoral images are arranged by the tooth number in case the tooth numbers have been defined to the images The number above or below a tooth number indicates how many images the patient has where that tooth is shown The intraoral images can be furth
23. collection of image properties labels The text field includes text that is added to the layout after the image property data of the selected label l e the text field of the label Img Exp mA adds the string mA after the image exposure mAs e g 10 mAs Click the LB field of the label row to add a line brake after the label row They can be handy if many labels are added to the same area of the layout Img Date Img Exp kv Img Exp mA _ Img Exp Time Img Exp DAP Free Text Img Scale 6 Img Comment By selecting a row and clicking De button the row can be deleted By selecting a label row and clicking the buttons Up and Down the label row can be moved in the table MON ann TY 2 Scale 37 ir no comments C 34 Planmeca Romexis User s Manual IMAGING MODULE When the image label is selected from the Contents table its characteristics such as opacity background BG and foreground color FG text color text font as well as relative position in the layout can be defined The relative position in the layout is chosen by clicking on the grey fields of the small image layout preview located in the vertical toolbar The changes in the label characteristics can be seen on the print editor layout San old 12 m sSerifB A gn Sample a Editing header and footer Header and footer can be set editable from Page Setup By clicking the header or footer on the layout the respective labels become
24. in the drive before attempting to use this option When forwarding the DICOMDIR file set make sure you include the DICOMDIR Directory information file specified in the Export To dialog and the adjacent images subfolder 1 4 Image Acquisition NOTE The ability to capture X ray images is defined in the user rights see chapter ADMIN MODULE In case a user does not have the right to capture images without approval the image acquisition buttons are disabled until an Image acquisition request for that current user active patient image type combination has been approved 1 4 1 Capturing Intraoral Images Select Study Flu 10 Fi ZU Intraoral images can be captured either as single images or into study templates containing a predefined set of multiple images To capture single images click the p3 button to initiate image capture mode The Intraoral Exposure Window appears When the X ray unit is in ready state a message Waiting for exposure appears on top of the window Prepare the patient for exposure and select exposure parameters See Planmeca Intra X ray manual for more information You can now expose X rays in the normal way After the exposure a message stating Saving the image appears and the image is automatically stored into the database Define the tooth numbers and sensor orientation and capture the next exposure or click Done to return to the Imaging module when all exposures have been captured To capture intraoral image
25. meta information Image data is stored onto the file system as individual files Both the database and the image data in the file systems need to be backuped and stored in a safe place Note that Planmeca claims no responsibility for the end users data security or for any malfunction in the computer system that may lead to data loss Acquisition The system is designed to automate the acquisition of images with minimum intervention from the user Provided that the user has selected the correct patient in Romexis software the acquisition taking an exposure and archiving of the image is almost exactly the same as with conventional film based imaging systems except that archiving is fully automated and no film processing is necessary The employed exposure technique is automatically stored with each image Settings Romexis provides various settings for the user to choose from A range of parameters and other options can be set to permit control over the main procedures The default settings have been chosen for a typical Romexis environment If required they can easily be changed in the Romexis Configuration application Planmeca Romexis A 3 INTRODUCTION TO PLANMECA ROMEXIS 1 5 Archiving The archiving of images in Romexis is organized under patient names The image data is stored in the file system The exposure values and basic patient data is stored in a database Multiple users can store and retrieve different images to and from
26. monitor the users activities or to review the dental unit settings Log Diagnostic Log view enables efficient daily monitoring of the dental unit events error and help messages as well as reviewing their event history Summary Device Summary provides a summary of information of the dental unit s use and maintenance with a form for entering and reviewing the maintenance operations done Info Info view provides the commonly needed instructions on the dental unit s operation E 2 Planmeca Homexis User s Manual CLINIC MODULE VIEWS 1 1 Clinic Monitoring Clinic monitoring offers a graphical overview of all the devices connected to Planmeca Romexis at the clinic It allows you to quickly evaluate the utilization of each section of the clinic or to spot operatories that require assistance Each workstation square shape in the layout dental unit circle shape in the layout pair is color coded based on their status and the tool tips show more information on the status and the active provider The provid ers devices or operatories can be located in the clinic with the Search feature A right click menu provides shortcuts to other views for the selected device In addition to routine monitoring functionality this view also allows the administrator to configure the clinic layout of up to eight floors with free placement of operatories as well as to upgrade dental unit software remotely dl Planmeca Romexis 2 0 0 12 B 24 10 2008 D
27. or double click the patient name You are presented with a dialog where you are required to define a reason for opening the patient record This dialog can be set optional in the Romexis Configuration application Planmeca Romexis Reason for accessing the patient Please selectthe reason for opening this patient file from the list below 5 New patient exam 5 Urgent condition O Recall exam O Treatment re evaluation Treatment in progress Update no visit Office work OK Cancel Select the appropriate reason and click OK Romexis automatically opens the Files module The reason for opening a patient record is saved and displayed in the dental record under the patient case history The name of the active patient record is always visible in the upper right corner of the screen Several patient records can be open at a time but only one of the open records is active at a time To close the active patient record click the Close Patient button next to the patient name The open patient records can be viewed using the drop down menu click the name and the active patient record can be modified by selecting another patient from the drop down list Close Patient milton lian v B 2 Planmeca Romexis User s Manual PATIENT SELECTION AND MANAGEMENT 1 4 Demographics The Demographics tab sheet contains all patient demographic information and is automatically selected when creating a new patient or editing an ex
28. pressure regulato UNITTYPE 1 E4 1 Short circuit in the cable from the MCB to the control panel suction holder i UNITTYPE 1 E4 2 Short circuit in the cable from the MCB to the control panel suction holder i Activate deactivate The Device Alerts tab allows configuration of error forwarding to user e mails Device Alerts and clinic specific alerts for dental unit use Usage Data Alerts To enable the sending of e mails the user must have Work E mail address entered and Listens to Device Alerts property enabled in user settings User s Manual Planmeca Romexis F 5 RESOURCE The Configure Device Alerts tab allows configuring of specific error and help events to be forwarded to a selected user s e mail Configure Device Alerts for Edmond Newton PLANMECA COMPACT UNIT ERROR CODES E General errors E E1 nn Output short circuit on MCB E1 01 Main water valve short circuit E1 02 Main air valve short circuit E1 03 Bowl rinse valve short circuit E1 04 Cup filling valve shart circuit E1 05 Water flush valve short circuit E1 06 Separator pulse valve short circuit only with Micravac s E1 07 Ejector valve short circuit only if defined as an option E1 08 Extra out 1 shart circuit High volume membrane valve reserved E1 08 Extra out 2 short circuit Saliva suction membrane valve reserved E1 10 Extra out 3 short circuit Reserved E1 11 Separator start signal Microvac s start valve short circuit
29. text field and click the Find button To search patients by their name choose the option Find by name from the drop down menu on the left of the search field Enter the patient s name in Last name First name format into the search field and touch the Enter key or click Find to make matching patients appear in the patient list To view all patients saved in the database use the sign as the search term NOTE Ifa partial name is entered Romexis will return all patients whose last name begins with that partial string In case you want to search patients by their first name replace the last name with the wild card Examples Doe John all patients with the last name Doe and first name John S all patients whose last name starts with the letter S omi all patients whose last name starts with Smi e g Smith and Smiley Van Cogh all patients with the last name Van Cogh Paul all patients whose first name is Paul Patients can also be searched by a captured image see section 1 12 Find Patient by Image on page 5 User s Manual Planmeca Romexis B 1 PATIENT SELECTION AND MANAGEMENT 1 2 Patient List Patients in the patient list can be sorted by ID name birth date age gender phone number the number of assigned providers and type for virtual and template patients by clicking the respective column title 13 Opening Patient Record After the patient search click the patient name in the patient list and click the Select button
30. the den tal unit control panel To restore the settings made and stored earlier click on the Restore Settings button After restoring the settings you can modify them and save the settings again to overwrite the settings stored earlier in the database Currently one set of stored instrument settings per user is available 1 2 2 Configuring Dental Unit Service Modes To change dental unit service modes with Planmeca Romexis go to the Unit Monitoring view of the desired unit and click on the wrench icon to enter service mode on the unit 9B When in service mode the current service mode is shown on the virtual unit control panel and the possible values are listed and described on the bottom right of the screen To change the value use the unit virtual control panel in the same way as when making changes at the actual unit To exit service mode either click on the wrench icon or Program on the virtual control panel NOTE Before accessing service mode on a unit remotely make sure that nobody is currently using or at the dental unit E 8 Planmeca Romexis User s Manual 1 3 CLINIC MODULE VIEWS Diagnostic Log The Diagnostic Log view enables efficient daily monitoring of the dental unit s events error and help messages as well as reviewing their event history Monitoring can be done remotely off site or on site when applicable Diagnostic Log enables the maintenance staff to have a timely and accurate understanding of the overal
31. the system simultaneously 1 5 1 Long Term Archive Long Term Archive LTA allows old images to be moved to a more permanent storage based on their age For more information on Romexis Long Term Archive feature please see Image Management under Romexis Configuration application Please note that Long Term Archive is not a backup system but appropriate backups should be maintained in addition to LTA media Disk Space Requirements for 2D Images The following gives approximate disk space requirements for different image formats Format Without compression With JPEG compression DIMAX2 3 normal resolution panoramic 5 0 MB 0 8 MB DIMAX2 3 normal resolution cephalometric 7 0 MB 0 95 MB DIMAX2 3 enhanced resolution panoramic 8 9 MB 1 1 MB DIMAX2 3 enhanced resolution cephalometric12 5 MB 1 9MB DIMAX2 3 high resolution panoramic 20 MB 2 2 MB Dixi2 3 BO normal resolution 560 kB 180 kB Dixi2 3 B1 normal resolution 940 kB 310 kB Dixi2 3 B2 normal resolution 1 3MB 430 kB Dixi2 BO high resolution 2 2 MB 720 kB Dixi2 3 B1 high resolution 3 8 MB 1 2MB Dixi2 3 B2 high resolution 5 2 MB 1 7 MB IMPORTANT SAFETY NOTICE JPEG conversion is a so called lossy compression the use of which can lead to loss of image detail and it cannot be guaranteed that the diagnostic value of the compressed image is equivalent to the original image While several studies see e g IADMFR CMI 97 Advances in Maxillofacial Imaging The loss of image quality in pano
32. to have marked ROI in ProModel or give a notice to Planmeca concerning the volume it can be written down in this field Reference is for order processing Appendix A 4 Planmeca Romexis User s manual User s manual PLACING PLANMECA PROMODEL ORDERS Price List button opens ProModel price list to your default web browser if your computer is not online clicking of Price List button gives the URL of the price list in your default web browser The prices in price list are recommended prices please contact your local Planmeca dealer for further price in formation Include nerves and Implants check box Tick the Include Nerves and Implants box if user has drawn mandibular nerve or placed implants in the patient s data in Romexis The colored nerve can be printed in ordered ProModel Implants will be included as cylinder representations Note In order to get the nerves showing in the ordered ProModel the ProModel order should be placed from Romexis 3D Module s Cross Section Implant tab Add Billing Address button will be enabled if user switches the tab from Same address for Delivery and Billing to Different Address for Delivery and Billing After switching user can push the Add Billing Address button and give billing address in case user has different delivery and billing addresses please see figure below Planmeca Romexis PLANMECA ProModel Billing Address Address Postcode State Country CANADA Re
33. to move ergodata 3 Start up Ergodata moved Client Parameters Romexis Service 3 Server Parameters Move successful restart Romexis Server Romeris Service is running Connected to server localhost The Data Folders settings sheet allows reconfiguration of the Romexis image and ergodata dental unit diagnostic data storage paths and optionally allows relocating all existing data to a new path Use the Set Path button to specify a new root folder for Romexis Data folders Eg if the root folder is specified as R Wwomexis data then romexis images romexis cache and romexis ergodata folders will be automatically created under it After the Romexis Server service is restarted all new images will be stored to the new location Use Move Data button to move all existing data files to the new location and update all database references to point to the moved files It is possible to change the path to point to a new location and have new files stored there while keeping existing files in the old location NOTE Romexis Server service must be restarted after changing the root path or moving images User s Manual Planmeca Romexis H 19 IMAGE 8 DATA MANAGEMENT Trash Reactivate and Empty Trash Patients or images which have been inactivated in Romexis can be seen by choosing the correct alternative in the drop down list By selecting patients or images from the list and clicking Reactivate the system restor
34. toolbar E 1 Adjust levels Gamma curve can be adjusted by moving the green line in the histogram The histogram can be cut from the ends by moving the red lines The levels can also be adjusted by moving the mouse vertically and horizontally on the image Input Values s Miu LR Overlay result histogram E Linear scale 247 Avg 2656 92 Max 3460 StdDev 424 36 A OK Cancel Use the small double arrow shown in the bottom left corner of the above screenshot to reveal the advanced options Use the up down arrows and the 7 7 button to scale the histogram to bring out details Enable Overlay result histogram to highlight the resulting histogram and Linear scale to draw the histogram in linear scale instead of the default logarithmic scale The Min Max Avg Average and StdDev standard deviation values show the corresponding grayscale values in the image or in the Region of Interest when one is active When pseudocolours are enabled this dialog is also used to select colours and to alter their balance To do so use the handles on the top of the dialog to adjust the colour balance Double click on a handle to change the colour for its range Click the small down arrow to apply preset colours Adjust brightness and contrast of the image Adjust sharpness of the image Adjusting can be done by using the sliders or by moving the mouse on top of the image Sharpen the image Sharpens the image according to the
35. typing browsing the desired location X Y from the Position and Size controls Position and Size Le Asos z 148 18 HHHK W 276 54 SH 1117 74 Image Borders Print Editor lets the user add borders to each image in the print layout The borders size can be changed typing browsing the desired border width W and height H from the Image Border controls The Image Border Fill Color can be changed by clicking BG color field and choosing the desired color The Image Border Edge Color can be changed by clicking the FG color field The borders can be rounded by typing browsing the desired radius R from the Image Border controls Image Border l EI W 3 00 zu 13 00 ac B6 rc Dg 3 00 ie gt lt gt Moving Images in the Layout The dragging of the images around the print layout can be eased by ticking the checkboxes Snap To Area Edges and Snap To Object Edges This way when the image is dragged around the print area it sticks to nearest edges and objects Snap To Area Edges Snap To Object Edges User s Manual Planmeca Romexis C 33 IMAGING MODULE Editing labels Image Labels The lower part of the vertical toolbar contains adjustments for image labels The labels can be hidden by unchecking the Show Labels checkbox Image labels can be added edited and deleted from the Contents table By clicking the Add button a new label row is created The label type can be selected from a
36. use to measure length over multiple points Draw the line by pressing the left mouse button down Release mouse button to finish C 16 Planmeca Homexis User s Manual IMAGING MODULE Line profile By clicking the Line Profile icon and drawing a line to the 2D image the user can view the gray scale profile of the respective line Min Max Average and Standard Deviation of the line profile are also available If the line profile gray scale values are very near to each other by ticking the Relative values checkbox the variations between these values are emhazised Input Values 7 Relative values Min 0 Avg Max 212 StdDev Show histogram By clicking the Show Histogram icon the histogram of the open image selected region of interest is shown A histogram is a graphical representation of the gray scale distribution in the image area By default the histogram is drawn in square root scale Linear scale can be enabled by ticking the Linear scale checkbox Max Average and Standard Deviation of the histogram data is also available Input Values Lt 54 4 Linear scale O Avg Max 255 StdDev Show measurements Show hide values User s Manual Planmeca Romexis C 17 IMAGING MODULE Draw Line Polyline T Draw line over single or multiple points Draw Line is a dual mode button hold down mouse button to call up mode selection between single line and polyline drawing left mouse button to define line rel
37. 0 Reset Page Size Orientation LANDSCAPE Page Size las Custom Page Width mm 210 00 Custom Page Height mm 297 00 OK Cancel Printing Images When you have defined the print settings in Print Setup click the Print button to start the printing al Exporting Images The print editor layout can be exported as a regular image to the hard disk Click the Export button to open the dialog window where the export resolution image format export folder and filename can be defined x Export Choose Export Resolution Screen Resolution 120 DPI Image Format jpg Print Resolution 300 DPI Folder C Documents and Settings wusenMy Documents Filename exported print OK Cancel C 30 Planmeca Romexis User s Manual IMAGING MODULE Browsing Images P To add more images to the layout click the Image Browser button The image browser opens to the lower part of the screen and let s you add images of the current patient to the print layout by double clicking on the desired image The image will be inserted into an image template slot for the respective image type if existing in the layout Adding Text Box Add Text Box button allows adding different free or itemized text lists into printouts The m following options are available e Add Free Text Box to Layout Add freely editable text box e Add Image Implant List to Layout Add an itemized l
38. 44mm User s Manual The Adjust tools can be applied on the slice views meaning the coronal sagittal and axial view and they enable the enhancement examination and measurement of the views Thickness Defines the displayed slice thickness of the slice views The resampling thickness can be adjusted from the drop down menu The option Bilinear applies a bilinear interpolation filter on the thinnest slice data resulting in a smoother but less detailed image Planmeca Romexis D 21 3D EXPLORER 2000 992 a Adjust contrast and brightness Regulates the contrast and brightness of the coronal sagittal and axial view By dragging the sliders the brightness and the contrast can be adjusted These settings are alternatively called Window and Level Select and Edit Object Toggle editing mode for annotations and measurements When active select an annotation or measurement to bring up handles that can be used to edit the control points of the selected item Export View To Other Tabs Exports the current displayed view of the slices to the Panoramic and Cross Sections tabs The processed slices are shown in the other tabs like in the Explorer Crop Volume for 3D Rendering Crop Volume for 3D Rendering crops the rendered volume lt is applied over the sliced views but affects only the 3D rendered volume view After pressing the Crop button move the mouse pointer over one sliced view Press the left mouse button and
39. 54 A Exposures 1 31 32 33 35 3 71 72 73 74 75 After all the images have been captured click Done 1 4 2 Capturing Panoramic Images NOTE To capture a panoramic image click the Im button to initiate panoramic image capture mode The Panoramic Exposure window appears When the X ray unit is in ready state a message Waiting for Ready appears on top of the window Prepare the patient for exposure and select the exposure parameters and drive the X ray to the ready position Refer to your Planmeca panoramic X ray unit s user s manual if uncertain When the panoramic unit is in ready position a message stating Waiting for Exposure appears on top of the window You can now expose the X ray as normal After the exposure a message stating Saving the image appears and the image is automatically stored into the database Click Done when the exposure has been taken to return to the Imaging module The L sign denotes the left side of the patient C 12 Planmeca Romexis User s Manual IMAGING MODULE 1 4 2 1 SmartPan Layer Panoramic Capture Panoramic Exposure User s Manual General The Planmeca Promax 3D can take both 3D and 2D images Available 2D imaging modes are panoramic bite wing and sinus exposure modes For the 2D images acquired with SmartPan only the pixel size 127um is available Image capturing Standard Pan including BiteWing ja Sinus modes CN To capture a panoramic image click this d bu
40. 7 I Sample 23 10 2007 C 28 Planmeca Romexis User s Manual IMAGING MODULE The Print Editor consists of the main toolbar located on the top and the vertical toolbar located on the right The main toolbar consists of buttons related to printing and viewing whereas the vertical toolbar consists of image specific adjustments related to the image size position and labels The vertical toolbar is image specific and is only showing when an image is selected MPlanmeca Romexis xi ee OgE e IN close CBCT 6 3 2008 18 52 19 Case Demo DOB ID 5353 Scale 100 PLANMECA Romexis Scale 100 a e PS 02 gt lt D o SansSerif Bold 12 m A il Sample 2245 Scale 100 j Text mGyxcm y Scale 6 3 2008 84 0kV 12 0mA PLANMECA Romexis Add Dei up Down User s Manual Planmeca Romexis C 29 IMAGING MODULE 1 8 1 Main Toolbar Page Setup In the Page Setup window the header and footer settings can be set visible and editable the page margins can be set and page size and orientation can be defined see section Editing header and footer on page 35 for more information Planmeca Romexis Page Setup Header Visible Footer Visible Margins Top Margin mm 10 00 Bottom Margin mm 10 00 Left Margin mm 10 00 Right Margin mm 10 00 E Editable Z Editable Height im 25 40 Reset Height mm 25 4
41. AL B 6 Chapter C 2D IMAGING MODULE T IMAGING MODULE Siiiccciccccicnsicctnewscectesecsseccsercesssdenrenavecnsicennncnavecehewsseese C 1 omg O C 1 Image Browsing and Viewing occcocccocccononnccnnaccnanonnncnnconanonanonanacorinarinanacaninons C 2 DICOM Media Storage DICOMDIR eese C 8 Mage ACQUISIION eee n C 11 image FOCCSSIN Orriols C 20 Mage Studies aut ia aia a S C 29 Moving Image to Another Patient occooccconcccncccnnccconcnnnncconcnnnncnnnnccnnancnncnenaness C 30 Inactvatiig Mage trabar lia artefactos C 30 Gopy Image to GlpDOSIU sosro e C 30 0 Printing Images 7 Print Edito usais C 30 UE ee inteeien M Rt C 38 ile 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 1 1 1 1 User s Manual Planmeca Romexis 1 TABLE OF CONTENTS 1 12 DICOM Storage amp Storage commitment optional occcoccccocnccncccconcnnos C 38 Chapter D 3D IMAGING MODULE T ono Bip D 2 Tal Opening a 3D VOUNGE urraca dcir D 2 1 2 Voume Opera lons asin a D 2 2 SOE AP CO REE smoro a i D 3 ZF SD Master Menu EOOl DAE arar iia acid D 4 e SD VOLMe VICWING td citas D 21 2 9 VOLUME AQUSIM NS ds D 22 3 3D PANORAMIC MODULE OPTIONAL D 28 3 1 Layer and Curve Slide Bar occccccnnccoccncccnnnconcnononnnnoncnononnnonnnnonnnnnnnnnnnnnnnnnnns D 29 e AS a e RE D 29 9 9 Panoramic OO esmine D 31 3 4 Adjusting Panoramic Ma
42. Desktop Planmeca Romexis Options for Sending Your ProModel Order Send Online Bum to CODWYD O Export to My Documents Accept ll Back For most of the fields a help text can be found making the order process as easy as possible for the user Appendix A 6 Planmeca Romexis User s manual APPENDIX B ROMEXIS VIEWER l GENERAL Romexis Viewer application can be distributed freely with images taken using Planmeca equipment Romexis is a convenient tool for sending images for referral allowing images to be easily accessed even in case the user does not have full Romexis software installed The features available in Romexis Viewer are the same with the Romexis installation used to export the viewer with some limitations Eg If the Romexis has been used to export the viewer with Implant module enabled then Implant module will also be available in the viewer except the saving feature In general the Viewer can be used to measure images while making new exposures however saving changes or measurements is not possible Also printing is more basic compared to the full version of Romexis software Romexis Viewer can open 2D files in DICOM format 3D files in DICOM MultiFrame and DICOMDir filesets 2 OPENING IMAGES User s manual Romexis Viewer is most commonly exported from Romexis accompanied with a DICOMDIr fileset of a patient s images In these cases the DICOMDir will reside in the same folder with Romexis Viewer and will
43. E 5 Resources E General La Person Lj security Lj Regional El 3 Imaging Lj Panoramic Lj Cephalometric Lj Intraoral 3 CBVT Lj Display Lj Dental Record E Communication Print gt Trash Management Lj Patients amp images 3 Start up Lj Client Parameters P Romexis Service E gt Server Parameters Lj server Lj Database show Help gt Login Username and Passward r pproval Username and Password Username and Password are required amp Username and Password are required O Username required Password is optional Username required Password is optional 5 Username is nat required O Username is not required Login only with Swipe Card Approval only with Swipe Card Password Maximum password age days O never expires lo Minimum password length lo Swipe Card Userid Swipe Card Password Track Mo in Swipe Card o Track Mo in Swipe Card n Start Column in Swipe Card lo Start Column in Swipe Card lo End Column in Swipe Card o End Column in Swipe Card o Lj External Communication Romexis Server is running The Login and Approval settings affect the information requested from users when logging into Romexis or when granting approvals This allows institutions to adjust the security measures in Romexis according to their local policies Login Username and Password Username and Password are required When loggi
44. Import single and multi frame e DICOM Export single and multi frame e DICOMDIR Media Storage DICOM functionality is described in chapters PATIENTS AND FILES MODULE 2D IMAGING MODULE and 3D IMAGING MODULE DICOM configuration is described in section 2 2 DICOM Configuration on page 10 in chapter ADMIN MODULE 1 11 Disclaimer IMPORTANT SAFETY NOTICE Note that Planmeca claims no responsibility for the end user s data security or for any malfunction in the computer system that may lead to data loss Since image processing and digital subtraction radiography can significantly alter the visibility of both large and small structures i e bone loss and caries which may result in either too many false positive or false negative findings Planmeca claims no responsibility for the software use actions or diagnoses made by the end user The qualities of the monitor can strongly affect the image quality The monitor qualities change when it gets older Never try first to correct under overexposure by taking a new image with new exposure values This should be done by adjusting the gamma and or contrast brightness to the right level If these adjustments do not help only then take a new image Cone beam computed tomography CBVT imaging is based on complex mathematical algorithms that produce high fidelity images however various sources may cause imaging artefacts that may lead to incorrect diagnoses if not properly inter
45. LANMECAIDXD00001 ReferencedSOPClassUIDInFile 1 2 840 10008 5 1 4 1 1 1 1 ReferencedSOPInstanceUlDinFile 2 16 840 1 113669 632 10 1 9 200 ReferencedTransferSyntaxUIDInFile 1 2 840 10008 1 2 1 Allow duplicate UIDs Y Prompt on existing patients 4 images selected Import Cancel First browse to and select the DICOMDIR file to be imported using the Browse button When an appropriate DICOMDIR file is selected a tree list with images and thumbnails is populated The tree list on the top left shows each patient in the DICOMDIR and their images in a hierarchical list When an image entry is selected in the tree list its DICOM tags will be displayed at the bottom and its thumbnail will be highlighted on the right To import images tick them in the tree list and deselect any unwanted patients and images After you have selected all desired images click mport to have new patients created when necessary based on the selection and the selected images imported to them If a patient with a same name as the one being imported is already found in the database Romexis will ask if you are sure you want to import the images to that patient instead of creating a new one Verify that the correct patient is in question before continuing All images that have an image UID Unique Identifier already in the database will be rejected unless you have enabled the Allow duplicate UIDs option at the bottom of the dialog 1 3 2 DICOMDIR
46. MAX2 3 high resolution 7 6 Ip mm 9 0 Ip mm 11 0 mode pan Transversal slicing mode DIXI2 3 normal resolution 38 um 13 2 Ip mm 13 2 Ip mm mode DIXI2 3 high resolution 19 um 26 3 Ip mm 26 3 Ip mm mode Table 2 3D volumes Voxel Voxel Calculated Exposure Imaging mode i size count resolution time High resolution 150x150 501x501 3 1 Ip mm 250 MB 21s x 150 um X isotropic 501 125 million Normal resolution 150x150 501x501 3 1 Ip mm 250 MB 15s x 150 um X isotropic 501 125 million Low dose 300x300 256x256 1 55 Ip mm 31 MB 15s x 300 um x 256 isotropic 16 8 million Large view 300x300 Variable 1 55 Ip mm Variable Variable stitched x 300 um isotropic Image sizes for dentition diameter 80 mm x height 80 mm for mandible or maxilla diameter 80 mm x height 50 mm for 3rd molar or molar implant diameter 40 mm x height 50 mm stitched volumes up to diameter 160 mm x height 110 mm A 2 Planmeca Romexis User s Manual 1 2 1 3 1 4 User s Manual INTRODUCTION TO PLANMECA ROMEXIS Image dynamics Each pixel in an image is represented by a numerical value in the computer memory Because of the numerical nonphysical nature of the image the brightness and contrast of the image can be altered and various image enhancement operations can be performed which are not normally possible with film images That is one of the main advantages of digital imaging but it is also necessary to understand this and k
47. Manual IMAGING 2 2 Cephalometric ai Planmeca Romexis Configuration 2 2 0 9 B 7 5 2009 PLANMECA General Settings E C3 Resources Lj General Lj Person Lj Security Lj Regional E 3 Imaging LJ Panoramic Resolution Image Format amp Normal TIFF Enhanced JPEG JPEG Quality bul Auto Enhancements Gamma correctian 1 0 0 15 1 00 Lj Cephalometric Sharpen Sharpening amount Lj Intraoral 3 CBVT Lj Display LJ Dental Record Despecle Lj PlanLink amp Diagnostics L Print oS Image amp Data Management Lj Data Folders Lj Trash Lj Long Term Archive gt Start up LJ Client Parameters LJ Romexis Service E 3 Server Parameters LJ Server P Database a External Communication Romexis Service is running Connected to server localhost User s Manual In the Cephalometric tab you can make adjustments to the image quality settings for the cephalometric images The Resolution and Image Format settings define how the images are stored in the database Autoenhancements include settings that affect the visualization of the images in Romexis Resolution Normal With normal resolution the pixel size is 0 132 mm Enhanced Enhanced resolution decreases the pixel size to 0 099 mm and improves the image quality Note the size of the image is much larger and the handling of the image is slower when the resolution of the image is higher Image Format The
48. Menu toolbar Toolbar on top including the common tools 2 3D Volume Viewing Main area of the Explorer with 3D volume viewports 3 Volume Adjustments Located on the right containing image processing tools specific to the Explorer module Mi Planmeca Romexis 2 0 0 7 B 9 10 2008 Helen Brown helen Licensed to Planmeca 8 x Close Patient ICase Demo X 2 aaa E m Uy X lw 2b PAE DP 6 3 2008 18 52 19 missing 35 45 y view Properties inactivate Ei 3 Thickness 10 11 6mm y volumes 1584 2496 IS Explorer E anoramic YP Implant P Ul Po a X o X oeus User s Manual Planmeca Romexis D 3 3D EXPLORER 2 1 3D Master Menu Toolbar NOTE The master menu toolbar contains buttons common to all 3D modules Functions available on this toolbar include 3D volume capture import printing measurement view management and others The functions are explained in the following in brief and references to sections providing more information are listed Buttons for Export saving a 2D view DICOM print and storage launch function and image properties are greyed out until a volume is opened daa A AA von Pees 773 aaa 3D Volume Acquisition Starts 3D exposure Only available in the Explorer module Refer to 3D Volume Acquisition for more information Artefact Removal Opens the Artefact Removal dialog for th
49. Mo o io Mo F 8 Planmeca Romexis User s Manual IMAGING Template Editor X In the Template Editor view double click the image slot to define the image type sensor orientation tooth numbers exposure order and placement in relation to other slots Planmeca Romexis image Type sensor Orientation Alignment X Panoramic 5 Align Left Cephalometric amp Center amp amp Center Intraoral Align Right Align Bottom E Photo ai CECT i 7 Void as 44 a3 42 41 31 32 33 34 33 a a g 85 84 83 82 81 74 72 fa T4 fa E a a NOTE The alignment X and Y are also used to position images into a print layout Appropriate alignment will allow images to be printed in larger scale with less whitespace in between User s Manual Planmeca Romexis F 9 IMAGING After you have defined all necessary information for all slots click OK and the new template is saved into the database Now the new template can be used in Romexis X ray module and in radiology approval process in the Clinical Record module 2 2 DICOM Configuration In order to configure DICOM destinations the following information is needed from the local network administrator e Network configuration information for Romexis workstation e Port numbers for DICOM configurations IP addresses AE title for workstation default AE title is ROMEXIS 1 NOTE If there are several Romexis workstations i
50. Nerve list Properties Delete Close 4 9 3D Rendered view See section 3D Rendering on page 23 User s Manual Planmeca Romexis D 39 IMPLANT MODULE 5 IMPLANT MODULE Romexis Implant module provides tools for planning an implant placement inside a 3D volume The Implant module extends the Cross Sections module and shares all features that it provides For information on common tools with Cross Sections module such as cross section panoramic and nerve adjustments refer to 4 3D CROSS SECTIONS MODULE OPTIONAL on page 32 Y r M A M X 3 Name olor Length mm Diameter mm Model ProductLine Manufacturer Left upper pre molar Tar 3 6 mdi mmm ft upper pre me ASNO Right lower molar Z 16 4444x16 0 Diameter 4 4 Default Romexis Implant module is designed to allow quick and effortless placement of implant models into the 3D volume with minimum number of mouse clicks A common workflow to place an implant model into a plan is as follows 1 Add implant model to the plan by using a default choice drawing to size or a specific model from library 2 Place the implant to the correct location and use control handles to orient it to match the patient s anatomy You can use all available views panoramic axial and cross sections for placement and orienting 3 You can change the size of the implant model from the Properties window or in the Implant Li
51. OCA E PLANMECA Romexis user s manual L 6Sr7LOOL TABLE OF CONTENTS Chapter A GENERAL 1 INTRODUCTION TO PLANMECA ROMEXIS A 1 1 1 Brief Introduction to Digital Imaging oocccoccccnccccncnconnconcncnncnnoncnnoncnnnancnnnonnns A 2 132 Securing the Image Dalai a e is A 3 tS AACOUISIION TREE a A 3 WA SOUS A PP uacwus bteaa ren vaath banatalue bongamtenraeceauaauunnons A 3 igo NP PIV AA E E A 4 a SINGS spices asec S UT A 5 LR MPa aa A 5 ko ARMA O LAU nasa A 5 jS EANO AA O A 5 TIO DICOM FUncloN ala RI TTE A 6 LIT DISC IM wm A 6 2 ROMEXIS MODULES ascsacarieiancann Ex aco ua ur e A 7 STARTUP cr A 8 Chapter B PATIENTS AND FILES MODULE 1 PATIENT SELECTION AND MANAGEMENT B 1 LE Patents Carchi A Ra B 1 G2 Palentina ci a B 2 13 Opening PatlentReco cscccstesscrrsecaidsdehn nt xiu eca uas cate eo e ei Leto aces B 2 pe Demodrapnios sti EET B 2 1 5 Adding and Editing Patients sicrete iiia ea a E Deana kE one B 3 120 Egdiling Fallen IMOMMAUOM a iio B 3 la ASSIONINO Palo MET t t Emm B 4 126 Pindiig ASsigmned Pallenis i5 tied oto b CAE a c B 4 1 9 Adding Template Pale oon hd eeu aste even eiu aset be cauto v dva de ento Ste ons B 4 1 10 Addirig vitua Patients xx dde ete au ut me vocet ds B 5 LAN WMVACUV ALINE ate ls eoo io oed ioa e tetusa dades iacob a B 5 Mates FN Paent by WIV dd B 5 2 DICOM QUERY RETRIEVE OPTION
52. Planmeca Romexis C 15 IMAGING MODULE modality specify tooth numbers and crop or reorient the image If disabled each scan is imported with default settings and modality is defined by the Default Image Type setting below Default Image Type Specifies the default modality for scanned images 1 4 5 2 TWAIN Auto Import Settings In some cases you need to configure TWAIN Auto Import Settings to allow you to have images automatically imported as part of the TWAIN capture However generally this is not required and you can safely ignore these settings 1 5 Image Processing 1 5 1 Vertical Toolbar Calibrate for measurement Click the icon draw the calibration line by holding the left mouse button down end the line with a right click and the calibration window appears dm Reference Length Length in pixels 378 Length in millimeters 40 Enter the length and click OK NOTE You should not use the calibration tool on CBVT snapshots as they are automatically calibrated Measure angle Click the icon draw the angle by pressing the left mouse button down Measure length Measure length over single or multiple points Measure Length is a dual mode button hold down mouse button to call up mode selection between Single measurement and polyline measurement Single measurement use to measure length between 2 points default Hold down left mouse button to define measurement release mouse button to finish Polyline measurement
53. QL Server LJ security Connect URL jdbc jtds sglserverilacalhastiramexis dbiinstance rornexis LJ Regional User ID romexis E 5 Imaging Panoramic Password romexis Cephalometric Active from 24h Clock HHMM 0 Intraoral L Intraora Active to 24h Clock HHMM 0 3 cBVT Display Poll interval min 1 LJ Dental Record Dc oM Communication ae Active from 24h Clock HHMM 0 rin ES Trash Management Active to 24h Clock HHMM lo LJ Patients amp images Poll interval min 1 gt Startup LJ Client Parameters Lj Romexis Service E Server Parameters LJ Server L3 Database LJ External Communication set Defaults Romexis Server is running Datagate External Patient Management System Romexis can connect to an external patient management system through datagate Datagate is a connection to the database from which Romexis polls for new external information e Active from Defines the starting hour of the day for the automatic datagate polling e Active to Defines the last hour of the day until which the datagate polling is on e Poll Interval min Defines the time interval between consecutive queries into the database H 28 Planmeca Romexis User s Manual SERVER PARAMETERS DICOM Romexis can be configured to use autostorage to send new DICOM images automatically to the external PACS image database Romexis polls for new DICOM images according to the Poll Interval from t
54. Settings To set up the display of the orientation overlays press the Show Hide Settings button In the Show Hide Settings window you can select the overlays to be shown Planmeca Romexis Show Hide Settings Rulers v Values Axial line Sagittal line Panoramic line Panoramic contour Close 3 2 5 Edit Annotations Use the Select and Edit Object tool to toggle editing mode for annotations and measurements When active select an annotation or measurement to bring up handles that can be used to edit the control points of the selected item User s Manual Planmeca Romexis D 29 3D PANORAMIC MODULE OPTIONAL 3 3 Panoramic tools With the Panoramic imaging tools the panoramic view can be defined and adjusted by drawing a curve to the axial view and choosing a range to be displayed amp Panoramic 2 3 3 1 Draw Panoramic Curve Romexis automatically places the panoramic curve To define a new curve click the Draw A Panoramic Curve icon Use the left mouse button to place points for the curve on the axial view When you are done click the right mouse button and the new panoramic view will be calculated NOTE All created panoramic curves will be saved and listed in the Select Panoramic Curve option Clicking the Delete Current Panoramic Curve icon deletes the panoramic curve currently displayed The standard curves are not deleted 3 3 3 Edit Panoramic Curve To edit the curve click the button
55. TIONAL 4 6 3 Show Hide Settings NOTE To set up the display of the orientation overlays press the Show Hide Settings button In the Show Hide Settings window you can select the overlays to be shown xj show Hide Settings Rules Values Axial line W Pancramic line Pancramic contour Cross section lines secondary crass section lines Pancrama referenced Ordinal cross section labels Merves Implants Mirror cross sections Cross sectional slice numbering can be changed between ordinal and panorama referenced 4 6 4 Editing Annotations 4 7 NOTE 4 7 1 Since the 3D volume cannot be moved or rotated in the Cross Sections module this has to be done in the Explorer or Panoramic modules editing annotations is possible by default when no other tool is selected Grab and drag the middle of the annotation to move the whole item or alternatively grab and draw the control points of the annotation to edit its shape Panoramic With the panoramic imaging tools the panoramic view can be defined and adjusted by drawing a curve to the axial view and choosing a range to be displayed Modifications to the panoramic curve in the Cross Sections Tab will effect the Panoramic Tab as they share the same curve and data range definition Panoramic Draw Panoramic Curve The panoramic curve is placed automatically by Romexis or taken over by the Panoramic Tab To define a new curve click the Draw Panorami
56. The reconstruction PC will start a recalculation of the 3D volume ignoring all those areas voxels above a certain grey level that have been flagged as undesired in step 3 by colouring them red Leaving the problematic areas out of the calculation will remove artefacts caused by amalgam or other metallic bodies from the recalculated volume Planmeca Romexis D 7 3D EXPLORER The bodies that caused artefacts will however still be visible To complete the process click Done Eliminate artefacts from captured image Artefact removal takes long time to execute several minutes to few Hours Connecting To Reconstruction PC Eliminating Artefacts Artefact threshold Automatically close this window when image is ready Cancel NOTE Move the threshold to the left until the amalgam or other metallic bodies appear red not further Too aggressive settings may affect dentin NOTE Multiple separate red areas will increase the calculation time Too many red areas can escalate the recalculation time and produce unwanted results Therefore the threshold must be defined individually for each volume NOTE Ifthe volume was taken with a Romexis version older than 1 4 you need to manually select the right frameset ID from the dialog Romexis asks the originally captured framesets from the reconstruction PC If the correct frameset is not on the reconstruction PC anymore it is not possible to proceed with the Artefact Removal 2 1 3 Stitching M
57. Thomas 2 8791 Potter Al t 0 3262 Hanseu vance 0 8470 Mitchel Fidela 0 4101 Mcmitlen Sung 0 6126 Eisenman Lorena 4141218990 26 Fer neck Thomas empia 2 2677 Glover Franiin 241972 34 Male 358 273 0256 neck Thomas virtual 1 8240 varrick Amee 0 7726 Roge janean 0 8504 Ostee vialton Mrs Curie Mar 1 4660 Siang Adrian 0 48392 Roby Bobbie 0 1686 Powell Ariel 0 4664 Nix ota Lani 0 8353 Hastings Dotty 2720 Hilgard Limo 0 5852 Thomas Carolin 0 8692 Line ANSON 0 1505 Byers Lawer 0 324764713 Katka Franz 14 2 1957 Ma 7823 36 connec 2 11 Pritcham Domin 0 0010 Schiller Friedr ohann Chrstopt 11 1950 Mz no Phor atime Schneck Thoma 2 2345 Stange lan Cook Alda 1 162478621784 Brecht Berthold 1451967 44 M 2625762 Schneck Thomas 2 0819 Eisenman Lorena 321984 23 Fema Schneck Thomas 1 436 Camp Blossom 1 8 1864 42 Malo X 3581502 347868 Schneck Thomas tual 2 3119 005 Jirny 0 6476734 Child Young 4219 4 Mae neck Thomas 1 2372623723 herder Johann Gomred 13 10 1964 42 Mae 1515454555 meck Thomas 2 1647 2542082 Lenz Jakob Michael Reinhold 1361949 57 Mae 4324324234 neck Thomas 1 User s Manual Planmeca Romexis B 5 DICOM QUERY RETRIEVE OPTIONAL 2 DICOM QUERY RETRIEVE optional DICOM Query Retrieve SCU Q R service is used for retrieving images from DICOM PACS servers Images can be first queried and then selected for retrieval to the local storage Once retrieved they can be processed independent of the remote server Use DICOM Sto
58. Thomas Schreck horas Friszm Man TEIG 7 Intra 2 3 2007 1520 Thomas Schneck thomas Frisch Man T8 T f Intra 2 3 2007 18 20 Thomas Schneck thomas Fisch Max TEM 7 intra 232007 125720 Thomas Schneck Ihomas Fiiach Maga TO 7 f intra 2 2 F007 10 35 Thomas Schmeck thomas Frisch Max Teig f Intra 2 3 2007 18528 Thomas Schneck thomas Frisch Max reag T f Intra 2 3 2007 18 27 Thorn s Schneck thomas Fiiach Ma Ta T Intra 2 3 2007 18 27 Thornas Schneck thomas Fisch Max TOM 7 f linia 2 3 2DOT 18 27 Thomas Schreck thomas Frisch Maz Teig a lintra 232007 1827 Thomas Schneck thomas Frisch Man Taag 7 1 Intra 232007 125727 Thomas Schneck thomas Fitch Max THM a Repon Summary AAA m ag Link Colina CAE Sum 43 ii Planmeca Romexis G 1 REPORT GENERATION 1 REPORT GENERATION Select one report mode from the drop down menu and press the Generate button selected Report Images Unapproved or Non Evaluated RepotResults Images Unapproved or Non Evaluated A Image Link Images By Capturer Ceph 2 3 2007 1Images By Date Ceph 2 3 2007 1Images By Date Range And Type Ceph 2 3 2007 User Events By Date Range Ceph 2 3 2007 TlLisar Events By Date Range And Type Intra 2 3 2007 13 3 amp 8 Notes Unapproved Intra 2 3 2007 1 Intra nin 4 Case Notes Unapproved By Student Perform your selection and click OK The selected report mode will be displayed 1 1 Image Link To view one of the listed images d
59. a Romexis 2 0 0 12 B 24 10 2008 Default Provider sysadm Licensed to Planmeca elx mada File Close Patient Marshall Nelly m Clinic Monitoring Unit Monitoring Diagnostic Log Patients Operatory 615 y Status WXPYBWP008209 testname User Default Provider Patient Marshall Nelly 10000 40000 200000 RPM Backrest angle 42 0 W amp H EA 50LT Brushless Micromotor Legrest angle 3 4 v inht ji Spray OFF Seat height 627 24 6 i HR Len 10 0 Hei 0 0 Ang 0 5 v Dry Mode OFF 1 100 na Sterile Water OFF Chip Blow AUTO OFF Fiber Light ON Ea ai Speed Power Limit OFF Reverse Rotation OFF Planmeca IntraCam Intraoral camera Satelec Ultrasonic scaler Bien Air MX Brushless Micromotor Syringe OFF ON Suction OFF 1 I I I I 1 i 1 I 27 10 2008 12 51 12 53 12 54 12 55 12 56 12 57 12 58 12 59 13 00 Bllw amp H Brushless Micromotor Satelec Scaler Showing 9 mins Z 1 00 E 28 1 MBien Air MX Brushless Micromotor The following metrics can be monitored e Chair position e Active instrument and power level when used e Instrument settings for all connected instruments Refer to the dental unit user s man ual on how to change the instrument settings e Suction and light use e Error description in plain language shown on the bottom right e Short history of den
60. a single DICOM image click the Open DICOM File icon gt on the toolbar Select Folder Containing Dicom Images CAtemp Browse Patient Name Date Time Filename Nelly Marshall 30 11 0002 0 00 marshall nelly cbvt dcm Nelly Marshall 19 8 2008 15 08 marshall nelly pan dcm Alternatively you can use the File menu option Open DICOM File Next browse to the DICOM file you wish to open in Romexis RomexisViewer will present you with a list of images found in the folder and require you to choose which image to open Please note that when a single DICOM image is opened any previously opened images will be closed To open a DICOMDir use Open DICONDir icon e on the toolbar Alternatively you can use the File menu option Open DICOMDir Next browse to the DICOMDir you wish to open and proceed with opening the DICOMDir as when starting the Romexis Viewer OK Cancel User s manual Planmeca Romexis Appendix B 3 Planmeca Oy Asentajankatu 6 00880 Helsinki Finland tel 358 20 7795 500 fax 358 20 7795 555 sales planmeca com www planmeca com PLANMECA Oy s PLANMECA Oy s Environmental Quality System Management System
61. able e PlanLink Agent Service must be running on each PC connected to a dental unit to record data during use The PlanLink Agent Service listens to activities on the dental unit and relays them to Planmeca Romexis Server for storage into database for later reference PlanLink Agent also manages saving and restoring of dental unit settings to and from the unit to database Therefore to ensure that a full log of use and hygiene procedures is collected it is important that the chairside PC is on and PlanLink Agent is running at all times when the dental unit is operated e Planmeca Romexis Clinic Module is a desktop application that is used to view data stored into Planmeca Romexis database When a dental unit is accessed in Planmeca Homexis Clinic Module a connection to the PlanLink Agent Service in the adjacent chairside PC is formed and any commands to the dental unit are relayed via the Plan Link Agent User s Manual Planmeca Romexis E 1 CLINIC MODULE VIEWS 1 CLINIC MODULE VIEWS The Planmeca Romexis Clinic Module user interface is divided into the views listed below explained in more detail in the following chapters Clinic Clinic monitoring offers a graphical overview of all connected devices at the clinic It allows you to quickly evaluate the utilization of each section of the clinic or to spot oper atories that require assistance Unit Unit monitoring allows real time view of the selected dental unit and it can be used to
62. able CD click OK to start the CD creation and writing process Resolution The desired resolution to be used for exporting DICOM files can be set here Bit Depth Select the volume bit depth 12 or 15 bits Include Nerves and Implants Export voxel representation of nerves and implants as cylinders present in the study Export Cropped Export cropped volume if cropping has been applied Anonymize Remove personal identification information from the export DICOM file 2 1 6 Saving 2D View Clicking the Save 2D View button 2D exports the current view from the screen and imports it automatically to the Romexis 2D Imaging Module see chapter 2D IMAGING MODULE where all the 2D image processing tools can be used xi Save 2D View Clickimages to select Color image Y Create single image OK Cancel D 14 Planmeca Homexis User s Manual 3D EXPLORER In the appearing window you can select one or more viewports by clicking on them To reselect click on the empty space of the viewport This selection enables you to choose specific images to the 2D Imaging Module There are 2 options for exporting 2D snapshots Color image if this option is checked an 8 bit color image will be created If the option is unchecked a 12 bit grayscale image is created Create single image if this option is checked one single image is created If this option is not checked single images from different views will be crea
63. ace CD Recording Device Device Bus opecify device bus where the CD Writer is located Change this only if the AUTOMATIC setting doesn t work Log CD burn Write a log of the CD writing process for troubleshooting purposes DICOM AE title for workstation and other workstation specific DICOM identifiers F 18 Planmeca Romexis User s Manual Chapter REPORT MODULE The Report Module enables to list several processes of Romexis as a report These reports contain direct links to images and patients as well as the possibility to print the report The Report Module offers three kinds of reports 1 Images by Date and Type 2 Images by Capturer 3 X ray log book Ml Planmec a Romexls 1 4 0 73 0 14 3 2007 Thomas Schrock diu G Es iMi User s Manual EEEE Report Images Uunapgreyed or N reEvaluased Fatah Open Link s Pr Report Results z z z image Link Prendas Usarnamae Patiari Nama Patent Ext ID Evaluation DAP 3 Copa 42007 15 13 Thomas Behneck eee Frisch Maa me OoOO m SSO M C ph 2 3 2007 1521 Thomas Schreck Is mias Fisch Maa El i jT Cph 2 3 7007 18 13 Tnarmas Schneck Mimis Fach Man 636 m dl Cepn 232007 16 70 Thomas Behneck thomas Fiisch Max HEL H Intra 2 3 2007 1327 Thomas Behneck tomis Goethe Johann E ELSE m pi n 232007 1327 Thomas Schneck m s Goethe Johann Waltgang TEA i T intr 2320071327 Tnarmas Schneck Mimis Goetha Acha
64. al images in the database When a new image is captured the Adjust Levels operation is automatically performed to the image with the Auto Enhancement group settings If the automatic adjustment is not satisfactory it can be undone by clicking the Undo button in the Imaging Module and the adjustments can be done manually in Romexis through the Adjust Levels function e Gamma Correction Adjusts the gamma curve of the image By adjusting the gamma value the image can be made to look more like a conventional x ray image e Sharpen The image can be sharpened with a specific filter and strength Low Medium or High e Despecle A specific filter can be used to remove noise from the image by selecting Despecle See sections 1 5 Archiving on page 4 and 1 6 Processing on page 5 in chapter GENERAL for information on image processing and archiving Planmeca Romexis H 11 IMAGING 2 4 CBVT MM Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis 3 General settings E 3 Resources LJ General LJ Person Lj security Lj Regional E E3 Imaging Lj Panoramic Default Settings Window 2000 Level 1000 Auto Enhancements Gamma correction 1 0 0 15 1 00 Auto Levels Min Pct 0 01 D Cephalometric Auto Levels Max Pct 96 0 01 Lj Intraoral CBVT LJ Display LJ Dental Record LJ Communication Print gt Trash Management LJ Patients amp images me start up
65. ality of the 3D rendered view but not 2D slices can be made e Low Low quality resolution with the lowest demand on hardware and low memory usage This setting is equal to Romexis 1 6 and previous versions Planmeca Romexis F 15 LOCAL SETTINGS NOTE e Normal Average resolution mode with modest memory requirements Dedicated graphics card recommended as graphic chips integrated on motherboard may degrade performance e High High resolution mode that demands a high end graphics card with a minimum of 256 memory on board Use Low Quality Preview When enabled previews of 2D and 3D views are shown in low quality when the views are manipulated Reconstruction Server The 3D reconstruction PC s Host Name and Port Number is defined here 2D Image Capture DIDAPI Enabled This setting requires Planmeca DIDAPI to be installed Image Reprocessing Enabled This setting enables Reprocessing of exposures in certain modalities Reprocessing allows easy exploration of different DIDAPI pre processing settings and is therefore well suited for identifying optimal settings during initial configuration of a X ray device A single exposure can be processed multiple times with different DIDAPI Configuration values applied and returned to Romexis each time as if it was a new exposure Starting from Romexis 2 0 R only panoramic exposures excluding tomographies and sinus mode can be reprocessed x DIDAPI ReProcessing DIDAPI ReProcessin
66. an search and select a patient to be added into the DICOMDIR Select a patient in the list and click OK to add it to the tree list You can repeat the Add Patient task to add multiple patients When patients are added into the DICOMDIR they will show in the tree list with all their studies and images in a hierarchical list You can browse the item DICOM tags and thumbnails by highlighting an item and referring to the bottom and right edges of the dialog Use the tick marks next to each item to include or exclude them from the final DICOMDIR file The Save Processed Image option at the bottom of the dialog allows you to export images with all image processing operations merged into the image as they have been defined in Romexis Save Annotations applies any annotations made in Romexis into the exported images Anonymize File s removes all patient information from the exported DICOM image s Export with Romexis Viewer option places a copy of Romexis viewer into the same folder with the DICOMDIR file set The contents of the export folder can then be written onto a CD using any 3rd party tools and handed to a customer or referrer Please note that it is possible to open DICOMDIR file sets in Romexis Viewer 2 0 version and later Planmeca Romexis C 9 IMAGING MODULE C 10 Burn DICOMDIR and Romexis Viewer to CD option allows you to write the DICOMDIR and a copy of the Romexis Viewer directly onto a CD Make sure you have an empty writable media
67. ant to recalculate the volume using the Artefact Removal Follow these steps to perform the removal 1 Use the sagittal or coronal view to align the axial view so that the whole teeth arch can be seen and the amount of amalgam visible is maximized in the axial view 2 Click the Remove Artefacts Pi button In the window that appears select the Artefact threshold by moving the slider The threshold can be set between O for pure black and 4096 for pure white amalgam for example ranges near value 4000 A decrease in the threshold value will remove more possible artefacts darker shades of grey and an increase will remove less In other words a decrease in threshold makes suspect areas more likely to be considered for removal Therefore decrease in value may also increase the processing time as more areas will need to be processed 3 Use the Artefact Threshold slider to set the grey level defines the threshold value above whose voxels will be considered as artefacts While you adjust the slider from right to left pay careful attention to the axial view you aligned in step 1 above Areas of amalgam which are normally bright white turn into red Keep moving the slider to the left until all presumed areas of amalgam have barely turned red and the dentin remains white or light grey 4 The Apply button starts the removal process Remember that the more voxels are being eliminated the more time it will take to process the 3D volume
68. arbage Collection Remove Service Service Control Start Service Set Defaults OK Cancel Romexis Service is a Windows program that starts Romexis Server every time Windows is started In this tab all settings for the Romexis Service can be configured Note Changes to these parameters take effect after you restart Romexis Service Romexis Service e Windows Service Name Defines the name of the Romexis Service in the Windows Services list e Executable Name Name of the wrapper executable to be used as Romexis Service e Startup Delay min Defines the Romexis Service Startup Delay in minutes Java VM Parameters These parameters affect the way Romexis Server is launched e JVM Path Defines the path to the Java Virtual Machine in use e Classpath Defines the files that the Virtual Machine uses e Main Class Defines the Main Class inside the RomexisServer jar H 24 Planmeca Romexis User s Manual START UP e Optional App Args Allows passing optional configuration parameters to Romexis Server normally specified in romexis_server properties e Optional JVM Args Allows passing optional configuration parameters to Romexis Server s Java Virtual Machine Normally specified in RomexisService ini e Max Heap Size Defines the maximum amount of memory which Romexis Server has in use e Aggressive Multi core Garbage Collection By selecting Aggressive Multi core Garbage Collection t
69. arpen Sharpening amount LJ Intraoral Despecle J CBVT LJ Display F Dental Record a communication Print 3 Trash Management LJ Patients amp images c start up F Client Parameters Lj Romexis Service E 3 Server Parameters LJ Server LJ Database Lj External Communication Romexis Server is running In the ntraoral tab you can make adjustments to the image quality settings for the intraoral images The Resolution Bits Per Pixel and Image Format settings define how the images are stored in the database H 10 Planmeca Homexis User s Manual NOTE User s Manual IMAGING Resolution Normal With normal resolution the pixel size is 0 038 mm High High resolution reduces the pixel size to 0 019 mm and is the mode for best resolution Note The size of the image is much larger and the handling of the image is slower when the resolution is higher Bits Per Pixel In the Bits Per Pixel group you can select whether the images are stored as 8 bit or 16 bit images The best dymaic contrast range is reached by using 16 bit per pixel but the images will be twice the size of 8 bit images Image Format The format in which the images are stored in the database The options are TIFF and JPEG JPEG Quality The JPEG Quality can be set to be Low Medium High or Maximum Auto Enhancements The Auto Enhancements group includes settings that affect the visualization of the images in Romexis They do not affect the origin
70. ate a virtual patient select the template patient from the patient list and click the Add virtual button lt may be a good idea to name each virtual patient so that the name also indicates the student name e Jane s Child Patient Virtual patients can be differentiated from other patients by entering Virtual in the Type column Inactivating Patients A patient can be removed from the patient list by clicking the nactivate button All patient information with images is however preserved Patient information can be reactivated or permanently deleted in the Romexis configuration application see chapter ROMEXIS CONFIGURATION APPLICATION Find Patient by Image Patients can also be searched by the image type date and image comments Define the search criteria and click the Find button The patients that match the search criteria appear in the list Open the patient by selecting the patient from the list and click the Select button e Patent De Kant immarue All Patents Y 109 I r GIC OM Workdist Find by image m image Typ nents fid Any Ld Panoramic z Sates Caphalometric Exposure Dato laa intraoral From 10 2 200 B Photo To 132007 CBCT Person ID Lasi Nam First Nerve Dale Of Birth Age Send Phe i Provider Tye Asug nts 527b Appleby Hoyt 0 6453 Do nkir Dar 0 1943 whitia Reid 0 4834 Basang Lao 0 144 said H 0 01 Kam immanuel 20 1 1901 46 wy neck Thomas 2 Freea 5 543 Weinganen Gall 1101875 31 Ms neck
71. brary 4 Verify margins and orientation and place next implant D 40 Planmeca Homexis User s Manual 9 1 User s Manual IMPLANT MODULE Implant tools Add default implant Use Add default implant tool to place a pre selected default implant into the plan The default implant can be defined in the mplant library Free draw placement Use the Free draw tool to draw an approximation of the implant s width and height using the patient s anatomy as a reference for sizing Then use Implant Library to search and select the nearest matching real implants from your library With this method you will get the correct length and diameter without first having to guess which size would provide the best fit Open implant library Use the Open Library to place implants directly from the Implant Library This allows you to first browse your selection of available implants and decide on the type before placing an implant into the plan After selecting the implant type press the Add button to add the selected implant into the plan You can then align the implant to match the patient s anatomy You can also use the mplant Library to add new implants into the library and modify existing designs See below for more information on the mplant Library Delete selected implant Use the Delete selected implantto remove the selected implant from the plan Properties for selected implant Use the Properties button to call up the Properties dialog sh
72. c Curve button Use the left mouse button to place points for the curve on the axial view When you are done click the right mouse button and the new panoramic view will be calculated D 36 Planmeca Romexis User s Manual 3D CROSS SECTIONS MODULE OPTIONAL NOTE All created panoramic curves will be saved and listed in the Select Panoramic Curve option Clicking the icon deletes the current displayed panoramic curve The standard curves are not deleted 4 7 3 Edit Panoramic Curve To edit the curve click the button and move single points in the curve or even the whole curve by grabbing the green line of the curve Change the position by dragging the points or the entire curve with the left mouse button To finish editing click the icon again Pressing this button shows a list of all saved panoramic curves All curves you draw are saved and named with the date and time they were created Click on an entry to recall and apply that curve User s Manual Planmeca Romexis D 37 3D CROSS SECTIONS MODULE OPTIONAL 4 8 Nerve Nerve The Nerve tools at the bottom right enable to add and modify nerve channels to the views 4 8 1 Draw Nerve To draw a new nerve channel click the Draw Nerve icon Use the left mouse button to place points either on the panoramic or on the cross sectional view for a curve depicting the nerve channel of the patient When you are done click the right mouse button and the nerve channel will be displaye
73. c X ray unit s user s manual if uncertain When the cephalostat unit is in the ready position a message stating Waiting for Exposure appears on top of the window You can now expose the X ray as normal After the exposure a message stating Saving the image appears and the image is automatically stored into the database Click Done when the exposure has been taken to return to the maging module 1 44 TWAIN TWAIN is a cross platform interface for acquiring images captured by scanners digital cameras or frame grabbers The manufacturer of the TWAIN device must provide a Source Manager and TWAIN Data source for your device to work with Romexis Romexis supports the current TWAIN 32 standard Refer to your device manufacturer s documentation for information on the availability of TWAIN_32 source modules C 14 Planmeca Romexis User s Manual IMAGING MODULE 1 4 5 TWAIN Capture e If you are using the TWAIN device for the first time check that you have the correct TWAIN source device selected by clicking the TWAIN Setup icon to bring up the TWAIN Settings dialog Then click the Select TWAIN Source button and choose the correct device from the list xi TWAIN Settings select TWAIN Source TWAIN Source Settings 7 Wait for TWAIN driver Close Prefer Memory Transfer Show TWAIN Launch Dialog Show Import Dialog Default Image Type Intraoral TWAIN Auto Import Settings InputDir o M EmorDir ll Au
74. cation associated with normal projection X ray imaging the measurements must be based on known reference objects in the image For this purpose a calibration tool is provided in the Romexis software When performing intensity measurements it should be noted that after certain image processing operations the relative intensities of the objects may be affected by their neighboring objects which may affect the reliability of e g bone density measurements with the help of a calibration step wedge The only image processing operations guaranteed NOT TO CHANGE the relative intensities so that measurements are independent of the measurement position are the brightness contrast and level adjustment operations No guarantee can be given between the intensity measurements of two different images 1 8 Annotation Images can be annotated with markers and text These annotations appear as an overlay on the image and can thus be turned on and off at will they do not affect the actual image 1 9 Printing Romexis supports DICOM compatible printers and Windows compatible printers User s Manual Planmeca Romexis A 5 INTRODUCTION TO PLANMECA ROMEXIS 1 10 DICOM Functionality Romexis supports following DICOM Digital Imaging and Communications in Medicine services e DICOM Storage SCU optional e DICOM Storage Commitment SCU optional e DICOM Query Retrieve SCU optional e DICOM Worklist SCU optional e DICOM Print SCU optional e DICOM
75. corresponding PC and dental unit pair into it Multiple floorplans can be used for multi floor multi clinic or other complex layouts by cre ating multiple floorplan files in PNG format on the server See the installation manual for more information 1 1 4 Centralized Planmeca Dental Unit Software Updates User s Manual The Update Firmware mode in the Clinic view control panel allows checking the software version installed on dental units as well as uploading new firmware to the selected units Use the _ button in the Clinic view s control panel to show the update options Update Firmware A list of all the connected dental units and their software versions is shown on the bottom of the screen Multiple units can be selected for upgrade by holding down the CTRL key while selecting units To choose the software to upgrade the selected units to use Find Files to browse to the MOT file that contains the new software To perform the upgrade click on Update Selected Units Planmeca Romexis E 5 CLINIC MODULE VIEWS 1 2 Device Monitoring Remote Control The Unit view allows real time monitoring of the selected dental unit and it can be used to monitor the user s activities or to review the dental unit s settings lt can also be used to store and restore the dental unit settings and in case of maintenance personnel to access dental unit service modes with full descriptions of each setting A Planmec
76. creen Image Format jpg amp Original images Folder C Documents and Settings usernMy Documents Filenamelexported_dicom Create patient and image information file Burm patient information to the export file OK Cancel Select the Processed images option to export the image s in 8 bit with all enhancements applied or select the Original images option to export original image s 8 or 16 bits depending on the original capturing mode If you are exporting multiple open images or a study you can either export the images as multiple files or as one single image all images merged into a single file by selecting the All images in one file option When exporting as multiple files a sequence number and file extension will be automatically added to the file name specified If you want to create a text file that includes image related information enable the option Create patient and image information file If you want to embed the image information directly on the exported image enable the option Burn patient information to the exported file Click OK to export the file s as specified 1 2 9 DICOM Import DICOM 3 0 format images can be imported using the DICOM Import function similar to gt other images See section 1 2 7 Importing Images on page 4 for more information on the import process 1 2 10 DICOM Import with Patient Data To import a DICOM image and to create a new patient from the infor
77. d as a coloured line in the panoramic view and as dots of the same colour in the cross sectional views 4 8 2 Delete Nerve This option deletes the currently selected nerve channel To select an existing nerve channel point the mouse on it and press the left mouse button or open the List of Nerves If no nerve channel is selected the action has no effect a Pf 4 8 3 Nerve Properties By clicking this icon the properties of a nerve channel can be adjusted A window opens where you can name the nerve and modify the colour and diameter To change the properties a nerve needs to be selected To select an existing nerve channel point the mouse on it and press the left mouse button or open the List of Nerves and select the nerve from the list Planmeca Romexis Nerve properties Mame Nerve Hid Diameter 00 72 mm D 38 Planmeca Romexis User s Manual 3D CROSS SECTIONS MODULE OPTIONAL 4 8 4 List of Nerves The option List of Nerves shows a listing of all nerves visible in the Cross Sectional tab In Ma the opening window nerves can be selected and deleted and their properties can be changed To delete a nerve deletes the nerve from both the list and the cross sectional tab select a nerve and click the Delete button To change the properties of a nerve select a nerve and click the Properties button The Nerve Properties window will appear for further information see Nerve Properties Planmeca Romexis
78. d rotation right mouse button When disabled the underlying volume can be moved and rotated similarily al Synchronise Sides T Enable Disable synchronisation of left PA line with right PA line When enabled the drawing of PA line length will automatically constrained to match the length of existing lines The length can still be adjusted using the view settings dialog which will then affect both PA lines simultaneously When disabled each PA line can be individually defined User s Manual Planmeca Romexis D 47 Chapter E CLINIC MODULE Planmeca Romexis Clinic module is an application that allows time stamped recording and real time monitoring and control of most technical and operator activities in Planmeca Compact dental unit The features available and the data gathered can be used for remote assistance service and maintenance support and preventive maintenance plan ning To be compatible with Planmeca Romexis Clinic module the Compact i dental unit must be PlanLink enabled and appropriate cabling to chairside PC is required The following fig ure illustrates the dental unit to PC connectivity See the installation manual for more infor mation on the requirements N ie RS232 Serial TCP IP Cable Planlink e Network T PCs Romexis Server RS232 Serial Chairside PC TCP IP Cable Planlink Lo e Each dental unit is connected to a chairside PC serial COM port with a Planmeca Planet c
79. del 2D View evels engih Angle aN iew jew ev Overlay Zoom Properties nag RDA 2 Sca mes Scale 1 22 Thickness J 1 3 a 14 20 mm y ZU a A Ls T gt 1584 2496 Z R f iu folu M Sis E Ye Ke L S SA y o x e Ca d K Panoramic Explorer Implant Scale 1 09 P en A Romexis TMJ module is designed to allow quick analysis of the TMJ area A common workflow to view termomandibular joints is as follows 1 Open the volume to be studied in Romexis Explorer module The volume can be a full head exposure a single TMJ or both TMJs stitched together with Romexis stitching feature The only requirement is that the TMJ region must be visible in the volume that is used Orient the volume in anterior posterior line so that the mandible is aligned correctly TMJ slices are perpendicular to the axial plane Also orient the left right line so that both condyles if visible are on the same axial plane 2 Use the Export View to Other Tabs button _ to apply the new orientation in other modules iu 3 Navigate to TMJ module User s Manual Planmeca Romexis D 45 TMJ MODULE 4 Verify alignment of the volume using the Axial view Use the slider on its right edge to bring condyles into view Draw right posterior anterior PA line using this tool 4 Start drawing by clicking on the middle of the condyle and then hold down the left mouse button
80. deleted from the template list User s Manual Planmeca Romexis C 31 IMAGING MODULE Zooming Print Layout QQ Adjusting images Right Click Menu The print layout can be zoomed in and out by using the Zoom In amp Zoom Out buttons The layout can also be fitted to view by clicking the Zoom to Fit button Clicking the right mouse button on top of an image opens a list of shortcuts to different layout related functions The image can be moved around the layout by dragging and resized from the image corners To remove the image from layout select Remove from layout on the right click menu Center Horizontally Center Vertically Scale Scale To Fit Send To Back Bring To Front Apply Crop Region Reset Crop Region Remove From Layout C 32 Planmeca Romexis User s Manual IMAGING MODULE 1 8 2 Vertical Toolbar The vertical toolbar is divided into two sections The upper section shows the name of the selected image and contains adjustments for image scale position size image borders as well as image behaviour when moved around the layout Image Size Image Position Image size can be changed by selecting different scale for the selected image Alternatively the size can be changed by typing browsing the desired image width W and height H from the Position and Size controls Scale 4 15 Image position on the layout can be changed by dragging the image around the layout Alternatively this can be done by
81. dmin module before the DICOM Storage service can be used see chapter ADMIN MODULE Open the image you want to store and click the dialog x DICOM Storage button Click OK in the opening AE Title MERGE_STORE_SCP L Calling AE Title ROMEXIS 1 Images can also be automatically stored to the DICOM archive after capturing see section DICOM Configuration in chapter ADMIN MODULE 2 1 10 Using Launch Button M A 3D image with patient information can be automatically transferred to a 3rd party application with the Launch button The 3rd party application path is defined in chapter ADMIN MODULE see section LOCAL SETTINGS Open the 3D image that you want to transfer and click the Launch button 2 1 11 View Operations User s Manual 3D volume Brightness Contrast and settings thickness and the position of the volume are automatically saved when the image is closed In addition the 3D Views tools can be applied to save the current displayed views Adjust Levels If the adjustment of the sliced views is not satisfactory the adjustments can be done manually by using the Adjust Levels window The gamma curve can be adjusted by moving the green line in the histogram The value can be seen and set in the box in the middle of the window The histogram can be also cut from both ends by moving the red lines which also affects the adjustment of Contrast and Brightness By pressing the arrows in the m
82. e 3D rendered view is disabled in image capturing workstations see chapter ADMIN MODULE The position in the volume can be freely adjusted by holding down the left mouse button and moving the mouse in the view All views are connected to each other which means that moving one view will affect the other views as well except for the rendered volume While moving the mouse in one view the two other views automatically move to the corresponding position The viewing angle can be rotated freely by holding down the right mouse button while moving the mouse When orienting the image you can recognize anterior posterior left and right anatomies by the A P L H letters respectively on the edges of the views These will automatically update to denote the nearest anatomy to the edge When moving the mouse cursor on top of the image a Hounsfield Unit HU value will be shown at the bottom right of the current view The value shown is an average value of 3 x 3 pixel area under the mouse cursor All views have orientation lines to provide a comprehensive view and the relation to each other This means that the view of the coronal plane e g is indicated with a green line in the sagittal plane axial plane and with a green auxiliary plane in the perspective view Likewise the sagittal and axial planes are indicated With the buttons of the Rendered Volume Auxiliaries it is possible to switch the auxiliary lines in the rendered volume on or off
83. e Long Term Archive LTA where the archived files should be placed and whether a maximum size for a single archive should be enforced eg 650 MB for CD Archives will be created as subfolders named ARCHIVE_1 ARCHIVE_2 etc under the Archive path If archive size exceeds the set maximum limit then any remaining images will be spanned into the next archive Every archived image is accompanied by an image information text file that will allow manually linking the images back to correct patients in a disaster scenario or to manually locate single images inside the archive H 20 Planmeca Romexis User s Manual IMAGE 8 DATA MANAGEMENT Archived images will have an archive thumbnail shown in Romexis client in place of the actual image thumbnail When the thumbnail is double clicked the user is presented with an option to browse to the correct archive with the Archive path provided as default Archive Images button will start the process of moving images from Romexis images folder to the Archive path Summary and progress information for the process is shown in the area below User s Manual Planmeca Romexis H 21 START UP 4 START UP 4 1 Client Parameters Fl Planmeca Romexis Configuration 2 2 0 15 8 5 25 09 PLANMECA Romexis General Settings E 3 Resources Connection ta Romexis Server Server Address 1 27 00 01 General Sever Port 1 099 Lj Security User ID LJ Regional
84. e SMTP Server host SMTP Server Port Defines the SMTP Server port Notification period mins Defines the delay in minutes after which an error is considered to be important enough to be reported in an e mail If an error is negated by itself or fixed by a user within this time limit then no error will be reported The error will still be shown in the dental unit event log Don t e mail for same error in mins Defines the time limit during which a persistent error will not be reported again Planmeca Romexis H 17 IMAGING 2 8 Print 9 Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis gt General Settings LIpndating Print Logo Files a i Client Loga Logo1 PNG wadata General xK o o F T Romexis Logo Logos PNG Update Security Footer Logo ngo3 PNG Update Lj Regional E gt Imaging O Panoramic Show Client Lago Cephalometric Show Romexis Logo 7 Intraoral Show Footer Logo 3 CBVT Lj Display Lj Dental Record Lj Communication Print 5 Trash Management a Patients images 5 Startup Lj Client Parameters Lj Romexis Service El Server Parameters F Server Lj Database P External Communication Show Logos in Printouts Romexis Server is running Updating Print Logo Files e Client Logo is shown in the top left corner of the printed paper e Romexis Logo is shown in the top right corner of the printed paper By default it is the Planmeca Romexis logo e Fo
85. e currently open volume Only available in the Explorer module Refer to Artefact Removal 5 Volume Stitching Opens the dialog for stitching together multiple adjacent 3D volumes Only available in the Explorer module Refer to Stitching Multiple Volumes Import Romexis native REC file DICOM multi frame and DICOM single file frame set respectively Refer to Importing 3D Images E Export Opens the Export dialog that allows selecting the export format and other options before exporting Refer to Exporting 3D Images Print Windows print and DICOM print respectively Opens the Print Editor dialog that allows the selection of views to be printed and other print options Refer to Windows Printing Print Editor and DICOM Printing Print Editor DICOM Storage Send open volume to DICOM storage requires full DICOM license Refer to DICOM Storage Launch Executes a user definable third party software with the currently open 3D volume Refer to Using Launch Button ProModel Order button Opens the integrated order form for ProModel For more information see Appendix D 4 Planmeca Romexis User s Manual 3D EXPLORER Save 2D View Save a copy of the selected view into the 2D Imaging module Refer to Saving 2D View 4 d r 7 Zoom Mode Toggles zoom operation of the mouse wheel on off Refer to Save Current View Measure length and angle m P respectively Refer to Save Curr
86. e the Cross Sections tab will be replaced by an Implant tab All features described below for Cross Sections will be available under the Implant tab See 5 IMPLANT MODULE on page 40 In the 3D Cross Sections Module cross sectional slices axia slices and panoramic images can be created from the 3D data The Cross Sections tab contains four views Axial views Panoramic view Cross sectional slices view 3D rendered view JE F i Pe e am el mexis 2 0 0 7 B 9 10 2008 Helianna Puhlin helianna Licensed to Planmeca ET a x Panoramic Explorer Volumes Implant Close Patient ICase Demo X RRA a Aa EXPE E448 16 3 2 2008 18 52 19 missing 35 45 v ih View Properties inactivate E 2 Y 3 scale Z a m U is y A g B The views can be expanded by clicking the small dual arrows in the ends of the view dividers or maximized by clicking the Maximize button D 32 Planmeca Romexis User s Manual 4 0 1 NOTE 4 1 4 2 User s Manual 3D CROSS SECTIONS MODULE OPTIONAL Adjusting slices in cross sections views Clicking the button in the upper right corner of the cross sections view opens a dialog where the number of cross sectional slices the distance between them the width of them and the thickness of the slices can be defined The 3D Panoramic Module and 3D Cross Section Module share the same panoramic cu
87. ease the button to finish 2 Draw single line use to draw line between 2 points default Hold down C4 7 Draw polyline use to draw line over multiple points Draw the line by pressing the left mouse button down and release the button to finish T rr Draw a horizontal line rr Draw a vertical line Draw an arrow Draw rectangle Draw an ellipse E E E E Draw text Click the icon and point with the mouse where you want to add the text Type the text to the opening window and click OK To edit the text later select the text with the Select annotations button see below and then double click the text Edit the text and click OK Select move edit annotations Click the icon and and take the mouse cross inside the arrow to the top of the graphics To move a graphic select and drag it to a new position This tool can also be used to edit annotations by moving their control points C 18 Planmeca Romexis User s Manual IMAGING MODULE Delete selected annotations or measurements Show annotations Shows and hides annotations Even if the annotations are hidden they are still stored with the image Select annotations When an annotation line arrow circle rectangle curve is selected its color and line width can be adjusted Use the Select Annotation tool to activate the annotation you want to edit When an annotation is active you can modify it using the Color and Width settings shown in the Image T
88. ected View In Device Monitoring View In Device Summary 1 1 2 Searching Clinic To perform a search at the clinic click on the Search button in the control panel at the bottom of the Clinic view Select the search criterion from the Search by drop down list and use the Name drop down list to select the exact item The matching operatory will be highlighted Planmeca Romexis Clinic Edition I X Search Search by Dental Unit El Mame Dental Unit OK Cancel E 4 Planmeca Homexis User s Manual CLINIC MODULE VIEWS 1 1 3 Configuring Clinic Layout To configure the clinic go to Clinic view and click Configure Layout in the control panel at the bottom of the screen When in configuration mode each operatory is shown as a black rectangle that can contain a PC and a dental unit The control panel contains items for new operatories and lists of available chairside PCs and dental units A PC or a dental unit becomes available in the list after it has first con nected to the server If a PC or a dental unit is not available in the list please verify that it can be connected and has been connected to Planmeca Romexis Clinic Edition Server Use the Create Operatory items to drag and drop operatories of desired orientation into the layout After placing each operatory you can name them to match for example the names used for the actual operatories at the clinic After placing an operatory you can drag and drop the
89. editable in the contents table of the vertical toolbar User s Manual Planmeca Romexis C 35 IMAGING MODULE 1 9 DICOM Print optional In case a DICOM Print license is purchased and installed images can be printed with DICOM compatible printers DICOM Print needs to be configured in the Admin module before the DICOM printer can be used see chapter ADMIN MODULE m Planmeca Romexis Se Wm al ning 5 0 0 Marshall Nelly CBCT 2 9 2008 16 24 48 Scale 4 00 Y Position and Size X 197 11 285 90 We 104 64 SH 139 68 KP K I Image Border NIS We 0 00 zi 10 00 eol re I R 000 Snap To Area Edges Snap To Object Edges Labels Show Labels Relative Position KB 1 waa 2 a l0 NET ed Set For All Labels Font SansSerif Bold 18 BG FG Opacity Contents Text Img Exp mA mA Img Exp Time S Img Exp DAP mGyxcm Free Text Scale Img Scale 96 96 Img Comment Add Dal Up Down 1 10 DICOM Storage amp Storage commitment optional In case a DICOM Full license is purchased and installed images can be sent to a remote DICOM application i e DICOM image archive PACS DICOM Storage needs to be configured in the Admin module before the DICOM storage can be used see chapter ADMIN MODULE Open the image you want to store and click the dialog xj DICOM Storage button Click OK in the opening AE Title MERGE STORE SCP Calling AE T
90. eep it in mind when using manipulated images for diagnosis The numerical nature of the image also sets an upper limit to the detectability of contrast differences differences in radio translucency in digital images This contrast resolution is expressed in terms of number of bits used in capturing and storing the image or in number of gray levels that the system can record See below for values of Planmeca equipment Device Number of bits Gray levels DIMAX all modes 12 4096 Promax 3D all modes 12 15 bit raw processing 4096 Note that although most computer screens can display only 256 8 bit or less gray levels and although it has been shown that the human eye can barely differentiate contrast differences in the order of 1 32 1 64 5 6 bits the human eye automatically adapts to the lightning conditions and this together with proper use of the light box makes it possible to detect smaller variations in film contrast Thus it is necessary to capture and record images at higher contrast resolution than 256 grey levels 8 bits More contrast latitude also allows more variations in exposure factors kV mA IMPORTANT SAFETY NOTICE Image processing can significantly alter the visibility of both large and small structures i e bone loss and caries which may result in either too many false positive or false negative findings if care is not taken Securing the Image Data Romexis uses database system for storing patient data and image
91. efault Orientation Restores the original orientation and settings of the views Zoom Mode When the Zoom Mode button is activated the sliced views can be scaled up and down Move the mouse pointer over the desired view and turn the mouse wheel into the appropriate direction up to zoom in down to zoom out D 18 Planmeca Homexis User s Manual 2 1 12 3D Image Properties 3D EXPLORER Click the Properties button to view Image properties or add an image comment Planmeca Romexis Image Properties File Info Width Height Murnber of Frames Pixel Size um Comments Ray Parameters serial Number Voltage kv Current m Exposure Time ts DAP motera 2 1 13 Deleting a 3D Volume DICOM Status Storage Status Date Time Destination A 3D volume can be deleted with the nactivate button The volume moves to trash and can be deleted permanently or reactivated in the Romexis Configuration Application see chapter ROMEXIS CONFIGURATION APPLICATION NOTE Deleting can be restricted with user rights See section Groups Tab Sheet in chapter ADMIN MODULE User s Manual Planmeca Romexis D 19 3D EXPLORER 2 2 3D Volume Viewing The 3D volume is displayed simultaneously in four different views Sagittal red Coronal green Axial blue and 3D rendered view The red blue and green lines across the views indicate the slicing planes in the views NOTE It is recommended that th
92. efault Provider sysadm Licensed to Planmeca ee File Close Patient Marshall Nelly Clinic Monitoring Unit Monitoring Y Diagnostic Log This is a sample clinic floorplan You can add your own plan by modifying the floorplani png file as instructed in the installation manual Search Units connected 1 1 Bl Romexis USER LOGGED IN Q Dental unit OK Dental Unit USAGE ALERT E Users logged in 171 D Romexis PATIENT SELECTED Q Dental Unit No CONNECTION Dental Unit ERROR _ Patients selected 1 1 Bl Romexis NO CONNECTION User s Manual Planmeca Romexis E 3 CLINIC MODULE VIEWS 1 1 1 Operatories Operatories represent rooms or work areas and they can contain a chairside PC squares in the layout and dental units circles in the layout It is important to match each chairside PC with its respective dental unit in an operatory as this specifies the link between them and enables logging of the dental unit s events The following information can be called up in a tool tip by holding the mouse over an oper atory e Name of the operatory e Name of the device and its current status e Name of the current provider logged in on the chairside PC e An alert or an error code message if present Operatory 01 Dental Unit testname OK Provider Provider Default USER LOGGED IN Right clicking on an operatory calls up a context menu that allows quick access to other views with the operatory automatically sel
93. enSrahor 3322007 14 04 Read Onh 100 x Provider Thomas Schneck Patent Hame Ci Erf Evaluation Image 1281150 Pir Imagi Hed image Open Copy Ecl Layoul 2 1 Previous Next Image By pressing the ext Image button the next image according to the report list will be opened The ore ima button opens likewise the previous image in the report list 2 2 Open Copy The pen Copy button opens an exact copy of the current image for further processing User s Manual Planmeca Romexis G 3 IMAGE VIEW 2 3 Set Layout The Set Layout button allows to choose a new temporary arrangement of the opened images Choose Layout Custom Custom r lo n n lo lo lo lo n f G 4 Planmeca Romexis User s Manual Chapter H ROMEXIS CONFIGURATION APPLICATION The Romexis configuration application is a separate application for global setting The Romexis configuration application can only be entered by users with Administrator rights Show Help gt Use the Show Help button to display an interactive help window that explains the options show Help gt under each item 1 GENERAL SETTINGS 1 1 Resources 1 1 1 General Im Planmeca Romexis Configuration 2 0 0 8 B 13 10 2008 PLANMECA Romexis gt General Settings Client Instance E gt Resources Show Instance Name in Client s title bar Lj General Show Username in client s title bar Lj Person E Allow more than one clie
94. ent View Adjust Levels Opens the viewport histogram adjustment dialog Refer to Save Current View Show hide Orientation Lines Toggles the visibility of orientation lines in the view as specified in Volume Adjustments Refer to Show Hide Settings sim E WD View Operations Em ms E Use these buttons to save recall from list delete or reset views Refer to Save Current View 31122007 16 08 41 view View 3D Volume Use this drop down menu and the View button to select and view 3D volumes of the current patient Refer to Importing 3D Images 3D Image Properties View and edit image properties Refer to A histogram is a graphic representation of the intensity distribution in the volume Inactivate Inactivates the currently open 3D volume Refer to A histogram is a graphic representation of the intensity distribution in the volume User s Manual Planmeca Romexis D 5 3D EXPLORER 2 1 1 3D Volume Acquisition Start the image capturing with the 3D Volume Acquisition ip button The image acquisition window appears NOTE See also ProMax 3D Dimax3 user s manual NOTE Do not perform any other operations during the 3D exposure Capture 3D Image Connecting To ProMax Press Ready at ProMax Initializing Vaiting For Ready laiting For The Exposure starts Automatically close this window when image is ready Two test images can be taken before the complete 3D volume ca
95. er Menu Toolbar with Planmeca ProModel Order Appendix A 2 4 1 Overview of Planmeca ProModel Order Form Appendix A 4 APPENDIX B ROMEXIS VIEWER APPENDIX B 1 1 GENERAL aS APPENDIX B 1 2 OPENING IMAGES 0ccoccoccconccconconncnnncnnnnonncnnnrnnnrnanenanenaneons APPENDIX B 1 3 VIEWING 3D IMAGES eere ee nenne APPENDIX B 3 4 OPENING ADDITIONAL IMAGES APPENDIX B 3 The manufacturer assembler and importer are responsible for the safety reliability and performance of the unit only if installation calibration modification and repairs are carried out by qualified authorized personnel electrical installations are carried out according to the appropriate requirements such as IEC364 equipment is used according to the operating instructions Planmeca pursues a policy of continual product development Although every effort is made to produce up to date product documentation this publication should not be regarded as an infallible guide to current specifications We reserve the right to make changes without prior notice COPYRIGHT PLANMECA 2009 06 PUBLICATION PART NUMBER 10014593 Revision 7 4 Planmeca Romexis User s Manual Chapter nu GENERAL 1 INTRODUCTION TO PLANMECA ROMEXIS This manual describes how to use the Planmeca Romexis imaging software which is devel
96. er sorted with checkboxes for type or by radio buttons for capturing date 6 All Dates 3 18 5 2008 3 10 5 2005 Clicking the intraoral image thumbnail opens the topmost image Clicking on a tooth number opens all intraoral images of that tooth in the bigger preview on the left Intraoral images which have no tooth number defined are located in the Other IO category C 2 Planmeca Homexis User s Manual IMAGING MODULE 1 2 2 Opening an Image Images can be opened directly by double clicking on them in the image browser or by SENSE selecting them in the image browser and then clicking the View Selected button Images can be closed by clicking the x icon in the image s horizontal toolbar 1 2 3 Opening a Study A study is a collection of related images of one patient Studies can be viewed with the Study tab A list of existing studies appears and by clicking the name of a study it is previewed in the image navigator To open an image from the study for adjustment etc select the desired image in the preview and click the View Selected button To view all images in the study click the View Study button See section 1 6 Image Studies on page 25 for more information on how to work with studies in Romexis 14 11 2006 FMXxX 18 r 6 2006 Bitewing Temple 7 6 2006 FMx 18 E a E m o View S
97. es the selected items to Romexis By selecting patients or images from the list and clicking Empty Trash the selected items will be erased permanently Long Term Archive Long Term Archive LTA allows old images to be moved to a more permanent storage based on their age Long Term Archive is not a backup system but appropriate backups should be maintained in addition to LTA media Planmeca Romenis Configuration 7 0 0 12 B 24 10 2008 PLANMECA Romexis gt General Settings E gt Resources Lj General LJ Person LJ Security LJ Regional E 9 Imaging LJ Panorarnic Lj Cephalometric LJ Intraaral J CBVT LJ Display LJ Dental Record Lj PlanLink amp Diagnostics 3 Print E Image amp Data Management LJ Trash Long Term Archive E gt Start up LJ Client Parameters LJ Romexis Service E E3 Server Parameters LJ Server LJ Database LJ External Communication Show Help Create Long Term Archive Archive images taken before 007 Year YYY 1 O Month MM Archive path D FRamexisVz 0 0 127 BYadmin Limit single archive sizeto 550 Mb Archive Images Cancel Pragress Archived images5 Creating archives 1 which contain images 5 Starting to archive images Created archive id 2 which contain images 5 Archiving completed successfully Romexis Service is running Connected to server localhost Creating Long Term Archive These settings specify which images are to be placed in th
98. ference Cancel Add Dealer Information button opens a new window in which user s local Planmeca dealer information can be given Dealer information is required for billing purposes this infor mation is filled by your local Planmeca dealer and it needs to be given once Please see figure Planmeca Romexis PLANMECA PreModea Dealer Contact Info Company Contact Person Address NAAA Postcode city State Country CANADA age Reference Accept Cancel Planmeca Romexis Appendix A 5 PLACING PLANMECA PROMODEL ORDERS e Payments of the ProModels by default via bill from your local Planmeca dealer other option is COD by UPS or Exchange Col lect by UPS Check the availability of the UPS payment service in your country on www ups com e Terms and Conditions can be found by clicking the hyper link in the terms and conditions section By selecting this box agree to these Terms and Conditions tab user must select the box to place one Planmeca ProModel order e Save this order form as a template button By saving the order form as a template user do not need to refill all the required fields every time when placing Planmeca ProModel order e After all mandatory fields are filled the Continue button will be enabled Clicking the button opens the last window where user can select the appropriate ordering type The ordering options include o Online order o Burn ProModel Order on CD o Export ProModel Order to
99. format in which the images are stored in the database The options are TIFF and JPEG JPEG Quality The JPEG Quality can be set to be Low Medium High or Maximum Planmeca Romexis H 9 IMAGING Auto Enhancements The Auto Enhancements group includes settings that affect the visualization of the images in Romexis They do not affect the original images in the database When a new image is captured the Adjust Levels operation is automatically performed to the image with the Auto Enhancement group settings lf the automatic adjustment is not satisfactory it can be undone by clicking the Undo button in the Imaging Module and the adjustments can be done manually in Romexis through the Adjust Levels function e Gamma Correction Adjusts the gamma curve of the image By adjusting the gamma value the image can be made to look more like a conventional x ray image e Sharpen The image can be sharpened with a specific filter and strength Low Medium or High e Despecle A specific filter can be used to remove noise from the image by selecting Despecle 2 3 Intraoral Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis General Settings Resolution Bits Per Pixel Image Format El E39 Resources Normal 16 TIFF General High SE O JPEG Person JPEG Quality a security T Regional Auta Enhancements E 3 Imaging n Gamma correction 1 0 0 15 0 60 Lj Panoramic Lj Cephalometric sh
100. g has been turned OM Please choose one ofthe options below RePracess Latest Image Choose Image to ReProcess Launch DIDAPI Config Turn ReProcessing OFF Only TIFF images can be reprocessed Please set Image Type to TIFF in Romexis Configuration application before using Image Reprocessing see paragraph 2 IMAGING on page H 7 When Image Reprocessing is enabled and panoramic exposure is started the above dialog is shown The following choices are available e ReProcess Latest Image Returns the most recent real exposure as a new image with current DIDAPI configuration applied e Choose Image to ReProcess Select an existing image in Romexis for Reprocessing apply current DIDAPI configuration on it and return the result as a new image e Launch DIDAPI Config Launches DIDAPI Configuration tool for changing DIDAPI preprocessing settings e Turn ReProcessing OFF Turns OFF the Image Reprocessing Enabled setting in Admin Local Settings F 16 Planmeca Romexis User s Manual Update Application definition X Path l CAProgram FilesiMaterialisevsimPlant Pra 11 0YSimPlant Pro exe Name 8imPlant Pro Command Line AN Add Item NOTE User s Manual LOCAL SETTINGS Heprocessing is usually used as follows 1 Check DIDAPI Configuration that preprocessing settings are 2 Expose an image of a patient or a test target 3 Enable Image Reprocessing in Admin Local Settings 4 Evaluate image a
101. ges eaen a a Ea e ee alae D 32 3 5 3D Rendered view adjustment ccooccoccccnconcconconcconinnnnononnconncnncnononnnnanenanonns D 32 4 3DCROSS SECTIONS MODULE OPTIONAL D 33 4T Adjusting a Mal SIICG Suso LT D 35 4 2 Adjusting panoramic slices coocccoccccccociccncoconanonconancnnononcnnonnnnnnnnnoncnnarennnnons D 35 4 3 Cross Sectional Slide Bar eese see desee cures a rains D 35 O MEE E T E D 36 AS A TO EUN D 37 A a suas ce mbaydecustal bin bo mpsueonr Geass D 39 4 7 3D Rendered VIEW Tm D 40 5 IMPLANT MODULE cunas D 41 Sel joies me rcp D 42 0 IMJMODULE esi iod inp opes ias bn exu de nera Ea D 46 ON MEE US Neo Ap HN D 47 Chapter E CLINIC MODULE T LINIC MODULE VIEW Siurana damian E 2 EY oOlnic MODIEOHEIG rra ass E 3 1 2 Device Monitoring Remote Control ooccooccncoccnccnccnccncnnoncnncnncnonnnnnnnonnnnoncnonanenoss E 6 E la Sic LOO cC Er E 8 1 4 Device Summa asic etc clado E 9 lor MEO NG ccc Cp E 12 Chapter F ADMIN MODULE 1 RESOURCE oa F 1 11I Groups TaD SNEG RR F 1 t2 Users Tap Smeel NOT ito iio F 4 WSs SA A E A F 5 2 Planmeca Romexis User s Manual TABLE OF CONTENTS 2 coca F 8 MESI uoti F 8 2 2 DICOM GoOnDIQuiatloli sssusa F 10 3 LEOCALSETIINGS 55 2 2 5 ct ia F 15 Chapter G REPORT MODULE 1 REPORT GENERATION cunas G 2 RM a 9 ERE RR UTE I UT E G 2 Ms Wr ele A CEDENS G 2 A doticnienimi teg etse aol aoa Geeta hacia
102. he 3D module can be accessed See chapter PATIENTS AND FILES MODULE A volume must be opened in the Explorer tab to use the Panoramic Cross sections or TMJ tab Planmeca Romexis D 1 3D VOLUMES 1 3D VOLUMES 1 1 Opening a 3D volume In the volumes tab patient s 3D volumes are listed and axial view thumbnail is displayed Thumbnail s axial slices can be scrolled with arrow or mouse wheel To open a 3D volume select the volume and click the View button or double click the volume line A Planmeca Romexis 2 0 0 7 B 9 10 2008 Helen Brown helen Licensed to Planmeca PLANMEGA File ir AA Exposure Date Image Size Pixel Size um Serial Number DAP mGyxcm la x Close Patient Case Demo Comments Volumes 31 3 2008 20 20 463 x 463 x 448 6 suuntaus 6 3 2008 18 52 501 x 501 x 501 160 Implant Panoramic Explorer missing 35 45 1 2 Volume Operations 1 2 1 Move Volume to Other Patient Right click on a volume in the Volumes list and choose Move to Other Patient then choose patient to move the volume to D 2 Planmeca Romexis User s Manual 3D EXPLORER 2 3D EXPLORER In the Romexis 3D Explorer the 3D volume can be captured existing volumes can be opened and adjusted as well as viewed in three different directions Images can be printed exported and sent to the DICOM archive in case the DICOM license is used The Explorer is divided into three different parts 1
103. he Romexis database e DICOM Polling Engabled Defines whether polling and automatic storage should be performed e Active from Defines the starting hour of the day for the automatic DICOM polling e Active to Defines the last hour of the day until which the DICOM polling is on e Poll Interval Defines the time interval between consecutive queries into the image database Set Defaults The default settings can be restored by clicking the Set Defaults button in the bottom right corner of the tab User s Manual Planmeca Romexis H 29 APPENDIX A PLANMECA PROMODEL QUICK GUIDE FOR PLACING PLANMECA PROMODEL ORDERS Planmeca ProModel is designed for dental professionals to use as an assisting tool for preoperative planning of difficult dental and maxil lofacial operations In no circumstances ProModel can be used in vivo Overview of the ProModel service e ProModel order button 5 opens the integrated order form in 3D Master Menu Toolbar in Romexis version 2 0 0 0 R and later e User has three options to place Planmeca ProModel orders via integrated ordering interface in Romexis version 2 0 0 0 R and later o Online order sends image and order form to Plan meca s FTP server o Burn ProModel order on CD using this option burns image and order form to portable media which can be mailed to Planmeca o Export to My Documents exports zip folder which includes the image and order form to user s local com puters M
104. he garbage collection can be enhanced Romexis Service Control e Start Service starts the Romexis Service e Stop Service stops the service e Remove Service stops the Service and removes it from the Windows Services list e Show Log opens the Romexis Service Log on the screen Set Defaults Default settings can be restored by clicking the Set Defaults button in the bottom right corner of the tab User s Manual Planmeca Romexis H 25 SERVER PARAMETERS 5 SERVER PARAMETERS Planmeca Romexis Configuration 1 7 0 18 B 15 1 2008 PLANMECA Romexis gt General Settings RMI ServeriClient Communication gt Resources RMI Server Host localhost General n RMI Server Part 1088 P Ferson Lj Security Class Server Regional Class Server Enabled E 5 Imaging Class Server Port 8081 LJ Panoramic Unit Communication PMUAPL P Cephalometric 3 Intraoral Diagnostics Enabled CBVT Diagnostics Log Enabled LJ Display Diagnostics Port 6812 LJ Dental Record 3 server Log Communication D Print Show Log 73 Trash Management LJ Patients amp images ce start up LJ Client Parameters Lj Romexis Service E gt Server Parameters Server F Database LJ External Communication Sel Defaults Romexis Server is running 5 1 Server RMI Server Client Communication e RMI Server Host Romexis Server IP or DNS name is configured here e RMI Server Port Defines the port for Romexis Server Clie
105. he general process for stitching is as follows 2 Align matching anatomy in the volumes Romexis places the volumes in the correct position according to exposure geometry information from ProMax 3D but you may occasionally need to adjust the alignment for better results Drag the volumes so that they align as closely as possible 1 Add volumes to be stitched into the work area 3 Select horizontal or vertical stitching mode according to the nature of the case at hand 4 Click Stitch and Romexis will take care of fine tuning the volumes for perfect match and stitches them together PlanmecaRomesis x Volume Stitching To combine multiple volumes into one first Ada the source volumes Then arrange the volumes to an approximately correct orientation and click on Stitch 43 12 2007 16 30 52 Add Remove Mode Horizontal Background Black T Stitching Mode Auto Size 0 x x voxels 0 0 0mm Stitch Gancel The Volume Stitching dialog is divided roughly into three parts see the figure above for an example On the top of the dialog view is a drop down list of volumes available for the current patient and buttons to add volumes to the work area or remove the most recently added volume In the middle of the dialog view is a work area where the volumes to be stitched are displayed where they can be aligned and where the results can be previewed Planmeca Romexis D 9 3D EXPLORER
106. hickness of the slices can be defined 4 5 Cross Sectional Slide Bar At the top of the Cross Sectional View is another slide bar Moving the slide bar right or left shifts the visible slices to the related direction along the panoramic curve If the shown section lines option is activated in the Edit Orientation Lines see 4 6 3 Show Hide Settings on page 36 they also get shifted in the axial and panoramic view The middle section is indicated by a red line and by a corresponding red ruler at the cross sections view D 34 Planmeca Romexis User s Manual 3D CROSS SECTIONS MODULE OPTIONAL 46 Adjust The Adjust tools at the top right contain accessories to process the views 4 6 1 Adjust contrast and brightness Regulates the contrast and brightness of the image views By dragging the sliders the brightness and the contrast can be adjusted The settings are saved automatically when the image is closed 4 6 2 Defining Data Range By pressing the Define Data Range button the area of interest for the panoramic image canbe defined You can select from which part lower or upper jaw the panoramic image is created In the appearing window move the sliders up or down to adjust The left slider restricts the upper jaw and the right slider the lower jaw This also affects the cross sliced view Planmeca Romexis Define data range User s Manual Planmeca Romexis D 35 3D CROSS SECTIONS MODULE OP
107. ia Resource Device Alerts Imaging Local Settings Configure Device Alerts Configure Usage Data Alerts Name ion Edmond Device Type Diagnostic Code 1 01 RESOURCE Close Patient Marshall Nelly v Diagnostic Text E1 01 Output Valve Aux short circuit on MCB Main water valve short circuit 1 02 E1 02 Output Valve Aux short circuit on MCB Main air valve short circuit 1 03 E1 03 Output Valve Aux short circuit on MCB Bowl rinse valve short circuit UNITTYPE 1 1 04 E1 04 Output Valve Aux short circuit on MCB Cup filling valve short circuit UNIT TYPE 1 1 05 E1 05 Output Valve Aux short circuit on MCB Water flush valve short circuit UNIT TYPE 1 1 06 E1 06 Output Valve Aux short circuit on MCB Separator pulse valve short circ UNITTYPE 1 1 07 E1 07 Output Valve Aux short circuit on MCB Ejector valve short circuit only if UNIT TYPE 1 1 08 E1 08 Output Valve Aux short circuit on MCB Extra out 1 short circuit High vol UNIT TYPE 1 1 09 E1 09 Output Valve Aux short circuit on MCB Extra out 2 short circuit Saliva s UNIT TYPE 1 1 10 E1 10 Output Valve Aux short circuit on MCB Extra out 3 short circuit Reserv UNIT TYPE 1 1 11 E1 11 Output Valve Aux short circuit on MCB Separator start signal Microvac UNIT TYPE 1 1
108. iddle the histogram can be scaled up or down to bring out details The button 14 restores the original scale of the histogram Measure angle Click the icon to draw an angle into a slice view by pressing the left mouse button down Drag to draw the first line and then click and drag to draw the second line Planmeca Romexis D 17 3D EXPLORER NOTE Measure length Measure length over single or multiple points Measure Length is a dual mode button hold down mouse button to call up mode selection between Single measurement and polyline measurement Single measurement use to measure length between 2 points default Hold down left mouse button to define measurement release mouse button to finish Polyline measurement use to measure length over multiple points Draw the line by pressing the left mouse button down release mouse button to finish All measurements are automatically stored as saved views use the Open Saved View button to call them back to view For information on editing measurements see 2 3 Volume Adjustments on page 21 A histogram is a graphic representation of the intensity distribution in the volume 449 letal atata la oK Jl Cancel Save Current View Saves the current displayed view Enter a name to the opening dialog Open Saved View Opens a previously saved view Delete a View from the Saved Views Delete one of the saved views from a list Reset View to the D
109. iew Reconstruction Server Host Mame Port Number 5000 Intra Cam Serial Connection CamComm CamComm Enabled Com Port Practice Maragement Software Interface PMBRIDGE PMBRIDGE Enabled 2D Port Number Image Caplure DIDAPI Enabled applied after reslarl Image Reprocessing Enabled applied immediately CD Recording Device External Applications Device Bus Select 2D Imaging Application 3D Imaging Application 3D Binning 1 3 Select Log CD burn for troubleshooting only Select DICOM AE Title for this workstation IRO MEXIS_1 station Name Institution Name Institution Department Name 3 1 3D User s Manual 3D Module Enabled on This Workstation This setting enables the organization to allow disallow access to the 3D module on a per workstation basis 3D Rendering Enabled Enabling this function generates 3D rendered view in 3D imaging module but consumes more memory This function should be disabled in image capturing workstations Surface Rendering Enabling this feature uses an optimised proprietary ray tracing engine to produce a real life solid object appearance to 3D volumes The Surface Rendering mode allows 4 different rendering styles that can be selected in the volume Rendering Style menu When this feature is disabled a more X ray like rendering is generated that allows see through anatomy 3D Rendering Texture Quality The following settings affecting the qu
110. in the library does not affect implants that have already been placed into the plan Delete Delete the selected model from the library Planmeca Romexis D 43 IMPLANT MODULE NOTE Deleting an implant from the library does not affect implants that have already been placed into the plan Set Default Set the selected model as the default implant This default selection is used by the Add default implant feature Add to Plan Use Add to Plan to add the selected implant into the current plan and automatically close the Implant Library dialog When you add implants from the library you cannot adjust their size with the Properties dialog To change the size use the Implant Library and the Replace selected button again Replace selected Use Replace selected to have the currently selected implant in the plan replaced with the implant model that is currently selected in the Implant Library The dialog will automatically close When you replace an implant with another from the library the dimensions of the placed implant can no longer be adjusted with the Properties dialog To change the size use the Implant Library and the Replace selected button again Implant Search Use the Search function to browse through large libraries for implants with certain properties Use the Search options to specify properties of the implant models to search for The Search button executes the search while the Clear button clears the search results
111. ing and reviewing the maintenance operations done As the summary shows the total number of hours for which each component of the dental unit has been in use since the latest maintenance operation the summary information can be useful for example when diagnozing a failing dental unit The maintenance summary is also useful for centrally tracking the kind of service the unit has received and to see what spare parts have been used The shortcut View in Diagnostic Log is available on top of the screen for viewing the diag nostic log automatically filtered for the selected unit Planmeca Romexis E 9 CLINIC MODULE VIEWS 1 4 1 Dental Unit Usage Summary The left side of the Device summary screen lists the following dental unit usage metric totals mileage in hours since the last reset The bar graph on the right Limit tracks the unit s use towards a preset alert limit Total The Total column indicates the total usage time of the dental unit or the operating light Current The Current column indicates the usage hours after the last reset usually annual main tenance or lamp change Usage hours are shown for Suction system use Chair adjustment Seat height Backrest Legrest Unit Total Current Limit TA Dental Unit 4237 8 h 14290 h BS ML Operation Light 1220 9 h 1220 9 h MM E Suction 9114 h l YA Chair Seat Height 6848 h i o Chair Backrest 8449 h e Chair Legrest 4418 h Total use of each instrument type individual i
112. ion Patient Identification defines which Patient ID is used to refer to patients The same ID is also used in patient search Romexis can maintain three different Patient IDs at one time e Custom ID refers to an ID typed into Romexis at patient creation or an ID generated by e g Axium e Other ID refers to an ID imported from another software where this usually administrative ID has been assigned to patients manually may e g refer to a patient s old paper file e Autonumber instructs Romexis to automatically assign a Patient ID to the created patient and to use this unique identifier This is viable only in cases where Romexis is used as the master patient management software Patient ID Sorting The following options are available when patient list is sorted by the Patient ID column e Insertion order Sort patients in the order they were entered into the database e Alphabetical Sort alphabetically 001 1111 22 aaa aab aba e Numerical Sort numerically ignoring leading zeros 001 22 1111 aaa aab e Prefix alphabetically Sort by leading alphabets and then numerically A22 A1111 B01 Patient e Give warning for Selecting all patients warns the user when all patients are searched at the same time from the database in the Patient Module User s Manual Planmeca Romexis H 3 GENERAL SETTINGS 1 9 Security all Planmeca Romexis Configuration 1 7 0 18 6 16 1 2008 PLANMECA RHomexis General Settings
113. ion of the 3D volume can be rotated e Axial view where the axial orientation of the volume can be rotated and where the panoramic curve is defined and shown e Panoramic view where the generated panoramic image is shown e 3D Rendered view By turning the mouse wheel on top of the sagittal or axial view the view can be zoomed in or out mexis 2 0 0 7 B 9 10 2008 Helianna Puhlin helianna Licensed to Planmeca E 8 x Close Patient Case Demo y mu L k C PES m 20 PA ER 16 3 2008 18 52 19 missing 35 45 y view Properties inactivate Scale 0 84 BN Scale 0 84 Thickness 10 48 mm v 1584 2496 oe p A Y li te J i J Implant_ Panoramic _Explorer_Y Volumes Panoramic Y E 3D Rend X E TII Deuwn Ey Holding down the left mouse button while dragging the Axial or Saggital view will move the 3D volume and holding down the right button will rotate it Refreshing the views may take a moment User s Manual Planmeca Romexis D 27 3D PANORAMIC MODULE OPTIONAL 3 1 Layer and Curve Slide Bar A slide bar is located at the right border of each view sagittal axial and panoramic In the sagittal and axial view the slide bar can be moved to scroll through the image layers This means that scrolling the slide bar of the axial view up and down moves the view inside the layers forward or backwards The corresponding orientation lines in the sagittal and
114. isabled this setting will have no effect Even if this setting is enabled automatic storage can be canceled per image in the image properties dialog e Two association mode for commitment If enabled a new socket communication is opened for establishing Storage Commitment If disabled the Storage socket is reused for establishing Storage Commitment Listening port for commitment If Two association mode for commitment above is enabled then this setting configures the port number where DICOM Storage Commitment messages should be expected Default is port 144 2 2 4 DICOM Query Retrieve Settings e Listening port Port number where DICOM Query Retrieve results should be expected Default is port 104 2 2 5 DICOM Default Specific Character Set To support patient names and information in different languages and character sets this setting allows a specific character set to be defined for saving DICOM files Set this option according to your local requirements to allow any DICOM compatible application to correctly read and display patient information as you have entered it F 14 Planmeca Romexis User s Manual LOCAL SETTINGS 3 LOCAL SETTINGS Resource Device Alerts Local Settings 3D Dental Unit Interface PlanLink 3D Module Enabled on This Workstation E Connect o Dental Unit at Startup 3D Rendering Enabled Hast Name Fl Surface Rendering Port Number 3D Rendering Quality Normal 7 Use Low Quality Prev
115. ist of implants only for 3D print e Add Image Diagnosis to Layout Add a copy of the image diagnosis if entered in the Image Properties only for 2D images or snapshots Adjusting Print Crop m To adjust the area of each image that will be included in the prints select the desired image and use the Adjust Print Crop tool Draw the crop region with mouse and apply crop from the right click menu The crop can also be cancelled from the right click menu by choosing Reset crop Region Showing Hiding Annotations Image annotations can be shown or left out of the print by clicking the button Show Annotations Saving Print Templates Print layouts can be saved as print templates for future use Click the Save Layout As E Ex Template button to save the current layout as a Named Layout or as a Default Layout The default layout will open always when the Print Editor is used whereas the named layout can be restored from the layout list The image will be inserted into an image template slot for the respective image type if existing in the layout Selecting Print Templates selecting the saved template name from the template list To add images to template double click the images from image browser A saved templated can be opened by clicking the Select A Saved Template button and E Deleting Print Templates Delete a saved print template by clicking the Delete Saved Template button and choosing the template to be
116. isting one Click the Edit patient button to edit demographic information and the Save patient button to save changes Please note that the changes are not saved automatically Click the Save patient button to save your changes 1 5 Adding and Editing Patients To create a new patient record click the Add Patient button which will take you to the Files module In the Files module you can enter the patient s Demographic information and add face photo to patient The compulsory fields are Person ID First name and Last name Click the Save Patient button to save the patient record into the database Please note that the changes are not automatically saved but the Save Patient button must be used A new patient search has to be made to view the newly created patient on the patient list dal Planmeca Romexis 2 0 0 12 B 24 10 2008 Default Provider sysadm Licensed to Planmeca Personal Address Person ID Address Line 1 Address Line 2 Title Address Line 3 First Name Address Line 4 Second Name Postal Code Third Name City Last Name State Name Suffix EUEEEGBMM M MMM Country CANADA Date Of Birth I Contact Gender Home Phone Marital Status v Work Phone Nationality CANADA Mobile Phone Language English Y Contact At Y Best Time To Call Occupation SSN Home Email Comments Work Email Assignment E Assig
117. itle ROMEXIS 1 C 36 Planmeca Homexis User s Manual NOTE User s Manual IMAGING MODULE To check the status of storage transaction use the Image Properties dialog DICOM Storage Commitment is also shown in the Image Properties next to the storage status When DICOM Auto Storage is enabled the storage of a single image can be canceled in the Image Properties dialog Images can also be automatically stored after capturing see section DICOM Configuration in chapter ADMIN MODULE and section 5 3 External Communication on page 28 in chapter ROMEXIS CONFIGURATION APPLICATION Planmeca Romexis C 37 Chapter D NOTE NOTE User s Manual 3D IMAGING MODULE Planmeca ProMax 3D generates three dimensional data of the maxillofacial area called an X ray volume The dimensions of the 3D volume varies depending on the source X Ray volumes are captured processed and stored in the 3D Imaging Module In addition the volume can be displayed and processed as a panoramic image and as cross sectional images Implant planning and TMJ modules provide more advanced features The 3D Imaging Module consists of five submodules divided into tabs These are explained in more detail below in their own sections O N 5 Volumes Explorer Panoramic OPTIONAL Cross sections OPTIONAL or Implant OPTIONAL in case implant license is installed TMJ OPTIONAL A patient needs to be selected before t
118. l status and functionality of the dental units The events are logged with all the relevant details and the event descriptions are listed in plain language in addition to error codes See the following example E48 1 Number of attached suction tube holders is wrong No suction holders detected 30 11 2007 16 34 E51 2 Cable from the foot control is loose 12 11 2007 16 32 1 4 User s Manual The Diagnostic Log view allows filtering of events by type dental unit and date and time If Dental Unit lt All gt and the current date are selected the Diagnostic Log view serves as a real time monitor of all dental unit problem events The Administration module allows for warding of the problems via e mail see F ADMIN MODULE on page 1 for more informa tion lt All gt Help Events Waterline Cleaning Events All Errors General Power Supply Control Panel Instrument Instrument Multiplexer suction Tube Holder Foot Control Operating Light separator System Patient Chair Main GPU To see an error in its context of use select an event and click the Show Event in Graph button to bring up a history graph of the unit in front of the selected event This can be especially helpful in troubleshooting as the problem can now be seen in the context of how the dental unit was used when the error occurred Device Summary Device summary provides a summary of information on the dental unit s use and mainte nance with a form for enter
119. lants E Export Cropped 7 Anonymize Folder cltemp File Name Prom ax_3D Export File Type Romexis is capable of exporting 3D volumes in 3 different formats The desired Export Format Type can be selected in the Export dialog as follows e Single Multi Frame DICOM File A single DICOM standard file that contains the 3D Image data in a set of Frames e Set of Single Frame DICOM Files A set of multiple DICOM standard files each of which contains a single Frame of the 3D Image data If images are to be exported as they were originally captured tick the Export Original not rotated selection All rotations and translations done to the image afterwards will not be exported with this function Planmeca Romexis D 13 3D EXPLORER Export Viewer with Multiframe image enables to export the volume frames together with an additional viewer program Both the 3D viewer program and the images will be saved to one folder This allows you to burn the folder on a CD and view it on a computer without Romexis or the DICOM viewer program Burn Viewer with Multiframe on CD allows direct writing of a Viewer CD with the currently open 3D volume onto a CD Before using this option make sure that there is a BLANK writeable CD R or CD RW disk in the CD drive Planmeca Romexis x O Planmeca Romexis 4 Please insert blank CD in your default CD ROM drive and click OK ok cancel After inserting a blank write
120. lick the View Study button To rearrange the images in the study drag an image from one slot to another using mouse In case you are dragging the image to an empty slot click Yes in the opening dialog Planmeca Romexis Arrange Images Arrange images in the study In case there is already an image in the target slot the system will ask whether you want to move the image to the top of the old image or whether you want to swap the images Planmeca Romexis Arrange images Arrange images in the study swap Images Cancel 1 6 2 Removing Image from Study To remove an image from the study drag the image outside the study window Note that the image will not be deleted but it will remain in Romexis as a single image Click Yes in the opening dialog Planmeca Romexis Detach Image Detach the image fram the study User s Manual Planmeca Romexis C 25 IMAGING MODULE 1 6 3 Adding Image to Study Open a study Select the image that you want to add to the study from the Image Navigator and add it to the first empty slot by double clicking the image You may need to click the Overview button to hide the study list and reveal the images underneath in the Image Navigator In case you want to add a new image to a slot that already contains an image detach the old image first In case you want to move an image to another slot just drag it with the mouse 1 7 Image Operations 1 7 1 Image Properties 1 7 1 1 Ge
121. mation included in the DICOM file use the DICOM with Patient option available in the File menu C 6 Planmeca Homexis User s Manual IMAGING MODULE 1 2 11 DICOM Export 1 3 1 3 1 User s Manual Open the images or study that needs to be exported Click the D COM Export E button to open the export dialog below DICOM Export Export File Type Processed images as they appear on screen Original images Folder C Documents end Settings lAdministratoriMy Documents Filenamelexported dicom E Anonymize File s E Create patient and image information file Select the Processed images option to export the image s with all enhancements applied or select the Original images option to export original image s as they were captured In DICOM Export the original bit value is always preserved Anonymize File s removes all patient information from the exported DICOM image s If you want to create a text file that includes image related information enable the option Create patient and image information file Click OK to export the DICOM file s with relevant patient information included DICOM Media Storage DICOMDIR The DICOMDIR file format specifies a standard way to organize storage and retrieval of DICOM format file sets to and from offline storage such as a CD A compatible DICOMDIR CD for example contains description and access information for all the studies on that CD Planmeca Romexis supports b
122. me Last Name Company Panoramic Address Postcode State Country Cross sections 3 Email Scale 1 13 11 17 Scale 1 13 11 58 Scale 1 13 Tele ProModel ID 2 EM Reference 9 UPS Cash On Delivery Exchange Collect Price Information Price List D Invoiced through your local Planmeca Dealer Same Address for Delivery and Billing Different Address for Delivery and Billing Add Dealer Information Ho V Include Nerves By selecting this box agree to these Terms And Conditions Save this order form as a template age Bio To place a Planmeca ProModel order from current volume user must fill the required fields in the form bolded The fields in order form are explained in detail below see figure 4 NOTE A volume must be opened in the Explorer tab in order to use the ProModel ordering otherwise the button is greyed NOTE Planmeca ProModel is not autoclavable and it is not recommended to use liquid disinfection by default NOTE In case of artefacts caused by high density objects such as amalgam or other metallic bodies it is recommended to use the Artefact Removal tool in your Romexis software before placing Planmeca ProModel order NOTE In case of separate mandible and maxilla is needed patient s 3D exposure should be taken with a mouthpiece on User s manual Planmeca Romexis Appendix A 3 PLACING PLANMECA PROMODEL ORDERS 2 2 Overview
123. n the network the workstations should have unique AE titles for example ROMEXIS 2 ROMEXIS 3 etc e AE titles Port numbers and IP addresses for the needed DICOM services Storage server Printer Worklist In the maging DICOM tab sheet all the default destination applications are defined By clicking the Select button the Default AE window opens Resource Device Alerts Imaging Local Settings Templates Applications Default Storage AE STORE SCP Select Setup Default Printer AE PRINT_SCP Select Setup Default WorklistAE DMWL_SCP Select Setup Default WR AE QR SCP Select Setup Romexis Server AE Title SCU fcr Romexis Server ROM EXIS SCU AE Title SCP fer Romexis Server ROM EXIS SCP Storage E Store new images automatically Query Retrieve Listening port 124 Default Specific Character Set ISO IK 100 Latin Alphabet 1 IS08859 1 F 10 Planmeca Romexis User s Manual IMAGING To add a new Application Entity AE click the Add button and define the AE title host name and port number in the opening window x MERGE PRINT SCP localhost 104 MERGE GR SCP localhost 104 MERGE STORE SCP localhost 104 MERGE WORK SCP localhost 104 Planmeca Romexis x New DICOM Application Entity AE AE Title STORE SCP HostName 127 0 01 Port Number 104 hu pported Transfer Syntax No Restriction ImpliciWRLiticEndian J Explici
124. n to Default Provider E Free Access NOTE All patient information is managed in the Files module Romexis automatically opens the Files module when the Add patient button is clicked Existing patients are also modified using this module 1 6 Editing Patient Information To edit the patient information of an existing patient click the Edit Patient button to enter the patient demographics view Edit the information as required and click Save User s Manual Planmeca Romexis B 3 PATIENT SELECTION AND MANAGEMENT 1 7 Assigning Patient 1 8 1 9 NOTE Patients can be assigned to providers with the Assign patient button Select the patient you want to assign from the list and click the Assign patient button to open a list of providers then choose the provider you want to assign the patient to Patients can have one primary provider and several secondary providers In case a patient already has one provider and the Assign patient button is clicked again the following dialog appears Planmeca Romexis o Assignment i ty Primary Assignment already exists Replace Primary Assign Secondary Cancel This allows the user to reassign the patient to a new Primary provider or assign new Secondary provider s for the patient To see the provider assigned to the patient click the button The number of the providers assigned to the patient is shown in the patient list Finding Assigned Patients To retrieve all patients that are a
125. nd use DIDAPI Configuration to adjust preprocessing to better match customer s preferences 5 Start new exposure and choose Heprocess Latest Image The original image is returned with new preprocessing settings and verify image quality Repeat steps 4 and 5 until desired image quality is achieved 6 Turn Reprocessing off External Applications Some 3rd party applications can be launched directly from 2D Imaging and 3D Imaging modules with the Launch button Image and patient information is transferred to this software simultaneously Click the Select button to define the path To make the definition e g Simplant Implant planning software browse the Simplant exe file Type the name of the Simplant and type the Command Line sf 960 OK J Cancel The launch feature requires that the receiving software is capable of receiving file and patient information via command line Please refer to the 3rd party documentation for correct parameters 3D Binning The 3D Binning option specifies a pre scaling operation to be done on 3D images before they are handed over to the launched application The operation is called binning and it combines two or more adjacent voxels into one reducing the resolution of the resulting image Binning does not affect the geometry or dimensions of the image Valid settings are e 1 UsSse original resolution and do not process the image This is also the default value If left blank e 2 A
126. nent mileage limits hours for preventive maintenance Unit instrument activation frequency to track inappropriate use Usage Alert Parameters Mame Delight Message Delight lamp must be replaced Type Maintenance Instrument Operation Light Used more than 2000 Selected more than times in seconds Activated more than times in seconds Planmeca Romexis F 7 IMAGING 2 IMAGING 2 1 Templates Templates are used for capturing multiple images to a certain predefined layout The template can contain intraoral panoramic and cephalometric X ray images and photos The template also defines the print layout and alignment for the images attached to it The list of existing image templates is shown in the left side of the list To edit an existing template click Update To prevent using a certain template for new studies click Inactivate However inactivating does not affect existing studies based on the template To create a template click New and enter a name for the new template in the opening window x Description Fwi 20 Click the button and choose the desired layout in the opening window You can use predefined layouts or customize how many images you want per row or how many rows of images you want in each column The last option allows you to create complex templates such as FMX 20 To enter the template edit view Click the desired layout option Choose Layout E Mo Mio o o
127. neral Image Properties Shows general properties for selected image including exposure information Allows defi nition of image type sensor orientation exposure date tooth numbers and image com ments Comments when available will be shown in the image title bar and can be used as search criteria in the Find by Image tab General Diagnosis Image Type Panorami Sensor Orientation r File Info Exposure Date 15 11 2007 Mirrar E Flip Horizontally Pixel Size urn Bits Per Pixel Width Height Image Format Ray Parameters Image Properties x serial Number Voltage kv 80 Current mA 4 0 Exposure Time s 0 016 DAP mGy cm2 MRay Quality Value 1 Comments tinh C 26 Planmeca Romexis Fr 34 Yr 35 y 74 75 36 37 38 User s Manual 1 7 1 2 1 7 2 1 7 3 1 7 4 1 7 5 1 7 6 User s Manual IMAGING MODULE Image Diagnosis Opens the image Diagnosis tab under Image Properties Shows and allows editing image diagnosis Diagnosis up to 2500 characters is supported Image Alignments Define the alignment of the image inside the layout slot Affects image placement on screen and in Export All images in one file operation Copy image to Clipboard The image can be copied to the Wind
128. ng Cephalometric Image Annotation Font Size 12 Lj Intraoral Image Measurement Font Size z J CBVT Display LJ Dental Record LJ Communication Print 3 Trash Management LJ Patients amp images ce start up Lj Client Parameters Lj Romexis Service E 3 Server Parameters LJ Server Lj Database P External Communication Romexis Server is running Background colors e Background for X Rays Defines the background colour for the taking of X rays e Background for Photos Defines the background colour for the image explorer Fonts e Default GUI Font and Default GUI Font Size define the default font for the graphical user interface e Image Annotation Font Size defines the font size for the image annotations e Image Measurement Font Size defines the font size for the measurements made on the images User s Manual Planmeca Romexis H 13 IMAGING 2 6 Dental Record m Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis General Settings E 3 Resources LJ General LJ Person Lj security LJ Regional E 3 Imaging P Panoramic LJ Cephalometric LJ Intraoral 3 cBVT LJ Display Lj Dental Record LJ Communication Print 73 Trash Management LJ Patients amp images E gt Start up LJ Client Parameters LJ Romexis Service E gt Server Parameters F Server LJ Database Lj External Communication Romexis Server is running Image Acquisition Request Approval Expi
129. ng NOTE A patient needs to be selected before the Imaging module can be accessed 1 1 Toolbars There are three types of toolbars and icons in the Imaging module user interface 1 The top toolbar contains buttons for launching image capture export import and general layout options 2 The vertical toolbar at the far right contains the image processing and annotation tools When using these tools any function i e Zooming can be applied on all open images in the image viewer not on images in the image browser EN 3 Each open image has its own horizontal toolbar image above the image These viewing and processing tools affect only that respective image The vertical image toolbar can be opened using the wrench button See 1 5 2 Image Toolbars on page 21 for more information Elpianmeca Romesss 1LE06E 28 5 2007 helisnna helianna sales Em na E SS A Close Patera Dams K eenhamina pink Oo see A A AT 24 5 TOUT 13 42 36 0 Wi TE YE Te TO m 50 28 4 Maa lio ep P x qo mtm ee EERE US H m sl ae EN Y 85 19 Y I a i E i E E 8 4 Sen Browser 06 f i y I X ER 2 12 2008 10 5 a 16122005 15 10 1 3 2007 16 50 ff E i AbD F EA B mcm M r3 CAT Caen View Sxbercled Clear Rohosh Ji 4 User s Manual Planmeca Romexis C 1 IMAGING MODULE 1 2 Image Browsing and Viewing 1 2 1 Image Browser module is opened The image navigator can be opened and closed by
130. ng in to Romexis the login can ask for both username and password Username required Password is optional Only username is required when logging in Login only with Swipe Card When additionally selecting this option the user can log in only with a swipe card Approval Username and Password Username and Password are required When granting approvals e g for image acquisition requests Romexis can ask for both username and password Username required Password is optional Only username is required Approval only with Swipe Card When additionally selecting Approval only with Swipe Card the approval can only be made with swipe card H 4 Planmeca Romexis User s Manual User s Manual GENERAL SETTINGS Password Functions not yet supported e Maximum password age days Sets the number of days that the password will be valid e Minimum password length Sets the required minimum length for the password Swipe Card User ID When swiping the swipe card the card produces an output text string that contains the user ID and password e Track No Number in Swipe Card Indicates the row in the text output from which the password string is read Assume e g the following typical Swipe Card output Jetestusera6yz8cat 0000948721 20060101 20070101 The User ID test user is located on the first track 0 starting from the second column 1 and ending in the eigth column 7 e Start Column in Swipe Card Indicates the c
131. ning the mouse wheel over a view will scroll through the image layers as the Layer Slide Bars do see 2 2 2 Layer Slide Bar and Maximize button on page 21 NOTE The rendered volume can be zoomed with and without the Zoom Mode button activated D 12 Planmeca Homexis User s Manual 2 1 4 a 2 1 5 Lp User s Manual 3D EXPLORER Importing 3D Images Native Romexis rec files 3D images in rec format can be imported to Romexis Click the mport button and browse to the file you want to import Only native Romexis 3D images that have been generated using Planmeca ProMax 3D and Romexis can be imported using this feature The extension of the imported image must therefore be rec A 3D image in DICOM 3 0 format can be imported to Romexis Click the mport button and browse the file to be imported The extension of an imported image file is dcm DICOM Files DICOM 3D Multi Frame Imports a single DICOM standard file that contains the 3D Image Data in a set of Frames DICOM 3D Single Frame set Imports a set of multiple DICOM standard files that each contain a single Frame of the 3D Image Data Exporting 3D Images x Export Properties Expart File Type Resolution a E ie Single Multi Frame DIZOM File lOrig 0 16 mm Bit Depth E Export Viewer with Multiframe image 12 Original Orientation E Burn Viewer with Mutiframe on CD 5 Set of Single Frame CICOM Files El Include Nerves and Imp
132. nstruments cannot be monitored Syringe Air motor and subtype Micromotor and subtype Turbine and subtype Polymerization light and subtype Scaler and subtype Based on the dental unit s events collected in real time a full history of the unit s cleaning operations is maintained and can be reviewed Entries of the last cleaning operations are shown for the following Planmeca Waterline Cleaning System full cycle disinfection Instrument flushing water Suction line cleaning E 10 Planmeca Romexis User s Manual CLINIC MODULE VIEWS e Use the View All shortcut to see a full history of the cleaning operations listed above in the Diagnostic Log Latest Cleaning Operations N Waterline Cleaning 30 11 2007 12 52 ak po Instrument Flush 43 2 2008 18 07 P JEMEN ERWIN cu suction Line Cleaning 23 2 2008 17 43 View All 1 4 2 Service History User s Manual The right side of the Device Summary screen shows a list of recent maintenance opera tions and a form for entering new maintenance records or for reviewing the previous records The following information is recorded from a service visit e Entry ID for quick reference e Date when carried out e Entry type e Service Visit A scheduled visit such as annual maintenance e Unscheduled Service Visit A visit that was not scheduled and may have caused unscheduled downtime for the dental unit Possibly caused by an unexpected Delight lamp failure or similar
133. nt Library Implant Library can be used to manage implants create new implants modify add implants to plan replace and search for implants Implants that are commonly used can be freely added and will be automatically grouped by manufacturer and product lines A general principle is that implants that have been placed into the plan are not affected by any changes made in the library To modify implants that are already placed modify the properties of an individual implant with the Properties button use the Replace function or the implant list x Implant Library Implant Library f Library search Manufacturer Product Implants E Default Length mm Diameter mm Diameter 2 0 Diameter 2 5 Diameter 3 0 Diameter 3 5 Diameter 4 0 Diameter 4 4 Diameter 4 5 Diameter 5 0 Diameter 5 5 Diameter 6 0 Diameter 6 5 Diameter 7 0 New Copy Properties Delete set Default Add to Plan Replace Close New Create a new implant in the Implant Library by specifying the required information Note that you can use the drop down lists to select existing manufacturers or product lines When entering numerous implant models the Copy function explained below may be more suitable Copy Copy the selected implant to a new one and change one or more properties This option is useful when creating groups of implants that share some properties Properties Modify the properties of the selected implant Changing the properties
134. nt communication Class Server e Class Server Enabled If this option is selected Romexis Server provides the latest PMUAPI classes to PMUAPI proxies which communicate with the dental units e Class Server Port is the port which Server listens to Unit Communication PMUAPI e Diagnostics Enabled Enables the communication between Planmeca dental units and Romexis e Diagnostics Log Enabled Starts the logging of the diagnostic communication e Diagnostic Port Defines the Romexis Server port for diagnostic communication H 26 Planmeca Romexis User s Manual 9 2 SERVER PARAMETERS Server Log By clicking Show Log the Romexis Server Log opens Set Defaults Default settings can be restored by clicking the Set Defaults button in the bottom right corner of the tab Database Planmeca Romexis Configuration 1 7 0 18 B 16 1 2008 PLANMECA Romexis 3 General settings E E3 Resources Lj General Lj Person Lj security LJ Regional E 3 Imaging Romexis Database 5 Solid Example URL jdbc jtds sqlsemrer serers paort database propertys value Oracle SQL Server JDBC Connect URL jdhcitds sqlserveridocalhostiromexis_ dh instance r0mexis User ID ramexis F Panoramic Password romexis n SPERISEITIENUS Test Connection LJ Intraoral 3 cBVT LJ Display LJ Dental Record LJ Communication Print 3 Trash Management LJ Patients amp images 3 Startup LJ Client Parameters
135. nt instance on ane workstation Security Instance Name MyClinic Lj Regional i M E 3 Imaging Lj Panoramic Lj Cephalometric Lj Intraoral L CBVT F Display a Dental Record a PlanLink amp Diagnostics 5 Print E Image amp Data Management Lj Trash Lj Long Time Archive gt Startup Lj Client Parameters Lj Romexis Service E gt Server Parameters Lj Server Lj Database Lj External Communication Romexis Service is running Connected to server lacalhost Cancel User s Manual Planmeca Romexis H 1 GENERAL SETTINGS Client instance Defines the Romexis Instance name that is shown in the Romexis title bar if the option Show Instance Name in Romexis title bar is selected You can insert some free text for example clinic name into the Romexis title bar All Romexis Clients that are connected to the same server have the same Instance name Allow more than one client instance on one workstation Selecting this option enables the starting of multiple Romexis Clients on the same computer 1 2 Person FR Planmeca Romexis Configuration 2 2 0 15 8 5 25 09 PLANMECA Romexis gt General Settings E 5 Resources Lj General LJ Person Lj Security Lj Regional E Imaging Panoramic Lj Cephalometric LJ Intraoral 3 cavtT Lj Display Dental Record PlanLink amp Diagnostics 3 Print gt Image amp Data Management Lj Data Falders L Trash L L
136. of Planmeca ProModel Order Form Planmeca Romer x PLANMECA ProModel Order Form Order Planmeca ProModel from the current volume Send current volume to Planmeca for troubleshooting ONLY Ttle FirstName LastName Company Address FO Postcode dan State Country CAMADA e Email Tele Fax ProModelID 2 Comments Reference Invoiced through your local Planmeca Dealer O UPS Cash On Delivery Exchange Collect Price Information Price List Same Address for Delivery and Billing Add Billing Address Different Address for Delivery and Billing Add Dealer Information Include Nerves and Implants By selectirg this box agree to these Terms And Condiions Save this order form as a template Continue Cancel Required fields include common information concerning the order company name address postcode city state and country Order confirmation will be sent to user s email account please give a valid email address e ProModel ID will be printed on ordered ProModel to make it individual As a default value is the person id of the volume under examination The default value is given by Romexis software This value can be changed as user likes lt can be in text numbers or special characters format e Comments field not mandatory is for special requests e g if user prefer the ProModel in different colour than the default white Also if user likes
137. olume is by default surrounded by a volume boundary box that may in some cases help properly orienting the 3D volume Use this button to turn the boundaries on off Show Perspective in 3D Rendering This button will turn on linear perspective that provides a more natural view of the anatomy By default the rendering is shown in an isometric style that has no perspective effect When in the default non perspective mode hold down the right mouse button and move the mouse up and down to produce a slicing effect in which the anatomy is sliced out as you move the mouse up This effect can be used to slice of thin layer of the anatomy or to clear obstructing anatomy from the view for example Show Hide Orientation Lines Toggles visibility of orientation lines and measurements in rendered view only 2 3 2 3 Rendering overlay User s Manual 3D Rendering overlay allows volumetric coloring of the 3D volumes based on the gray scale values in the image It allows coloring of soft tissue and airways for example enhancing the informative value of the 3D rendering Use the Show Overlay to turn the overlay on off and the Overlay Properties to specify the qualities of the overlay present in the image Show Overlay Turn the overlay on off If no overlay is defined then the Overlay Properties Dialog is automatically presented see below On large volumes please be patient as the display of the overlay may take a while at each time the volume i
138. olumn in the text output where the password string starts e End Column in Swipe Card Indicates the column in the text output where the password string ends Swipe Card Password See Swipe Card User ID above for more details Planmeca Romexis H 5 GENERAL SETTINGS 1 4 Regional Fl Planmeca Romexis Configuration 2 2 0 15 8 5 25 09 PLANMECA Romexis Tooth Identification System FDUSO General Settings E 3 Resources General O ADA L Person Regional Settings L Security D Regional Country CANADA E 5 Imaging LJ Panoramic Lj Cephalometric anguzge English Show State State Prompt Do O Lj Intraaral EN x Ch 3 CBVT Lj Display PIM Prcmpt Lj Dental Record ProMocel Price List Lj PlanLink amp Diagnostics Print gt Image amp Data Management Data Folders Lj Trash Long Term Archive Start up LJ Client Parameters Lj Romexis Service 3 Server Parameters Romexis Service is running Connected to server localhost Cancel Tooth Identification System e FDI ISO This option means the two digit FDI World Dental Notation e ADA Universal Numbering System adopted by the American Dental Association Regional Settings These settings specify default values and available settings in the Patient Demographics e Country defines the default country for demographics e Language defines the default language for demographics e Sh
139. ong Term Archive Start up Client Parameters Romeris Service gt Server Parameters Mame Formatting Mame Display Order Dor t Format Family name First name Capitalize First Letter Firstname Family name Capitalize ALL Patient identification Custom ID defined by organization or from other software Custom ID other ID E Autonumber Patient ID Sorting Insertion order t Alphabetical O Numerical Prefix alphabetically then by numeric value Patierrl Access Reason is required when accessing patients Give warning for Selecting all patients Romexis Service is running Connected to server localhost Name Formatting ok Cancel The Name Formatting selection affects the formatting of name display on the screen e Don t Format displays the names as they were entered into the database e Capitalize First Letter makes sure that the first letter of each name is always capitalized and the rest remain in lower case e Capitalize ALL capitalizes all letters in a name Name Formatting affects the processing of searches for names so that when Don t Format is used searches are case sensitive while Capitalize First Letter Capitalize ALL make searches case insensitive User s Manual H 2 Planmeca Romexis GENERAL SETTINGS Name Display Order In Name Display Order you can decide which name family name or first name is displayed first in Romexis Patient identificat
140. ontains buttons common to all 3D modules The functions are explained in detail in Romexis User s Manual starting from the version 2 0 AA 7 IAE e D Planmeca ProModel order button is enabled by default In case you would like remove the order button from 3D Master Menu Toolbar follow the instructions below Disabling the Planmeca ProModel ordering button User must have administrator rights in Romexis to disable or enable the Planmeca ProModel ordering button Select Admin from the toolbar Click the Local Settings tab Click the Show ProModel Order Button Click Save Restart your Romexis software oF c N After restarting Romexis software the Planmeca ProModel order button has been disabled Planmeca Romexis User s manual PLACING PLANMECA PROMODEL ORDERS Planmeca ProModel order Opens the Planmeca ProModel order form to place an order from current 3D volume Only available in 3D module Clicking the Planmeca ProModel order button opens the integrated order form in Romexis please see figure 3 Close Patient Stitching Images ET ug uoa E 5 5147 T 2p PETER FEUR 14 10 2008 14 32 22 Test Comments ey Properties Inactivate Scale 0 75 Os Scale 0 75 s Planmeca Romexis Volumes PLANMECA ronda Order Form Order Planmeca ProModel from the current volume Explorer Send current volume to Planmeca for troubleshooting ONLY Title First Na
141. oolbar Color E WA Sketch a free line Sketch a free line for demonstration purposes Note Sketch lines are not saved or stored and are lost when image is closed Zoom to fit All open images are fitted to view 1 1 All open images are scaled to 1 1 User s Manual Planmeca Romexis C 19 IMAGING MODULE C 20 Planmeca Romexis Uniform scaling for all images Magnifier 2x Invokes the magnifier glass 2x on the image The magnifier can be moved on the image Show overview When the image is zoomed in the images can be panned with an overview window Flashlight Enables a movable square Flashlight overlay that allows regional filter for Gamma Contrast amp Brightness Invert Equalize Sharpen and Emboss Use the mouse scroll wheel to adjust the size of the filter area and right click to switch between different filters See also Flashlight setup below Flashlight setup Similar to Flashlight function above but allows setting of Gamma Contrast amp Brightness values The settings are image specific Use the mouse scroll wheel to adjust the size of the filter area and the radio buttons or the right click to switch between different filters Process i Gamma IJ 1 5 Contrast amp Brightness o la 25 it p 0 Invert 2 Equalize 2 Sharpen Emboss Adjust contrast and brightness Invokes contrast and brightness control to all open images You can adjust the brightness and contrast by d
142. oped to be used with the Planmeca digital X ray units and the Intracam intraoral video cameras Read this manual carefully before using the system NOTE The ProMax 3D X ray unit other digital X ray units and Intracam camera have separate manuals which should be used in conjunction with this manual NOTE This manual is valid with the following software versions Planmeca Romexis 2 2 R Planmeca Proline software PK 5 08 PG 5 08 or later 5 13 or later recommended ProMax software 1 05 or later 1 31 0 or later recommended Planmeca ProOne software 1 0 0 or later Planmeca Intra software 1 20 or later NOTE Romexis can be used under Microsoft Windows XP Windows Vista Business Windows 2003 Server or Windows 2000 operating systems Romexis conforms to Windows user interface standards Mac OS operating systems are supported with certain limitations NOTE User organization must take care of protecting the computer and the network by using up to date virus and malware protection software and firewall Planmeca Romexis is a registered trademark of Planmeca company Romexis imaging C E software fulfills the requirements of Directive 93 42 EEC Planmeca Romexis allows the user to view enhance and archive images and it can also be used to take images with all the present and future Planmeca digital imaging devices Romexis supports all the basic functionality required to view and manipulate images as well as offers full support for multiple user
143. ot produce the expected results Both Auto modes provide a snap to feature that recognizes matching anatomy and pulls the volumes into the correct position during the alignment as if they were magnetic Adjust Slices These sliders see Fig 1 for an example allow selecting the slice shown for each volume If the volumes do not share anatomy in the same slice the sliders can be used to adjust the slice shown so that a common anatomy can be seen in all volumes This is especially necessary when doing vertical stitching as the anatomy shown by the default center slice 125 of the top and bottom volume will be 2 4 cm apart The tick box on the left of each slider controls the visibility of each volume To stitch together three volumes follow these steps 1 Add all three volumes into the work area by selecting them from the list of available volumes and by clicking the Add button 2 Align the volumes by dragging them to correct positions See below for examples 3 Click Stich and wait for Romexis to iterate for the best alignment and save the stitched image into the database D 10 Planmeca Romexis User s Manual 3D EXPLORER Volume Stitching To combine multiple volumes into one first Aga the source volumes Then arrange the volumes to an approximately correct orientation and click on Stitch 43 12 2007 16 30 11 Y Add Remove Mode Horizontal Background Black stitching Mode Auto Adjust Slices
144. oter Logo is shown in the bottom left corner of the printed paper The image which will replace a logo must be in Portable Network Graphics file format png The height of all logos is limited to 1 0 inches By clicking the Browse button the user can browse for the image and by clicking the Update button the image is updated to Romexis database Show Logos in Printouts The logos to appear can be selected here H 18 Planmeca Romexis User s Manual IMAGE amp DATA MANAGEMENT 3 IMAGE amp DATA MANAGEMENT 3 1 Data folders W Planmeca Romexis Configuration 2 2 0 15 8 5 25 09 JO x PLANMECA Romexis Show Help G General Settings Romezis Data Folders E 3 Resources LJ General Image Folder iromexis_ datalromexis images LJ Person Cache Folder ZJromexis datalromexis cache E security LJ Regional Ergodata Folder JJromexis datalramexis ergadata El C3 Imaging aL Set Path Move Data LJ Panoramic E Cephalometric Lj Intraoral UNE E CBVT Iimage folder changed to Ziraomexis datal romexis images Cache falder changed to Ziromexis datalromexis_ cache LJ Display Erga falder changed to Jromexis_datafromexis_ ergadata LJ Dental Record PlanLink amp Diagnostics otarting to move images E Print Image count 2 ades moved PlanmecaRomexis 3 G Image amp Data Management Data Folders Deleting cache am Message E Trish Cache deleted Long Term Archive Starting
145. oth DICOMDIR import and export functions Before you start using DICOMDIR import or export make sure that the user has appropriate import and export images permissions granted in the Romexis Administration module See 1 1 Groups Tab Sheet on page 1 in chapter ADMIN MODULE for more information on permissions DICOMDIR Import DICOMDIR Import allows you to import a set of multiple patients with their patient information and images from DICOMDIR into Romexis To start importing images from a DICOMDIR click on the DICOMDIR mport button or use the File DICOMDIR Import menu option Planmeca Romexis C 7 IMAGING MODULE MM Planmeca Romexis x DICOMDIR Import First select a DICOMDIR file with the Browse button and then choose the images to impor CAKuvatiDICOMDIR Browse 5 42005 10 10 E Image 136 lO Pres E E Study 20050328 36 PA E Series 1 10 E Image 137 lO Pres Y Patient Planmeca Dimaxis 630 529 2300 E Y Study 20050415 1 Planmeca images E Y Series 1 10 Y Image 3 10 Pres iv Image 4 lO Pres eries 3 PX Y Image 1 DX Pres Study 20050415 4 ProMax Ceph V Series 4 DX v Image 1 DX Pres co A ENERO Study 20050628 Study 100 Series 1 10 E Image 100 lO Pres Study 20050628 Study 101 Series 1 10 i ae 101 MA 15 4 2005 10 10 Value InstanceNumber 1 ReferencedFilelD IMAGESIP
146. ouble click on the blue image name in the left column Image Link or select the image or several images by holding down control and press the Open Link s Open Link s button The Image View tab opens and the selected image s is shown Image Link Provider Username Patient Name Patient Ext ID Ceph 2 3 2007 15 13 Thomas Schneck thomas Frisch Max 7636 Ceph 2 3 2007 15 21 Thomas Schneck thomas Frisch Max 7636 Ceph 2 3 2007 16 13 Thomas Schneck thomas Frisch Max 7636 Ceph 2 3 2007 16 20 Thomas Schneck thomas Frisch Max 7636 1 2 Patient Link By double clicking on a red patient name a patient file can be opened directly for further processing Patient Mame Frisch Max Frisch Max Frisch Max Frisch Max Goethe Johann Wolfgang Goethe Johann Wolfgang 1 3 Refresh The Refresh Refresh button updates the current report on the screen 1 4 Print Reports can be printed with the Print button Open the report you want to print and click the Print button The preview window appears and the report is printed according to the layout on the screen G 2 Planmeca Romexis User s Manual IMAGE VIEW 2 IMAGE VIEW The Image Viewtab displays images opened from the report in the Report Generation tab Each open image has its own horizontal toolbar above the image These viewing and processing tools affect only that respective image see chapter 4 section 1 7 2 As images are viewed Read Only no changes will be saved aport G
147. ow State amp Prompt Enables showing an input field for patients home state or similar and a freely configurable prompt text e Show PIN amp Prompt Enables showing an input field for patients personal identification number or similar and a freely configurable prompt text e ProModel Price List Specify the HTTP address location of the regional ProModel price list H 6 Planmeca Romexis User s Manual 2 IMAGING 2 1 Panoramic FR Planmeca Romexis Configuration 2 2 0 15 6 5 25 09 ARomexis 3 General Settings El 5 Resources Lj General LJ Person L Security Lj Regional E c Imaging Panoramic LJ Cephalometric Lj Intraoral 3 cBvT LJ Display LJ Dental Record L PlanLink amp Diagnostics Print gt Image amp Data Management F Data Folders Lj Trash LJ Long Term Archive 5 start up Lj Client Parameters LJ Romexis Service C Server Parameters PLANMECA Resolution Bits Per Pixel Image Format a Normal ia 16 TIFF O Enhanced e 8 0 JPEG High JPEG Quality Auto Enhancements Gamma correction 1 0 0 15 1 00 sharpen Sharpening amount Diespecle cBitewing Auto Enhancements Gamma correction 1 0 0 15 1 00 sharpen Sharpening amount Despecle Save Auto Focus Images Romexis Service is running Connected to server localhost
148. own below This dialog can also be shown by double clicking on any implant Planmeca Romexis x Implant properties Default Library Diameter 4 4 ae 44x 16 0 Mame Right lower molar Length mm 16 00 Diameter mm 4 4 Use the mplant Properties dialog to change the name colour length and diameter of the selected implant The dialog allows setting the length and diameter of the implant accurately in tenths of a millimeter Use the Library button to move to the mplant Library Planmeca Romexis D 41 IMPLANT MODULE NOTE Ifthe implant has been added or replaced from the Library the length and diameter cannot be changed as they are fixed to the values that were set in the library To change the measurement of such an implant use the Replace feature in the Library List implants in the plan E The List Implants dialog shows you all implants that are present in the current plan Use it to change the name colour length and diameter of the listed implants The dialog allows setting the length and diameter of the implant accurately in tenths of a millimeter by using a keyboard entry Planmeca romesis x Implant list Length mm Diameter mm Model ProductLine Manufacturer Left upper pre molar 222220 12 3 6 Right lower molar Ls 16 4444x16 0 Diameter 4 4 Default Properties Delete Close D 42 Planmeca Homexis User s Manual 5 1 1 NOTE User s Manual IMPLANT MODULE Impla
149. ows clipboard by right clicking the image and selecting Copy to clipboard from the pop up menu Moving Image to Another Patient An image can be moved to another patient by right clicking it and selecting Move from the pop up menu Define the patient to receive the image using the Search dialog Assign as Face Photo Assigns the selected image as patient photo shown for patient in Demographics screen under Files module Inactivating Image An image can be inactivated by right clicking the image and selecting nactivate from the pop up menu When the image is inactivated it will disappear from Romexis but will remain in the image folder on the hard drive The image can be permanently deleted in the Romexis configuration see chapter 9 ROMEXIS CONFIGURATION APPLICATION Planmeca Romexis C 27 IMAGING MODULE 18 Printing Images Print Editor Romexis Print Editor is a comprehensive tool for printing 2D and 3D regular and DICOM images The Print Editor let s you add multiple images of different type on the same print layout These images can be scaled in size and cropped and labels of the image properties can be added to the layout among other things MPlanmeca Romexis X 220 im nu OM Ez PAN 23 10 2007 8 02 26 NOTE Image not calibrated 1 00 Potilas 2D PLANMECA Romexis 0 E 1 1 i A i Scale 200 A E Y d i Labels L 3 NA 23 10 2007 4 23 10 2007 i NE o SansSerif Bold 12 26 11 200
150. panoramic view automatically move to reflect the changes Moving the slide bar of the panoramic view modifies the radius of the panoramic curve and the change is immediately reflected in the axial view by the panoramic curve moving in or out in relation to the patient s anatomy When the slider is released the panoramic view is automatically updated with the new curve 3 2 Adjust The Adjust tools at the top right contains accessories to process the views Adjust 3 2 1 Defining the Slice Thickness of the 3D Volume Thickness 0 48 The 3D volume thickness can be adjusted from a drop down menu This affects the display of the image in the sagittal and axial views but not in the panoramic view 3 2 2 Adjust contrast and brightness 28999 99 Regulates the contrast and brightness of the image views By dragging the sliders the brightness and the contrast can be adjusted The settings are saved automatically when the image is closed mi an 3 2 3 Defining Data Range By pressing the Define Data Range button the area of interest for the panoramic image can be defined You can select from which part lower or upper jaw the panoramic image is created In the appearing window move the sliders up or down to adust The left slider restricts the upper jaw and the right slider the lower jaw D 28 Planmeca Romexis User s Manual 3D PANORAMIC MODULE OPTIONAL Planmeca Romexis Define data range 3 2 4 Show Hide
151. pply binning so that the volume shrinks to half of the original so that for example a 0 16mm resolution results in 0 32mm resolution e 3 Apply binning so that the volume shrinks to one third of the original so that 0 16mm resolution results in 0 48mm resolution A recommended output to use in 3rd party implant planning software is 0 32mm or 0 48mm voxel size When exposing in High resolution or Standard modes 0 16mm use binning value 1 or 2 resulting in 0 32mm or 0 48mm and with the Low dose mode 0 32mm use binning value 1 or blank resulting in 0 32mm Planmeca Romexis F 17 LOCAL SETTINGS Dental Unit interface Use the PLANLINK Dental Unit interface to enable Intracam activation and foot pedal automation in Romexis This setting should be used instead of Intracam Serial Connection only in case the PLANLINK service is in use In most cases however this should be disabled and the Intracam Serial Connection explained below should be used instead Please note that the PLANLINK operation requires a PLANLINK enabled Planmeca Compact i unit Intra Cam Serial Connection CamComm Enable this setting to enable Intracam activation and foot pedal automation in Romexis using standard Serial Connection The Comm port needs to be specified correctly and is in most cases COM1 Please note that this requires the use of Planmeca Compact unit Practice Management Software Interface PMBRIDGE Enables Practice Management PMBridge interf
152. presented e Grade Scale The Grade Scale can be selected manually for example A B C or alternatively 10 9 8 by setting the grade scale from the best to the worst User s Manual Planmeca Romexis H 15 IMAGING 2 7 PlanLink amp Diagnostics FR Planmeca Romexis Configuration 2 2 0 15 8 5 25 09 PLANMECA Romexis Show Help 73 General Settings E Resources PlanLink Compact Unit Lock Dor t Lock Units General Locs Units on Chair side PC Shutdown PlanLink Proxy L FEE save Liagnastic Events to Database LJ Security n e 7 m i Save all errors cleaning operations and helpcodes LJ Regional Save all errors and cleaning operations E E Imaging 0 Dor t save anything F Panoramic LJ Cephalometric Export Ergadata files Lj Intraoral Exportto Zip 3 CBVT Lj Display Dental Unit User Settings Dental Record Send Service Modes PlanLink amp Diagnostics 5 Print Image amp Data Management LJ Data Folders E mail Notifications SMTP Server Hast Mame localhost SMTP Server Port 25 LJ Trash Notification period mins 5 Long Term Archive Don t e mail for same error in mins 60 L3 Start up Lj Client Parameters Romexis Service 5 Server Parameters Romexis Service is running Connected to server localhost OK Cancel PlanLink Compact Unit Lock Specifies whether the dental unit sho
153. preted Image interpretation should only be done by a competent person who is familiar with the CBVT imaging capabilities limitations and artefacts of the ProMax 3D A 6 Planmeca Romexis User s Manual ROMEXIS MODULES 2 ROMEXIS MODULES The Romexis software is built around different software modules Each of them is designed to perform special tasks These modules can be accessed through the navigator buttons located in the vertical toolbar on the left edge of the screen 1 Patient module providing patient selection and management 2 Files module holding demographics 3 Dental record module optional 4 Imaging module for X ray and other imaging needs 5 3D Imaging module for ProMax 3D images optional 6 Clinic management optional 7 Report module 8 Admin module The navigator toolbar is always visible and it can be used for navigating between the modules at any time during the work process NOTE The visibility of the Romexis modules and functions are controlled by license and user rights Depending on the installed licence and user rights the functionality described in this manual can vary User s Manual Planmeca Romexis A 7 STARTUP 3 STARTUP After startup the user is presented with a login window if so defined in the Romexis Configuration application see chapter ROMEXIS CONFIGURATION APPLICATION The appearance of the Login window may differ from the above depending on
154. pturing begins to activate deactivate the test capture refer to ProMax 3D user s manual With this function two images in an angle of 90 to each other more particularly one coronal and one sagittal image will be captured This means that patient positioning can be verified before the final exposure and additional radiation caused by an otherwise possibly required retake can be prevented Capture 3D Image Connecting To ProMax Press Ready at ProMax Initializing aiting For Ready aiting For The Exposure starts Exposure Starting Exposure FramesGrabbed 1 FramesGrabbed 2 Y Automatically close this window when image is ready D 6 Planmeca Romexis User s Manual 3D EXPLORER After all exposures have been captured and the reconstruction calculation is done the 3D study is automatically saved into the database under the patient file and displayed on the screen see the figure above for an example If ProMax 3D stitching mode is used the stitching window is automatically presented in Romexis For more information see 2 1 3 Stitching Multiple Volumes on page 8 2 1 2 Artefact Removal User s Manual Objects of high density such as amalgam or other metallic bodies can cause artefacts on X ray images because the radiation cannot penetrate them Artefact Removal is not automatically applied when the volume is reconstructed but if disturbing artefacts are present after a successful capture you may w
155. r vrallgang EEN m 1 Intra 2 3 2007 1331 Thomas Schn ck thomas Gostha Johann Weollgang TBTUSRT m 21 Intra 2 3 2007 1331 Tnamas Schnack thomas Casta Johann wonging TBTUES n H intra 232007 1132 Thomas Schreck Pret ri aa jGaoema Johann Walt ang FATHER 7 aT Intra 2 3 2007 1437 Mom s Schack In rrias Gostha Johann agang LLLI m 21 Intra 2 3 7007 14 40 Thomas Schnack Mimis Gosthe Johann alt ama TS LE i hal Intra 2 3 7007 14 41 Thomas Schack thomas taste Johann Volt ang UGN n i Intra 2 3 7004 14 41 Thomas Schreck h mas anama Jahan MONA FATHER Y aT intra J 3 2007 1441 Tnaria amp Schnri ck In rrias Gostha Janann an Ee m 21 intra 3237007 1441 Thomas Schnack thomas jGoema Johann Walging MTA LE I 2T Intra 2 3 7007 14 41 Th mas Schack mamas Goethe Johann Volta ang UGN n i finra 2 3 2007 14 42 Thomas Schneck thomas Goem a Johann vromgang HUEN 7 21 Inia 232007 14 42 Thomas Schneck thomas Guerra Johann Woligang Teraeer i 1 intra 2 3 2007 14 42 Thomas 3chnack thomas Goema Johann viol gang GT UCOT ii intra 2 3 2007 14 42 Thomas Schnack thomas Cosme Johann Viol gang TarH BI 1 lintra 2 1 007 1443 Thomas 3chneck thomas Dora Johann vrolgang UELH m f intra 2 3 2007 1443 Thomas Schneck thomas Guerra Johann vigligang Teraeer i inira 2 3 2007 14043 Thomas 3chnack thomas Goshe Johann Woligang 7GT COT ii intra 2 3 200 14 43 Thomas Schnack thomas Goes Johann Violfgang UEN 1 lintra 2 3 2007 14 44 Thomas 3chneck thomas Q
156. rage function to send processed images back to the DICOM PACS server Use Query button to list images for a patient at the Patient Root Level Retrieve button to retrieve the selected images and Study button to list images at the Study Root Level all Patients Y DICOM Worklist Patients Y DICOM Worklist DICOM QueryRetrieve Find by Image by Image Patient DICOM SAR Query Person ID QR_AE TITLE MERGE_QR_SCP m Retrieve Last Name CALLING AE TITLE ROMEXIS_1 Person ID Last Name First Name Date Of Birth 13 10 2008 11 32 DICOM Query Retrieve log B 6 Planmeca Romexis User s Manual Chapter ea 2D IMAGING MODULE 1 IMAGING MODULE The Imaging module is used for X ray image and photo capturing processing and storing The centre of this module is used by the image viewer to show images that are captured or opened by the user The image viewer automatically places images into a layout attempting to maximise their viewable size The layout can be modified by clicking the Layout button see section 1 2 6 Layout Button on page 4 for more information on layouts The bottom of the Imaging module is normally employed by the image browser that allows the user to open images into the image viewer by double clicking on them The image browser can be hidden and made visible using the Browser button see section 1 2 Image Browsing and Viewing on page 2 for more information imagi
157. ragging the sliders or by moving the mouse on the image while pressing the left mouse button Horizontal movement changes the brightness and vertical the contrast User s Manual IMAGING MODULE Region of interest Use the Region of Interest tool to specify and select the area of effect for image processing tools and certain measurements Use this tool together with for example image Histogram tool to view grayscale values of a region Note that it is possible to specify multiple regions and to switch between them by using the Region of Interest tool Active region is denoted in green and inactive regions in blue color Use Delete Measurements tool or Delete key to delete the selected region 1 5 2 Image Toolbars 1 1 Scales the image 1 1 Zoom in zoom out Show image properties Opens the General tab under Image properties window where the tooth numbers for intraoral images can be defined the image can be rotated flipped and the image file info and exposure parameters can be viewed Show image diagnosis Opens the image Diagnosis tab under Image Properties Shows and allows editing image diagnosis Diagnosis up to 2500 characters is supported User s Manual Planmeca Romexis C 21 IMAGING MODULE Horizontal image toolbar Show vertical image processing toolbar Opens the vertical image toolbar Close the image B Maximize the image C 22 Planmeca Romexis User s Manual IMAGING MODULE BEEN Vertical image
158. ramic radiography using image compression C G H Sanderink et al indicate that the loss of data may be insignificant Planmeca cannot guarantee that it is safe to use compressed image data for diagnostic purposes 1 The actual achievable values depend on the individual image 2 Because of the extensive disk space requirements and the additional X ray radiation needed to achieve the same low level of noise quantum mottle the user should carefully evaluate the advantages of using the enhanced high resolution mode A 4 Planmeca Romexis User s Manual INTRODUCTION TO PLANMECA ROMEXIS Disk Space Requirements for 3D Images 3D volume 8x8 High resolution DICOM 3 0 format 250 MB multi frame 3D volume 8x8 Low dose DICOM 3 0 format 31 MB Normal resolution multi frame 1 6 Processing Note that some of the image processing operations radically alter the appearance and possibly the diagnostic value of the image However it is always possible to restore the image to its original state or undo modifications one by one 1 7 Measuring The measurement tools allow both geometric and relative intensity i e radiotranslucency or brightness contrast measurements to be made When performing geometric measurements it should be noted that image processing operations even just adjusting the brightness contrast can alter the apparent geometry of the objects in the image Also because of the normal distortions most notably varying magnifi
159. rve and data range definition Therefore when one is changed in either of the tabs the changes will be reflected in the other tab as well Sagittal or axial rotation of the 3D volume is defined in the Panoramic Module and also affects the Cross Section Module Edit Cross Sectional Slice Interval To edit the cross sectional slice interval move the slider up or down If the section lines are activated in the Edit Orientation Lines see 4 6 3 Show Hide Settings on page 36 the adjustment is visible in the axial view indicated by the yellow lines After moving the slider the cross sectional view gets updated accordingly Edit Cross Sectional Slice Width To edit the cross sectional slice width move the slider up or down If the section lines are activated in the Edit Orientation Lines see 4 6 3 Show Hide Settings on page 36 the adjustment is visible in the axial view indicated by the yellow lines After moving the slider the cross sectional view gets updated accordingly Planmeca Romexis D 33 3D CROSS SECTIONS MODULE OPTIONAL 4 3 Adjusting axial slices Clicking the button in the upper right corner of the axial view opens a dialog where the number of axial slices the distance between them and the thickness of the slices can be defined 4 4 Adjusting panoramic slices Clicking the button in the upper right corner of the panoramic view opens a dialog where the number of panoramic slices the distance between them and the t
160. ry Days agg Approval Expiry Hours ag Clinical Menus Show Menu Numbers Show Menu Guidance Show Tooltips Odontogram Show Tooltips Show Large Perio Boxes Case History Create CaseHx Mote For Approvals Warn About Unapproved Mates Image Acquisition Request Student Evaluation Evaluate All Case Notes Show Student Grade Evaluation Show Student Free Evaluation Grade 1 Best Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 3 Grade 10 Worst 10 g E 7 E 5 4 show Help gt e Approval Expiry Days Sets the image acquisition request approval expiration time in days 1 day 24 hours e Approval Expiry Hours Sets the same time in hours Clinical Menus e Show Menu Numbers Shows Clinical Menu numbers e Show Menu Guidance Shows menu guidance e Show Tooltips Enables tool tips in the clinical menus Odontogram e Show Tooltips Enables tool tips in the Odontogram e Show Large Perio Boxes Enables large perio boxes in the Odontogram H 14 Planmeca Romexis User s Manual IMAGING Case History e Create CaseHX Note for Approvals Creates a case history note of every approval e Warn About Unapproved Notes If Warn About Unapproved Notes is selected Romexis warns about unapproved notes Student Evaluation e Show Student Grade Evaluation Enables the Grade Evaluation when approving case notes e Show Student Free Evaluation The Free Evaluation field is
161. ry date e Entry reason selectable from the following e Scheduled Service Visit e Service Visit e User Guidance Visit e Remote Service e Remote User Guidance e Error events that the service entry negates can be selected from the list of all errors Click the Add and Remove buttons to modify the list Once negated the errors no longer show in Diagnostic Log Date Code 12 11 2007 16 20 36 2 12 11 2007 16 20 36 2 Add Remove e Elapsed Time For recording the time consumed on the service operation e Spare Parts A list of components used Part number part name and quantity can be recorded as listed in Planmeca s spare part manuals for example e Free comment A field for explaining for example the steps taken during the mainte nance e Reset Values Set a service point to reset the units summary counter values Use these options after servicing a part or the dental unit The options can be changed at a later point in case an erroneous recording was made These settings only affect the display of summary values and they do not affect the data stored into the database which remains fully available for reporting e Dental Unit Resets the dental unit counter when for example annual maintenance is done e Operation Light Resets the operation light counter when the lamp is changed 1 5 Info View The Info view provides commonly needed instructions on the dental unit s operation
162. s first opened Planmeca Romexis D 25 3D EXPLORER Overlay Properties The following properties can be defined for the overlay Overlay Properties coor I sa Threshald 659 U Transparency 50 96 Color Specify the color that the chosen gray values should appear in Threshold Specify the grayscale value to be colorised between 0 4095 Transparency Specify the level of transparency of the overlay against the rendering 096 for fully opaque and 100 for fully transparent 3D Rendering Options A Set Rendering Options The following options are available for Surface style rendering Rendering methods Maximum Intensity Projection MIP Rendering smoothing slider NOTE NOTE 3D rendered view quality can be changed in Romexis Admin module see chapter ADMIN MODULE D 26 Planmeca Romexis User s Manual 3D PANORAMIC MODULE OPTIONAL 3 3D PANORAMIC MODULE OPTIONAL In the 3D Panoramic Module panoramic views can be generated from the 3D data The panoramic image generated can be adjusted and processed in multiple ways The image range and thickness can be defined as well as the selection of the appropriate curve for the construction of the panoramic view Also an export of the displayed view with Save 2D View to the 2D IMAGING MODULE can be done The image can also be printed from Panoramic Module The Panoramic tab contains four views e Sagittal view where the sagittal orientat
163. s into a study template click the button 10 5 2006 FMzE 18 Intra Intra Intra l Intra 18 16 16 1 24 76 26 28 E A E 14 15 i Intra Intra Intra 1 1 21 LM M MI 10 Intra Intra Intra Intra 18 16 46 48 16 14 44 46 76 17 15 24 26 36 34 26 28 38 36 E E 4 Intra Intra Intra Intra 46 48 44 46 36 34 38 36 Planmeca Romexis User s Manual IMAGING MODULE Select the desired study template from the list At the beginning of the list there are empty templates and at the bottom of the list there are studies with dates that already include images captured earlier 1 Intra Irii ES rr 11 31 173 a 8 1 14 Intra Inka Iria nia PtH ARR 15 05 03 46 BAP 25 33 28 78 38 34 10 ti 12 intra Intra intra ir TET DES S 7 18 Lr ou 15 35 aoe Jania Orianitation j po While capturing images using a study Romexis walks through the template in a predefined order denoting the current image to be captured by a blue border around the slot Follow the tooth numbering and sensor orientation as shown on the top also predefined in the template User s Manual Planmeca Romexis C 11 IMAGING MODULE You can cancel the process with the Cancel button in which case the captured images are saved and the incomplete study is preserved for later use Intraoral Exposure g 3 14 Intra Intra 24 26 36 34 26 28 38 36 Sensor Orientation 13 4 21 22 2 s4 s3 52
164. s on a common image archive that can be located on a network server Special attention has been paid to keep the operation of the Romexis system as simple as possible However it is important to realize that no computer system can be operated continuously and successfully without competent software and hardware support Especially in mission critical applications such as the archival of patient images adequate care must be taken so that the continuous operation of the system is ensured This includes but is not limited to ensuring that hardware and software support is available phone help and user training has been organized and that the backing up of patient data has been arranged lt is recommended that a competent system integrator service is engaged for this purpose User s Manual Planmeca Romexis A 1 INTRODUCTION TO PLANMECA ROMEXIS 1 1 Brief Introduction to Digital Imaging Digital images are composed of small dots called pixels much like photos in a newspaper The size of each pixel sets an absolute upper limit on what can be observed See the table below for the pixel sizes and corresponding theoretical maximum resolutions Note that because of the magnification inherent in all projection X ray techniques the theoretical resolution at the object level is slightly higher Table 1 2D images DIMAX2 3 normal 132 um 3 8 Ip mm 4 5 Ip mm 5 5 resolution mode DIMAX2 3 enhanced 99 um 5 0 Ip mm 6 0 Ip mm 7 3 resolution mode DI
165. selected orientation Film Size Several choices This setting allows forcing the printer to use a certain film size Magnification Type Default Replicate Bilinear Cubic None Default will use the default magnification type of the printer while the others can be used to overrule Smoothing Type Please refer to your DICOM printer manual for more information on this setting Magnification Factor The multiplier to magnify prints Set this to a value larger than O to scale images up or down 0 5 will yield 50 size 1 yields 100 while 1 5 yields 150 scaling Leave empty to let the printer fit the image on the film Header Text Height Text height for text in header Values between 20 50 are usually good Leaving this empty will cause no header to be printed Please note that if a magnification is applied in printing the text sizes will also be scaled accordingly Footer Text Height Text height for text in footer Values between 20 50 are usually good Leaving this empty will cause no footer to be printed Annotation Text Height Text height for annotation Values between 20 50 are usually good Leaving this empty will cause no annotations to be printed Planmeca Romexis F 13 IMAGING 2 2 3 DICOM Storage Settings e Store new Images automatically Specify whether newly captured images should be automatically processed by the server side automatic DICOM Storage Please note that if the server side automatic DICOM Storage is d
166. settings in the tool above User s Manual Planmeca Romexis C 23 IMAGING MODULE Vertical image toolbar MN mu Noise removal 93 Invert the image Apply Ceph filter to bring up more facial soft tissue Adjust the vertical green lines to specify the area of effect Use the Gain Slider to adjust the strength of the filter higher values will bring out more tissue Apply pseudocolours Use the Adjust levels dialog to modify the colours Save modifications Homexis saves image modifications automatically when the image is closed In case you want to save the image while working with it use the Save button El H Ia Revert to original Removes filters and grayscale adjustment from the image and shows it without preprocessing as it was when received from the X Ray unit Undo c Redo C 24 Planmeca Romexis User s Manual IMAGING MODULE 1 6 Image Studies An image study is a collection of related images of one patient lt is always based on a study template where tooth numbers and exposure order can be predefined See section Templates in chapter ADMIN MODULE for information on how to create image templates and section 1 4 Image Acquisition on page 10 for information on how to capture images to a study 1 6 1 Arranging Images in Study To view an overview list of populated studies enter the Imaging module and click the Study button in the Image Navigator To open the selected study c
167. ssigned to the current user the Find assigned button can be used to list these patients from the database Adding Template Patients For educational purposes Romexis offers a combination of template and virtual patients The idea of template patients is that supervisors can create virtual patient cases for students to practice on in simulation laboratory Thus template patients are not real patients but represent possible patient cases that can then be cloned into virtual patients for the students to actually work on The supervisor can define a template patient s oral status medical dental history and import images to the template patients Template patients are created by clicking the Add template button Before students can actually start working on a template patient it needs to be cloned into a virtual patient that can then be assigned to individual students Template patients can be differentiated from other patients by a Template entry in the Type column B 4 Planmeca Romexis User s Manual PATIENT SELECTION AND MANAGEMENT 1 10 Adding Virtual Patients NOTE 1 11 1 12 Fl Planmeca Romexis 1 4 0 279 0 5 3 7007 Thomas 5chneck thomas After the supervisor has created a template patient virtual patients for students can be created The idea is that each student has their own virtual patient s to work with but all students start from the same template patient that is with the same clinical problem set To cre
168. ssion granted he can freely modify the toolbars directly without entering the Admin module as follows These personal customisations will be automatically applied to each user when they login to Romexis F 2 Planmeca Romexis User s Manual User s Manual RESOURCE To open the toolbar specific customisation menu click on the arrow in the top right corner of the toolbar if Toolbar Borders are enabled you want to customise or right click on any button in the toolbar The following options are available in the toolbar customisation menu X ray TET MD we oso o Show Text ahels p A Y Show Toolbar Borders Ceph Intra Intra ue Customize Toolbar Exp wiStudy ERD wIPS Pan Exp Pan Exp Ceph Exp Reset Toolbar to Defaults Intra Exp Intra DEP Y vi v Intra w Study J af Show Text Labels Show the function of each button in a text label below the button Show Toolbar Borders Show a title bar and border for each button group Customize Toolbar Allows showing and hiding buttons in each button group Reset Toolbar to Defaults Reset the currently selected toolbar to settings for the user s group To show or hide complete toolbars or reset all toolbars to defaults at one right click between the toolbars or in any empty area next to the toolbars to call up the general cus tomisation menu as shown below Ceph Intra Intra Intra TWAIN TWAIN Import DICOM DICOM
169. tVRLittleEndian 4 ExplicitvRBigEndian A OK Cancel In addition to AE Title Host Name and Port Number parameters the Transfer Syntax to be used can be set to No Restriction automatically negotiated or limited to a certain Transfer Syntax for increased compatibility User s Manual Planmeca Homexis F 11 IMAGING 2 2 1 DICOM Storage Setup In the opening Storage Setup window the DICOM Storage Settings can be changed or checked xi DICOM Storage Setup AE Title STORE SCP Reuse association for Singlefrarre CT images Supports Enhanced Multiframe CT images Send Images with processing apolied 7 Send Images with annotations applied Storage Commitment enabled Twc association made for commitment Listeinc part far commitment 146 Timeout for commitment 5s 130 DICOM Storage Setup options e Reuse association for Singleframe CT images Specify whether a single storage association should be reused for all frames in a Singleframe CT image set If disabled a new association will be opened for each frame e Supports Enhanced Multiframe CT images Enable this option if you prefer to have 3D volumes sent to DICOM Storage in multiframe format See your DICOM Storage server documentation for more information e Send Images with processing applied Enable this option to have all image enhancements applied in Romexis to be merged into the image that is sent to DICOM storage
170. tal unit operation in line graphics e Instrument type and power level Different instruments are denoted with different colors e Seat height E 6 Planmeca Romexis User s Manual CLINIC MODULE VIEWS e Backrest angle e Operating light level e Syringe on off e Suction on off Instrument Backrest Op Light I I I I 11 38 11 40 11 42 11 43 MiwaH Brushless Micromotor Satelec Scaler Showing 5 mins Z 1 76 E 639 WE Bien Air MX Brushless Micromotor In addition to monitoring the following shortcuts are available to perform routine opera tions on the dental unit e Enter service mode on dental unit Before doing so make sure that nobody is using the dental unit e Save current settings from the dental unit into the current user s profile in Planmeca Romexis central database e Load stored settings from the current user s profile into the dental unit e Start short instrument flushing e Start long instrument flushing e Start Waterline Cleaning System cycle e Set BienAir micromotor reverse operation mode e Set BienAir micromotor torque operation mode User s Manual Planmeca Romexis E 7 CLINIC MODULE VIEWS 1 2 1 Storing And Restoring Personal Settings To store personal dental unit settings first make the desired settings on the unit Refer to the dental unit user s manual on how to change the instrument settings After you have made the desired settings click on the Save Settings button below
171. te all patients Report Print demographics System Administration Patient Queries View DICOM Worklist View DICOM Query Retrieve OK Cancel Use the Update button to alter the permissions of an existing group Use the nactivate button to inactivate the user group User s Manual Planmeca Romexis F 1 RESOURCE 1 1 1 Customising Toolbars The primary way of customising toolbars in Romexis is via user groups This allows each specialist group at the clinic to see a customised set of tools suitable for their work on any Romexis workstation they may use Personal customisations are possible if a user s group has the Edit Toolbars permission granted The Toolbars tab allows flexible toolbar customisation for each user group By default all toolbar buttons are visible and they should be selectively hidden by adding them to the Hidden list on the right Update Group Sroup Sroup Name Pmbridge Users Description Permissions Toolbars select Toolbar to Edit 3D Imaging Horizontal Image Processing Image Titlebar 2D Imaging Vertical Visible Input Hidden o 3D Capture er Artefact Removal Stitch Volumes a Raw Import 33 DICOM MF Imp A DICOM SF Imp Output E Export Volume 5 Print Editor zz DICOM Print o DICOM Storage l Launch Ext App X7 Pro Model aa Save 2D Measure View T Adjust Levels NOTE OK Cancel If a user belongs to a group that has the Edit Toolbars permi
172. ted 2 1 7 Windows Printing Print Editor User s Manual Click the Print button d to start printing to a Windows printer Use the Save 2D View dialog to specify which viewports to print or to create one image or single images for Print Editor To open images in Print Editor click OK For more detailed information see paragraph 1 8 Printing Images Print Editor on page C 28 xj Save 2D View Click images to select Color image Create single image Planmeca Romexis D 15 3D EXPLORER MpPlanmeca Romexis AO a Pl si C000 Case Demo DOB ID 5353 Scale 100 POS V o 1 2 222 Scale 100 P j 6 3 2008 84 0kV 12 0mA PLANMECA i Romexis 2 1 8 DICOM Printing Print Editor PLANMECA Romexis Scale 100 E Close CBCT 6 3 2008 18 52 19 11 00 22 08 Sezo Labels SansSerif Bold 12 m A 8 Sample Text mGyxcm Scale Img Scale 96 96 Mana mm Click the DICOM Print button 3 to start printing with DICOM compatible printers See paragraph 2 1 7 Windows Printing Print Editor above NOTE ADMIN MODULE D 16 Planmeca Romexis For help on configuring DICOM print see section DICOM Configuration in chapter User s Manual 3D EXPLORER 2 1 9 DICOM Storage NOTE In case a full DICOM license is purchased images can be sent to a remote DICOM application i e DICOM image archive PACS DICOM Storage needs to be configured in the A
173. the settings configured by your administrator After a successful login Romexis enters the Patient module where patients are managed The name of the current user is shown in the title bar A new login is initiated by clicking the Login button The Logout button closes all patient files and logs out the current user NOTE If a new Login is performed while another user is currently logged in all patient records are closed but the current views will be remembered and will be shown when a patient is next accessed by a user This function allows multiple authorized personnel to conveniently view and modify a patient s status using their own credentials If the Logout feature is used no views will be remembered and the patient data will be opened with default view when next time accessed A 8 Planmeca Romexis User s Manual Chapter sa PATIENTS AND FILES MODULE 1 PATIENT SELECTION AND MANAGEMENT After startup the Patient module opens automatically In the Patient module you can Search for a patient in the database Open a patient file View and sort a list of patients Add new patients Edit patient information Assign patients to a certain doctor student Search for patients assigned to a certain provider Create template patients Create virtual patients Inactivate patients 1 1 Patient Search Patients can be searched by ID or by name To search a patient by ID enter the patient ID in the
174. tif C 4 Planmeca Romexis User s Manual User s Manual After IMAGING MODULE selecting the file s and clicking Open a window for setting image parameters appears Select the image type and for intraoral images also define the tooth numbers For multiple images you are prompted separately for each image If you click Cancel to skip a single image when importing multiple images Romexis will ask Continue importing images Click Yes if you want to continue importing the rest of the images tar i T 74 f ve Image Type Exposure Date 9 Panoramic 10 11 2006 v Cephalometric gt gt AAA EE l Intraoral Photo ara ee ee 31 32 33 34 35 as 71 72 73 74 1175 PA AA A A A A A A A A A A AA AA AA oK Cancel It is also possible to crop the image when importing Click the Crop button click and drag the mouse on the top of the image to specify the area of interest A green rectangle will appear to denote a selection in process When the mouse button is released the rectangle will turn red to denote a successful selection Planmeca Romexis C 5 IMAGING MODULE 1 2 8 Exporting Images Lg Open the image s or study that needs to be exported Click the Export button x Export Export File Type Processed images as they appear on s
175. to Import From Input Dir To acquire an image from the TWAIN device click the Acquire image using TWAIN button to start the TWAIN interface Refer to the scanner camera user s manual for information on how to proceed with the device you are using 1 4 5 1 TWAIN Source Settings User s Manual Wait for TWAIN driver Close Specifies whether a Close command is expected from the TWAIN driver to signal the end of scanning session If disabled only single scan is expected to be received When enabled multiple scans can be made in one session which are all returned in one batch when the scanning dialog is closed If the scannersoftware is capable of scanning multiple images in one session this setting should be enabled Prefer Memory Transfer Enables Memory Transfer instead of Native Transfer mode Hefer to your scanner documentation for more information on supported and or preferred mode For scanning color images Prefer Memory Transfer should be enabled Show TWAIN Launch Dialog If enabled a dialog is shown when the scanner software has been launched via TWAIN On some lower end systems bringing up the TWAIN interface can take some moments during which it may be useful to notify the user of the process Some virus scanning software is also known to slow down the TWAIN launch Show Import Dialog Specify whether the Romexis image import dialog should be shown for each imported image The image import dialog allows the users to choose image
176. tton to initiate panoramic image capture mode The Panoramic Exposure window appears When the X ray unit is in ready state a message Waiting for Ready appears on top of the window Prepare the patient for exposure and select the exposure parameters and drive the X ray to the ready position Refer to your Planmeca panoramic X ray units user s manual if uncertain When the panoramic unit is in ready position a message stating Waiting for Exposure appears on top of the window You can now expose the X ray as normal Xx Adjust SmartPan Layer Bl o Save Done I Cancel After exposure an image Layer 0 appears on the screen By clicking the left and right arrows on both sides of the Adjust Smart Pan bar new layers are processed 4 3 2 1 0 1 2 3 4 which can then be browsed through the menu To select layers click Save when the desired layer appears on the screen To open the selected layers in the Romexis 2D Image processing view click Done Planmeca Romexis C 13 IMAGING MODULE 1 4 3 Capturing Cephalometric Images E m qe To capture a cephalometric image click the 1 j button to initiate the cephalometric image capture mode The Cephalometric Exposure window appears When the X ray unit is in ready state a message Waiting for Ready appears on top of the window Prepare the patient for exposure and select exposure parameters and drive the X ray to ready position Refer to your Planmeca cephalometri
177. tudy View Selected View Selected Delete Study Delete Study Clear 1 2 4 Creating a New Study An empty study can be created with the Ea button Select the template you want to use to create a new study For information on how to add images to an empty study see section 1 6 3 Adding Image to Study on page 26 Please note that to capture X rays directly into a template you should follow the instructions in section1 4 1 Capturing Intraoral Images on page 10 in this chapter 1 2 5 Closing All Images All open images can be closed by clicking the button User s Manual Planmeca Romexis C 3 IMAGING MODULE 1 2 6 Layout Button Images open in the viewer can be arranged into a temporary layout with the L button Choose Layout Custom Custom q lo n lo gt o lo o lo gt o These layouts are also used to position multiple images for printing If the same layout is used frequently it is advisable to define and use a study template instead See the previous sections for using studies and chapter ADMIN MODULE section 2 1 Templates on page 8 for how to define templates 1 2 7 Importing Images Click the button and browse to the image file to be imported Several images can be imported at the same time by holding down the Shift or Ctrl key while selecting files intra4 tif pan12 jpg pan1 amp JPG ls pan16 TIF ceph1 TIF pan8 TIF DP100000 T1F E PSP
178. uema Johann Wolgang UELH i lintra 2 3 2007 14044 Thomas Schneck thomas oema Johann Violfgang Tereear n 1 intra 2 3 2007 15 13 Thomas Schnack thomas Frigch Max 7636 1 4 intra 2 3 2007 15 21 Thomas Sehnack tomas Friseh Max 7836 1 mira 2 3 2007 15 36 Thomas Sehnaek thomas Friseh Max 763b nm i inira 2 3 2007 15 39 Themas Sehnack thomas Friszh Max 7836 t intra 2 3 2007 15 30 Thomas Sehnaeck thomas Frigeh Max 7676 17 1 intra 2 3 2007 15 42 Thomas Sehnack tomas Frisch Max 76036 1 lintra 2 3 2007 18 42 Thomas Sehnaek thomas Friseh Max 763b n El inira 2 3 2007 15 50 Thomas Sehnack thomas Frigeh Max 7836 5 t Em 2 3 2007 15 51 Thomas Sehnack tomas Frigzh Max 7636 7 1 Jintra 2 3 2007 15 51 Thomas Sehnack tomas Frisch Max 7836 4 1 lintra 2 3 2007 15 51 Thomas Sehmeck thomas Fiigch Man 7636 inira 2 3 2007 16002 Thomas Schreck thomas Frisen Mar 7835 intra 2 3 2007 1607 Thomas Schreck thomas Frisch Maw 76 36 7 intra 2 3 2007 1607 Thomas Schneck inamas Fiach Mar 7636 7 1 intra 2 3 2007 16 02 Thomas Sehnaek thomas Friszh Mas 71636 7 1 intra 2 3 23007 1606 Thomas Sehnark nomas Frisen Mas 7636 7 f intra 2 3 2007 1606 Thomas Schreck thomas Frisch Maw 7636 7 i Intra 2 3 2007 1606 Thomas Sehnaek homas Frsem Mar 7636 7 1 intra 2 3 2007 1606 Thomas Sehmeck thomas Frisch Man 7636 7 1 intra 2 3 2007 16 13 Thomas Sehmeck nomas Frisenm Mas 7636 7 4 intra 2 3 2007 16 13 Thomas Sehmeck thammas Frisch Maw 7636 7 i uk 132007 16 13
179. ues automatically based on the curve of the histogram To modify the Pseudo Colours manually drag the rectangles above the histogram left or right With this the position and range of the specific colour can be altered By double clicking the rectangle the colours can be changed for an individual selection The R button resets the settings of the Pseudo Colours From the arrow button ready made color maps can be selected NOTE Ahistogram is a graphic representation of the intensity distribution in the volume Show Pseudo Colours in 3D Rendering Available only in X ray Style rendering Clicking this icon changes the greyscale to colours In the Adjust Levels window of the 3D Rendering the colours for the different tissues can be modified Rotate Light Direction Available only in Surface Style rendering D 24 Planmeca Homexis User s Manual 3D EXPLORER 2 3 2 2 Rendering Orientation Tools The rendered volume view has three coloured planes indicating the coronal sagittal and axial planes These planes help you in orienting the three slice views in relation to the 3D rendering and actual anatomy The planes can be shown hidden by pressing the corresponding buttons at the right side of the rendered volume views as follows Show coronal plane green Show sagittal plane red Show axial plane blue Show Hide all planes The following options are also available Show Hide Volume Boundaries The 3D v
180. uld be locked when PlanLink proxy service is not available to collect diagnostic information If locking is enabled the dental unit will be inoperable when the connected PC running PlanLink proxy is shut down or otherwise connection cannot be established between the PC and the dental unit When connection is re established the dental unit will again become operable after a power cycle Save Diagnostic Events to Database Specifies whether the diagnostic events and messages collected from the dental unit should be save into the database The default setting is recommended Export Ergodata files Export to Zip Use this function to export all recorded diagnostic data ergodata from dental units to a zip file for troubleshooting purposes H 16 Planmeca Romexis User s Manual IMAGING User s Manual Dental Unit User Settings Send Service Modes Enable this setting to include dental unit service mode settings when dental unit settings are stored to database and restored back to dental units In normal operation this should be left disabled but can be useful at dental unit installations if numerous new dental units must be configured identically E mail Notification Romexis Server can be configured to send alert e mails when specific diagnostic events take place in dental units Romexis sends the e mails to the SMTP Server configured here Device alerts can be configured using Romexis Client Admin Module SMTP Server Host Name Defines th
181. ultiple Volumes You can produce larger volumes in Romexis than the native maximum of 8 x 8 cm allowed by ProMax 3D This process is called stitching and it involves joining together 2 or more volumes captured from neighbouring anatomy When positioning the patient for stitched imaging it is important to consider the barrel like shape of the volume and to allow adequate overlap between each volume See also the latest ProMax manuals for information on automatic stitching modes available at X ray exposure time If ProMax 3D is set to the stitching exposure mode the Stitching dialog is automatically presented at the exposure time The volumes are automatically added and aligned so that the user only needs to check the correctness of the alignment and click Stitch to finish For vertical stitching the volumes must first be prealigned by hand in Romexis using the stitching mode Auto with Tilt Volumes can also be re stitched or volumes captured not using ProMax 3D stitching mode can be stitched manually The following applies to re stitching and manual stitching D 8 Planmeca Romexis User s Manual NOTE User s Manual 3D EXPLORER All volumes are converted to 300 um voxel size for stitching This resolution corresponds to that normally achieved using ProMax 3D Low Dose exposure mode To start stitching volumes together make sure that the patient has at least two appropriate volumes and click the Stitch Multiple Volumes Into One Es button T
182. while dragging to define the length and direction of the PA line Romexis will automatically introduce the opposite half of the line and round its total length to nearest millimeter To finish the line release the left button and Romexis will automatically populate the slice views Draw left PA line using this tool r Repeat the process described in step 5 By default the Synchronise Sides tool d is enabled so that the left PA line length is constrained to match that of the right PA line In this case only the direction of the left PA line needs to be defined To specify a left PA line of different length disable the Synchronise Sides tool Use the view settings dialogs to adjust the number width and Spacing of me PA and lateral slices similar to other 3D modules 8 To adjust the position of the PA lines verify that the Set TMJ Edit tool Wt is enabled and then use left mouse button to move a PA line or right mouse button to rotate To adjust the width of the slices length of the PA line either use the slice specific settings menu or redraw the line D 46 Planmeca Romexis User s Manual TMJ MODULE 6 1 TMJ Tools Y Draw Right PA Line i Use to draw and define the posterior anterior PA line for the right side slices Draw Left PA Line Use to draw and define the posterior anterior PA line for the left side slices Xx kv Set TMJ Edit Enable disable editing of PA lines that allows moving left mouse button an
183. x Implant Library Implant Library Library search Search options Search result Product Line Manufacturer Manufacturer 5 Diameter 5 0 Default 5 Diameter 5 0 Default 5 5 Diameter 5 5 Default Productline 5 5 Diameter 5 5 Default amp Diameter 6 0 Default 6 Diameter 6 0 Default Length min max 13 Diameter min max le 16 search Clear sel Default Add to Plan Replace Close D 44 Planmeca Romexis User s Manual TMJ MODULE 6 TMJ MODULE Romexis TMJ module allows convenient viewing and diagnosis of the tempormandibular joint regions After drawing posterior anterior line PA line for each side of the anatomy multiple dedicated lateral slices and PA slices are provided These views correspond to a double lateral PA exposure but can be easily aligned rotated and adjusted to give a better understanding of the anatomy in the region Romexis TMJ module therefore offers similar diagnostic value as TMJ programs available in some X ray devices but allowing multiple studies with single exposure to be generated NOT FOR RESALE E Close Patient Patient Test amp A E gt n el E a A T soot Q 2 M 4 A i Be tefact ttc Raw DICOM DICOM DICOM Launch Pro ave Adjust Measure Measure ave Select Delete Reset Progae if logge mage vemova Ime pot I Print Storage M Export Print Dict av V I ag nport iF imp SF imp olume Edito Ext App Mo
184. xisting Patients 20 11 2007 11 04 13 IMAGESICTE llt 1 2 840 10008 5 1 4 1 1 2 2 16 840 1 113669 632 10 20080925 1 2 840 10008 1 2 1 2116 840 1 113669 632 10 20080925 8 images selected Import Cancel Pan CBVT Ceph Photo Other lO intra View Selected Clear Selection Selected 0 Appendix B 2 Planmeca Romexis User s manual VIEWING 3D IMAGES 3 VIEWING 3D IMAGES To view 3D images in Romexis Viewer first move to the 3D module by using the module browser on the far left Select the image you want to view and then click View or double click on the item Switch between Explorer Panoramic and Cross Section Implant modules if available by using the browser tabs on the left edge of the viewing area For more information on how to view and enhance 3D images please see chapter C 3D IMAGING MODULE Please note that some features such as exposure export and DICOM are not available in Romexis Viewer m Planmeca Romexis Viewer 2 0 0 4 B 2 10 2008 lx ata Marshall Nelly Ga NE EEUU MER as Exposure Date Image Size Pixel Size um Serial Number Kv mA E DAP mGyxcm Comments Preview Imaging 21 10 2008 14 01 160 Implant Panoramic Explorer Volumes 4 OPENING ADDITIONAL IMAGES it Romexis Viewer can also be used to open single DICOM images or to open DICOMDir filesets outside the default Viewer folder To open
185. y Documents OS WinXP e Using any of the above described ordering methods in Romexis software the patient s image is automatically anonymized meaning that all patients person related information is removed from the 3D volume e To place a Planmeca ProModel online order with integrated ordering interface in Romexis software computer needs to be online Internet access and possible firewalls need to be set to accept outgoing FTP connections e Order confirmation and courier package tracking number will be sent to customer s email account User s manual Planmeca Romexis Appendix A 1 PLACING PLAN MECA PROMODEL ORDERS 2 PLACING PLANMECA PROMODEL ORDERS Planmeca ProModel is a patient specific physical model made from Promax 3D imaged volume The ProModel can be used as a supportive tool in preoperative planning of dental and maxillofacial operations The ProModel is designed to be used with the original ProMax 3D imaged volume the ProModel should not be used as only tool for planning operations This user s manual is valid for Planmeca ProModel order with integrated ordering interface in Romexis version 2 0 0 0 R and later for placing Planmeca ProModel orders 2 1 3D Master Menu Toolbar with Planmeca ProModel Order ice eyes NOTE Appendix A 2 In this manual new features available in Romexis 2 0 0 0 R and later versions Planmeca ProModel ordering button and interface are introduced The master menu toolbar c

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