ROTOGRAPH PLUS - Ritter Dental Australia
Contents
1. The following table shows the programmed values according to the selection made Large Size Medium Size Small Size 35 36 37 Adult 33 85kV 17sec T5kV 17sec 17sec Child 34 14sec 65kV 14sec 60kV 14sec Child 34 with deceleration TOkV 15sec 65kV 15sec 60kV 15sec ramp These values have been set bearing in mind the screen film combination and consequent mA calibration as described at chapter 4 RTG PLUS CE 20 Rev 1 USER S MANUAL Operating instructions 6 2 2 2 Manual exposure refer to Figure 9 To select the manually technical factors follow the next procedure 1 Depress button 38 kV the button function will blink 2 Depress buttons 41 increase or 40 decrease on the hand control selecting the desired kV value to be used After 2 seconds the function button LED stops blinking The unit is now ready for the next step 0 2 2022020220 he kV can vary from a minimum of 60kV to a maximum of 85kV with steps of 5kV If after having reached the minimum or maximum values of the kV range additional decrease or increase is requested the following messages will be displayed Minimum or Maximum the minimum or maximum set kV values will subsequently be displayed Rev 1 21 RTG PLUS CE USER S MANUAL Operating instructions 6 2 3 Preparing the patient refer to Figure 2 and Figure 3 RTG PLUS CE Ask the patient t2. 4 4 ada nurse 36 6 5 Ceph examination not available on ST 37 6 5 1 Prepare cance E ere wan ae oe onda ea eee ame 37 6 5 2 tea E hod vhs 38 6 5 2 1 Programmed exposure Latero Lateral refer to Figure 9 38 6 5 2 2 Manual exposure refer to Figure 9 39 6 5 3 Preparing the patient refer to Figure 10 40 6 5 4 Performing the exposure refer to Figure 9 42 6 6 Messages on display refer to Figure 8 and Figure 9 44 6 7 Identification and correction of defects in dental radiographs 46 6 7 1 Defects due to wrong patient 00 01 46 6 7 2 Defects due to wrong setting of radiological data and dark room 47 6 7 3 Defects in the film due to equipment LL 48 7 MAINTENANCE 55 This publication can only be reproduced transmitted transcribed or translated into any human or computer language with the written consent of VILLA SISTEMI MEDICALI S p a This manual in English is the original version RTG PLUS CE li Rev 1 USER S
3. Command fuse Filament fuse Compensation of the mains voltage automatic fluctuation 0 5 max 60 85 kV 5 kV steps 10 nominal voltage 10 10 mA 10 nominal voltage 10 Apparent line resistance High voltage KV accuracy Anodic current Anodic current accuracy Equipment Exposure time Panoramic 17s adult 14s child with deceleration ramp 15s child Exposure time TMJ1 TMJ2 see note 1 9 4s child Exposure interval PAN amp TMJ 240s 1 16 duty cycle Film size PAN amp TMJ 12 7x30 cm 5 12 Image mean enlargement PAN amp TMJ eo Inherent filtration of the PAN cassette Imm Al eq 70 kV Exposure time Cephalometric 0 2 3s in 19 position see note 1 Rev 1 11 RTG PLUS CE USER S MANUAL Technical features General characteristics Exposure time accuracy CEPH 10ms for times lt 0 33s0 for times gt 0 33s Reference current time product CEPH 3 mAs 70 of the max power Film size CEPH 18x24 cm 8 x10 std 24x30 cm 10 x12 optional Focus Patient distance CEPH 150cm 59 Focus Film distance CEPH 165cm 65 image mean enlargement NOTE 1 o These examination are not available on the ST version this feature cannot be field upgraded Tubehead features 5 Manufacturer VILLA SISTEMI MEDICALI Buccinasco MI Italy Max peak tube potential 85 kV Nominal power 0 630 kW 85kVp 10mA Total filtration 2 5mm A
4. 2 3 steps 3 4 5 and 6 e Dental arch not symmetrical The sagittal median line does not correspond to the reference centring light Corrective action Reposition the patient see paragraph 6 2 3 step 6 e Upper apical zone too dense The patient is not keeping his lips tightly together and is not holding the tongue against the palate Corrective action See point 6 2 3 step 8 RTG PLUS CE 46 Rev 1 USER S MANUAL Operating instructions 6 7 2 Defects due to wrong setting of radiological data and dark room e Under exposed or over exposed film The number of kV set are not adequate for the patient s build more likely an error in development Remedy repeat the examination with a different value see paragraph 6 2 4 If the error happens again call the Technical Assistance e Film completely black The film has been exposed to light or undergone radiation Remedy check efficiency of the dark room and do not keep new film near the source of X rays e Veiled film The edges of the film not involved in the dental arch are not fully transparent with absence of definition on whole film Remedy do not use expired films check the efficiency of the safe light in the dark room and do not keep films near to sources of radiation e Film with branched striations The film has accumulated electrostatic charges owing to rapid rubbing against its casing or the intensifying screens have not been treated with antistati
5. 4 5 6 7 Adult OPG Values Sec Degrees Degrees Degrees Degrees 18 sec 10 17 sec 10 Child OPG Sec Degrees Degrees Degrees Degrees 16 sec 10 14 sec 10 16 sec 10 with decel 14 sec 10 with decel Control Villa Sistemi Medicali S p a Rev 1 Adult TMJ1 Sec Degrees Degrees Degrees Degrees 16 sec 10 5 20 sec 10 Child TMJ 1 Sec Degrees Degrees Degrees Degrees 16 sec 10 4 70 sec 10 Diaphragm 18x24 asym Diaphragm Diaphragm 8x10 sym Diaphragm 18x24 sym Diaphragm 30x24 sym Diaphragm 8x10 asym 57 Adult TMJ 2 Sec Degrees Degrees Degrees Degrees 16 sec 10 5 20 sec 10 Child TMJ 2 Sec Degrees Degrees Degrees Degrees 16 sec 10 4 70 sec 10 Diaphragm 10x8 asym Diaphragm 24x18 asym Diaphragm 12x10 sym RTG PLUS CE USER S MANUAL THIS PAGE IS INTENTIONALLY LEFT BLANK RTG PLUS CE 58 Rev 1 6908914203_ 2 0434 VILLA SISTEMI MEDICALI S p a Via Delle Azalee 3 20090 Buccinasco MI ITALY Tel 39 02 48859 1 Fax 39 02 4881844 DEL Vv Medical Systems Group
6. is manufactured according to the following standards e General safety IEC 601 1 IEC 601 1 1 IEC 601 2 7 IEC 601 2 28 IEC 601 2 32 e Electromagnetic compatibility IEC 601 1 2 e Protection from radiation IEC 601 1 3 The symbol CE grants that ROTOGRAPH PLUS complies with directives 93 42 for medical devices issued by the European Community Classifications ROTOGRAPH PLUS is an electro medical X ray device belonging to Class I type B as per classifications IEC 601 1 foreseen for a continuous working at intermittent load RTG PLUS CE 14 Rev 1 USER S MANUAL Technical features 5 2 X ray tubehead curves Tube CEI OPX 105 0 5x0 5 Loading chard CERES LITI CHE IEEE de LIBI TERRE M B LIE 1 dM 0 01 0 1 1 10 100 Anode cooling chard 30 650W 550W 450W 300 W NAA Le WAAL Rev 1 15 RTG PLUS CE kV mA USER S MANUAL Technical features Technical factors measuring method The peak tube potential is directly measured with a non invasive kVp meter accuracy 3kVp When performing the measurement make sure that measuring probe is completely covered by the X ray beam A direct measurement of the high voltage can only be carried out by specialized technicians in a suitable testing laboratory as it requires disassembling of the tubehead The output current is determined by measuring with a digital multimeter accuracy 0 5 by connecting t
7. the manufacturer according to the size or to operate a manual function i e with the possibility to change the set values Programmed exposure Latero Lateral refer to Figure 9 Change the previous examination be made in manual exposure to pass to the pre programmed exposure press on of the program button Adult 33 or Child 34 To program the new configuration operate on push button Adult 33 and Child 34 and on push buttons Large Size 35 Medium Size 36 and Small Size 37 in the different programmed configurations there are only variations in the exposure time but not in the kV values The following shows the pre programmed values according to the combination made for a Latero Lateral exposure Large Size Medium Size Small Size 35 36 37 Adult 33 80kV 1sec 80kV 0 8sec 80kV 0 7sec Child 34 SOkV 0 7sec 80kV 0 5sec 80kV 0 4sec Such values have been set bearing in mind the screens film combination and subsequent mA calibration as reported in chapter 4 NOTE The kV and time values for Postero Anterior or Anterior Posterior examination must be manually set as indicated on the table of next paragraph CE 38 Rev 1 USER S MANUAL Operating instructions 6 5 2 2 Manual exposure refer to Figure 9 Should a manual exposure be chosen there will be the possibility to change both the kV and time values operating as hereunder described 1 Press the button kV 38 or time 39 the enabling button will ligh
8. to remove the tubehead from its support and access the internal components RTG PLUS CE 2 Rev 1 USER S MANUAL Safety information 2 1 Rev 1 Warnings The system has not been designed to be used in presence of vapours anaesthetic mixtures that are flammable with air or oxigen or nitrous oxide Ensure that water or other liquids do not get into the machine so as to prevent short circuits and corrosion Always disconnect from mains before cleaning the machine Where necessary accessories such as lead sealed aprons must be used to protect the patient from radiations Only the patient and the operator may remain in the room during the execution of the radiography examination ROTOGRAPH PLUS has been developed for continuous use with intermittent load The prescribed operating cycles to allow the heat accumulated by the radiogenic source to be discharged must be observed Although the appliance has been designed to have a reasonable degree of protection from electromagnetic interference it must be installed ata certain distance from electricity transformer rooms static continuity unit portable two way hand radios and cellular phones The latter may only be used at a distance of over 1 5 meters from all elements of the machine All instruments or equipment for professional use and used near the machine must be in conformance to the electromagnetic compatibility standards Nonconforming instruments whose low im
9. AY TUBE OPX 105 Manufacturer CEI Bologna ITALY E 0 5 336 Filtr inherent 0 bmmAleq ROTOGRAPH PLUS Model 9308025X0Y Line 2X0 V 5A 50 Hz Duty Cycle 17 240 max exposure time 17 s Manufactured MMMMY Y Y Y SIN XXYYZZZZ 20090 Buccinasco 0434 20090 Buccinasco MILANO ITALIA MILANO 3a 3b Diaphgram label Diaphgram label not present on ST version not present on ST version Manufacturer Villa Sistemi Medicali S p A Via delle Azalee 3 20090 Buccinasco ITALY DIAPHRAGM iit TO BE USED WITH RTG 200 RIO PLUS Model 61086520 FFD 500 20 S N XXYYZZZZ SIZE PANORAMIC Manufactured Y Y Y Y COMPLIES WITH DHHS PERFORMANCE STANDARD 21 CFR SUBCHAPTER J 4 5 Collimator label CEPH device label Made in Italy Made in Italy BEAM LIMITING DEVICE Model 610865XX FFD 500 1650 SIN XXYYZZZZ Manufactured MMMMYYYY 20090 Buccinasco MILANO ITALIA CEPHALOMETRIC DEVICE for ROTOGRAPH PLUS Model 82088150 S N XXYYZZZZ Manufactured MMMM YYYY 20090 Buccinasco MILANO ITALIA 6 Remote control label Manufacturer Villa Sistemi Medicali S p A via delle Azalee 3 20090 Buccinasco ITALY HAND HELD CONTROL Model 72087555 SIN XXYYZZZZ Manufactured MMMM YYYY COMPLIES WITH DHHS PERFORMANCE STANDARD 21 CFR SUBCHAPTER J RTG PLUS CE 8 Rev 1 USER S MANUAL Description 4 2 Rev 1 Des
10. MANUAL Introduction 1 INTRODUCTION NOTE he present manual is updated for the product it is sold with in order to grant an adequate reference to use properly and safely the product The manual may not reflect changes to the product not impacting operating modes or safety This manual is fully applicable for units having serial number 20103064060 ROTOGRAPH PLUS manufactured by Villa Sistemi Medicali is a radiological device which allows to carry out radiological examinations of the dento maxillo facial complex ROTOGRAPH PLUS is available in the following version For PANORAMIC examination only ST version e For PANORAMIC examination and examination of the Temporo Mandibular Joint TMJ e The latter is also available with the CEPHALOMETRIC device in order to carry out CEPHALOMETRIC CEPH examination This manual provides to the operator the instructions for proper and safe use of the appliance The appliance must be used strictly following the procedures described in this manual and never for activities other than those for which it was designed Before using the appliance we recommend to read carefully this manual Keep it in a safe place near the unit for future reference ROTOGRAPH PLUS is an electromedical appliance and may be used only under medical supervision i e with the supervision of highly qualified persons with the necessary know how regarding X ray protection The user is responsible for
11. Proceed operating as for points 6 2 3 steps 1 2 and 3 2 Position the patient in the skull clamp with the chin resting on the appropriate support and against the vertical reference rod of the same and rest the hand on the side handles but instead of biting with the incisors the centring bit as in the Panoramic exposure the examination has to be carried out with a closed mouth 3 Proceed operating as for points 6 2 3 steps 5 6 7 and 8 Performing the exposure Proceed as for point 6 2 4 following the relevant notes RTG PLUS CE 36 Rev 1 USER S MANUAL Operating instructions 6 5 Ceph examination not available on ST version 6 5 1 Preparing the equipment If depressing button 28 Figure 9 the message Equipment not set is displayed and the function LED blinks press a second time the button so as to obtain reading of the message regarding the interlock to be enabled The following are the messages that can be read during preparation of the Cephalometric function and the concerned operations to follow 1 2 Rotating arm unlocked rotate anticlockwise the upper knob 5 Figure 8 Please rotate X ray generator on CEPH position release lever 4 and rotate anticlockwise the tubehead until insertion of the mechanical locks is noted Please insert the CEPH beam limiter remove the PAN TMJ collimator if present and insert the appropriate CEPH collimator NOTE In CEPH examination different types of collima
12. ROTOGRAPH PLUS User s manual Release 22 November 2002 Rev 2 USER S MANUAL Revision history Revision history 30 03 01 New ST version New rotating arm without bellows General improvement of text and picture Ref RDM 5016 RDM 5018 RDM 5082 Rev 2 RTG PLUS CE USER S MANUAL Contents THIS PAGE IS INTENTIONALLY LEFT BLANK RTG PLUS CE Rev 2 USER S MANUAL Contents Contents 1 INTRODUCTION 1 1 1 Icons appearing in the manual 1 2 SAFETY INFORMATION 2 CS esse ELM MERE M ELEM 3 2 2 Invironmertitalrisk and disposal E eden aet ono eds 4 253 DVIMDOLS USC Ce m 5 3 CLEANING AND DISINFECTING PROCEDURES 6 4 DESCRIPTION 7 labels 7 42 DESID O 9 o TECHNICAL FEATURES 11 o l Standards esula allea 14 5 2 ray tubehead CUVE Soiree E E E E EAE 5 did Technical factors measuring method prassi 16 Dods SOVERATO seid amica semences deines rand rds 17 6 OPERATING INSTRUCTIONS 18 6 1 Switching on the EQUIP MIC chus hands 18 6 2 Panoramic X ray dr tog ele eee 19 6 2 1 Preparing the equipment refer to Figure 8 and Figure 9 19 6 2 2 Programmed Manitial Ex pos Ure o Eva RR ERU Re Se VET 20 6 2 2 1 Programmed expos
13. a via remote control If it is necessary the operator must stand at a distance of at least 2 meters 78 3 inches away from the X ray source and if possible on the opposite direction No other persons other than the operator and the patient are allowed to stay in the examination room during the examination 1 Check if the exposure data are correct paragraph 6 2 2 press the rays button 42 during the whole time of the exposure as the control is a dead man type checking the simultaneous operations of the X ray signalling light 43 and the acoustic ray signal Should the X ray Cassette not be inserted the message CEPH FILM HOLDER NOT PRESENT will be displayed _ 2222000000000 0000 EM he start of arm rotation and the emission of rays take place with a delay of four seconds after pressing button 42 allowing preheating of the tube filament and check all the set value 2 After exposure release the patient from the positioning device remove the film cassette and proceed to open the cassette and develop the film in the dark room The following message will be displayed Wait please which identify an automatic countdown of 1 minute allowing the cooling of the tubehead anode NOTE o After each examination replace the ear centering pins Mag WARNING w Should the patient move during the exposure stop the exposure immediately by releasing the rays control button 42 thus stopping the rays emission The
14. abled The messages that can be read during the Panoramic function setting and the relevant actions to perform are the following 1 PAN TMJ film holder not present insert the X ray cassette in the appropriate support 2 Please rotate X ray generator on PAN TMJ position push the lever 4 and rotate the tubehead anti clockwise until insertion of the mechanical lock is noted 3 Rotating arm unlocked rotate the upper knob 5 anti clockwise 4 Please insert the PAN TMJ beam limiter install the PAN TMJ collimator in place of the CEPH collimator 5 Press again the button 27 After completing the system SET UP adjust the chin support as follows Chin support Chin support PANORAMIC 1 SINUS 1 PANORAMIC Rev 1 19 RTG PLUS CE 6 2 2 6 2 2 1 USER S MANUAL Operating instructions Programmed Manual exposure After setting the unit as previously described previous point it is now possible to choose whether to operate an exposure in a preset mode meanings with the kV values preset by the manufacturer or to operate an examination in the manual function with possibility to change the preset kV values Programmed exposure refer to Figure 9 Push button 33 for adult program or 34 for child s To check the new configuration depress push buttons Adult 33 and Child 34 there will only be a variation on kV and time pressing buttons Large Size 35 Medium Size 36 and Small Size 37 there will be a variation on kV
15. ark room and develop the film lt lt 33 _ After each examination clean carefully both chin support and temples clamp and replace the bite RTG PLUS CE 24 Rev 1 USER S MANUAL Operating instructions WARNING If the patient should move during the exposure stop the exposure immediately by releasing the rays control button 42 interrupting the rays emission and the arm movement The message Change film please will appear for a few seconds on the display and successively the message Push RESET The cassette is then to be removed and in the dark room a new film inserted the return button 32 is then to be pressed to bring the machine in the starting position The return end is evidenced by the message OK which will disappear when the button 32 is released NOTE If the event the film in the cassette has not been replaced and a further exposure made no impediment message will appear but due to the double exposure the film will give no diagnostic results If for external reasons or incorrect operation the X ray emission times should exceed 17 seconds a backup security timer will come into operation cutting out the emission after 20 seconds the arm rotation will continue until the natural stop point Rev 1 25 RTG PLUS CE USER S MANUAL Operating instructions 6 3 TMJ examination not available on ST version NOTE When performing TMJ examinations the rays emissions is discontinuo
16. as Waiting time 4min for 6 3 1 4 been performed PAN or TMJ exposures 6 3 2 3 and 1min CEPH exposures 6 5 4 Equipment not set Not all interlocks are Press a second time the enabled function button to display the interlock to be enabled PAN TMJ film holder 6 2 1 step 1 Missing of the PAN film Insert the cassette in not present holder cassette 17 in the relevant support 16 the relevant support Please rotate film NO reference The film holder cassette Rotate the knurled knob holder to PAN TMJ1 support 16 is not in the 13 clockwise to position position correct position the cassette Rotating arm unlocked 6 5 1 step 1 The arm is in PAN TMJ Rotate clockwise the condition arm upper knob 5 CEPH film holder not 6 5 4 CEPH X ray has been Set the cassette in the present requested without the special support cassette being inserted Please rotate X ray The X ray generator is Operating on the lever 4 generator on PAN TMJ in CEPH position rotate the X ray position generator clockwise Please rotate X ray 6 5 1 step 2 The X ray generator is Operating on the lever 4 generator on CEPH in PAN TMJ position rotate the X ray position generator anti clockwise Please insert the 2 The CEPH collimator is Insert the PAN TMJ PAN TMJ beam limiter in or there is no collimator collimator inserted RTG PLUS CE 44 Rev 1 USER S MANUAL Operating instructions Please insert the CEPH 6 5 1 step The PAN TMJ beam limi
17. c liquid Remedy clean the screens with the appropriate liquid e Film with indistinct detail but good contrast The film is not well pressed between the intensifying screens Remedy change the cassette and the plate felt e Completely white film It has not been exposed to X rays or wrong development Remedy verify the X rays emission by checking light and acoustic signal light 43 Figure 9 If the defect persist check the development process If still not corrected call for Technical Assistance Rev 1 47 RTG PLUS CE USER S MANUAL Operating instructions 6 7 3 Defects in the film due to equipment e If the film exhibits zones not fully radiated or even completely white it almost certainly means a defect of alignment between beam of X rays and film or partial or total absence of radiation in this cases call the Technical Assistance e In case of Ceph examinations with absence of evidencing of patients profile in a latero lateral sense have the filter setting checked by the Technical Assistance RTG PLUS CE 48 Rev 1 USER S MANUAL Operating instructions Rev 1 49 Pu RH m 10 11 12 13 Figure 8 Stand PANORAMIC chin support Bite Block Tubehead Tube rotation release lever for panoramic ceph position Arm locking pin Centering mirror Skull Temple clamp support Skull Temple clamp control knob Motor group unit Column Slider Release handle for positioning
18. cal results this will increase image s quality Eventually use a manual programming mode Rev 1 31 RTG PLUS CE USER S MANUAL Operating instructions 6 3 2 2 Preparing the patient refer to Figure 5 1 Open the skull clamp support 7 by acting on the appropriate knob 9 2 If not already use for TMJ1 place a standard bite on the chin support 3 Instruct the patient to open the mouth up to the maximum maintaining the mandible fixed and lining on the chin support patient s chin has to stay against the vertical plane of the chin support As a consequence patient s head will be slightly rotated backward 4 Instruct the patient to place the inferior scissors teeth against the lower part of the bite used for the panoramic examination this procedure will help the patient to stay in a correct position during the exposure 5 Press push button 20 to light on the centring device In this way both mid sagittal 45 and Frankfurt plane 46 will light on Adjust the patient s head in order to have the vertical light beam 45 to lean on the corresponding anatomical reference In order to check the patient s centring operator can tilt the mirror 6 towards himself thus obtaining the a front view of the patient WARNING Do not align the patient to the Frankfurt plan in the case the patient will be re positioned again with the Frankfurt plane horizontal it is possible that the condiles will fall out from the exposed area
19. cassette in PAN TMJ modes Slit assembly Rotating arm Film cassette support Film cassette Horizontal light beam height control knob Light cross beam button Chin support TMJ SINUS Also used as an accessory to raise children s chin by sandwiching it with the standard Panoramic chin support Patient positioning handle and slider support unit of the motor group Brake release button Collimator for PAN TMJ CEPH Focus position point RTG PLUS CE USER S MANUAL Operating instructions Ne E E amp 00 6 DOE OE OASE Eee C O E Figure 9 Remote control 27 Panoramic mode Selection 36 Medium Size Selection 28 mode Selection 37 Small Size Selection 29 TMJ1 mode Selection 38 Selection 30 TMJ2 mode Selection 39 Push button Multifunctional 31 Test mode dead man button 40 Decrease kVangles or times CEPH 32 RESET dead man button 41 Increase kV angles or times CEPH 33 Adult Selection 42 X rays push button dead man button 34 Child Selection 43 X rays emission pilot LED 35 Large Size Selection 44 Alphanumeric display Rev 1 51 RTG PLUS CE USER S MANUAL Operating instructions 90 ol 53 54 55 56 57 1 53 Figure 10 Skull clamp unit for cephalometry Skull clamp unit release knob Reference pin for skull clamp Cassette support unit Nose rest unit Fran
20. complying with the legal requirements regarding the installation and operation of the equipment 1 1 Icons appearing in the manual Indicates a NOTE the utmost attention shall be devoted to the Y reading of paragraphs marked by this icon Indicates a WARNING paragraphs marked with this icon cover Ww patient and or operator safety aspects Rev 1 1 RTG PLUS CE USER S MANUAL Safety information 2 SAFETY INFORMATION w WARNING Read this chapter very carefully VILLA SISTEMI MEDICALI designs and manufactures equipment in compliance with safety requirements moreover it provides all the necessary information for correct utilization as well as warnings related to risks associated to X ray generators Villa Sistemi Medicali shall not be responsible for e any use of the ROTOGRAPH PLUS different from that for which it has been designed any damage to the equipment the operator or the patient caused either by incorrect installation and maintenance not compliant with the procedures contained in the relevant user s and installation manuals provided with the equipment or by incorrect operation techniques e any mechanical and or electrical changes effected during or after installation different from those reported in the service manual Only qualified service personnel authorized by VILLA SISTEMI MEDICALI is allowed to perform technical interventions on the equipment Only authorized personnel is allowed
21. cription ROTOGRAPH PLUS has been designed to perform the following examinations Panoramic examination all versions e SINUS examination of the paranasal sinus all versions e Examination of the Temporo Mandibular Joints TMJ with open or closed mouth on a single film not available on ST version e Cephalometric examinations CEPH of the skull if equipped with the cephalometric optional device not available on ST version with 1 65 mt 65 inches focus film distance and 1 5 mt 59 inches focus patient distance the allowed examination may be made with different parameters according to the setting of the remote control please refer to the specific chapter of this manual ROTOGRAPH PLUS is controlled by a soft touch console and equipped with an alphanumeric digital display for a clear indication of the working parameters and operative messages The operative cycle is entirely run by a microprocessor controlling its different modes from programming of the emission parameters according to the chosen examination and the patient s size to the voltage fluctuation and to the notification of possible anomalies failures or errors The excellent quality radiographs thus obtained is the result of a clever design based upon the pseudo elliptic rotation system the original light beam luminous cross pattern centering system the use of green emiting Rare Earth Intensifying screens and most of all the small dimension of t
22. e X ray activation always be commanded from an X ray protected area via remote control If it is necessary the operator must stand at a distance of at least 2 meters 6 6 feet away from the X ray source and if possible on the opposite direction No other persons other than the operator and the patient are allowed to stay in the examination room during the examination 1 Check if the exposure data are correct paragraph 6 2 2 then press the X ray button 42 during the whole time of the exposure as the control is a dead man type checking the simultaneous operation of the rays signaling light 43 and the acoustic ray signal NOTE he start of arm rotation the emission of rays take place with a delay of four seconds after the activation of button 42 allowing preheating of the tube filament and check all the set value 2 After exposure the message Push RESET will be displayed the patient may then be released from the positioning device the film cassette removed by pulling upwards the return button 32 pressed to move the machine back to the starting position After full return the message OK will be displayed which will disappear when the button 32 is released 3 With Reset operation performed and with button 32 released the following message is displayed Wait please indicating a waiting time of 4 minutes to allow cooling of the tubehead anode 4 It will now be possible to open the film cassette in the d
23. es examination 21 Figure 8 Chin yrs eget Chin support PANORAMIC SINUS 6 3 1 2 Programmed Manual exposure Rev 1 To change from the programmed to the manual function and viceversa proceed as described at paragraph 6 2 2 bearing in mind that the kV and time parameters in the programmed exposure are indicatively the following numbers refer to Figure 9 Large Size Medium Size Small Size 35 36 37 TMJ 1 and 2 Adult 33 85kV 5 20sec 75kV 5 20sec 5 20sec TMJ 1 and 2 Child 34 4 70sec 65kV 4 70sec 60kV 4 70sec Such values have been set considering the screens films combinations and consequent mA calibration as mentioned in chapter 4 The times reported in the previous table are the sum of the exposure time for the right condyle with the one of the left condyle while the arm rotation time remains the same as the one reported for the panoramic examination 27 RTG PLUS USER S MANUAL Operating instructions 6 3 1 3 Preparing the patient refer to Figure 4 1l Askthe patient to remove all metal objects located in the zone involved in radiography necklaces earrings spectacles hair clips movable dental plates etc Make sure that there are no heavy articles of clothing such as overcoats jackets ties polo neck sweaters etc in the radiography Zone 2 Have the patient put on the protecting apron or similar protective devices in accordance with the regu
24. he focal spot This particular rotation system allows an orthogonal imaging of all teeth and wide image layer with an optimum focused zone of 10 mm for the incisors and 20 mm for the molars ROTOGRAPH PLUS besides operating in the programmed mode can also operate in the manual personalized mode by modification of the parameters as described in chapter 6 In the Panoramic and TMJ modes with all interlock enabled it is possible to activate the TEST push button 31 see Figure 9 at the end of the manual The TEST functioning mode allows the operator to check the functionality of the selected examination cycle or to show to the patient the examination he will undergo including all movements of the machine without emitting X rays 9 RTG PLUS CE USER S MANUAL Description The TEST push button as X RAY button are a dead man buttons which means thus if they are released during the examination cycle the latter is interrupted stopping the movements in progress To re start the cycle first reset the unit by means of the key 32 Figure 9 than start again the function which was interrupted The following intensifying screen film combinations are recommended in order to obtain good quality images Intensifying screens Films Type Supplier Type Supplier KR II KONIKA MG KONIKA Los MG MG KODAK T MAT G RA KODAK Regular T XD HT KR II KONIKA H AGFA MAT G RA KODAK Regular The above listed intens
25. he probes to the connectors of Al PCB as indicated in the Service Manual digital multimeter set to VDC 20V 1V 1mA The exposure times are determined by using a timer counter having an accuracy of 0 1 measuring the duration of part of the voltage applied to the primary side of the tubehead during the exposure phase RTG PLUS CE 16 Rev 1 USER S MANUAL Technical features 5 4 Overall dimension 406 16 VA S LEID ae 1140 45 1170 46 1970 77 1 2 Figure 1 ROTOGRAPH PLUS overall dimension Rev 1 17 RTG PLUS CE USER S MANUAL Operating instructions 6 OPERATING INSTRUCTIONS NOTE EN he procedures explained in the next pages make often reference to Figure 8 Figure 9 and Figure 10 located at the end of this chapter To easily consult this Figures unfold pages in order to make it visible while reading other pages of the manual 6 1 Switching on the equipment 1 Push the button on the control panel to turn the equipment ON The CHECK function is so activated verified by the lighting up of the LED S on the remote control and the display pixels The software checks the enabled operating function with the corresponding LED signal In
26. ifying screens are all of the Green Rare Earth emitting type Use of screens and films different from those stated on the table above requires system recalibration by an Authorized Technician The calibration of the above mentioned combination has only an indicative value The effective adjustment depends on different factors such as the real dose emitted by the unit the film development system and the user predilection for more or less devise images The good quality of the image does not exclusively depend on ROTOGRAPH PLUS but a great importance is to be given to the film developer and dark room techniques Therefore it is necessary e to perform developer maintenance as indicated by the manufacturer instructions e to check regularly the level of the used chemical substances substituting them at time intervals as indicated by the manufacturer instructions usually a direct function of the number of radiographs developed and chemicals concentration RTG PLUS CE 10 Rev 2 USER S MANUAL Technical features TECHNICAL FEATURES General characteristics ROTOGRAPH PLUS Manufacturer VILLA SISTEMI MEDICALI Buccinasco MI Italy Class I with type B applied parts according to IEC IP20 220 230 240V 50Hz Degree of protection Rated line voltage Line frequency Max line current at nominal voltage oA rms momentary 0 5A stand by 1 15 KVA 230V 6 25 T O SA T 0 315A F Maximum power
27. ive negative results the operator must contact the authorized service personnel Rev 1 55 RTG PLUS CE USER S MANUAL MAINTENANCE LOG BOOK This log book has to be filled in by the authorized VILLA SISTEMI MEDICALI engineer after installation and after performing the preventive or corrective maintenance visits Installation Date uui ee Rs Technician aed d Maintenance Dabe 226246682 Technician be es at a Seem wach LR tA es ae Sa Maintenance HALE MERE T Tecnician sagged T r OD ade CAUSE oe delie ae e Kaaa ce SE eR Maintenance Dale a dde RC Vds Technician CIEL Tct Maintenance Dare ets at POC CUM vevesi etsn haue eee is GIS PEL he a nung Lx the Do Maintenance Date urs Seco ee ee Technician rensede eae ee Sow Be ER S cube allea Lean Maintenance Date decr ee ari x e Technol Pes pula e RTG PLUS CE 56 Rev 1 USER S MANUAL Final test table This table is reserved to Qualified and Trained Service Technician Data setted on Hand Control for Rotograph PLUS S N Voltage supply for rotation motor A1 V1 R39 ALVI dec R40 Decelerating ramp for Central OPG 41 Off Off Off Off Off o 1 2 3
28. kfurt plane reference rod Scale referred to nose for repetition of exposure Nose rest rod 58 99 60 61 62 63 Centring ring Nose rest block knob Skull clamp unit rod Distance regulating knobs for skull clamp unit rods Handle for arm positioning according to the patient tallness Break button RTG PLUS CE USER S MANUAL Maintenance T MAINTENANCE As for all the electrical devices in addition to proper use this unit also requires periodical checks and maintenance This precautions will insure a safe and efficient performance of the device The preventive maintenance consists of checks that can be carried out directly by the operator or by the authorized service personnel The checks that can be carried out directly by the operator are the following check that the tubehead does not have oil leakage check that the cable of the remote control is not damaged check that the unit does not show damages that may affect the protection against radiation check that no metallic noise are generated by the column or the rotating assembly Once a week check that the metal ropes of the column are not damaged or broken the ropes can be seen on the side of the column while performing exposure release the X ray push button and check that the beeper stops beeping immediately Every 6 months check that the label are not damaged and well attached WARNING w If any of the above checks g
29. l eq at 85 kV Insulation Oil bath Leakage radiation at 1 m 0 25 mGy h 85 kV 10mA 1 16 duty cycle Maximum power 85 kVp 10 Type of circuit Single phase self rectifying RTG PLUS CE 12 Rev 1 USER S MANUAL Technical features VILLA gt m m 7 C2 gt a ray tube features Manufacturer CEI Bologna Italy CEI OPX 105 0 5 IEC 336 Inherent filtration 0 5 mm Al eq Anode material Tungsten Nominal voltage 105 kVp D Filament maximum current 00 Filament maximum voltage Anode thermal capacity 30 kJ 5 dux O e 62 7 Weight of apparatus and parts Slider net weight 56 kg 123 5 pounds 48 kg 106 pounds 24 kg CEPH device net weight 12 kg Column net weight Tubehead net weight 5 pounds 26 5 pounds 28 kg 62 pounds 203 pounds Control unit net weight Slider counterweights net weight 92 kg Environmental conditions Maximum operating temperature range 10 40 50 F 104 F Operating relative humidity range 30 75 Transportation and storage temperature 20 70 4 F 158 F Maximum transportation and storage relative humidity lt 90 non condensing Minimum atmospheric pressure for 630 hPa transportation and storage H D Qa Rev 1 13 RTG PLUS CE USER S MANUAL Technical features 5 1 Standards and regulation The ROTOGRAPH PLUS equipment
30. lations in force in the various countries making sure that it does not interfere with the trajectory of the X rays beam 3 Bring the patient in standing position up to the chin support and using the handle 22 release the brake button 24 in order to position the slider so that the chin support resting plane is aligned with the patient s chin 4 Position the patient in the skull clamp with the chin resting on the appropriate support and against the vertical reference rod of the same Furthermore position the hands on the lateral knobs 22 5 Press the push button 20 to light on the beam centering lights In this way both reference lights mid sagittal 45 and Frankfurt planes 46 are lighted on adjust the patient s head in such a way that mid sagittal light is on the respective anatomical plane while the Frankfut s one is parallel to the corresponding plane Horizontal beam Frankfurt plane 46 if needed can be height adjusted in relation to the patient s dimensions the adjustment is made by acting on the appropriate knob 18 In order to check the patient s centring operator can tilt the mirror 6 towards himself thus obtaining the a front view of the patient 6 After the end of the patient s centring bring the height of the skull clamp a little above the patient s orbital bone and close the skull clamp leaving the two temple clamp roads 7 by acting on the appropriate knob 9 This will help the patient to hold the correct po
31. message Change film please will be displayed for a few seconds it will then be opportune to remove the cassette and insert a new film in the dark room RTG PLUS CE 42 Rev 1 USER S MANUAL Operating instructions NOTE Should the film in the cassette not be replaced and a subsequent exposure carried out no impediment message will be displayed but due to the double exposure the film will give non diagnostic results If for external reasons or incorrect operation the rays emission times should exceed 3 seconds a backup security timer will come into operation cutting out the emission after 5 seconds Rev 1 43 RTG PLUS CE USER S MANUAL Operating instructions 6 6 Messages on display refer to Figure 8 and Figure 9 As described in chapter 4 ROTOGRAPH PLUS is entirely controlled by a microprocessor that besides controlling the emission parameters and the line voltage fluctuation indicates the different equipment s operating modes by means of appropriated messages on display 44 the eventual anomalies and mistakes The following table shows the different messages that could be displayed their cause and relevant actions 6 2 2 2 and With control button 40 Select a correct value 6 5 2 2 it has been required a value lower than the allowed one 6 2 2 2 and With control button 41 Select a correct value 6 5 2 2 it has been required a value higher than the allowed one Wait please 6 2 4 X ray exposure h
32. munity to electromagnetic fields is known must be installed at least 3 meters away from the ROTOGRAPH PLUS and be powered via an independent electric line ROTOGRAPH PLUS must be switched off during the entire period of use of ESU Electro Surgery Units units or similar equipment Clean or eventually disinfect the chin support positioning handles temples clamp support nose rest and any other part that may come in touch with the patient At the end of the examination replace the bite and the ear rods 3 RTG PLUS CE USER S MANUAL Safety information Although the X ray dosage supplied by dental radiology appliances is on average low and distributed over a relatively small surface the operator must take the necessary precautions and or follow the safety procedures for both himself and the patient during an exposure We recommend that the X ray activation always be commanded from an X ray protected area via remote control If it is necessary to operate the exposure near the patient remain at the maximum distance allowed by the remote control cable in the direction opposite to the emission of the rays at a distance of at least 2 meters 6 6 feet from both the radiation source and patient 2 2 Environmental risk and disposal A number of machine parts contain materials and liquids that upon completion of the machine s life cycle must be disposed of at recovery centers established by the local health units The machine contain
33. n and rotation will be interrupted On the display will appear the message Change film and after about two seconds Press reset alternating The cassette has to be removed and loaded with a new film on the dark room The return button 32 15 then to be pressed to bring the machine in the starting position The return end is evidenced by the message OK which will disappear when the button 32 is released NOTE LL MA E LLLALI1 ehlITT In the event that the film in the cassette not being substituted and a further examination made no error message will appear but due to a double exposure the film will give no diagnostic result 2 Atthe end of second emission step on the display of the hand held control the message Press Reset will appear The return button 32 is then to be pressed to bring the machine in the starting position The return end is evidenced by the message which will disappear when the button 32 is released RTG PLUS CE 30 Rev 1 USER S MANUAL Operating instructions 6 3 2 Performing the TMJ2 examination 6 3 2 1 Preparing the equipment 1 Select TMJ2 modality by pressing the push button 30 Figure 9 2 Leaving the film used on the previous examination on the cassette rotate the film holder from PAN TMUJ position to the TMJ2 rotating anticlockwise the knurled knob 13 Figure 5 NOTE Operator has to evaluate the needs to increase the kV selection of one step from some clini
34. o prevent from shortcircuits and corrosion of inner parts Clean the painted surfaces the accessories and the connection cables using only a damp cloth and neutral detergents Take care to dry the parts with a dry cloth Do not use corrosive or abrasive solvents alcohol gasoline trielina The bite rod the centering bite and the ear centering pins must be replaced after each examination where they have been used In addition the bite must be disinfected by using a 2 Glutharaldeid solution following the rules provided by the manufactures of the cleaning solution itself The chin support the patient positioning handles the nose rest and the temple clamp must be carefully cleaned and disinfected with a 2 Glutharaldeid solution or similar find out what is available e g Milton after each examination where they have been used 6 Rev 1 USER S MANUAL Description 4 DESCRIPTION 4 1 Identification labels ROTOGRAPH PLUS is labeled with a set of labels identifying different components according to the requirements of the international standards The following picture shows the position of the different labels Rev 1 7 RTG PLUS CE USER S MANUAL Description 1 2 ROTOGRAPH PLUS label Tubehead label Made in Italy Made in Italy DIAGNOSTIC SOURCE ASSEMBLY Model MRO5 Type 8408651X S N XXYYZZZZ Manufactured MMMM Y Y Y Y Output max 85kVp 10mA Total Filtration 2 5mmAleq IEC522 X R
35. o remove all metal objects located in the zone involved in radiography necklaces earrings spectacles hair clips movable dental plates etc Make sure that there are no heavy articles of clothing such as overcoats jackets ties polo neck sweaters etc in the radiography Zone Have the patient put on the protecting apron or similar protective devices in accordance with the regulations in force in the various countries making sure that it does not interfere with the trajectory of the X rays beam Bring the patient in standing position up to the chin support and using the handle 22 release the brake button 24 in order to position the slider so that the chin support resting plane is aligned with the patient s chin Position the patient in the skull clamp with the chin resting on the appropriate support and rest the hands on the side handles 22 have the patient bite with the incisors in the groove of the bite block mounted on the appropriate rod 2 making sure both upper and lower anteriors are set in the groove of the bite piece Press the centring device activation button 20 When this is done two crossed beams of light illuminate both the sagittal median line 45 and the horizontal line for the Frankfurt plane reference 46 The centring device stays illuminated for about 40 seconds if this time is insufficient to carry out the centring operations the activation button 20 may be pressed again Bring the height of the skull clam
36. of the film 6 After the end of the patient s centring bring the height of the skull clamp a little above the patient s orbital bone and close the skull clamp leaving the two temple clamp roads 7 by acting on the appropriate knob 9 This will help the patient to hold the correct position during the examination RTG PLUS CE 32 Rev 1 USER S MANUAL Operating instructions Figure 5 TMJ2 position RTG PLUS CE 33 Rev 1 USER S MANUAL Operating instructions ILL ISTEM EDICAL 6 3 2 3 Performing the exposure refer to Figure 9 1 After having the modality selected and with LED on signalling the correct machine set press X ray push button 42 on the hand held control NOTE e In the event of the x ray control button being activated before the correct placement of the cassette the message Please rotate film holder to TMJ2 position will be displayed e X ray emission starts with a delay of four seconds after the operation of the exposure push button in order to allow the preheating time of the tube filament and check all the set values Arm s rotation will start a little in advance regarding the emission e On TMJ examination the X ray emission does not last for all the rotation but it is interrupted corresponding with the central middle part of the mouth As a consequence both acoustic and visual emission signals are interrupted in accordance with the emission e X ray push button i
37. own procedure is acting At the end of this procedure the LED of the last examination performed will light on The cassette holder has automatically placed itself to the TMJ1 position RTG PLUS CE 34 Rev 1 USER S MANUAL Operating instructions 3 It will be now possible to remove the film cassette and in the dark room open it and develop the film NOTE If for external reasons or incorrect operation the emission times should exceed 5 seconds a safety backup timer intervention will come into operation interrupting emission but the arm rotation will continue until the end Rev 1 35 RTG PLUS CE 6 4 1 6 4 2 6 4 3 6 4 4 USER S MANUAL Operating instructions Sinus examination The SINUS examination aim is to show the structure located in the sinomaxillary area Preparing the equipment The equipment setting is like the one described at point 6 2 1 as the only difference between the Panoramic Exposure and the Sinus one is due to the different chin support used the chin support to be used in the Sinus examination is as follows numbers refer to Figure 8 at the end of this manual Chin 5 Chin support PANORAMIC SINUS gt e 1 Programmed Manual exposure To change from the programmed function to the manual one and viceversa proceed as described at point 6 2 2 bearing in mind that the kV and Time seconds parameters in Sinus exposure are like the Panoramic ones Preparing the patient 1
38. p a little above the patient s orbital bone and centre the patient until the position of perfect alignment with the Frankfurt and sagittal median lines is obtained The Frankfurt plane light beam must be adjusted for height in relation to the patient s size the adjustment is made by acting on the appropriate knob 18 In order to check the patient s centring the operator can tilt the mirror 6 towards himself thus obtaining a front view of the patient Lastly bring the patient s head into contact with the two temples clamp rods 7 by acting on the appropriate knob 9 After the head has been positioned the patient has to make a movement with his feet towards the stand This will give better distension of the spinal column in the cervical region eliminating white ghosting of the spine on the radiograph in the zone of the lower incisors Check centring again advise the patient to close mouth and eyes ask then to swallow and bring the tongue against the palate and remain motionless for the exposure 22 Rev 1 USER S MANUAL Operating instructions Figure 2 Panoramic position Figure 3 45 Sagittal median line 46 Frankfurt plane line Rev 1 23 RTG PLUS CE USER S MANUAL Operating instructions 6 2 4 Making the exposure refer to Figure 9 NOTE During the emission of X rays protection of the operator and surrounding personnel must be in accordance with the rules in force in the respective countries Th
39. s dead man type this means that the emission and arm s rotation are interrupted if the push button is released The push button must be held pressed also during the above emission interruption e In case of patient s moving during arm s rotation the exam has to be interrupted releasing the emission push button in this way both emission and rotation will be interrupted On the display will appear the message Change film and after about two seconds Press reset alternating The cassette has to be removed and loaded with a new film on the dark room The return button 32 is then to be pressed to bring the machine in the starting position The return end is evidenced by the message OK that will disappear when the button 32 is released e Inthe event that the patient will move during TMJ2 exposure and after TMJ1 mode already executed it is not mandatory to repeat also TMJ1 exposures This modality has to be repeated if for diagnostic reasons both open and closed moth results has to be on the same film 2 Atthe end of the TMJ2 examination on the display of the hand held control the message Press Reset will appear The return button 32 is then to be pressed to bring the machine in the starting position The return end is evidenced by the message that will disappear when the button 32 is released At this point the message Wait please will appear indicating that the automatic pause to allow anode cooling d
40. s the following materials and or components e Tubehead dielectric oil lead copper iron aluminum glass tungsten beryllium e Control box and remote control iron copper glass resin non biodegradable plastic casings e Column rotating arm extensions iron lead aluminum copper non biodegradable plastic materials glass resin NOTE Disassembling part of the unit must be performed by Villa Sistemi Medicali personnel or by authorized technical people M NOTE VILLA SISTEMI MEDICALI or its representative will not be responsible for the disposal of dismissed machines by the user and relative costs RTG PLUS CE 4 Rev 1 USER S MANUAL Safety information 2 3 Rev 1 Symbols used Symbol Description Equipment with Type B applied parts according to IEC 601 1 o ema ce _ Protection ground Functional ground OFF equipment not connected to power line Warning read the documentation provided with the unit Conformity to the CE 93 42 Directive aa ON equipment connected to power line 5 RTG PLUS CE USER S MANUAL Cleaning and disinfecting 3 CLEANING AND DISINFECTING PROCEDURES In order to guarantee a careful hygiene and cleaning it is advisable to follow scrupulously the procedures hereunder reported WARNING w Disconnect from the mains before cleaning the unit RTG PLUS CE Do not allow liquids and water to enter inside the unit t
41. sition during the examination RTG PLUS CE 28 Rev 1 USER S MANUAL Operating instructions Figure 4 TMJ1 position RTG PLUS CE 29 Rev 1 USER S MANUAL Operating instructions 6 3 1 4 Performing the exposure refer to Figure 9 1 With the LED of push button 29 lit up check if the exposure data are correct paragraph 6 2 2 then press the X ray button 42 during the whole time of the exposure as the control is a dead man type checking the simultaneous operation of the rays signaling light 43 and the acoustic ray signal NOTE e X ray emission starts with a delay of four seconds after the operation of the exposure push button in order to allow the preheating time of the tube filament and check all the set values Arm s rotation will start a little in advance regarding the emission e On TMJ examination the X ray emission does not last for all the rotation but it is interrupted corresponding with the central middle part of the mouth As a consequence both acoustic and visual emission signals are interrupted in accordance with the emission e X ray push button is dead man type this means that the emission and arm s rotation are interrupted if the push button is released The push button must be held pressed also during the above emission interruption e In case of patient s moving during arm s rotation the exam has to be interrupted releasing the emission push button in this way both emissio
42. t unit 54 outwards as far as possible after releasing it by means of knob 59 Raise the nose rest rod 57 as much as possible and rotate the Frankfurt plane alignment rod 55 outwards Bring the patient to the skull clamp unit in erect position and position the centre of the skull clamp rods previously disinfected in the auricular opening To do this turn the slider by means of handle 62 and the brake release button 63 Fastern the patient s head between the rods so that the points enter the auricular opening Figure 6 Bring up the nose rest 54 and adjust the patient s Frankfurt plane plane passing through the auricular openings and the lower part of the orbital cavity according to the plane defined by the centre points 58 and the alignment rod 55 when the latter is fully downward Figure 6 Exclude alignment rod 55 by rotating it outwards and bring up the nose rest unit 53 at the same time adjusting rod 57 until contact with the front to nasal Figure 7 40 Rev 1 USER S MANUAL V 9 D Q E V amp D amp D E S Figure 6 Figure 7 RTG PLUS CE 41 Rev 1 USER S MANUAL Operating instructions 6 5 4 Performing the exposure refer to Figure 9 NOTE During the emission of X rays protection of the operator and surrounding personnel must be in accordance with the rules in force in the respective countries The X ray activation always be commanded from an X ray protected are
43. t up 2 Depress buttons 41 increase or 40 decrease on the hand control selecting the desired kV value to be used After 2 seconds the function button LED stops blinking The unit is now ready for the next step NOTE he kV can vary from a minimum of 60kV to a maximum of 85kV by steps of 5kV The time second can have one of the following values 0 20 0 23 0 26 0 30 0 33 0 36 0 40 0 45 0 50 0 60 0 70 0 80 0 90 1 00 1 30 1 60 2 00 2 50 3 00 If after having selected the maximum or minimum value of kV or seconds a further increase or decrease is erroneously asked the following messages Minimum o Maximum will be displayed Afterwards the set minimum or maximum value of kV or seconds will appear on display To take a Postero Anterior PA or Anterior Postero AP projection you must set kV and Times as specified in the following table taking into consideration the screens films combinations and consequent mA calibration as reported at chapter 4 Large Size Medium Size Small Size 35 36 37 Adult 33 80kV 2sec 80kV 1 6sec 80kV 1 3sec Child 34 80kV 1 3sec 80kV 1sec 80kV 0 8sec Rev 1 39 RTG PLUS CE USER S MANUAL Operating instructions 6 5 3 Preparing the patient refer to Figure 10 RTG PLUS CE The patient must be prepared as per point 6 2 3 steps land 2 Open the skull clamp rods 60 to maximum aperture by means of knob 61 Move the nose res
44. ter CEPH modality not enabled NO reference collimator is in or there is no collimator inserted CEPH control button 28 pressed and unit not equipped with this device Insert the CEPH collimator Press the button of another examination NOT CEPH Please unlock rotating 6 2 1 The arm is in CEPH Rotate the upper knob 5 arm position anti clockwise Please rotate film holder to TMJ2 position Line voltage too low Line voltage too high Impossible to regulate the line voltage Push RESET TMJ modality not enabled Memory data corrupted Call Technical Assistance Technical Assistance 6 3 1 4 and 6 2 4 6 3 1 4 and 6 3 2 3 NO reference me lee Out of Order N 1 Call After having requested a TMJ2 exposure the film holder is not in the correct position Line voltage outside the 1096 of the nominal value Line voltage outside the 10 of the nominal value There is a continuous voltage fluctuation during the cathode pre ignition phase A PAN or TMJ cycle has been interrupted while in progress The arm return run is completed TMJ examination has been requested on a unit not equipped with this feature Rotate the film holder anti clockwise operating on the knurled knob 13 1 Make sure the line voltage is within the 10 of the nominal value 1 Make sure the line voltage is within the 10 of the nominal value Call Technical Assistance Press the RESET b
45. the event that the equipment is not set for a proper function the display will show the message Equipment not set and the panoramic function LED will blink Select the chosen function and push for the second time the same button with blinking LED the display will now indicated the step which needs to be performed Should there be more steps to be enabled they will be displayed one at a time and automatically excluded after the corresponding action has been performed 2 With the proper steps performed for the selected function see chapters regarding the single tests the LED stops blinking 27 28 29 or 30 Figure 9 and the procedure will remain lit with the equipment sets as default in the following configurations e ADULT with push button 33 LED lighted up e MEDIUM SIZE with push button 36 LED lighted up e Display 44 shows the kV alternatively to the exposure times THE UNIT IS READY RTG PLUS CE 18 Rev 1 USER S MANUAL Operating instructions 6 2 Panoramic X ray examination 6 2 1 Preparing the equipment refer to Figure 8 and Figure 9 For NON ST version the equipment has to be prepared for PANORAMIC examination by inserting the appropriate beam limiter unlocking the rotating arm and inserting the film holder If pressing the button 27 the message Equipment not set is displayed and the relevant function LED blinks push the button a second time in order to display the message concerning the interlock to be en
46. tors are used according to the X ray cassette size the available collimators are Standard size in inch 10 8 asymmetrical L L Optional 8 x10 symmetrical P A A P 8 x10 asymmetrical L L 12 x10 symmetrical P A A P Standard size in cm 18x24 asymmetrical L L Optional 18x24 symmetrical P A A P 24x18 asymmetrical L L 30x24 symmetrical P A A P The first value of the above mentioned collimator sizes refers to the horizontal dimension of the film Loosen knob 50 Figure 10 raise pin 51 Figure 10 so that the skull clamp unit can be adjusted according to the examination to be made i e latero lateral postero anterior antero posterior put back the pin and lock knob 50 Load in the dark room the film holder cassette the size of which is indicated on the collimator Insert it in the cassette holder unit 53 Figure 10 in the correct position according to the installed collimator following the position indicated on the cassette holder panel lock it lowering the upper guide by mean of the special knob M NOTE During a CEPH exposure no chin support of any kind is needed Rev 1 37 RTG PLUS CE 6 5 2 6 5 2 1 RTG PLUS USER S MANUAL Operating instructions Programmed Manual exposure After having set the equipment as described in the previous point it is now possible to chose whether to operate an exposure in the pre programmed mode i e with the kV and time values set by
47. ure refer to Figure 9 20 6 2 2 2 Manual exposure refer to Figure 9 21 6 2 3 Preparing the patient refer to Figure 2 and Figure 3 22 6 2 4 Making the exposure refer to Figure 9 1 24 6 3 TMJ examination not available on ST 26 6 3 1 Pertormine the MIT examina tiny ani 27 Mold Preparing ie rateali 27 6 3 1 2 27 6 3 1 3 Preparing the patient refer to Figure 4 28 6 3 1 4 Performing the exposure refer to Figure 9 30 6 3 2 Pertorming the TMJ2 examination 31 0 9 2 T cla 31 6 3 2 2 Preparing the patient refer to Figure 5 32 6 3 2 3 Performing the exposure refer to Figure 9 34 Rev 1 1 RTG PLUS CE USER S MANUAL Contents 0 4 SINUS CXatDIablOLTEs ss sedeo EM IT a M RES 36 6 4 1 Preparing the equiprHellb duda M dod 36 6 4 2 Progranimed Manualeposuire sunari alii 36 6 4 3 Preparing the palle rit Jue onde uri roy vi 36
48. us as it is interrupted during the transition phases between the different projections NOTES 0 0 4245 259524522 For ST version pressing the TMJ1 TMJ2 button will appear the message TMJ modality not enabled The TMJ functions allow to obtain 4 different images on the same film by means of two different programs The 4 images represent the right and left condyle of the temperomandibular joint TMJ both with closed TMJ1 or open TMJ2 mouth With TMJ1 projection there is exposure of the film lateral portions while the centre part will be exposed with the TMJ2 projection We suggest to follow the sequence TMJ1 and 2 RTG PLUS CE 26 Rev 1 USER S MANUAL Operating instructions 6 3 1 6 3 1 1 Performing the TMJ1 examination Preparing the equipment 1 The modality is selected by pressing one of the keys 29 or 30 Figure 9 if the message Equipment not ready and the corresponding LED is blinking press once again the key to visualize the message explaining which action has to be performed to finish the equipment s preparation 2 Messages that can be displayed for TMJ1 preparation are the same as for the panoramic modality so please refer to this section of the manual for the explanation and actions reference to paragraph 6 2 1 3 The equipment preparation has to be completed removing the chin s support for standard panoramic 1 Figure 8 and replacing it with the one for sinus
49. utton 32 Release button RESET 32 Press the button of another examination NOT TMJ Call Technical Assistance Call Technical Assistance Call Technical Assistance 1 If line voltage is outside the specified range 10 contact the local power company in order to take the necessary corrective actions Villa Sistemi Medicali S p a will not bear any cost for proper line set up Rev 2 RTG PLUS CE USER S MANUAL Operating instructions 6 7 Identification and correction of defects in dental radiographs exposure 6 7 1 Defects due to wrong patient positioning e ncisor too wide and indistinct The patient does not grip the bite block with the incisors or bends the rod towards the outside of the equipment Corrective action Reposition the patient also checking alignment of the Frankfurt plane through the centring device Please refer to the note on the centring see paragraph 6 2 3 steps 3 4 and 5 e incisor too small and indistinct The patient is positioned with an error opposite to point a above Corrective action Refer to point above e Radiograph with white central zone The patient s spinal column prevents the rays from passing because it is too compressed Corrective action Recheck alignment of Frankfurt plane and try to stretch the cervical tract of the column as much as possible by correcting slider height and shifting the patient s feet towards the stand see paragraph 6
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