Home

User Manual

1. 8 14 1 VTO Visual Treatment Objective The Visual Treatment Objective known as VTO is the simulation of a prediction of treatment with or without growth If the simulation is only of growth we call it Prediction of Growth Ortomed EVO generates the prediction of growth according to the mathematical algorithms defined in Ricketts Bioprogressive technique published by the author In order to perform VTO treatment we must have the traced radiograph We select the treatment plan to which we wish to add the VIO and we add it by clicking on the treatments icon of the upper menu If we do not have a treatment plan we must create it See page 48 VTO Treatment Treatment Mame WTO Growth Movements Required Years without growth Hemiarch Total 0 0 Lower arch 0 0 0 0 0 0 1 0 ed Discrepancy Spee Curve 0 0 A Repositioning 1 low 0 0 E Space 0 0 A 4 f f W Autocalculate Movements Editor E t Stripping 0 0 eames Straighten Molars 0 E spanziorn E traction Total Accept Cancel The VTO box all numerical values are expressed in mm Treatment Name Enter the name our VTO Growth in this menu we select the years of treatment with patient growth In the case of adults we select without growth The VTO is based on the initial calculation of space of the Lower Arch With this value the program will add and subtract the mm that we indicate in each box Page 57
2. Discrepancy we enter the discrepancy value of the Lower Arch of the patient using the negative sign for lack of space and positive sign for extra space E space or Nance space this is the space we gain by the eruption of a tooth that occupies less space than the previous tooth We find this situation in changes of dentition Spee Curve here we write the mm that we gain or lose if we modify the Spee curve Relocation of Lower 1 we enter the amount in mm that we want to move the lower incisive forward or back Stripping if we use stripping we enter the mm that we have gained Straightening Molars rotated or flattened molars tend to occupy more space in the arch We enter the mm gained or lost on placing them in their correct position Expansion we enter the mm gained by performing expansion Extraction obviously if extract we will gain the millimetres of the tooth teeth extracted Ortomed EVO calculates the Total mm of arch design In the upper part we have the Hemiarch total since we are in a lateral view Ortomed will suggest a design to us for the position of the incisive canine and molar If we want to change the values we deselect the Auto calculate option In the lower part there is a box for entering Comments To configure the teeth in the upper arch or to modify the values of the dental box by hand we use the Movements Editor VTO Values Editor Horizontal Vertical Rotation Upper Incisor
3. Pnt 9 Right Point of the retro molar fold 3 Mark the line of the upper seam and the projection of the lower This line will serve for the study of symmetries with the Upper Seam and Lower Seam points first of the upper arch and then the lower 4 Mark the central corrected arch line the arch through which we want the teeth to pass green SD Fold 795 Point of the right retro molar fold Molar Pnt 345 right Canine Pnt 346 right Inter central Pnt 347 Canine Pnt 348 left Molar Pnt 349 left IF Fold 796 Point of the left retro molar fold Page 97 Il Fold 797 Point of the right retro molar fold Molar Pnt 350 right Canine Pnt 351 right Inter central Pnt 352 Pnt Canine 353 Left Canine Point Molar Pnt 354 left Fold ID 798 Point of the left retro molar fold This would be the calculation of the complete advanced analysis of models Once all the points are placed we go to calculation mode and open the analysis report with the report button Page 98 hae ortomed maa User Manual Rev October 2008 The analysis report is opened in the View Report tab in the left menu gortomed 8 7010 30 6 8010 30 7 1040 30 7 0010 30 6 010 30 ist Molar 10 50 0 50 Necessary Length 48 001 500 2nd Molar 9 5040 30 31d Molar 5 3010 40 Necessary Length 13 2021 00 Standard 15 15 30 0 50 Canine Width 17 50 0 50 Canine Height 11 40 0 50 Mo
4. 0 0 2 0 0 l 0 0 We can modify the position and rotation of the Lower Incizor 0 0 0 0 0 0 3 teeth independently Mol ll Bera ae ae We enter the values of the horizontal and Lower Molar poo oo lt vertical movements in mm and of the rotation pa ey ors Page 58 Fl infomed mortomed Have User Manual Rev October 2008 If we are missing some point for performing the VTO the program will show us a window with the missing points Ortomed EVO Error Some points are missing impossible to continue O Upper Incisive af OK x Cancel We enter the missing points and create the treatment again Example of prediction of growth at 1 year Example of prediction of treatment without growth Black initial drawing Red VTO Page 59 8 14 2 SVTO Surgical Visual Treatment Objective The Surgical Visual Treatment Objective known as S V TO is the simulation of a prediction of surgical treatment To perform the STO treatment we must have the traced radiograph We select the treatment plan to which we want to add the STO and we add it by clicking on the treatments icon of the upper menu If we do not have a treatment plan we must create it See page 48 STO Treatment EN LX IsTO Horizontal Vertical Rotation bi anilla 0 0 Ant Segment 2 Post Segment 2 Up Subapical gt Lo Subapical t Vertical Mandible oo Sagital Mandible
5. 1 28 1 32 6 0 83 6 82 0 28 41 47 0 03 41 93 0 77 8 28 2 22 3 90 11 03 5 27 Left 11 03 0 03 12 82 2 58 10 52 3 62 21 96 0 58 HA 6 55 0 67 0 31 Right Left L Malecclusion 42 70 1 50 LNecessary 42 7011 50 LL Comected 42 70 1 50 iDiscrenanew 0 0011 50 Correction 0 00 1 50 i5pace 0 00 41 50 L Malocclusio n 12 20 11 00 L Nepessany 20 301 000 LL Comected 12 80 1 00 iDiscrenanow 7 501 1 00 Correction 0 00 1 00 44 11 1 41 41 93 0 77 47 44 4 74 2418 2 18 1 69 7 89 3 31 5 51 11 17 1 63 3 7610 54 10 43 2 37 1 39 3339 2 36 2 58 47 17 4 47 DA 25 46 88 4 12 1 4 1 8 3 47 3 47 1 33 1 53 Right Left 3 28 3 52 8 2212 02 10 05 2 75 1 00 8 50 2 07 2 77 T2410 200 5 20 105 6 15 Space T 50 1 00 D66 6 24 Am 5 73 7 2011 00 5 6 044 ATS Back Fint 7 2041 00 6 18 102 3 3 84 Document generated by Ortomed EWO Infomed Ortomed EVO calculates the Teething Sizes the Form of the Arch and calculates the Front and Back Space for the Upper and Lower arch Page 99 11 7 Study Manager These are the parts of an advanced study of models study Manager Visible Layer In this case we have two layers Model Photograph O ae as Photography of Models and Se E Occlusogram with the sub layers Mesio distal parameters Mesio distal parameters Central Arch Line Central Arch Line LCA Corrected Central Arch Line LCA Ctral Line Corrected Arch sea
6. 25 26 2 Double click the tele radiograph image to enter in the work window If you maximize it with the right button of the mouse pointer you can set it to process instead of open The bottom right icon appears crossed out in red this means that the image is not calibrated Press it and drag the mouse pointer along the cephalostat rule or the line that you have drawn on the original image prior to scanning Leave the mouse pointer still enter the value in mm and press ENTER Leave the window and enable the icon Ortomed EVO in the main window Once you open Ortomed EVO press Create cephalometry because the first time you enter you cannot Open nor Delete Afterwards these are enabled It will ask if you want a cephalometric analysis or an analysis of dental models Once inside Ortomed EVO first click on the Selection of methods option in the Utilities menu in order to choose the method of analysis This will determine which craneometric points it will ask for Press on the left and then on the arrow to pass it over to the right Once the method is chosen the first time press on the Points placement icon to start placing them By pressing the pencil icon we enter in Drawing mode If you make a mistake press on the right to reselect the badly placed point and click on the new position it is redrawn automatically Once the points are placed press on calculation mode In the Method box press the arrow of t
7. saves automatically when the application closes Print Print command Export to Geslmag With this option you can export the image of the study that you have on the screen to Gesimag Preferences Preferences panel where you can set certain program parameters Preferences Ortomed Preferences Environment Show a short description of the Dynami y JP l E a ut measurements Description type Soften image a Locution points p r Preview cephalometry being imported W Draw cephalometry Image type Real image f Mini image Preferences panel Utilities Page 22 Possibility of showing a short description of the points in the upper bar or in a text Balloon Preview cephalometry being imported Draw cephalometry Real or miniature representation of the Image Enable dynamic Measurements Soften image Enable speaking points pg infomed ortomed User Manual Rev October 2008 Selection of methods menu that allows you to select the cephalometrics Analysis or Analyses to be performed Associate Image menu to associate the radiograph with its photograph Automatic insertion of cephalometry menu for automatic placing of cephalometric points on the radiography starting from 2 points of reference Once the program places the points the user must relocate them in their exact position Warping Morphing menu for simulation of the treatment plan Rotate image menu for rotation
8. Global Ricketts superimposition on Sella turcica with the initial cephalogram in black and the final cephalogram in red View report Patient Images Dynamic measurements Study Manager Layer Xray Cephalometry Ricketts Analysis Soft Tissues Bone Structure Dental Structure Cephalometric Planes Texts Points Superimpositions 21 10 2008 Global Superimpositi Soft Tissues Bone Structure Dental Structure Cephalometric Planes Texts Points EJ ES E E EX E EX la Superimpositions121 7 10 2008 Global Super Colour H RGB 255 000 000 Thickness Very fine v M Transparencies Below we see the 5 Ricketts sectors superimpositions 1st Sector on Pterygoid Cavity 2nd Sector on Nasion R J Page 48 Pg infomead Dental Technology 3rd Sector Front Nasal Spine 4th Sector on Mandibular Branch Centre Xi 5 ortomed fave User Manual Rev October 2008 5th Sector on Soft tissues Page 49 8 11 Dynamic measurements Dynamic Measurements permit planning of future treatment With these measurements we see that by moving the desired points they change automatically We find the Dynamic Measurements in one of the four tabs in the left menu We click the Maintenance of dynamic measurement profiles button to open the profile editing window y Dynamic Measurements Profiles Editor Methods Gnathos Analysis Harvold McN amara Analysis HSA Analysis HSR Panoram
9. Teleradiography i e radiography from a distance this ensures margins of magnification accepted between 2 and 6 and depends on the distance of the X ray emitter from the radiographic plate This distance in the Orthopantomograph type X ray apparatus which permits the tube to be rotated to convert into Teleradiography apparatus is normally of the order of 1m 75 cm Specific equipment in centres making maxillofacial studies may include apparatus for lateral Teleradiography of the cranium in which the distance from the X ray emitter to the plate is 2m 50 cm In the 1950s the Bolton Foundation used Tele X ray equipment with a focus almost 4 m from the radiographic plate thus obtaining radiographic images with a very low magnification Page 15 That is why when we are going to work manually on an X ray to make a cephalometric drawing we do not consider which magnification we will use Instead we take the measurements using a rule directly on the X ray itself understanding that we are practically in a 1 1 ratio and taking into account that all cephalometrics standards provide for magnification Likewise when we are going to perform a cephalometry using Ortomed EVO the first thing we must do is a calibration of the image This consists of giving a control distance i e a distance known to us If we have X ray apparatus with a graduated ruler in the Nasion support we must take account of the concepts of magnification mentioned
10. We open the cephalometry on which we wish to superimpose we calculate the method and the Superimposition button in the upper buttons menu will be enabled Patient s cephalometries We select the superimposition icon This will open a screen showing the dates of the different cephalometries already performed on_ the patient 2110 2008 We select the date we wish to superimpose and in the lower part we select the superimposition Style which will depend on the method chosen We apply the superimposition by clicking on the camera button 12 years 0 months 13 years 0 months In this example we can see the Ricketts 14 years 0 months i superimpositions globally or by sectors 15 years 0 months 16 years 0 months We can also superimpose our cephalometry aa with the Bolton Foundation Standards selecting style of superimposition the age we want to use and clicking on the Global Superimposition over Sella camera icon Global Superimposition over Sella 1 Sector over Pterygoid 2 Sector over Nasion Sector over Anterior Nasal Spina 4 Sector over Mandible Ramus center Sector over Soft Tissue Once the cephalograms are superimposed we will be able to change the colours of the drawings as we wish Now the Study Manager will appear a new layer called Superimpositions This layer contains all the superimpositions we make on the patient Page 47 8 10 Example of Ricketts Superimpositions The following example is of a
11. calibration is 20 Page 18 pg infomed ortomed User Manual Rev October 2008 5 Calibration of models Once the models photography is entered in Gesimag we can perform the process of calibration Correct calibration is a requirement for correct evaluation of the measurements of a models study made by computer The process of calibration gives a real reference of a measurement a tooth or an object to the computer 5 1 Gesimag calibration screen gt The page following presents a Gesimag screen with the calibration option The following actions are recommended gt To identify an anatomical or physical structure in this case a tooth or a group the socket find the real measurement of this structure gt Locate it on the screen using an ample zoom to allow us to be precise gt Using the icon of the mini calibration ruler on the bottom left of the screen while holding down the left button of the mouse pointer draw a line on the control structure When you release the mouse pointer button this line is marked gt Enter the value in mm on the screen for this purpose The minimum distance to calibrate is 10 mm Page 19 5 2 Example of the model calibration process We magnify the image in the reference area 0 select the bottom right icon 1 Click a point of the socket 2 and drag to select the other point 3 A box will appear in which we indicate the distance 4 in mm between the two marked points accor
12. ellipse or a b geometrical figure The figure that appears by default is a square but we can change this in the Edit Toolbar We can change the figure in the drawing toolbar The line component Permits us to draw a line in the report By default a horizontal line appears situated on top but we can change the style of the line for example to vertical in the edit toolbar The bar code component This component allows us to enter a bar code in the report We can see the text to show in this code in the toolbar We can also change the configuration of the bar code by right clicking on it and choosing the Configure option in the pop up menu that appears The CheckBox component a A CheckBox is a box that can appear as checked or not By default it appears checked or selected To change this status we have to right click on the control and deselect the checked option in the pop up menu that appears Page 107 12 3 How to add new fields to a report The most useful aspect of making a report is the ability to combine the information with the program data We can place this data wherever we like in our Report but if we place it in the detail we will be able to see all the records that should appear There are various ways of placing the fields The easiest way is to have the Data Tree visible and drag the fields to where we want them Data Tree x To show the Data Tree select Data Tree in the View Toolbars
13. of the image for cases where the radiograph is not in the Frankfurt plane parallel to the floor Help About Ortomed EVO menu showing the contracted licenses program version etc Multimedia Panel showing video tutorials on the main aspects of the program How to make a cephalogram How to do a growth prediction etc 6 2 Top bar buttons Drawing i s pi i Treatment Plan Treatment Image The bar buttons are grouped by drawing or calculation method Buttons common to the 2 methods Show Hide the image Take Measurements allows us to take distances or angles Print the cephalometry Export drawing and or fusion for report to Gesimag Page 23 Start Microsoft Word O Drawing method the icons for the drawing method are Automatic insertion of cephalometry Selection of points or lines Placing of points Drawing of lines Freehand drawing i Delete point or line Calculation mode Ricketts Analysis Choose calculation method EN See Calculations report Button to perform superimpositions Evaluate a formula as it is entered 6 3 Buttons for the treatment plan Creates or Deletes a treatment plan Adds or deletes VTO and STO treatments Image Associates or deletes the image to or from the radiograph Warping Morphing Page 24 pj infomed m ortomed User Manual Rev October 2008 6 4 Left menu Has a button that provides the possibilit
14. on our computer screen For example we can measure from the tip of the nose to the tip of the lower lip of the patient In adult patients if the distance from the sella turcica to the tip of the nose is 119 mm you can calibrate simply by clicking between these two anatomical areas and entering the control distance i e 119 mm 4 2 How can we speed up this calibration process It is sufficient to draw a segment of the same length on the X ray itself with an indelible opaque marker if possible in an already standardized way we will make this tracing on an area of the radiography that does not hide anatomical structures For example we can systematically make a segment measuring 50 mm that is parallel to the Frankfurt plane but under the soft menton in order not to interfere or on the upper area of the hypophysis which in contrast will always be visible Page 16 pg infomed ortomed User Manual Rev October 2008 In this way on scanning the radiography and having it on the screen we will always look for that reference as a control for calibration In the Ortomed EVO cephalometry program we could have left a default calibration as long as the same scanner is always used but we decided to force it to always make a calibration This ensures a 100 correlation in the taking of measurements regardless of whether the image is scanned photographed with a digital camera received as a graphic file or comes from digital X
15. ray equipment in DICOM format 4 3 Gesimag calibration screen gt The page following presents a Gesimag screen with the calibration option The following actions are recommended gt Identify an anatomical or physical structure in this case a ruler and find the real measurement in this structure s plate gt Locate it on the screen using an ample zoom to allow us to be precise gt Using the icon of the mini calibration ruler on the bottom left of the screen while holding down the left button of the mouse pointer draw a line on the control structure When you release the mouse pointer button this line is marked gt Enter the value in mm on the screen for this purpose The minimum distance to calibrate is 10 mm Page 17 4 4 Example of the X ray calibration process We magnify the image to the reference area 0 select the bottom right icon 1 Click on a point of the ruler 2 and drag to select the other point 3 A box will appear in which we indicate the distance 4 in mm between the two marked points according to the option Accept 5 AE 7E 6 oe9 2 oc 245 wrp Or a AA Calibration process Enier distance in miimeters between the two points 5 Y coon an ae JA M4 Pe A long calibration distance is recommended because a longer distance limits the amount of any error A 1 mm error in a 50 mm calibration represents 2 but the same 1 mm error ina 5 mm
16. start to mark the points We click the mesiodistal points of each tooth with the left button We repeat this process for all the teeth Once finished we click the right button to pass to the next section Then we mark the line of the upper alveolar arch selecting the 2nd icon from the points palette We mark the alveolar arch line with the left button Marking from the right dentoalveolar limit to the left or vice versa Once finished we click right the button In red line of upper alveolar arch Page 83 Then we mark the mesiodistal diameters of the teeth of the Lower Arch selecting the 3rd icon from the points palette We click the mesiodistal points of each tooth with the left button We repeat this process for all the teeth Once finished we click the right button to pass to the next section Mesiodistal marking of lower arch Then we mark the line of the alveolar Lower Arch selecting the 4th icon from the points palette We mark the alveolar arch line with the left button Marking from the right dentoalveolar limit to the left or vice versa Once finished we click right the button In red line of lower alveolar arch Page 84 pg nremec wortomed User Manual Rev October 2008 10 4 Method Calculation When the analysis is complete we click the calculation mode button to see the discrepancy panel Analysis of models Upper Model Total Mesiodistal Width Alv
17. to create and finally press the right button of the mouse pointer to close the line Page 34 pj infomed mortomed Have User Manual Rev October 2008 8 4 Modification or readjustment of points and structures The insertion of cephalometric points involves drawing the corresponding anatomical structure this was discussed in the chapter on the insertion of points This anatomical drawing has associated cephalometric points to define it drawn as small squares these are the points that have calculation value Nevertheless in the calculation you will also see some small blue by default points in the anatomical structure These points do not have calculation value They are relocated by the selection command to the ideal place according to clinical judgement This ensures an exact correlation between the cephalometric drawing and the radiography of the patient since relocating these help points makes the drawing of the anatomical structure readjust to the desired profile As well as being able to move these help points with the same selection command we can relocate if necessary the square points i e the cephalometric point itself which is used in the calculation We have 3 ways of readjusting points always in drawing mode We select the point with the arrow and relocate it to the desired position Delete the point and relocate it by selecting the point from the points palette in the left menu Select t
18. us a series of components that Icy 2 2a ad a im we can add to the layout We will look at them in detail later We will only mention now that their main feature is that they are independent of the program data e we can put whatever we want into them Data Components This bar shows us a series of components that we can use a ta a E to work with the program data These components always show the value of the program field that we indicate EE Advanced Components iB These components have a very specific use which we will see later Report Tree x Report tree Object Outline Report tree opens a pop up window that shows us the design of the report in schematic form in which we see the sections y ese and controls that we have put la Detail EA Viewing areas in the English version Header Header Detail Detail Footer Page footer Data Tree Shows all the program data that we can access In the upper part there is a box with one or various data sources Groupings of data from different sources In this case there is only one data source but there can be more In some versions these data sources are called Pipelines In the new versions they are shown with names that identify the data they contain Page 103 In the lower part we have the fields available to use for each source as well as their type String String of characters Boolean Logic Yes No True False Integer DateTime D
19. 0 a Rotations Genioplasty oo Operations cua The STO box all numerical values are expressed in mm If we are missing some point for performing the VTO the program will show us a window with the missing points We enter the missing points and create the treatment again Page 60 pj infomed m ortomed User Manual Rev October 2008 In the STO box we enter the movements of the different structures We can rotate and move them in all directions On entering these values the program will generate automatically the name of the corresponding operations in the lower part of the Operations box In the upper part we enter the name our STO The structures with which we can work are Complete maxilla Vertical cut of the jaw Front segment of the maxilla Sagittal cut of the jaw Back segment of the maxilla Rotation of the jaw Upper subapical part Genioplasty Lower subapical part Example Mandibular advancement Y Black initial drawing Orange STO Page 61 8 15 Warping and Morphing These terms refer to the action of simulation on Photography or lateral Radiography of the evolution of treatment or growth The term Warping refers to the case of starting with a real image lateral photograph of the patient to arrive at a fictitious simulated image of growth orthodontic treatment or surgical treatment The term Morphing refers to the following case starting
20. 31 234 65 198 201 204 207 210 213 216 219 222 225 228 231 50 194 197 200 203 206 209 212 215 218 221 224 227 35 190 193 196 199 202 205 208 211 214 217 220 223 25 187 190 193 196 199 202 205 208 211 214 217 220 15 184 187 190 193 196 198 201 204 20 7 210 213 216 5 177 180 183 186 189 192 195 198 201 204 20 7 210 Documento generado por Ortomed EVO Infomed Page 94 Falinfomed w ortomed User Manual Rev October 2008 11 6 Example of Advanced Models Analysis Next we describe how to place all the points of an Advanced Analysis of Models With this example we see the process of placing the points of an advanced models analysis The advanced analysis of Models gives us very complete information from the study of arches mesiodistal diameters molar width height etc We perform points placement in the same way as in the previously described analyses The order of placement always forms a clockwise circle We select the Points placement button in drawing mode and start to mark the points 1 Mark the mesiodistal diameters of all the teeth We start with the diameters of 18 28 38 and 48 If these or any other teeth are missing we do not mark them and continue with the next one We start the upper arch from Distal 18 to mesial 11 and from mesial 21 to distal 28 The program marks some circles in red with the of canine molar and inter incisive points Next we mark the Lower Arch from Di
21. 6 4 Left menu 25 6 5 Right menu 25 7 Analysis available 27 8 LATERAL Analysis of Cranium 29 8 1 Selection of Cephalometrics Analysis to be performed 30 8 2 Insertion of cephalometric points and drawing of anatomical structures 31 8 2 1 How is the cephalometric drawing made 31 8 2 2 Structure defined by a point 31 8 2 3 Structure defined by two points 32 8 2 4 An example of predefined insertion according to various cephalometric points 33 8 3 Freehand drawing tools 34 Page 3 8 4 Modification or readjustment of points and structures 8 5 Example of Ricketts Analysis 8 6 Study Manager 8 7 Example of Customizing Drawings 8 8 Rotation of the Image to adjust the Frankfurt plane 8 9 Superimposition of cephalograms 8 10 Example of Ricketts Superimpositions 8 11 Dynamic measurements 8 12 Adaptation of Photography with Radiography 8 12 1 Example of adaptation 8 13 Transparency and Magnifying Glass Effect 8 14 Treatment Plans 8 14 1 VTO Visual Treatment Objective 8 14 2 SVTO Surgical Visual Treatment Objective 8 15 Warping and Morphing 8 16 How is cephalometry performed step by step FRONTAL Analysis of Cranium 9 1 Selection of Cephalometrics Analysis to be performed 9 2 Insertion of points 9 3 Modification or readjustment of points and structures 9 4 Example of FRONTAL Ricketts Analysis 9 5 Study Manager 10 Models discrepancy study 10 1 Insertion of points 10 2 Modification or readjustment of points 10 3 Exampl
22. Fiifomed CC oromedea Dental Technology User Manual Rev October 2008 ortomed User Manual Rev October 2008 Page 1 Ortomed EVO User Manual Total or partial reproduction of this book is not permitted nor can it be computer processed or broadcast in any form or by any means electronic mechanical photocopy recording etc without prior or written permission from the holders of the Copyright RIGHTS RESERVED 2008 Reserved for the 1st edition in Spanish by INFOMED Tecnolog a sanitaria C Aribau 197 199 2 Right 08021 Barcelona IMPRESO IN ESPANA PRINTED IN SPAIN Page 2 pg infomed ortomed User Manual Rev October 2008 Index 1 introduction 2 Start Gesden express 2 1 Register a patient 2 2 selection of patients A 10 2 3 Membership recorra S 3 Membership and image scan 14 3 1 Obtaining a radiographic Image ___ O 4 3 2 Obtaining models _ O O ae MA 4 Calibrating the radiographic image 15 4 1 How do we calibrate if we do not have the image of the Nasion support rule ____ 16 4 2 How can we speed up this calibration process 16 4 3 Gesimag calibration screen 17 4 4 Example of the X ray calibration process 18 5 Calibration of models 19 5 1 Gesimag calibration screen 19 BA AA 19 5 2 Example of the model calibration process ____ 20 6 General description of the main screen 21 6 1 Upper menu 22 6 2 Top bar buttons 23 6 3 Buttons for the treatment plan 24
23. Occlusal R Protr L Protr Oclusal L Oclusal R Page 75 R Canine L Canine R Apex L Apex R Incisive L Incisive R Incisive L Incisive R Apex L Apex RAG Menton Once all the points are placed we select the calculation mode and the analysis to be represented Method and we calculate the analysis Page 76 By ortomed Have infomed User Manual Rev October 2008 Dental Technology Archivo Utilidades Ayuda Multimedia i S Y v es Tl M todo Analisis Frontal de Ricketts Frontal de Ricketts y S v Est ndar Superposici n Plan de Tratamiento y Tratamiento y Imagen v Vestibular Inf I X 409 Y 246 We open the report of the Ricketts 32 values analysis with the report button EM Page 77 mr ortomed i 1 70 0 00 ao 200 200 10 04 3000 2700 1945 D 2 00 300 1964 300 3 55 10 35 3 00 376 The report gives us the name of the means value deviations Standard Difference and a small diagnostic for each measurement Page 78 pg ntemee wortomed User Manual Rev October 2008 9 5 Study Manager It is found in one of the four tabs in the left menu It permits us to see all the components radiography photography treatments of our study in the form of layers The properties panel for changing the characteristics of the layer selected is found in the bottom part of the menu The study Manager works contextually showing us the specific p
24. a Dental Technology User Manual Rev October 2008 Front Condyle Back Condyle Porion Anterior Nasal Spine ANS Point A Posterior Nasal Spine PNS __ Front gonial Page 37 Symphysis Menton Gnation Pogonion Point B Mid Point Point M Symphysis Pogonion Manion Gnation Upper Incisive Apex Upper Incisive Limit Lower Incisive Limit Lower Incisive Apex Upper Canine Tip Lower Canine Tip Upper Distal Molar Lower Distal Molar Premolar Occlusal a Page 38 E E bl m ortomed ESS Dental Technology User Manual Rev October 2008 Soft Nasion Mid nasal Tip of nose Lower Nasal Subnasal Soft Point A Upper lip tip Upper Commisure _ _ a Columela Page 39 Once all the points are placed we select the calculation mode and the analysis to be represented Method and we calculate the analysis me File Utilities Help Multimedia a Y Q x e iw Method Ricketia Analysis D v Standard V 3uperimpositior lt Treatment Plan v ES X 1014 Y 324 We use the report button to open the complete 32 value Ricketts analysis report Page 40 gt ortomedi Dental Technology User Manual Rev October 2008 Patient Data Measurements 14 Molar Relation Canine IB Relation IC Owenet Projection ID Overbite IE Lower Incisive Extrusion IF Intercisive Angle A Convexity 4 38 Normal IB Lower Facial Height A 20 x IA Upper Mol
25. al camera you can take the photo of the patient immediately by pressing the Photography icon This opens a dialogue box for selecting the digital file to assign to the patient which you will see when you go to membership When you have entered all the information be sure to accept the changes with the Accept button Observe that this has two labels for the two membership record screens Address and personal details Other data E dani Gesden EVO Express Orto Data Patients System Multimedia Help AJO O 6 DD X Patients Add Modify Delete Accept Lance Print List Close I Other Data Odontogram Residence Data A Address ZIP Code y gt to 6557 Madeon Trail Sw 12H OL Patient Data City State Province Country Calgary v AB CANADA INC O Personal Telephone Work Telephone Mobile Phone Fax Orthodontic Charting Y fi 403 538 2357 e mail E derek dentalcalaary com Irom dentalcalgary com Field 1 Field 2 poe IO Personal Data A Birth Date Years Sex Marital Status Field 3 12 10 1990 all 18 years M single y Date of Register Occupation Children Field 4 20 06 2007 El Student 1 9 English_GELITE MSOLER2 Build 07 1201 377 12 Description of this label s fields Address data area Address enter the address provided by the patient P C postal code City enter the town Using System Tables Management Towns you will
26. ancel Page 110 We select the field by which we wish to group we can group into various groups Each group will have its own group header and footer but it will not be necessary to define more than one detail The order of the groups is important as it determines their hierarchical relationship The first group will be the main one by which the data will be grouped If we want to delete a group we only have to access the groups select the group we want to delete and click the delete button pj infomea m ortomed User Manual Rev October 2008 Appendixes Appendix 1 Problems and incompatibilities Report Builder should function correctly on any computer that has a printer installed It is essential to have a printer defined in the computer Even if it does not have a printer physically it can have one installed in the operating system With some models of printer like the majority of Hewlett Packard and some of the Epson printers it is necessary that the printer exists and is turned on or accessible via network If the printer is not available on starting ReportBuilder the printer controller will give an error This error does not occur with the majority of Epson Lexmark and Canon printers for example Appendix 2 Units You will have noticed that in the side of the report there are two rulers to help place objects with precision 1 These rulers can appear with different units of measu
27. ar Position 16 55 x MB Low Incisive Intrusion aya X IIC Upper Incisive Protrusion 4 92 Normal HID Low Incisive Inclination HJ o ME Upper Incisive Inclinat 20 79 x IIF Occlus Plane Mand Brant 1 06 Normal MIS Plane Inclinat 12 19 x VIA Cranial Deflection VIB Front Cranial Length WiC Back Facial Height VID Position of the Asc Branc WIE Fonon Placement WIF Mandibular Arch VIG Mandibular Body Length The report gives us the name of the means the value deviations standard difference and a short diagnostic of each measurement Page 41 8 6 Study Manager It is found in one of the four tabs in the left menu It permits us to see all the components radiography photography treatments of our study in the form of layers The properties panel for changing the characteristics of the layer selected is found in the bottom part of the menu The study Manager works contextually showing us the specific properties of the layer selected In this way the user only sees the necessary characteristics Study Manager Layer selected ont Tissues Bone Structure Dental Structure Cephalometric Planes Texts Points T IRRRRRR Colour Thickness Transparencies Lines Fills Page 42 pg infomed ortomed User Manual Rev October 2008 All the layers have visibility field By selecting it you can show or hide the layer Each layer has the following properties X ray layer This has appli
28. arency By moving the slide we see how the photograph will merge with the radiograph The photograph starts at 100 opaqueness going down to 0 at which point we will only see the radiograph 75 Photo 25 Radio 50 Photo 50 Radio 25 Photo 75 Radio Page 54 SS ortomedi Dental Technology User Manual Rev October 2008 Magnifying glass effect We select the Magnifying glass Effect in the properties menu to enable it Clicking on the photograph we will see the bone and dental structure of the radiograph with a viewfinder on the photograph Both the Transparency and the Magnifying glass Effect are very good tools for communicating with the patient The magnifying glass effect will help the patient understand the diagnostic and consequently have a better acceptance of the treatment Page 55 8 14 Treatment Plans In order to create a treatment first we must create a treatment plan by selecting the New treatment plan button from the upper menu Mew treatment plan Specify a name forthe Treatment Plan Dr Smith Cancel We enter the name of our treatment plan and press OK In each treatment plan we can group different treatments We can create as many treatment plans as we wish create different treatment plans for different options or create treatment plans according to different doctors in order to compare them Page 56 pg nremee wortomed User Manual Rev October 2008
29. atabase engine distributed free of charge in the MSDE version of Microsoft for up to a maximum of 6 concurrent users also allows the system to adapt to the legislation in the Constitutional Law on Data Protection This regulation places clinical and health related issues at the highest level of protection The system includes the necessary part of the powerful Gesden database for clinical use and the Gesimag images portal which will enable the clinic to define its case presentation screens with all of the patients graphical history sorted in order permitting it to communicate the clinical case to the patient or the patient s guardians It is also possible to print templates on paper or in electronic format This permits the rapid exchange of high quality information with the patient or with professional colleagues for consultation of clinical cases When creating the program many years ago a set of requirements was considered The current version not only respects these requirements but adds to them criteria like reliability of the measurements exact correlation of the cephalogram with the radiography as well as easy rapid and intuitive use of the system The latest version of the program for performing different methods of cephalometry includes a series of tools that make it more versatile than previous versions and than other programs on the market Page 7 2 Start Gesden express Gesden is started from the direct access ico
30. ate or time String i Integer Whole number E a Double Number with decimal places ss fs To enter a new field in the report once the data tree Sting 40 window is shown simply click on the chosen field String 30 and drag it to the report lf necessary move the Data String 40 Tree window to the side of the screen String z5 Boolean Boolean The size field tells us the maximum number of ee characters a character string can have cd 2 In the lower part there are two tabs In the Presentation tab we can choose the format with which ee these fields will be shown Data Standard This toolbar contains the most common actions Dnus se Create a report Open an existing report Save report Configure Page Print Preliminary View Cut Copy Paste Page 104 pg inromed Bortomed User Manual Rev October 2008 It is important to mention that a report depends directly on the data it can show If we try to open a report that is designed to work with other data different from that with which we are working we will lose the previous design and the report will be unusable for the old data Format fsa po em z u A 4 T T With this toolbar we can control the format of the control that we include in the report As with any normal text processor like Microsoft Word we can edit and change the styles Edition CO The edit bar allows us to modify the content of the controls their label or associate
31. aw These values along with the values of Total proportion and proportion of the anterior segment in the Proportions section Now you will be able calculate the values of Discrepancy for the anterior segment 3 3 and the Total Discrepancy Page 92 Fa ems m ortomed User Manual Rev October 2008 11 5 Example of Moyers Analysis Next we describe how to place all the points of a Moyers analysis With this example we see the process of placing the points of an advanced models analysis Moyers analysis was applied in order to relate mesiodistal width of the lower incisives to the prediction tables and identify the value to use in our town We place the points of the same way as for the Bolton analysis but we select only the teeth of the Lower Arch i e from 36 to 31 and 41 to 46 We select the Points placement button in drawing mode and start to mark the points The following drawing shows us the complete Moyers analysis On the left with photography of the models and on the right without photography Ortomed EVO first calculates all the mesiodistal diameters distance between the mesial and distal points of each tooth Then it calculates the sum of the incisive and lateral of each side the sum of the 4 incisives and calculates the space available for both sides The report shows us the values calculated and the Moyers Probability tables Page 93 Once all the points are placed we go to calculation mode and open
32. be able register those you use most frequently Bear in mind that you will not be able to write free text here so you must define it beforehand Province automatically you will be able to link the town to its province from System Tables Management in the Towns table Page 11 Country you can associate the province with the country in the same table This method is automatic When you indicate the town the province and country information will be included Home telephone Indicate the home telephone number Work telephone enter the work telephone number Mobile enter the mobile number provided Fax if the client patient has a fax enter it Patient photo if we scan the photo of the patient or if we take a photo with a digital or intraoral camera which creates video output we can include it here by using the browse button in Windows Explorer E mail if the patient has an e mail address indicate it here We can communicate with the patient with this procedure Website if the patient has a personal or corporate website we can enter it Other data free fields for other information Personal data area Born in date of birth Age automatic included automatically on entering the data of birth This has a bearing on the tooth diagram since there baby tooth diagrams up to 6 years mixed 6 to 9 years and adult 10 years or over Of course you can also choose to place deciduos teeth in a
33. cations to give a better view of the radiography in the process of placing points Brightness a slide control to raise or lower intensity Contrast a slide control to raise or lower intensity Negative a filter to invert the grey scale This filter helps us to detect the soft profile Relief a filter that highlights the contours of the radiography Colourimetry applies colours by quantity of grey scale There is a button to undo all the changes made if we wish Lateral Cephalometry Layer The cephalometry layer has 6 sub layers Soft tissues Bone Structure Dental Structure Cephalometric Planes Text and Points If we change the properties of the cephalometry layer the common properties of the sub layers will change automatically But if we want to change a specific sub layer property we must change only the properties of the sub layer in question Colour we can change the colour of the drawing by selecting one from the list or by entering RGB Colour GB 000 000 1 74 colour coordinates Thickness Ver fine Thickness we can select a line thickness of Very Transparencies fine Fine Medium Thick or Very thick Lines Transparency we can change the degree of Fills M transparency of the lines and of the colour filled structures Page 43 The following sub layers have the same type of properties Soft tissues Bone Structure Dental Structure and Cephalometric Planes Colour to change the colour
34. cephalogram on paper or acetate for superimposition on the teleradiograph in the negatoscope as if it were done manually e Also we can see or not see the notes plans etc Different layers are visible e They will be Soft Tissues Bone structure Dental structure Cephalometric pages Texts Points gt Superimposition e In SUPERIMPOSITION the superimposition colours can be changed Each system has its superimposition style For example in Ricketts there are three Total Y Sector Ya Sector Lateral photo and others e Select the mode and press the Camera icon the latest planes and the structures will be seen in red for example depending on what we have defined and the previous in blue e We can print at any moment when we have it on screen always on transparent paper as when done by hana e For superimposition mark two dates two X rays with points already given to see the growth of the child in an interval of time The ideal is Pre treatment cephalometry Cephalometry in treatment to date X Post treatment cephalometry Page 65 VTO Selection of method and then VTO VTO is the objective of treatment the growth of the cranium in 1 2 or 3 years with or without treatment starting from the points given Warping re adaptation of the lateral photography of the patient to the previously calculated VTO and Morphing a video showing the evolution from the
35. ck on Utilities Selection of methods in the upper menu This screen is divided in two In one we have the set of methods available and in the other the methods we are going to use You simply have pass from one screen to another to select the analysis to be performed 4 Ortomed EVO File Utilities Help Multimedia oa i P Q R Ti A Drawing ta ES gt 3 Treatment Plan w View report Patient Images Dynamic measurements Study Manager Visible Layer X ray Cephalometry AS A Please select the method to be used You can save it as a default methods Available methods Methods to use HSA Panoramic Analysis Frontal Analysis PA Skull Ricketts Frontal Analysis 7 Save by default ou O ama Page 72 PEPP Treatment Image v lt 14 g a j Z S yet re pg infomed m ortomed User Manual Rev October 2008 9 2 Insertion of points In order to mark points we select drawing mode then we select the points placement loo and we mark all the points that the program asks us for When the analysis is completed we click the calculation mode button to see the results report 9 3 Modification or readjustment of points and structures We have 3 ways of readjusting points always in drawing mode We select the point with the arrow and relocate it to the desired position Delete the point and relocate it by selec
36. ction button to go back to the starting situation The Escape escape key will do the same The label control Allows us to set a control in which we can specify any text that does not occupy more than a line The text shown can be modified in the Edit toolbar The Memo Control This allows us to place a control in which we can specify a text but unlike the label control here we can specify more than one line If we edit the control from Edit toolbar we can only specify one line but if we right click on the Memo control that we have put in the report a pop up menu will appear with the option Lines which lets us specify the number of lines this control will contain The RTF Text Control This control is similar to Memo but while in the control Memo all the text must have the same style the RTF Text control allows us to specify different fonts sizes and colours for letter sets within the control To modify the text of the control we can right click with the mouse pointer on the Control that we have created and select the option Edit An editor will appear 18 Rich Text Editor ED fez File Edit sas a MIE 4B zZ u 2a J I J 1 1 I I I I I J J 1 1 A I I i 1 t Row 1 Cok 1 The Variable component of the system This component allows us to enter the computer date and time of the moment automatically into the report l e this control will always show the system date or time in the report
37. d field Drawing The drawing toolbar allows us to specify the background colour of the figures that we use to design the report as well as the typo and colour of the line and its thickness Alignment and Spacing It will often be useful for us to have the controls S int I l i i me Te ha E aligned so that there are no jumps Instead of doing this manually we can select various controls with the Shift key pressed down and let these toolbar buttons align themselves or space themselves in the same way Sometimes it will be useful for various controls to have the same width or height In this case we can select these controls and allow the buttons of this toolbar to make their size equal We can modify the size of the objects with the keyboard by holding down the Shift key while pressing the Cursors Push Permits more precise adjustment of the position of the controls We can do the same if while we have the controls selected we press the Control key and the Cursors to move the controls Standard Components The main feature of this collection of components as we mentioned previously is the fact that they are free controls i e we can put whatever data we wish into them p A E E 2 amp ta E Page 105 The Selection Control Ti This control is simply a wildcard for going to selection mode If we choose a E control and we do not wish to use it we can press the sele
38. ding to the option Accept 5 In this case we have chosen the socket because it is a measurement we know in this model and is a generous one 45 mm r Gesimag Professional 390 02 o 224 Calibration process Enter detance in miimeters between the two poms A long calibration distance is recommended because a longer distance limits the amount of any error A 1 mm error in a 50 mm calibration represents 2 but the same 1 mm error ina 5 mm calibration is 20 Page 20 Fl infomed mortomed Have User Manual Rev October 2008 6 General description of the main screen Upper menu Omomad EVO See 7 Epee Treatment AA ESA ACA om REND reatmeet Pian Treat image Plan iT Menu Upper l Patent images bar Dynamic measurements Study Manager buttons Visible Layer E era El F Cephabometry Left menu Radiography of the patient Ortomed EVO has undergone certain design changes compared to the 2005 version These changes have been made to provide new features and for better usability of the software Page 21 6 1 Upper menu File Utilities Help Multimedia File Printer selection Here you can select the printer for printing reports cephalograms By default the program selects the printer configured in the system With this option you can select another printer Save Ctrl G You can save the changes made in your study at any time The program
39. duct It should be horizontal the head of the child inclined neither forward or backward e There are more than 50 methods of calculating a cephalometry and 100 different points therefore first choose the method or combination of methods desired Save the method with the checkbox if there is only one and it is the same e ZOOM MODE on completing the positioning of points also in normal or enlarged mode to modify help points added e It is not necessary to draw the soft profile lt will go by joined points and is automatic Once the points are placed we can enter in ZOOM and make fine adjustments to match it with the cephalometry Although this is not normally necessary e Various points are generated automatically which are placed by the program according to its mathematical algorithms The automatic insertion of templates takes care of drawing bone dental and soft structures adapted to the problem case e Before processing calculation mode drawing mode can be used for retouching Page 64 pg infomed ortomed User Manual Rev October 2008 gt Interpretation e The negative is sometimes very useful for contrasting degrees of the grey scale We can return immediately to positivization e Removing points in the layers menu when printing the cephalometry helps in its Interpretation of the plans which is what is important e The background can also be removed the radiograph In this way we can see the print of the
40. e a very good X ray for subsequent rapid recognition of points 3 2 Obtaining models There are 2 ways of entering images of models in the program The first now obsolete is to scan the models directly In these cases we obtain images that are of poor quality and somewhat dark The second way which we recommend is to photograph the models Is important to have a single photograph of the upper and lower model as the majority of the analyses are on the 2 arches in the same image Page 14 pj infomea m ortomed User Manual Rev October 2008 4 Calibrating the radiographic image Once the radiographic image is entered into Gesimag we can perform the calibration process Correct calibration is necessary for correct evaluation of the measurements of a digital cephalogram made by computer The process of calibration gives a real measurement or object reference to the computer Effect of magnifying the radiological image according to the distance Distance from xray focus to Patient The Image magnification effect is related to the distance from the focus to Patient Distance from xray focus to Patient The top figure shows the difference in the image projected from the X ray emitter to the radiographic plate or digital capturer where the shorter the distance between emitter and plate the larger the image that is projected This is why the radiological concept for taking side X rays of the cranium is that of
41. e of discrepancy analysis 10 4 Method Calculation 10 5 Study Manager 11 Advanced study of models 11 1 Selection of Model Analysis to perform 11 2 Insertion of points 11 3 Modification or readjustment of points and structures 11 4 Example of Bolton Analysis 11 5 Example of Moyers Analysis Page 4 35 36 42 45 46 47 48 50 52 53 54 56 57 60 62 64 71 72 73 73 74 79 81 82 82 83 85 85 87 88 89 89 90 93 pg infomed 11 6 Example of Advanced Models Analysis 11 7 Study Manager 12 Advanced Report Customizing 12 1 How to create reports using Report Builder 12 2 The Report Builder screen 12 3 Howto add new fields to a report 13 Corollary mortomed User Manual Rev October 2008 95 100 101 101 102 108 113 Page 5 Page 6 pg infomed m ortomed User Manual Rev October 2008 1 Introduction The Windows 2000 XP and Vista version of the Ortomed EVO cephalometry computer program incorporates many features including capacity to perform cephalometrics analysis by several methods lateral frontal superimpositions growth predictions discrepancy measurements advanced studies on models V T O S T O studies of soft profile on lateral photography and studies of symmetry on frontal Warping and Morphing photography The system operates in the latest generation environment of the Microsoft SQL database engine which enables it to configure screens and customize reports This SQL d
42. e patient We can show the patient the future treatment that we want to carry out including if we wish different treatment options We should not forget that Ortomed EVO produces simulated images and that these virtual images are the result of having applied a series of algorithms in accordance with the latest theories of orthodontics guided by parameters entered by the user But it is not necessarily going to be the final profile of the patient after the orthodontic or surgical treatment This means that this tool serves us for guidance communication and marketing to the patient but in no case will we provide the patient with a copy of the final profile Page 63 8 16 How is cephalometry performed step by step gt Previous Requirements e Consult with Infomed for the hardware requirements of each situation gt Calibration e Each image is calibrated independently always from Gesimag If there is an Orthopantomograph use a sagittal rule for cephalostat If not or if the patient provides an un calibrated teleradiograph scan it with a transparent rule placed on the scanner Take care with the magnification the value of the rule must be set by the multiple of magnification if we measure 50 mm and the teleradiograph is magnified by 20 in Gesimag we indicate that it measures 60 mm instead of 50 20 of 50 mm 10 mm e If there is no cephalostat align with the Frankfurt plane horizontal between orbital and auditive con
43. e patient s record by selecting it from the list writing their surname If the patient has to be registered press the Register button 3 Enter the compulsory fields of date of birth and gender F1 required by the standards 4 In Gesimag s main window click on the icon Import image from TWAIN scanner in order to open the scanner window or press Import image of file to incorporate it via a digital photo camera or from the file created by the digital Orthopantomograph 5 Draw a visible line on the teleradiograph measuring at least 5 cm if you observe that the cephalostat rule is not placed on the original image This will serve for its subsequent calibration 6 If using a scanner scan the image with the following parameters The image must be between 1 and 3 Mb in size To obtain this scan with a resolution of 150 to 300 ppp Enable transparencies to scan tele X rays or panoramic X rays Enable opaque to scan dental models or photos Cut the selection box of the image to adjust it to your choice Pre view before and press SCAN when it is ready 7 Once in the Gesimag window if you have scanned various images you must press on each one and then on the Save icon 8 In the main window of Gesimag observe that all the images in the patient s list have been incorporated sorted by cataloguing date Page 67 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
44. eolar Arch length Discrepancy Lower Model Total Mestodistal Width Alveolar Arch length Discrepancy These are the results of the discrepancy analysis We have the values for the Upper Model for the Lower Model Mesiodistal Width sum of all the mesiodistal diameters Arch Length length of the alveolar arch drawn Discrepancy Length of Arch Mesiodistal Width In cases of lack of space it will give us a negative discrepancy value 10 5 Study Manager In the Study Manager we can see the parts of our study Study Manager Visible Layer Model Photography In this case we have the layers E Occlusogram Photography of Models and Occlusogram Mesio distal parameters with the sub layers Mesiodistal Diameters Central Arch Line LCA and Arch Central Line As in the lateral cranium cephalometry we can change the properties of each layer to the user s taste Page 85 Page 86 pinto med mortomed lave User Manual Rev October 2008 11 Advanced study of models FE 6 2 poo i l 9 3 xxx 9 98 lx ET 1 51 gt 44 6 51 belt 4 82 x 4 90 Page 8 11 1 Selection of Model Analysis to perform Before inserting the points we must select which method s we want to use In this way the program only asks us for the points necessary for the desired analysis To select the cephalometric Analysis we must click on Utilities Selection of methods in the upper menu This screen is divided in two o
45. etric points add graphic standards for superimposition etc This allows Infomed s R amp D Department to perform cephalometric customizations and made to measure studies in a short time Once the Ortomed button is clicked with the radiography selected for the study We select the type of Analysis to be performed New cephalometry Select image type of the image on which you Will apply the cephalometry Image type C Frontal x ray of skull Models discrepancy study C Advanced study of models Soft tissues study on lateral andor frontal photography Page 28 pj infomea Pz ortomed ES 8 LATERAL Analysis of Cranium Page 29 8 1 Selection of Cephalometrics Analysis to be performed Before inserting the points we must select which method s we want to use In this way the program only asks us for the points necessary for the desired analysis To select the cephalometric Analysis we must click on Utilities Selection of methods in the upper menu This screen is divided in two one showing the set of methods available and the other the methods we are going to use Simply pass from one screen to the other in order to select the analysis to perform 4 Ortomed EVO olle JE File Utilities Help Multimedia k Y Y es D w 4 Drawing N tu q gt 8 Treatment Plan v Treatment Image v View report Patient Images Dynamic measurements Study Manager Visible Layer i xray Cephalometr
46. f the point the drawing of the structure and a red cross showing where the point is In the lower part are the X and Y mouse pointer position coordinates expressed in pixels from the top left corner of the image Page 26 pg infomed 7 Analysis available mortomed User Manual Rev October 2008 Ortomed offers the possibility of making Lateral and Frontal analysis discrepancy studies on e Models advanced studies of models and studies of soft tissues on photography Lateral Analysis Aguila Burstone Legan Soft Burstone Legan Cervera Corbett Prediction Postrgrad Development Downs Epker Fish Clemens Garcia Coffin Gnathos Harvold McNamara HSR Jarabak M S E Mahony McNamara Olmos Echarri Petrovic Powell Surgical Various Tech Ricketts Ricketts summarised Ricketts G McNamara Ricketts Gugino Roth Jarabak Schwarz Steiner Steiner McNamara Soft Tissues Tweed Tweed Merrifield U C V Various Tech 1 2 3 4 5 Vertebrae Vertical Determination Perfilometry Page 27 FRONTAL Analyses Advanced study of models Frontal Advanced study of models Ricketts Frontal Analysis Bolton Frontal M Moyers HSR Panoramic Transversal ADS ADI Cervera Models discrepancy study Photo studies of soft tissues Facial Profile Ortomed EVO has an interpretation system incorporated with an editor that permits you to add and modify measurements and standards to draw plans include cephalom
47. g the left icon in the top part of the Patients screen although we recommend the use of function keys F5 patient selection FF dani Gesden EVO Express Orto Patents System Muliewmedia A ACO E Odoriogr wn Toolbar a e Add to register E Modity to edit Pater Data e Delete to remove La E Accept to validate Orthodontic AA y e Cancel exit without Charting changes Print printing 1 9 Englksh_GELITE MSOLER Build 07 1201 377 12 You can then write the surname of the patient you want to find and use the INTRO key to skip the fields until you reach the Accept button if there is a match with those presented on the selection screen You can also click on the Filter button to show the complete list ordered alphabetically We recommend the first option remember that access is more efficient with the keyboard than with the mouse pointer MP Patient Selection 5 x Qh Search eh New Last Name Mame History Number a fshumer TT Find A fleet ewe o a MEMS ivan Fetis 0e Picie 10002 Shumer Derek 403 538 2357 In this screen we can see that there is a match with shumer written manually in the Surname s field Page 10 Mn ortomedir User Manual Rev October 2008 2 3 Membership record The first thing you will observe is the patients membership record with the identification photo if it is included If you have a digit
48. he point we want to relocate and reposition it gt The following screen shows square points cephalometric and round points help generated in the jaw line Page 35 8 5 Example of Ricketts Analysis Next we describe how to put all the points of a Ricketts cephalogram We have chosen this analysis because it is the one most commonly used In this example we will see the process of placing points We select the analysis to be performed See page 22 We select the t Placement of points button in drawing mode In the right menu we have the list of points to place These are the points necessary for the selected analysis Now we can place the first point from the list Nasion We have a number of aids for placing points One is the point icon which shows the anatomical structure drawing with a red cross to show the exact position We also have a definition in the upper part or as a balloon for points voiced by loudspeakers and for the point name at the cursor point For voiced points and definitions the options must be enabled in the file preferences menu gt of the top menu Once the Nasion is placed it will ask us automatically for the following point Sella turcica and so on until the last point Menton The points of the Ricketts Cephalogram in the order of the program are Nasion Sella Turcica Orbital Upper Pterygoid Lower Pterygoid Basion S turcica gt e E Nasion Orbital Page 36 A a lt
49. he points of the teeth from 41 to 46 consecutively first the mesial point and then the distal point Mesial 42 Distal 42 The following drawing shows us the complete Bolton analysis On the left with photography of the models and on the right without photography Page 91 Once all the points are placed we go to calculation mode and open the analysis report with the report So gt button The analysis report is opened in the View Report tab in the left menu ortomed F PETG Cephalometric Study Bolton Analysis 2910 2008 Diff Value Diff Value Data Std x Diff Value Diff Walue Central Lateral Canine ist Prenmolar 3 y 2nd Prennolar ist Molar F i ist Molar Maxilar Sum 6 3 3 Mandibular Sum 3 3 Maxilar Sum 12 6 4 a Mandibular Sum 12 8 5 Total Proportion 341 3 x 7 72 i 100A E3 Mandibular agy l Maxilar SN E gt dd um 1 Maxilar Sum 127 8 5 Ideal Mand 123 Average 31 3 Mand Amount deal mand Giscrenaney 12 q Previews Maxilar Sum 8 3 2 23 05 Average 71 2 1 3x350 1002 06 Maxilar Sum 6 3 3 Ideal Mand 6 27 06 27 06 HM Mand Amount Ideal mand Biscrepancy 6 e 23 T Document generated by Ortomed EVO Infomed Ortomed EVO first calculates all the mesiodistal diameters distance between the mesial and distal points of each tooth Then it performs the sum of canine to canine 3 3 and of molar to molar 6 6 of the maxilla and the j
50. he pull down menu and select the method which may be one or various depending on the previous selection made in point 18 When you generate the cephalometric planes you will be able print them with the Print cephalometry icon To obtain the diagnostic press the See calculations report icon You can also print it You can generate superimpositions if you have another previous analysis of the patient You can do this by dates and by sectors You can also view the VTO with without treatment at 1 2 or 3 years with without growth Also by Ricketts sectors You can also view the STO It is possible to rotate by Cervera age standards You can superimpose the cephalogram on the lateral photo of the patient In the Ortomed EVO version you can design you own written reports Page 68 pame ortomed User Manual Rev October 2008 28 In the Ortomed EVO version you can modify the calibre of the traces you can virtualize the photo of the patient using Warping and simulate the transfer from a real situation to a simulated one by Morphing Page 69 Page 70 Fainfomed ortomed User Manual Rev October 2008 9 FRONTAL Analysis of Cranium Page 71 9 1 Selection of Cephalometrics Analysis to be performed Before inserting the points we must select which method s we want to use In this way the program will only ask us for the points necessary for the desired analysis To select the cephalometric Analysis we must cli
51. ic Analysis Jarabak Analysis M S E Analysis Mahony Analysis McNamara Analysis Olmos Analysis P Skull Petrovic Analysis Powell Analysis Prediction Analysis Profilometr Ricketts Frontal Analysis Ricketts G McN amara Analysis Profile Canine IB Relation IC Overjet Projection ID Overbite Steps to create a profile Measurements l Molar Relation Canine IB Relation IC Overjet Projection ID Overbite IE Lower Incisive Extrusion IF Intercisive Angle 118 Convexity IIB Lower Facial Height 1118 Upper Molar Position IIIB Low Incisive Intrusion IIIC Upper Incisive Protrusion IID Low Incisive Inclination NE Upper Incisive Inclinat INF Occlus Plane Mand Branch IIG Occlusal Plane Inclinat PA Lip Protrusion IVB Upper Lip Length g Add selected measurements to profile Create new Save as t X Save profile y A Remove profile Cancel Reload We create our profile with the Create New Button and we give it a name We add the measurements that interest us to our profile For this we select the measurement or measurements of the analysis that interests us and we select Add selected Measurements to profile The desired measurements appear in the lower menu Wecan change the colour of the measurements name with the button EX We save the profile and close the window These measurements are totally configurable We can place the desire measurements from a single meth
52. ick Adjust lf we have made a mistake in any step of the process we click on the Reset button to perform the process of adaptation again Page 52 infomed mortomed Have Dental Technology User Manual Rev October 2008 8 12 1 Example of adaptation 1 Move 2 Block 3 Adjust At this stage we have a coinciding radiograph drawing and photograph Ortomed EVO rotates and scales the images for exact superimposition In some cases we can see a point that does not coincide in the soft profile These points are usually commisures and the lip tips This is because the posture of the lips in the radiograph and in the photograph of the patient are different In these cases we can change this small difference by moving the points If the majority of the soft profile does not coincide it is because of a bad association and we must repeat the process Image Menu gt Delete Image and Associate again Page 53 8 13 Transparency and Magnifying Glass Effect In order to view these two advanced image effects we have to have the photograph and radiograph of the patient associated previously With these utilities we can see the correspondence between these two images We see that we have a new layer called Photography in the study manager We select the layer and we see the two applications in the lower properties menu ray4 Picture Transparency a Ga an eta M Magnifying glass Transp
53. in another way There are two tabs in the lower part of the data tree toolbar the Data tab which is the one we have used up to now and the of Presentation tab Data Layout If we access the Presentation tab we will see various options Data Tree xl Create Style w All Vertical t Labels Grid Font A C Fields Grid Font A Company Action Club Company Action Club Data Lavout The create option has various options e All on dragging the field it creates two components the label and the field e Label on dragging the field it only creates the label e Fields on dragging the field it creates only the field control not the label In All we are asked if the style is to be Vertical or tabulated Page 109 In label and fields if we select the Grid option on dragging the field is automatically surrounded by a square so that it appears as though in a grid If we select the Font option we can choose the format of the font that will appear by default in all the labels and fields created from that moment on Create Groups The data that we have to show must often be grouped by one of the fields For example it may interest us to group a list of persons by town such that the report takes the form Town1 Person Person2 Person3 Town2 Person4 Person5 Person6 The best way of defining this is with the Groups option in the Report menu Break On le Data Field On Group Change C
54. initial to the final state STO Selection of method and then STO STO is the objective of surgical treatment starting from the operations given Warping re adaptation of the lateral photography of the patient to the previously calculated STO and Morphing a video showing the evolution from the initial to the final state Reports The reports can be viewed at any time according to the points placed and the retouches that are made to adjust them better to the lateral Teleradiograph of the cranium which is our contact with reality Retuning to drawing mode we can modify a point and with the pull down menu of methods from calculation mode can regenerate both the cephalogram the planes and the results sheet the diagnostic report If there are many asterisks in the diagnostic or if the case is very unusual or the points are badly placed it may even be because points have been left unplaced or their position is wrong In this case MODIFY POINTS AGAIN IN DRAWING MODE If points are missing the report indicates those that are missing in red If you want to see what diagnostic results from modifying a specific point you can use Dynamic Measurements or go back to the report and see what happens If 1 point is missing the report tells you which one is not defined System tab You can also select a new method and if points are missing the calculations report will show you You can also implement some poin
55. ject to continual modifications due to adaptations to the program to which it refers You can update it via INFOMED s internet website for its distributors and registered customers Please send us any suggestions about this manual or the software product you have just acquired The way of advancing in the design of products that are most satisfactory for you always results from incorporating the client s needs Thank you very much for your collaboration Page 113
56. lar Width 23 00 0 50 Molar Heiaht 35 00 1 00 1 00 0 05 L Malocel LNecessary 40 601 1 50 LL Corected 46 60 1 50 tDtscrenancy 0 0011 50 Correction 0 00 1 50 Right Left 12 002 1 00 19 20 1 00 12 00 1 00 7 204 1 00 0 00 1 00 Diff Walue 39 05 0 35 6 23 0 31 2 19 1 09 6 89 0 15 3 71 0 99 10 44 0 09 46 31 0 09 7 89 2 01 3 30 13 34 3 85 Rigi 15H 0 04 19 06 1 55 16 62 5 22 26 38 3 35 HH 4 34 0 97 0 03 43 21 2 61 4651 0 09 31 26 4 50 2 70 2 70 7 46 7 48 9 96 2 04 71 911 31 3 9 2 11 207 3 27 407 4 07 Diff Value Left 2 250 45 8 09 1 45 225 1 15 6 450 55 4 91 1 73 11 87 1 37 47 82 1 22 7 44 2 45 3 30 16 34 2 35 Left 32 80 6 25 A782 1 22 34 70 2 10 2 03 5 03 11 9011 90 6 87 5 87 8 0 3 45 7 4411 78 8 50 3 50 4 10 2 30 2 16 2 16 2970 2008 Lower Arch Data Std x wa FEV Diff Value Diff Value Right Left 5 2010 30 5 80 0 30 6 80 0 30 6 8010 30 7 10 0 30 ist Molar 11 20 0 60 Necessary Length 42 70 1 50 2nd Molar 10 50 0 50 31d Malar 35 8010 50 Necessary Length 20 70 1 00 Standard SIS 17 00 0 50 Canine Width 15 40 0 50 Canine Height 6 30 0 50 Molar Width 21 40 0 50 Molar Height 31 30 0 10 Index C 0 98 0 05 3433 0 13 7 07 1 27 6 34 0 26 TOM 0 24 2 00 0 90 11 52 0 32 45 23 2 53 9 76 0 74 3 80 42 41 T _ Ri 12 41 1 41 12 62 2 78 11 22 4 38 24 00 2 60 ST 4 47 0 74 0 27 611 0 91 4 92 0 88
57. m Seam Lines Lines Texts Texts Points points As in the lateral cranium cephalometry we can change the properties of each layer to the user s taste Page 100 Pin fomed Bj ortomed Baws User Manual Rev October 2008 12 Advanced Report Customizing Y R e w Method Ricketts Analysis Printing Design Once you have clicked onthe analysis desired nextto the Method pull down the pull down menu that you see nextto the icon for generating diagnostics reports opens a selector for entering report design mode 12 1 How to create reports using Report Builder A report is a document that shows us information In a report we have various sections Pageheader header ES Pagefooter footer The page heading is always in the top part of each page If more than one page is used it is repeated in one The page footer is always at the very bottom of the page If the report occupies various pages all will have the same page footer at the very bottom The detail is the data we wish to show In the detail we only have to specify the forma of one of the records we want to show and this will be repeated automatically for the whole section of the page as many times as we have records occupying various pages if necessary Page 101 We can also have another section called summary which is shown immediately after the last record In this case the detail occupies two and a half sheets The
58. med EVO offers the possibility of customizing all components of the cephalogram to the user s taste Change of soft profile colour change of line thickness transparencies in opaque structures teeth pterygoid change of measurement and text font and customizable layer visibility Study Manager Visible Layer X ray E Cephalometry Ricketts Analysis Soft Tissues Bone Structure Dental Structure Cephalometric Planes E E ES ES ES EX Cephalometry Ricketts A is T exts Colour RGB 255 255 255 Source Arial Size Transp In this example we can see Soft tissues Red colour with type thickness Very Thick Bone Structure Dark Blue colour Dental Structure light green colour and semitransparent background Cephalometric Planes yellow colour Texts white colour and Courier New font size 12 Cephalometric points visibility disabled Page 45 8 8 Rotation of the Image to adjust the Frankfurt plane The upper menu has Utilities gt Rotate Image Serves to rotate X rays that were not originally in the right position Normally we will rotate until the Frankfurt plane is horizontal 0 PPren Page 46 Falinfomed w ortomed User Manual Rev October 2008 8 9 Superimposition of cephalograms The Ortomed EVO program permits superimpositions to be made of one or various cephalograms to do this we must have all of the X rays to be superimposed traced with the same analysis
59. menu del DECI bo DBTab We select the data item that we wish to place and drag it into the report Fields for OBEnc Integer sting 50 At first two components appear The first is a label ie with the name of the field As it is a label we can site e change the text that it shows Sking 15 l o des ae The second component is a label but it is EM Logo String 50 associated with the field that we have chosen It String 20 may show no text or the value of one of the Integer records with which we are working In the edit toolbar we can change the field that will be shown At first both controls appear as selected On moving a component both will be moved and we cannot use the edit toolbar to change the properties In order to do this we must click anywhere in the report to deselect the components and then select the component for which we wish to change the options Data Another way of adding controls to the report is to use the Data components toolbar This is equivalent to the standard components toolbar but instead of specifying the text that they will show we specify the field that they will represent in the edit toolbar We have to make this link manually it is not done automatically la Page 108 pg nromed Bortomed User Manual Rev October 2008 Format We can specify the format of all the components using the toolbars available to us However if the component is the field we can specify the format
60. n adult tooth diagram using the icon that exists for the purpose Gender choose Man M or Women W from the pull down menu Marital status you can define this as required Wildcard 3 and 4 free fields for other information Registration date date of registration in the clinic Profession you can indicate the occupation in this field in order to segment the portfolio of active patients and subsequently perform filtering to make personalized special offers Children no of children Use the tab or INTRO key to move among the fields You can also use the mouse pointer to mark where you want to write The F1 function key gives internal help for almost all fields so if you pre configure their content it will be easier to enter the data If you record a long list search for the item by writing the first letter to find it quicker This figure shows the dental technicians who work for this clinic meaning that you can then to relate patients to work by dental technicians simply by selecting from the list Predetermined texts Kind of predetermined text Common Text y The Other Data tab is for entering the reference information and other data Page 12 Fa infomed mortomed Ex User Manual Rev October 2008 Other Data Label Description of this label s fields References Area Tax ID NIF The F1 function key will supply the NIF letter You do not have to use dots or hyphens in the input ma
61. n created in the desktop or from the Windows Start menu Once launched it requests the user name and password The default user and password are ADMINISTRATOR ADMINISTRATOR or CLINIC CLINIC A _ _ __ _ _ _ _ _ _ _ _ _ _ __ _ _ _ ___ _ _ _ __ __ _ __ _ _ __ _ __ hwo Arrerr antral EA k E A ye A ea NT Le II Engligh_GELITE MMSOLERE gesden gesimag ortomed gesimplant gaiton ds ceracg TANGA Ge imagen cefaiomaetrigs geen de implantes Edition Express Orto Vers 2007 03 Build 07 1201 377 12 Is important to use the User Manager in the system menu to change the user and password Page 8 pj infomed m ortomed User Manual Rev October 2008 2 1 Register a patient To register a new patient press the New icon in the previous window Selection of patients A window will appear for recording data Membership Data case history no name surname s and invoicing data By default the patient client is invoiced but an insurer or other patient called a client since he she may not be a patient at our clinic can also be indicated Mene selection Search fe New Patient Data History Humber assignment Example 12345 lt NO DEFINED FORMATS gt Mame Last Name C Page 9 2 2 Selection of patients Once Gesden is open an introduction screen appears inviting you to select or register the first patient by usin
62. ne showing the set of methods available and the other the methods we are going to use Simply pass from one screen to the other in order to select the analysis to perform File Itilities lelp Multimedia i Y CR ez D Ti Drawing N 4 po y Treatment Plan Treatment Image vw View report Patient Images Dynamic measurements Study Manager Visible Layer Y Model Photography Occlusogram Calculation Methods ul Please select the method to be used You can save it as a default methods Distal 18 Available methods Methods to use Advanced Study of Models Bolton Analysis Cervera Keys ADI Cervera Keys ADS i Garcia Coffin Analysis Models i Mesial 16 M Save by default E Model Photograph w A X 35 Y 52 Page 88 pg infomed ortomed Mx User Manual Rev October 2008 11 2 Insertion of points In order to mark points we select drawing mode then we select the points slacement t icon and we mark all the points that the program asks us for When the analysis is completed we click the calculation mode LS button to see the results report 11 3 Modification or readjustment of points and structures We have 3 ways of readjusting points always in drawing mode We select the point with the arrow and relocate it to the desired position Delete the point and relocate it by selecting the point from the points palette in the left menu Select the point we want to relocate and rep
63. nose Lower Nasal Subnasal Soft point A Upper Lip and Upper Commisure When these points are inserted a profile is drawn automatically that adapts to the soft profile of the patient In this type of tracing help points without cephalometric value are also generated automatically permitting maximum adjustment of the predefined drawing to the real case Automatic soft profile using a curve smoothing algorithm it adjusts exactly to the requested points compensating the anatomical forms Page 33 8 3 Freehand drawing tools Apart from predefined structures the Ortomed EVO program also allows as many additional drawing to be made as necessary lt has two tools for this purpose one allowing direct freehand drawing and the other allowing drawing by segments once these are inserted with the mouse pointer the drawing will be smoothed automatically simply by clicking on the right button The line Drawing buttons are in the upper bar with the drawing mode selected The drawing mode selected Drawing Ws FN A e Icon for drawing by segments and automatic line smoothing Icon for drawing lines in freehand mode gt Example of drawing using segments and automatic smoothing The air ways have been drawn note how in order to view them better the image has been made negative using image commands Simply click on successive segments with sufficient jumps to create the perimeter of the figure you wish
64. od or from different methods in a single profile Now we can select our profile from the menu by opening the pull down menu and see the measurements Page 50 pg infomed Dynamic measurements Personal measures Medida End Initial Stan Standard Diagnosis lA Molar Relation 0 000 0 846 3 00 3 00 Class Canine IB Relation 0 000 2 170 2000 2 00 3 00 Class IC Overjet Projection 0 000 1341 2500 2504250 Class ID Overbite 0 000 0 400 2 500 2 502 2 00 Open Bite Measurement End Initial Standard Diff Standard Diagnosis Deviations mortomed User Manual Rev October 2008 We can view the name of the measurement Initial value Final value Standard Diff Standard Diagnostic and Deviations By right clicking on the measurements we can see hide the column that interests us If we now move a cephalometric point we will see how all the measurements related to this point change The Initial value will be in the Initial field and the new value in the Final field Important if you do not see a change in the measurements it may be that the dynamic measurements in the upper menu have no activities File gt Preferences Dynamic Measurements Page 51 8 12 Adaptation of Photography with Radiography The process of associating the photograph with the radiograph consists of adapting the photograph of the patient to the radiograph in three simple steps For correct adaptati
65. of the drawing Cephalometry Ricketts Analysis Soft issues by selecting one from the list or by entering RGB colour coordinates Colour H IRGE O00 000 74 Thickness we can select a line thickness of Very fine Fine Medium Thick or Very thick Thickness Very fine Transp I I I I I I I 1 Transparency we can change the degree of transparency of the lines Texts sub layer By selecting the Text sub layer we can change the properties of all texts the number that appears superimposed in the cephalogram TESS nn Gee Colour to change the colour of the drawing by Eephalometry Hickels Analysis texts selecting one from the list or by entering RGB Colour Ml RGe 000 000 174 colour coordinates Source E Arial vo Font and Size we can change the letter type and size of the text that appears in the drawing Size Transp Transparency to change the degree of transparency Points sub layer By selecting the Points sub layer we can change the properties of the cephalometric points and of the help points Colour to change the colour of the drawing by selecting one from the list or by entering RGB Colour H RGE 000 000 000 colour coordinates Transp DIA Transparency to change the degree of transparency of the points Ricketts Anal Page 44 2 ortomedi Dental Technology User Manual Rev October 2008 8 7 Example of Customizing Drawings With the latest viewing tools Orto
66. on of the images they must comply with the following requirements The photograph and the radiograph must be from the same date The X ray must be well taken without any double structures The photograph must be well taken We take the right profile with the patient positioned exactly at 90 to the camera The camera must also be at the same height as the head note in some cases the patient has some asymmetry and double structures appear In these cases we can use radiography Before adapting the 2 images we must ensure that we have entered them in our Gesimag file Starting with an X ray that is well calibrated and traced we can associate its image by clicking Image gt Associate Image in the top treatment plan menu top right A window with the instructions for selecting the lateral photograph of the patient will open Insertion of an Image To insertan image to the study 1 Select the image from the patient s list of Images 2 Press the Insert button to start the process of adapting the image with the cephalogram of the study Insert Selected Image The selected photograph will appear in miniature As we have the radiograph with its cephalometry perfectly calibrated we can adapt it to the photograph in 3 steps 1 Make a known point in the cephalogram coincide with the photograph Any point of the soft profile may be valid 2 Block this point 3 Make anther point coincide and cl
67. osition it Page 89 11 4 Example of Bolton Analysis Next we describe how to place all the points of a Bolton analysis With this example we see the process of placing the points of an advanced models analysis Bolton Analysis is a method developed to evaluate discrepancies in tooth size mesiodistal diameter of the crown between the upper and lower arches We select the analysis to be performed See page 78 We select the Placement of points button in drawing mode In the right menu we have the list of points to place These are the points necessary for the selected analysis Now we can place the first point from the list Distal 16 Once Distal 16 is placed we will automatically be asked for the next point Mesial 16 and so on until the last point is reached Distal 46 The program asks us for all mesiodistal points from 6 to 6 of the Upper Arch and Lower Arch The order of placing points always forms a clockwise circle Mark the points of the teeth from 16 to 11 consecutively first the distal point and then the mesial point Distal 16 Mesial 16 Then mark the points of the teeth from 21 to 26 consecutively first the mesial point and then the distal point Mesial 22 Distal 22 Page 90 pj infomea m ortomed User Manual Rev October 2008 Lower arch Mark the points of the teeth from 36 to 31 consecutively first the distal point and then the mesial point Distal 35 Mesial 35 Then mark t
68. previously Consequently if we measure or know the distance of the millimetre ruler that is incorporated in the Nasion support we will not use this value as the calibration distance but rather the value measured on the X ray itself For example in an image that comes with the Nasion support ruler in place we know that this always measures 5 cm However in a typical case if measure in the radiographic plate the ruler will not measure 5 cm but around of 5 3 cm these 0 3 cm appear as the effect of magnification by projection and therefore if we use the image of this ruler as the calibration reference in Gesimag s calibration screen we will not put a value of 5 cm but of 5 3 cm In this case there is a magnification of 6 6 of 50 mm 3 mm In this way we are working with a coherent concept since the standards as already mentioned take into account the magnification by projection We also ensure in this way a correct 1 1 correlation between the print of the cephalometric drawing and the lateral X ray itself All of the direct measurements in the results report will show real information For this reason if we superimpose the cephalogram over the original Teleradiograph as long as the operator has taken account of magnification the image will be equivalent 4 1 How do we calibrate if we do not have the image of the Nasion support rule We simply have to measure a distance on the radiographic plate that is easily locatable afterwards
69. rement Depending on the version of Report Builder the default unit is the inch We can change these units in the Units menu in Report We can select millimetres tenths of millimetre screen pixels and printer pixels A pixel is a point whether of the screen or of the printer The number of pixels in a screen are defined by the resolution A resolution of 800x600 indicates that the screen has 800 pixels in width and 600 in height Sometimes the pixels in a screen coincide with the pixels that the printer can show but sometimes not Appendix 3 Previewing The preliminary presentation of the report allows us to see how the design of our report looks on the screen without needing to print it each time MER Page 111 In this screen we can see a single toolbar Print Button amp Shows the configuration dialogue box of the printer prints the document View Button Permits 3 ways of seeing the document to be specified e The complete document e Adjusted to the page width Fl e Real size Zoom EJ If the view buttons are not suitable we can specify a Zoom with our measurement The real size correspond to a zoom of 100 Sheets Aap UN A report can have various sheets With these buttons we can go to the first sheet the previous sheet the sheet that we indicate the following sheet or the last sheet respectively Page 112 pg infomed ortomed User Manual Rev October 2008 13 Corollary This manual is sub
70. roperties of the layer selected In this way the user only sees the necessary characteristics Page 79 Page 80 pj infomea Bz ortomed lave User Manual Rev October 2008 10 Models discrepancy study fsa a9 11 2 ra Page 81 10 1 Insertion of points Discrepancy is determined by the length of the alveolar arch minus the mesiodistal size of all the teeth We mark all the mesiodistal points of all the teeth Then we mark the line of the alveolar arch and Ortomed calculates the value of the Discrepancy for us To mark points we select drawing mode then we select the points palette icon in the right menu and we mark the points with the drawing mode line drawing E When the analysis is finished we click the calculation mode button to open a window with the values of the mesiodistal sum length of arch and discrepancy of each arch 10 2 Modification or readjustment of points a Readjustment of points is always done in drawing mode We zoom on the desired area and select the line we wish to modify We can delete the line with the delete icon or We can select one of the vertices of the line modifying its position Page 82 pj infomed m ortomed User Manual Rev October 2008 10 3 Example of discrepancy analysis With drawing mode selected we mark the mesiodistal diameters of the teeth of the upper arch selecting the 1st icon from the points palette We click the line drawing button and
71. sk Title Associated description such as Mr Mrs Ms etc Discount this discount can be applied automatically to treatments and price quotes Other data of interest free text fields for notes Page 13 3 Membership and image scan We use the Gesimag program to enter images of the patient We store all of the images of our patient in Gesimag photographs X rays and models Once entered we can use Ortomed to make cephalometrics studies and studies of models 3 1 Obtaining a radiographic Image The image can be obtained using various devices such as e Digital Radiology equipment connected directly to the computer In these cases the radiography arrives directly from the digital Radiography software to Gesimag We have a connection to the majority of commercial Image companies e Via Scanner with backlighting device for X rays The minimum scanner measurements for scanning lateral and panoramic X rays are A4 format and the scanner must have a cover with backlighting also A4 in size Infomed will advise you how to choose between different models e Using digital Photography By taking the radiography and putting it in the negatoscope we can make a photograph of the radiograph e Fro an external file Directly from an external USM memory file of a network unit or of a digital camera At Infomed we recommend the use of digital X rays If you have analogical X rays capture them with a scanner Is important to hav
72. stal 36 to mesial 31 and from mesial 41 to distal 48 Page 95 2 Mark the central pathological arch line red The points to mark of the upper arch are Pnt 1 S Point of the right retro molar fold Pnt 2 S Right Molar Point mid point between the 1st molar and the 2nd Pnt 3 S Right Canine Point mid point between the canine and the 1st premolar Pnt 4 S Right SIS mid point between the lateral and canine Pnt 5 S Inter incisive Point mid point between the right and left incisive Pnt 6 S Left SIS mid point between the lateral and canine Pnt 7 S Left Canine Point mid point between the canine and the 1st premolar Pnt 8 S Left Molar Point mid point between the 1st molar and the 2nd Pnt 9 S Left Point of the retro molar fold The points to mark of the Lower Arch are Page 96 pj infomed mortomed User Manual Rev October 2008 Pnt 1 Left point of the retro molar fold Pnt 2 Left Molar Point mid point between the 1st molar and the 2nd Pnt 3 Canine Point mid point between the canine and the 1st premolar Pnt 4 Left SIS mid point between the lateral and canine Pnt 5 Inter incisive Point mid point between the right and left incisive Pnt 6 I Right SIS mid point between the lateral and canine Pnt 7 Right Canine Point mid point between the canine and the 1st premolar Pnt 8 Right Molar Point mid point between the 1st molar and the 2nd
73. summary is shown immediately after the detail finishes pink section The page header and footer are repeated on each sheet Additionally we can define groups which allows us to group the data by a field value In this case we have a general detail and a detail for each group that we define 12 2 The Report Builder screen L Fa LL F7 Taal E I s F tho File Edit View Report Help Design Preview A E E Ree SI ot Woo ho I ES I a I Header Detail Footer Ready Left 0 Top 0 Width 0 Height 0 A This is an example of the Report Builder screen with an empty report Three sections can be distinguished Header Detail and Footer In the upper part we have two tabs Page 102 pg nremee wortomed User Manual Rev October 2008 Desir Preview The Design tab takes us to design view which allows us to modify the review style of the report add or remove fields etc The Preview tab brigs us to a preliminary view of the report where we can check at each moment what the changes we make to the report design look like Toolbars The Report Builder reports manager has various toolbars of tools The first time we access Report Builder we will only see some specific ones but we can see the rest or hide the ones we do not need in the Toolbars menu within View menu Standard Components a E o This bar shows
74. t not specified by the specialist for the chosen method but which your way of working leads you to include using the Formula option or by request to the R amp D Department at INFOMED Standard This option is only valid for Cervera Once calculated with the Cervera method it appears as available for this option Page 66 pg infomed ortomed User Manual Rev October 2008 e Planes and a facial must be left followed by rotation compared to the standard so that the cephalometric planes are as parallel as possible e Rotate to a greater or lesser degree to reach a COMPROMISE OF PARALLELISMS BETWEEN THE DIFFERENT PLANES between the Standard and what comes out in our cephalometry e t may be preferable not to have any exact parallel but for them to be as close as possible AS A GROUP o Process to perform a cephalometric analysis with Ortomed EVO 1 Connect and switch on your scanner before starting your PC it must be a model with an A4 transparencies module Place the centring template leaving the lamp calibration area free and place the tele radiography centred in the opening of the template If it does not fit cut it to size If the rule of the cephalostat included in the image is not marked draw a 100 mm line with a marker in the zone of the cranium in order to be able to calibrate afterwards It is also possible to enter the image by photographing with a digital camera against the negatoscope 2 First open th
75. the analysis report with the report button paoromes Logo Datos Paciente Estudio Cefalom trico An lisis de Moyers Fecha impresi n 29 08 2008 Medidas Arcada Inferior Central 483 5 01 Suma Inc Lat Der 11 44 Lateral 6 61 5 89 rin 00 os Suma Inc Lat Izq 10 91 pPrembiar10 718 7 55 Suma 4 Incisivos 22 34 Premolar 2 8 04 8 09 E Disponible Der 19 47 Molar 1 11 41 11 19 E Disponible Izq 21 69 Tablas de Probabilidad de Moyers Tablas de predicci n de la suma del ancho mesiodistal del canino primer y segundo molar a partir de la suma del ancho mesiodistal de los cuatro incisivos inferiores Superiores 195 2 205 a 25 2 225 23 25 2 245 25 os 216 28 221 224 227 229 232 235 238 240 243 2456 85 210 213 215 218 221 224 226 229 232 235 237 24 0 75 20 6 209 212 215 218 220 223 226 229 231 234 237 65 204 206 209 212 25 218 220 223 226 228 231 234 50 200 203 20 6 208 211 214 217 219 222 225 228 230 35 196 199 202 20 5 208 210 213 216 219 221 224 227 25 194 197 199 202 205 208 210 213 216 219 221 224 15 190 193 196 199 202 24 207 210 213 215 218 22 1 5 185 188 190 193 196 19 9 201 204 20 7 210 212 215 Inferiores 195 2 25 a 25 22 225 2 235 2 25 25 95 211 214 217 220 23 226 229 232 235 238 241 244 85 205 208 211 24 217 220 233 226 229 232 235 23 8 75 201 204 20 7 21 0 213 216 219 222 25 228 2
76. ting the point from the points palette in the left menu Select the point we want to relocate and reposition it Page 73 9 4 Example of FRONTAL Ricketts Analysis Next we describe how to place all the points of a Ricketts Frontal cephalogram In this example we will see the process of placing points We select the analysis to be performed See page 63 We select the Placement of points button in drawing mode In the right menu we have the list of points to place These are the points necessary for the selected analysis Now we can place the first point on the list Crista Galli We have a number of aids for placing points One is the point icon which shows the anatomical structure drawing with a red cross to show the exact position We also have a definition in the upper part or as a balloon for points voiced by loudspeakers and for the point name at the cursor point For voiced points and definitions the options must be enabled in the file gt preferences menu of the top menu Once the Crista Galli is placed it will ask us automatically for the following point L Socket and so on until the last point Menton The points of the Ricketts Frontal Cephalogram in the order of the program are Next page Page 74 infomed mw ortomed Dental Technology User Manual Rev October 2008 Crista Galli L Socket Orbital R Socket Orbital R Nasal L Nasal ZA AZ LJ RJ ANS L AG R Protr L Protr R Occlusal L
77. very large structure appears it is because the image is badly calibrated Those structures that are defined by two or more cephalometric points are adapted automatically to the anatomical structure we describe two example cases 8 2 2 Structure defined by a point Nasion point As well as the cephalometric point help points are created to permit adjustment of dimension and rotation For help points to appear you must double click on the structure The cephalometric point is square and the help points are round Page 31 8 2 3 Structure defined by two points gt Upper Incisive As it is defined by two cephalometric points the apex and limit of the incisive the drawing adapts to the structure when these are inserted Another example of anatomical structure insertion is the use made of template definition when programming the application creating the Sella turcica and Basion point insertion in order to predefine this structure Page 32 Fa nremsa m ortomed laws Dental Technology User Manual Rev October 2008 8 2 4 An example of predefined insertion according to various cephalometric points Is the case of the soft profiles these have been differentiated in two parts from soft Nasion to an upper commisure and from lower commisure to soft menton gt Example of predefined drawing according to various points with the following points in the upper soft profile part gt Soft Nasion Mid nasal Tip of
78. when we view it or print it The Variable Component Allows a variable value to be specified In the edit toolbar we can change what type of variable will be represented characters currency date etc Also by right clicking we can access the Timing menu which allows us to specify how often this variable adjusts to new values Page 106 pg infomed ortomed User Manual Rev October 2008 The Image component This allows us to include a fixed image in the report If we right click on the new control that we have created we can access different menus e Image allows us to search and specify which image we will use in the report The image must be saved in one of the following formats BMP WMF EMF JGP JPEG GIF or ICO which are the most common formats for normal images e Maintain appearance Proportions Enabling this option means that although we change the size of the image it will never appear to be stretched although we will only be able to change the size proportionally to the original of the image e Stretch The image is adjusted automatically to the size of the control If no we do not enable this option the image always stays at its original size even if it is cut off e Transparent The background colour of the image becomes transparent i e it allows viewing of what is underneath the image control including colours The Figure Component Og Permits figure to be inserted i e you can draw a rectangle an
79. with a real photo for example the lateral photograph at the start of treatment and another simulated image created by Warping Morphing will recreate the process of simulated movements between one image and another to create a video In order to enable the Warping Morphing we can click on the last icon in the upper menu of treatment plan buttons or use the Warping Morphing option in the utilities menu To perform the process we must have performed the lateral cephalometry of the patient See page 23 adapted the photograph well to the radiograph See page 44 performed a treatment whether prediction of growth VTO or STO on this superimposition See pages 48 to 53 Inthe Study Manager select the treatment to be simulated Example of the Process of Warping Jrtomed EVO Simulacion Heat bbnnkt amp amp E Simulation of STO of a patient with mandibular deficiency Page 62 ASRS o _______ fmortomedazw Dental Technology l User Manual Rev October 2008 Example of the Process of Morphing AN mios edil i ia ttt pr AA 4s 4 ry eee A PA WTF AV US gah An AH 4 v a Y ui vi Vie i Simulation of VTO of a prediction of growth at 1 year Once Warping is performed we click on the video button last icon of the central icons bar to generate the video simulating progression of the treatment Warping and Morphing are very powerful tools for communicating with th
80. y Calcul atio Met D Ki Please select the method to be used You can save it as a default methods Available methods Method s to use Aguila Analysis a Ricketts Analysis Analisi Cefalom tric J Pericot Burstone Legan Analysis Cervera Analysis Corbett Analysis Desarrollo Postgrado Analysis Downs Analysis Epker Fish Clemens Analysis Garcia Coffin Analysis Gnathos Analysis Harvold McNamara Analysis HSA Analysis Jarabak Analysis M S E Analysis Mahony Analysis McNamara Analusis Save by default X 149 Y 44 Page 30 pjinfomea BF ortomed fave User Manual Rev October 2008 8 2 Insertion of cephalometric points and drawing of anatomical structures 8 2 1 How is the cephalometric drawing made When creating the Ortomed EVO cephalometry program an anatomical structure was associated with each cephalometric point these were differentiated by ages based on Bolton Foundation growth standards When we enter the patient s date of birth in the Gesden membership record the program will associate the anatomical structures nearest to the patient s age with the cephalometric points It will generate one ore more help points as well as the point with cephalometric value this will allow the structure to be enlarged reduced or rotated in order to correct it with the greatest anatomical precision on the radiography The prior correct calibration of the image is very important When a very small or
81. y of hiding it or adjusting it to the desired measurement with the possibility of seeing the menu and the cephalogram at same time without superimposed windows The left menu is made up of 4 different tabs View report a tab that lets us see and print reports of the calculations in our studies Images of the Patient viewing the images of our patient that we have entered in the Gesimag program Double clicking will let us see them larger Dynamic measurements for dynamic measurements to function we must enable the option in the preferences menu of the top File menu Study Manager it allows us to see all the parts of our study in the form of layers The properties panel for changing the characteristics of the layer selected is found in the bottom part of the menu 6 5 Right menu The upper part has the radiography in reduced size with a box showing the area of the zoom that we see on the screen It has a button for showing or hiding it There are 3 Zoom buttons on the left Zoom out A Zoom out button Adjust A button for seeing the whole image in complete screen mode Zoom in A Zoom in button The three following buttons will help us to view the points in a palette 205 See all points in the palette See only placed points in the palette See only unplaced points in the palette 0671 1 46 Page 25 On the right there is a points palette We will see a series of large icons with the name o

User Manual

Contents

Download Pdf Manuals

Related Search

Related Contents