97050191

Rev. 16
2021-09

NNT - USER MANUAL

EN
USER LICENSE

The software, of which the Author is and remains the owner for all purposes, is granted to the User as a non-
exclusive and free license for an indefinite duration.
The user license does not include the right to obtain the software in source format, nor to have the related logical
and design documentation.
Therefore the User acknowledges that the Author is and remains the sole, exclusive and legitimate owner of all
property, copyright and economic use rights of the software and related documentation.
The User is aware and expressly acknowledges that software products, in general, cannot be developed in such a
way that they operate without errors with respect to all possible applications and uses and that updated Software
versions may introduce new errors not present in the previous version.
Therefore the User expressly agrees that the Software may contain errors.
To this end, the User undertakes, in his/her own interest, to always and diligently make backup copies of the
archives (data and images) in order to remedy possible malfunctions of the Software product, as well as of the
systems on which it is installed. Therefore we recommend to regularly make backup copies of all acquired images.
Acceptance of the possibility that the Software may contain errors is a necessary condition for the Author to grant
the User the license to use the Software Product.
This license only grants the right to use the Software as End User, in the manners described below and in
accordance with the additional conditions and warnings contained in the documentation.

NOTES

This document is provided as a means of consultation for the user to use the program described here.
CEFLA s.c. reserves the right to make changes to the contents of this manual without prior notice.
This document, in whole or in part, may not be modified, copied, reproduced, distributed, saved on magnetic or
optical media, and published on websites and other on-line services without the written permission of CEFLA s.c.
The original version of this manual is written in Italian.
All other products and brand names shown in this document are registered trademarks of their respective
manufacturers.
The program is manufactured by
CEFLA s.c.
Via Selice Provinciale 23/A
40026 Imola (BO) Italy
All rights reserved.

2 USER MANUAL EN
Contents
ENGLISH

1. INTRODUCTION TO THE MANUAL ......................................................................................................................... 6

1.1. CONTENTS .......................................................................................................................................................... 6
1.2. DEFINITIONS ....................................................................................................................................................... 6
1.3. STYLISTIC CONVENTIONS ................................................................................................................................ 6
2. STARTING PROCEDURES ...................................................................................................................................... 7
2.1. SOFTWARE INSTALLATION............................................................................................................................... 7
2.2. SOFTWARE CONFIGURATION .......................................................................................................................... 7
2.3. MINIMUM AND RECOMMENDED SYSTEM REQUIREMENTS ......................................................................... 8
3. MAIN SETTINGS ....................................................................................................................................................... 9
3.1. GRAPHICAL OPTIONS........................................................................................................................................ 9
3.1.1. USE OF THE GDI+ OPTION ........................................................................................................................ 9
3.1.2. SELECTING REPORT COLOURS ............................................................................................................. 10
3.1.3. SELECT THE INFORMATION TO BE INCLUDED IN THE REPORT ....................................................... 10
3.1.4. USING OVERLAY COLOUR CONVERSION OPTION (B/W PRINTERS ONLY) ...................................... 10
3.1.5. USING “PRINTER COLOUR USAGE AND COLOUR CONVERSION” OPTION ...................................... 11
3.1.6. PRINT OPTIMIZE........................................................................................................................................ 11
3.1.7. APPLY A RULER ON THE IMAGES .......................................................................................................... 11
3.2. PROGRAM THEMES ......................................................................................................................................... 12
3.3. CONFIRMATION MESSAGES........................................................................................................................... 12
3.4. 3D MODE SELECTION ...................................................................................................................................... 12
3.5. REPORT HEADER ............................................................................................................................................. 13
3.6. SELECTING THE APPLICATION MODE .......................................................................................................... 14
3.7. MANAGEMENT OF RAW DATA ........................................................................................................................ 14
3.8. CONFIGURING AN EMAIL BOX ....................................................................................................................... 15
3.9. CONFIGURING INSTALLATION AND CLIENT DATA ...................................................................................... 16
3.10. OTHER ........................................................................................................................................................... 17
4. OPENING OF EXAMS ............................................................................................................................................ 18
4.1. OPENING OF EXAMS BY PATIENT ................................................................................................................. 18
4.1.1. OPENING OF EXAMS BY VIEWER ........................................................................................................... 21
4.2. OPENING OF EXAMS BY DOCUMENT TYPE ................................................................................................. 22
4.3. SELECTING A PATIENT .................................................................................................................................... 23
4.3.1. UNUSED PERSONAL DATA CLEANING .................................................................................................. 26
5. IMAGE MANAGEMENT .......................................................................................................................................... 27
5.1. CHANGING THE IMAGE PALETTE .................................................................................................................. 27
5.2. HIDING IMAGE OVERLAYS .............................................................................................................................. 29
5.3. SAVING IMAGES IN DIFFERENT FILE FORMATS .......................................................................................... 29
5.4. SAVING A SCREEN SHOT................................................................................................................................ 30
5.5. USE OF COMMAND GROUPS.......................................................................................................................... 31
5.5.1. “ZOOM” GROUP ......................................................................................................................................... 32
5.5.2. “COMMANDS” GROUP .............................................................................................................................. 33
5.5.3. “TOOLS” GROUP........................................................................................................................................ 34
5.5.3.1. DISTANCE TOOLS ........................................................................................................................... 34
5.5.3.2. LINE AND ARROW TOOLS .............................................................................................................. 34
5.5.3.3. TOOLS OF LINES AND ARROWS WITH TEXT ............................................................................... 34
5.5.3.4. MARKER TOOLS .............................................................................................................................. 35
5.5.3.5. TEXT TOOLS..................................................................................................................................... 35
5.5.3.6. ANGLE TOOLS.................................................................................................................................. 36
5.5.3.7. PROFILE TOOLS .............................................................................................................................. 36
5.5.3.8. IMPLANT TOOLS .............................................................................................................................. 37
5.5.3.9. VOLUME TOOLS .............................................................................................................................. 42
5.5.3.10. OBJECT PROPERTIES .................................................................................................................... 45
5.5.4. “3D COMMANDS” GROUP ......................................................................................................................... 46
5.5.5. “REPORT” GROUP ..................................................................................................................................... 46
5.6. VIEW IMAGE SERIES........................................................................................................................................ 47
5.7. ENLARGED AND FULL-SCREEN IMAGE MODE ............................................................................................ 47
5.8. RESTORING IMAGE FACTORY POSITION ..................................................................................................... 49
5.9. SENDING THE IMAGES VIA EMAIL ................................................................................................................. 49

EN USER MANUAL 3
 5.10. SAVING IMAGES IN THE 2D DOCUMENT ...................................................................................................50
6. DICOM IMAGES ..................................................................................................................................................... 51
6.1. EXPORTING IMAGES IN DICOM FORMAT ......................................................................................................51
6.1.1. SAVING "AXIAL SEQUENCES" ..................................................................................................................52
6.1.2. SAVING "ALL IMAGES" ..............................................................................................................................52
6.1.3. SAVING FROM AXIAL AND MPR VIEW ....................................................................................................53
6.1.4. SAVING SINGLE IMAGES ..........................................................................................................................54
6.2. IMPORTING IMAGES IN DICOM FORMAT.......................................................................................................55
6.2.1. LIMITATIONS TO IMAGE IMPORT IN DICOM FORMAT IN THE SOFTWARE ........................................56
6.3. SAVING 2D IMAGES IN DICOM FORMAT ........................................................................................................57
6.4. IMAGE STORING ON PACS ..............................................................................................................................57
6.5. EXPORT SETTINGS ..........................................................................................................................................57
6.5.1. GLOBAL DICOM .........................................................................................................................................58
6.5.2. NNTDICOM .................................................................................................................................................59
6.5.3. SAVING IN DICOM FORMAT .....................................................................................................................60
7. REPORT TEMPLATES........................................................................................................................................... 61
7.1. FOREWORD .......................................................................................................................................................61
7.2. CREATING A NEW SINGLE-PAGE TEMPLATE ...............................................................................................61
7.3. MODIFYING AN EXISTING SINGLE-PAGE TEMPLATE ..................................................................................62
7.4. DELETING A SINGLE-PAGE TEMPLATE .........................................................................................................62
7.5. CONVERTING A SINGLE-PAGE TEMPLATE ...................................................................................................62
7.6. COPYING A SINGLE-PAGE TEMPLATE ..........................................................................................................62
7.7. MULTI-PAGE TEMPLATES ...............................................................................................................................63
8. REPORT ................................................................................................................................................................. 64
8.1. STANDARD REPORT ........................................................................................................................................64
8.1.1. SELECTING THE TEMPLATE ....................................................................................................................64
8.1.2. INSERTING IMAGES IN THE REPORT .....................................................................................................65
8.1.3. INSERTING IMAGES IN AUTOMATED MODE ..........................................................................................66
8.1.4. REMOVING IMAGES FROM A REPORT ...................................................................................................66
8.1.5. INSERTING NOTES IN THE REPORT .......................................................................................................66
8.1.6. REMOVING NOTES FROM THE REPORT ................................................................................................67
8.1.7. REPORT TEXT DATABASE .......................................................................................................................67
8.1.8. ADDING PAGES TO A REPORT ................................................................................................................67
8.1.9. REMOVING PAGES FROM A REPORT ....................................................................................................67
8.1.10. MODIFYING TEMPLATE OF REPORT PAGE ......................................................................................68
8.1.11. MODIFYING VISUALIZATION OF REPORT IMAGES .........................................................................68
8.1.12. USE OF “DRAW ONLY ON REFERENCE IMAGE” COMMAND ..........................................................68
8.1.13. USE OF “HIGHLIGHT CROSSES ON PANORAMICS” CONTROL ......................................................69
8.1.14. PERFORMING MEASURES OF DISTANCES OR ANGLES ................................................................69
8.1.15. INSERTING EXAM/PATIENT DATA IN THE REPORT ........................................................................69
8.1.16. PRINTING A REPORT ...........................................................................................................................69
8.1.17. SAVING THE REPORT .........................................................................................................................69
8.1.18. SAVING IN PDF FORMAT .....................................................................................................................70
8.1.19. SAVING IN DICOM FORMAT ................................................................................................................70
8.1.20. OPENING A REPORT ...........................................................................................................................71
8.1.21. MODIFYING PATIENT DATA ................................................................................................................71
8.2. FAST REPORT ...................................................................................................................................................72
8.2.1. SELECTING THE TEMPLATE ....................................................................................................................72
8.2.2. INSERTING IMAGES IN THE REPORT .....................................................................................................74
8.2.3. REMOVING IMAGES FROM A REPORT ...................................................................................................76
8.2.4. INSERTING NOTES IN THE REPORT .......................................................................................................77
8.2.5. REMOVING NOTES FROM THE REPORT ................................................................................................77
8.2.6. REPORT TEXT DATABASE .......................................................................................................................77
8.2.7. ADDING PAGES TO A REPORT ................................................................................................................78
8.2.8. REMOVING PAGES FROM A REPORT ....................................................................................................78
8.2.9. SAVING THE REPORT ...............................................................................................................................79
8.2.10. PRINTING A REPORT ...........................................................................................................................79
8.2.11. SAVING IN PDF FORMAT .....................................................................................................................79
8.2.12. SAVING IN DICOM FORMAT ................................................................................................................79
8.2.13. OPENING A REPORT ...........................................................................................................................79

4 USER MANUAL EN
 8.2.14. MODIFYING PATIENT DATA ................................................................................................................ 79
9. MANAGING DOCUMENTS ..................................................................................................................................... 80
9.1. IMPORT .............................................................................................................................................................. 80
9.1.1. IMPORTING BY DOCUMENT .................................................................................................................... 80
9.1.2. IMPORTING BY PATIENT .......................................................................................................................... 80
9.2. EXPORT ............................................................................................................................................................. 81
9.2.1. EXPORTING BY PATIENT ......................................................................................................................... 81
9.2.2. EXPORTING BY DOCUMENT ................................................................................................................... 81
9.2.3. ANONYMISATION OF THE PATIENT........................................................................................................ 82
9.3. DELETING DOCUMENTS ................................................................................................................................. 83
9.4. USING SEVERAL ARCHIVES ........................................................................................................................... 84
9.5. BURNING CDs AND DVDs ................................................................................................................................ 84
9.5.1. BURNING A DISC BY DOCUMENT ........................................................................................................... 85
9.5.2. BURNING A DISC BY PATIENT ................................................................................................................. 86
9.5.3. CREATING A VIEWER ............................................................................................................................... 86
9.5.4. BURNING SOFTWARE .............................................................................................................................. 87
9.5.5. BURNING A VIEWER DISC WITH OR WITHOUT DICOM FILE ............................................................... 89
9.6. TRANSFERRING DOCUMENTS OR PATIENTS BETWEEN ARCHIVES ....................................................... 90
10. OTHER FUNCTIONS .............................................................................................................................................. 91
10.1. 3M & DICOM PRINTERS ............................................................................................................................... 91
10.2. SYSTEM FILES BACKUP .............................................................................................................................. 91
10.3. PROGRAM INTEGRATION WITH THIRD-PARTY SOFTWARE (PARTNERING SOFTWARE) ................. 92
10.4. SELECTING AND ACQUIRING FROM TWAIN SOURCES .......................................................................... 93
10.5. COMPATIBILITY WITH VDDS PROTOCOL ................................................................................................. 93
10.6. DOSE BOOK TOOL ....................................................................................................................................... 93
10.6.1. CONVERTING A DATABASE ............................................................................................................... 94
10.6.2. STARTING THE DOSE BOOK TOOL ................................................................................................... 94
10.6.3. REQUESTING ONE OR MORE PATIENTS ......................................................................................... 95
10.6.4. REQUESTING ALL PATIENTS ............................................................................................................. 95
10.6.5. CONSULTING DATA ............................................................................................................................. 95
10.6.6. CREATING A REPORT ......................................................................................................................... 96
10.6.7. PRINTING A REPORT .......................................................................................................................... 96
10.6.8. FILTERING THE EXAMINATION LIST ................................................................................................. 97
10.6.9. SENDING THE REPORT VIA EMAIL ................................................................................................... 97
10.7. METAL ARTEFACT REDUCTION (MAR) ALGORITHM ............................................................................... 98
10.7.1. FOREWORD.......................................................................................................................................... 98
10.7.2. USAGE .................................................................................................................................................. 99
10.8. HEADREST STICK REMOVAL FUNCTION ................................................................................................ 100
10.9. DATA BACKUP ............................................................................................................................................ 102
10.10. MULTIROOM SCANNER SYSTEM ............................................................................................................. 103
11. TROUBLESHOOTING .......................................................................................................................................... 104
11.1. WARNING TO RESTART PC ...................................................................................................................... 104
11.2. ERRORS GUIDE.......................................................................................................................................... 104
11.3. LOG ERROR ................................................................................................................................................ 105
11.3.1. SEND DATA VIA E-MAIL .................................................................................................................... 106
11.3.2. SENDING INFORMATION / ERRORS VIA CLOUD ........................................................................... 106
11.4. REMOTE SUPPORT.................................................................................................................................... 107
12. IEC61223: ACCEPTANCE TEST .......................................................................................................................... 108
12.1. POSITIONING OF THE PATIENT SUPPORT [PARAGRAPH 5.1] ............................................................. 108
12.2. PATIENT POSITIONING ACCURACY [PARAGRAPH 5.2] ........................................................................ 109
12.2.1. AXIAL PATIENT POSITIONING ACCURACY [PARAGRAPH 5.2.1].................................................. 109
12.2.2. SAGITTAL AND CORONAL PATIENT POSITIONING LIGHT [PARAGRAPH 5.2.2] ........................ 109
12.3. TOMOGRAPHIC SECTION THICKNESS [PARAGRAPH 5.3].................................................................... 110
12.3.1. TOMOGRAPHIC SECTION THICKNESS FOR AXIAL SCANNING [PARAGRAPH 5.3.1] ................ 110
12.3.2. TOMOGRAPHIC SECTION THICKNESS FOR HELICAL SCANNING [PARAGRAPH 5.3.2] ........... 111
12.4. DOSE [PARAGRAPH 5.4] ........................................................................................................................... 111
12.5. NOISE, MEAN CT NUMBER AND UNIFORMITY [PARAGRAPH 5.5] ....................................................... 112
12.6. SPATIAL RESOLUTION [PARAGRAPH 5.6] .............................................................................................. 115
12.7. "CONTRAST SCALE” TEST ........................................................................................................................ 117

EN USER MANUAL 5
1. INTRODUCTION TO THE MANUAL
1.1. CONTENTS

This document has been designed as means of consultation to provide information and instructions on use of the
software described therein, further in this document referred to as the “program”.
The user shall fully read and understand this manual before using the equipment. It is highly recommended to keep
this manual along with further documentation and to use it as an handbook in order to instruct new staff in using the
equipment.
1.2. DEFINITIONS

Definition Meaning
CBCT or CB3D Cone Beam Computed Tomography
CBCT DEVICE Radiation-emitting device that uses CBCT technology
2D DATA ONLY Feature available only for data coming from 2D devices.
CBCT DATA ONLY Feature available only for CBCT data.
MAIN WORKSTATION Personal Computer directly connected to a CBCT DEVICE.
USER MANUAL OF THE
Specific manual for the device that operates together with the program
DEVICE

1.3. STYLISTIC CONVENTIONS

The following table illustrates the stylistic conventions adopted by this manual:
Text tools Example Meaning
Bold Italic File → Open Menu or toolbar item
Italic Patient File Window Title
Bold Underlined Apply Button Command
<text> <Demonstration template> Typed text
CAPITAL LETTER ENTER Keyboard command

Important safety information and any notes are included in the manual as shown here:
DANGER:
Warns of the presence of a potential danger that could injure a person or that can cause death.

WARNING:
Warns of the presence of a potential danger that could damage the device.

NOTE:
Provides additional information not related to the safety of the device, the patient and the
operator.

NOTE FOR VIEWER VERSION:

It indicates that the functions described in the paragraph are not available when the program is
distributed as Viewer, where Viewer is intended as a limited version of the program.

6 USER MANUAL EN
2. STARTING PROCEDURES
2.1. SOFTWARE INSTALLATION

NOT AVAILABLE FOR VIEWER VERSION

In order to properly install and uninstall the program, the qualified user must refer to the documentation included in
the installation disk.
2.2. SOFTWARE CONFIGURATION

NOT AVAILABLE FOR VIEWER VERSION

This paragraph provides a description of the different software configurations available, some of which can be
activated through a special USB hardware key.
Following is a brief description of each software suite:
EXPERT: through this configuration the user may take advantage of all the potentials of the program, both in the 2D
and the CBCT environments.
In particular, it is possible to perform scans (if the workstation is connected directly to the CBCT scanner), or
otherwise perform anyway all the operations of primary, volumetric and secondary reconstruction, of 3D image
generation, and of report creation and printing allowed by the software.
PROFESSIONAL: Professional configuration allows creating new studies, performing secondary reconstruction and
creating and printing reports, starting from volumetric data (created by the primary reconstruction).
ULTIMATE: if the workstation is directly connected to the CBCT scanner, this configuration acts exactly like an
EXPERT configuration.
If, on the other hand, the workstation is not directly connected to the CBCT scanner, the functions are similar to a
PROFESSIONAL configuration.
BASIC: it allows viewing, printing, and saving in a personal archive, previously created reports with the above-
mentioned configurations. The user will also be able to add distance and angle measurements and modify brightness
and contrast of single images.
Any information relating to the program installed and the characteristics of the workstation can be viewed by selecting
the Help → About menu.

EN USER MANUAL 7
2.3. MINIMUM AND RECOMMENDED SYSTEM REQUIREMENTS

For more details on minimum and recommended hardware and software requirements for workstations directly
connected to reference or additional devices, refer to the “Minimum and Recommended System Requirements”
attachment.

8 USER MANUAL EN
3. MAIN SETTINGS

Using the Tools → General Settings… command, you can display

the general program configuration window.

The window is divided into "tabs” detailed here below:

3.1. GRAPHICAL OPTIONS

The user is given the possibility to customize the graphic attributes of some objects used by the software.
Select the Graphic options… tab.
The left part of the window shows the list of objects (A) that
may be modified.
The preview image (B) shows the selected object with the
current attributes.
On the right there are the buttons and controls to be used
to modify the graphic attributes of an object (C). These
controls vary according to the type of object selected
By selecting the “Save” button the new attributes will be
applied to the objects.

3.1.1. USE OF THE GDI+ OPTION

Check the “Use GDI+” flag to enhance the drawing of the overlay.
This area also includes the settings to define the thickness of the lines of the printed report.
Nine options are available:
1. Thickness x1: the thickness of the printed overlays will be the same as the one defined on screen.
2. Thickness x2: the thickness of the printed overlays will be twice the thickness of the one defined on screen.
3. Thickness x3: the thickness of the printed overlays will be three times the thickness of one defined on screen.
4. Etc…
Since the printing thickness can vary depending on the printer, it is recommended to perform a few tests using
different setting to find out which one provides the best result.

EN USER MANUAL 9
3.1.2. SELECTING REPORT COLOURS

Different areas of the report can be associated with various colours. These areas are:
• Report page background area (Page BK) represented in orange.
• Image background area (area not completely filled by the image (Item BK), represented in yellow.
• Text showing the patient information (Patient data) represented in blue.
Here below are the steps to follow to change the colours associated to any of the three areas.
In the “Report colours” section, click the button associated
with the colour area you wish to modify.
The “Colour” window will appear.
Select the colour you wish to use and click the “OK”
button.
The preview image will be updated displaying the new
colour.

3.1.3. SELECT THE INFORMATION TO BE INCLUDED IN THE REPORT

In order to choose the information to be included in the report in the Patient field, select the Change… button located
in the Exam info on report section.
From the Exam info on Report window, check the fields you wish to be included in the Patient field of the report. The
last field allows to show such information only on the first page of each report. Select the “OK” button to apply
changes.

3.1.4. USING OVERLAY COLOUR CONVERSION OPTION (B/W PRINTERS ONLY)

This function defines how to manage colours and texts of the report images using a Black/White printer.
Click on the “Change” button of the “Overlay and text colour conversion” area.
The “Overlay Colour Conversion” dialogue will appear. Three options are available:
1. Default (R2_NOT): The overlay will take on a colour opposite to the colour of the background.
2. Lighter (R2_MERGEPEN): The overlay will take on a colour opposite to the colour of the background and then
they will be become lighter.
3. Darker (R2_NOTXORPEN): The overlay will take on a colour opposite to the colour of the background and then
they will become darker.
4. White (R2_WHITE): The overlay will always be drawn in White.
5. Black (R2_BLACK): The overlay will always be drawn in Black.

The text of the report can be printed in two different ways, that can be selected using the two buttons here included.
This modality applies to the following texts: text inside the images, patient data, report comment, page footer.
Here below are the two modalities:
• “Force white BK”: all the texts will be printed in black on a white background.
• “Outlined”: the texts with a coloured background will be printed in black on a white background like the “Force
white BK” modality. All the texts with transparent background will be printed in white with black border.

10 USER MANUAL EN
3.1.5. USING “PRINTER COLOUR USAGE AND COLOUR CONVERSION” OPTION

This flag defines how to manage colours when printing

Select one of the three available options:
1. Automatically selected: it automatically recognizes the type of printer (colour or black/white) and decides how to
manage colours.
2. Force colors: prints coloured objects always using colours and, with b/w printers, replaces colours with grayscale.
3. Force Monochrome: always prints using black and white, for any printer.

3.1.6. PRINT OPTIMIZE

Printing section includes the Optimized print process option that, when enabled, uses a slightly slower process that
improves compatibility with printers.

3.1.7. APPLY A RULER ON THE IMAGES

It is possible to apply a ruler on the right side of scout, axials, transaxials (single and sequence) and panoramic
images.
In the “Image ruler” area select the “Setup” button.
The “Image ruler setup” dialog will appear. Select the “Enable”
button.

The following options will be enabled:

• Ruler colour: it allows choosing the colour of the ruler.
• Ruler step: it allows (through two buttons) setting the distance
between ruler marks (1 or 5 mm).
• Line width: it allows setting the length of the marks.
• Ruler values: it shows/hides the numeric values of the ruler. If
enabled, the “Font type” button allows changing the font of the
ruler values.
The preview image will show the current ruler settings in real time.

By selecting the “OK” button the current settings of the ruler will be
saved and in the “Image ruler” area the ruler active status will be
shown.

EN USER MANUAL 11
3.2. PROGRAM THEMES

Selecting the Theme tab, the theme selection window will be

displayed.
Select one of the available themes, observing in real time the
way the program looks.
By selecting “Black BK on images” a black background will be
displayed in the image area.
It is also possible to set a customised background image by
loading it using the button “Load custom image”.
Once the theme has been selected, press OK to store the
choice made or Delete to restore the previous theme.
Click the OK button to store the changes.

3.3. CONFIRMATION MESSAGES

Selecting the Messages confirmation tab, the confirmation

message window will be displayed.
Select the desired messages by checking the box next to the
icon.
Click the OK button to store the changes.

3.4. 3D MODE SELECTION

Selecting the 3D tab, the 3D mode selection window will be

displayed.

For further information on these functions, please refer to the

“3D” attached document.

12 USER MANUAL EN
3.5. REPORT HEADER

The header of the report is the area designated to contain information concerning the user or the user's office.
This area may be filled in with text and it is possible to add a logo to it. Once created, the header will be automatically
inserted into each page of the report in the section dedicated to it.
Select the Report tab. The dialog "Report header setup" will be displayed.
Below is a brief description of this dialog.
A) Text formatting buttons.
B) Editing area.
C) Logo preview.
D) Header preview.
Use the editing area to enter the information you wish to
provide in the header.
Using the text formatting buttons, you can select the font type,
style, formatting, size, and colour.

Use the “Insert Logo” button to select the logo file you wish to add. This file must be in BMP format.
A preview of the logo will be shown once the logo has been selected.
Click on the “Update Preview” button to show a complete preview of the header.

NOTE:
The image shown in the preview is the exact
representation of the header.
This image will then be enlarged or reduced
(maintaining the proportions between height
and width) so that it is contained within the
area reserved to it in the report.
To optimize the header as much as possible it
is recommended to use fonts of a size that fills
as much as possible the area reserved to the
text.

You can also reduce this area by using the targets placed on its sides. This reduces any unused space inside the
header.
At the end click on the “OK” button.
NOTE:
If the program is suitably configured for the use of different work archives (refer to Par. 7.4 - "Use
of several archives") after confirming the header modification/setting, it will be possible to choose
whether the modification made will be applied only to the reports produced using the current
archive, or to all the reports of the various archives set.

EN USER MANUAL 13
3.6. SELECTING THE APPLICATION MODE

Selecting the Application mode tab, the application mode

selection window will be displayed.
For further information on these application modes, please
refer to the attached documents:

“Dental Radiology Mode”

“Maxillofacial surgery mode”
“ENT Application Mode”
“Medical Application Mode”
“Veterinary Application Mode”
“Dentist 2D Mode”
“Veterinary 2D Mode”

NOTE:
“Dentist 2D Mode”
“Veterinary 2D Mode”
Set these modes to use 2D documents only.
It is possible to choose whether to ignore any
inserted hardware dongle.

WARNING:
The “Veterinary Application Mode”” is for
veterinary use only: do not use in case of human
patients

3.7. MANAGEMENT OF RAW DATA

Selecting the RawData management tab, the advanced scan

mode setting window will be displayed.
It is possible to select between:
Standard mode
it automatically manages the reconstruction of the scan data.

The “Change amount” button allows selecting the number of

3D scans to maintain. If the set number is higher than 20, the
least recent scans will be deleted

Advanced mode
It allows managing the RawData and performing
reconstructions with a higher resolution.

When “Advanced mode” is selected it is possible to disable the

automatic primary reconstruction process after the scans.

Click “OK“ to store the changes.

For more information about this function, please refer to the
“Acquisition operations” attachments of the different devices.

14 USER MANUAL EN
3.8. CONFIGURING AN EMAIL BOX

A personal email box may be configured in order to use various

functions within the program. To access the configuration
panel, select the E-mail tab.
The panel allows choosing between two modes: Windows
Default Client and Web-based (SMTP).

The Windows Default Client option uses the currently selected

email client through the operating system (Outlook,
Thunderbird, etc.); therefore, no configuration is necessary.

WARNING:
Make sure that the external software for email
management is set up and working.

Choosing Web-based (SMTP), you can enter the configuration data to use your (outbox) email box via SMTP
connection. Enter all the information required, making sure that it is correct and updated; moreover, you can specify
the maximum size allowed of the outbox email attachments.
WARNING:
The information needed to set up the SMTP email is supplied by the email service provider and is
subject to rules independent of the program. Make sure that you enter the most updated
information indicated by your provider and that you set up the email account so as to allow
external applications to access your email box.

EN USER MANUAL 15
3.9. CONFIGURING INSTALLATION AND CLIENT DATA

Upon software starting, if not already done from the Installation

& customer data tab, you will be prompted to enter some basic
information concerning the program user. If the message is
ignored, it will be shown every time the software is started,
until the entered information is confirmed by means of the OK
button or until you specify that such message must not be
shown any more.

The entered information will be used to optimise the technical

service: e.g. customer data will be entered automatically in the
LOG ERROR file (described in paragraph 9.3) that the user
can send via email.

In addition to user information, this window includes some

fields that can be only edited by the technical service (Service
level) to specify some additional values.

(e.g., entering an email address in the corresponding field

allows sending the LOG ERROR file described in paragraph
9.3 to the specified address. Moreover, specifying a Device
S/N allows using such serial number in case it is not present
on the device or in case the device is off or faulty.)

16 USER MANUAL EN
3.10. OTHER

The selection of the Miscellaneous tab displays the “Other

settings” window that allows you to enable the automatic
creation of a 2D placeholder in a 2D document when a Primary
Reconstruction is performed.

- Automatically save a 2D Placeholder

It enables the automatic creation of a 2D placeholder in a
2D document when a Primary Reconstruction is made.

- Show all creation buttons…

It will show all the commands for the creation of new slices
(even if not provided for the current view) in the study
document

- Exclude QA Phantom…
QA Phantom will be excluded in automatic export processes

- Auto Assign:
the program will prompt to assign any new imported 2D
image to the current patient

- Overlay on exported images:

It allows applying overlays to the exported images after
clicking on the “save image as” command.

- TWAIN on toolbar
Allows to display and select which TWAIN function
commands to show on the main command and 2D
document toolbar.

EN USER MANUAL 17
4. OPENING OF EXAMS

NOTE:
If the “Maxillofacial surgery” Application Mode is selected, refer to the relevant paragraph
available in the specific annex to open the exams

4.1. OPENING OF EXAMS BY PATIENT

It is possible to open the archived exams by filtering them

by the patient with whom they are associated. To do this:

1) From the main window, select File → Open by patient…

or press the appropriate button (see figure).

The patient selection window will be shown (called “ Classic

style”):
2) Press the “Update list” button to see the complete list of
available patient records or type part of the surname to
go directly to the patient desired.
3) Select the patient’s name and confirm with “OK”.

A list of documents associated with the selected patient will

be shown.
4) Select the required document and confirm with “OK”.

One may change the search query by performing an advanced search and filtering by different fields.
To do this:
1) From the patient selection window, click on the settings
modification button.

18 USER MANUAL EN
 2) Change the selection from "Classic style" to Advanced
style" and confirm by clicking on "Apply".

3) A window will pop up asking you to confirm the change.

Click on “Yes” to make the change effective.

At this point, by clicking on the “Advanced search” button, you can do a search by the fields shown in the image
below.
NOTE:
Search fields are not exclusive, therefore, by selecting several parameters in the various fields,
the filters will add up.

EN USER MANUAL 19
 To view further details (columns) in the display window:

1) From the patient selection window, click on the column

display button.

2) Add the desired columns and confirm by pressing “OK”.

20 USER MANUAL EN
4.1.1. OPENING OF EXAMS BY VIEWER

It is possible to open the archived exams by filtering them

by the patient with whom they are associated. To do this:

1) From the main window, select File → Open by patient…

or press the appropriate button (see figure).

The patient selection window will be shown (called “ Classic

style”):

2) Select the patient’s name and confirm with “OK”.

EN USER MANUAL 21
4.2. OPENING OF EXAMS BY DOCUMENT TYPE

It is possible to open the archived exams by filtering them

by type of document. To do this:

1) From the main window, select File → Open by

document… or press the appropriate button (see figure)

The document selection window will be displayed:

NOTE:
Depending on the configuration of the software
used, some buttons may not be available for
selection.
2) Press the button corresponding to the type of required
document.
3) Select the patient’s name associated with the document
and confirm with “OK”.
NOTE:
It is possible to filter the patients list by typing
part of the surname in the dedicated field, or by
other search criteria by clicking on the
"Advanced search" button (1).

It is also possible to filter the list of patients

based on the date the patient's personal data
have been entered in the software (3).
In particular, you can view:
- All the patients
- Today’s patients
- Patients in last 7 days
- Patients in last 30 days
- Patients in last 3 months
- Patients in last 6 months
- Patients in last year

22 USER MANUAL EN
4.3. SELECTING A PATIENT

NOT AVAILABLE FOR VIEWER VERSION

It is possible to make the patient selection: this selection

allows centralizing on the patient chosen those operations
that relate to the association with a record (such as
opening the documents).
To select a patient:

1) Click on the appropriate button (see figure).

The patient selection window will be shown (called “Classic

style”):
2) Press the “Update list” button to see the complete list of
available patient records or type part of the surname to
go directly to the patient desired.

From this screen it is possible to:

A) Select the patient’s name and confirm with “OK”.
B) Select the patient’s name and delete it from the software by using the “Delete patient record” button.
C) Add a new patient record in the software by using the “Add new patient...” button.
D) Change the existing records by using the “Edit patient record…” button.
E) Delete patient records not associated with any document by using the “Unused records cleanup” button (see
following paragraph).

EN USER MANUAL 23
 The following window will be displayed in case of patient
record management.
Use the buttons on the right side to enter, respectively, a
patient image and a text that can be formatted and printed.

It is possible to enter some optional data on the patient

record by clicking on the relevant button at the bottom of
the window (e.g. Additional DICOM fields, secondary
address, insurance no., etc.).

One may change the search query by performing an advanced search and filtering by different fields.
To do this:
1) From the patient selection window, click on the settings
modification button.

2) Change the selection from "Classic style" to Advanced

style" and confirm by clicking on "Apply".

24 USER MANUAL EN
 3) A window will pop up asking you to confirm the change.
Click on “Yes” to make the change effective.

At this point, by clicking on the “Advanced search” button, you can do a search by the fields shown in the image
below.
NOTE:
Search fields are not exclusive, therefore, by selecting several parameters in the various fields,
the filters will add up.

To view further details (columns) in the display window:

1) From the patient selection window, click on the column

display button.

EN USER MANUAL 25
 2) Add the desired columns and confirm by pressing
“OK”.

In case of patient confirmation (point A), you will see his

name in the main window.
At that point it will be possible to:

3A) View documents relating to the patient by selecting

the required type using the command Open by
document... or view all documents relating to the
patient by using the command Open by patient.

3B) Deselect the patient by clicking on the appropriate

button (see figure).

4.3.1. UNUSED PERSONAL DATA CLEANING

Use the “Unused records cleanup” button, to delete the

patient records that are not associated with any document.

WARNING:
In order for the procedure to be successful in
stations that share the same database, it is
necessary to close the program on all stations
except the one involved in the procedure.

26 USER MANUAL EN
5. IMAGE MANAGEMENT
5.1. CHANGING THE IMAGE PALETTE

The visualisation window allows setting the image palette and any filters.

By double-clicking on the image you wish to modify, the

“Visualization Window” will be displayed.

There is a preview image that instantly allows seeing

how the modifications apply to the image.
To the right of the preview image there is a scrollbar
that allows moving inside the group of selected images.
The scrollbar to the left allows applying a filter to the
image. The type of filter to be applied can be selected
by means of the Sharp and Sharp+ buttons above the
scrollbar.
NOTE:
The Sharp filter cannot be used on the images
of the documents created through artefact
reduction procedure MAR, refer to par. 8.10.
A cursor within the window enables the modification of
the image brightness and contrast: dragging the
cursor to the right/left changes the contrast and to the
top/bottom the brightness.
(CBCT DATA ONLY) The options located to the right
allow selecting the image tone. Available tones are:
Grey, Sepia, Blue Film, Red, Flame and Spectrum.
To modify the relationship between the greyscale and
the image values, use the two arrows under the
greyscale.

The button located between the greyscale and the

options inverts the colours used
The three scrollbars to the left of the greyscale are:
- Gamma: it modifies the curve trend by changing the
ramp into an upward-sloping and downward-sloping
curve to improve the visualisation of soft and hard
tissues.
- BEnh (CBCT DATA ONLY) it gradually applies a filter
that enhances hard tissues.
- STS (CBCT DATA ONLY) it applies a filter that
gradually smooths soft tissues.

EN USER MANUAL 27
 It is possible to pre-set up to a maximum of three windows
of greyscale and filters per image type, to load at a later
stage. To do that:
a) (Optional) Select one of the three buttons
"Wnd1", "Wnd2" or "Wnd3".
b) Modify the greyscale settings.
c) Click on the “Record” button. The “Select window”
box will open.
d) Select one of the three buttons "Wnd1", "Wnd2" or
"Wnd3". The window will display the “Ok” button.
e) Select the “Ok” button to save the settings in the
selected window.
To load one of the levels saved, click on the
corresponding “Wnd” button.
NOTE:
Before a new document is created, the Wnd1
is set as default.

After making all the adjustments (greyscale and filter),

select “Apply”.

The “Apply To” window will be displayed.

Select how you want to apply your changes:
a) Current Image: changes will be applied only to the
selected image.
b) Current Image Group: changes will be applied to the
images belonging to the selected image group.
c) (CBCT DATA ONLY) All images: (it may be
disabled) changes will be applied to all the images of
the study.
(When selecting this option a message will appear,
reminding you that the filter will not be applied to any
image and the palette will not be applied to the 3D
and scout images).

At the end click on the “OK” button.

Press the “Reset” button shown in the figure to reset the

palette to the predefined settings.

28 USER MANUAL EN
5.2. HIDING IMAGE OVERLAYS

The image overlays are all the graphic objects (lines, arrows, distances, angles, text, profiles, markers etc.) that can
be manually added to the images. A simple command can be used to temporarily hide all these objects in order to
display the image in its original state, or to hide only the types of overlays that are of no interest.
To deactivate all overlays, select the “Show/hide image overlays”
command from the main toolbar of the study.
Deselect the command to restore the visualization of the overlay.
To deactivate only certain overlays, select one of the following
commands from the main toolbar of the study:

“Show/hide factory overlays”

“Show/hide custom overlays”
“Show/hide marker overlays”
“Show/hide implant overlays”
“Show/hide implant’s axes”
“Show/hide volumes overlays”

Deselect the command to restore the visualization of the overlay.

5.3. SAVING IMAGES IN DIFFERENT FILE FORMATS

Each image can be saved in a JPEG or BMP format. To save an image in a different format, follow the steps below:

From inside the study select File → Save Image As...

The cursor will change its appearance to reflect the selected
command.
Left-click on the image you wish to save.

The “Save As” window will appear with a suggested file name. Browse for the directory where you want to save the
file.
From the “Save As Type” list select the file format in which you wish to save the image.
Click on the “Save” button to save the file. After the file has been saved, the “ Save image as…” command is still
active and it is possible to save other images. Right-click to deactivate it.
NOTE:
The “Save image as…” command for the images in different formats is available also in the
RawData and Volumetric Data.

EN USER MANUAL 29
5.4. SAVING A SCREEN SHOT

The screen shot process consists in taking a picture of what is displayed at that moment on the screen and saving it
in a graphic format.
1) From the main toolbar select the Screen shot…. button.

2) The cursor will change to reflect the selected command. Select

the screen you wish to capture and left-click on it.

3) The “Save As” window will appear with a suggested file name.
Browse for the directory where you want to save the file. From the “Save As Type” list select the file format in
which you wish to save the image. Click on the “Save” button to save the file.
After the file has been saved, the “Save image as…” command is still active and it is possible to save other images.
Right-click to deactivate it.

30 USER MANUAL EN
5.5. USE OF COMMAND GROUPS

Lines, angles, distances, remarks, profiles, markers, and implants can be added to each image (except 3D images).
For the 3D images, only lines and text can be added.
This paragraph will show how to apply these overlays to the images
Based on the type of document (study, volumetric, etc.) and on the
type of available exam, several groups of commands will be available
on the right side of the window:

Hide commands button

It allows hiding all the groups of commands from the window

Zoom
It includes commands required to enlarge/resize images inside the
visualization window

Commands
It includes commands required to create new slice, cross, curved,
multiplanar sections and 3D models

Tools
It includes commands required to create distances, lines with text,
circles, markers, lines, profiles, regions, angle measurements and to
enter implants or volumes

3D commands
It includes commands required for the rotation, activation /
deactivation of the relevant overlays and for the selection of the
presets related to the 3D views

Report
It includes commands required to create reports (entry of images,
notes, etc.)

All groups can be hidden / viewed by clicking on the arrow on the

side of the name

EN USER MANUAL 31
5.5.1. “ZOOM” GROUP

It includes commands required to enlarge/resize images inside the visualization window

Select the icon shown in the figure to use the magnifying glass tool. Once the option is selected the mouse cursor will
take the shape of a magnifying glass.
Move the cursor over the image to enlarge it. The enlargement
automatically disables the default overlay display while displaying
overlays entered by the operator.

To close the tool right-click or select again the magnifying glass

icon.

The remaining buttons allow enlarging / resizing the images by a default % (100 – 75 – 50%) or by a chosen % (by
setting it with the “Setup Zoom” button).

32 USER MANUAL EN
5.5.2. “COMMANDS” GROUP

It includes commands required to create new slice, cross, curved, multiplanar sections and 3D models

NEW SHARP 2D SECTION

Select to trace a new Sharp2D section
(“New Sharp2D section”)

NEW SLICE SECTION

Select to trace cross sections
(“New slice section”)

NEW CROSS SECTIONS

Select to trace cross sections
(“New cross sections”)

NEW CURVED SECTION

Select to trace a curved section
(“New curved section”)

NEW MULTIPLANAR SECTION

Select to trace a multiplanar section
(“New multiplanar section”)

NEW TMJ SECTION

Select to trace a TMJ section
(“New TMJ section”)

NEW 3D MODEL
Select to trace a new 3D model
(“New 3D model”)

NEW FREE CUT SECTION

Select to trace a free cut section
(“New free cut section”)

For more details on these features, please refer to the relevant “Annexes” to this manual

EN USER MANUAL 33
5.5.3. “TOOLS” GROUP

It includes commands required to create distances, lines with text, circles, markers, lines, profiles, regions, angle
measurements and to enter implants or volumes.

The tools available are indicated below divided by type:

5.5.3.1. DISTANCE TOOLS

NEW DISTANCE NEW DISTANCE

(“New Distance”) (“New Distance”)
NEW BROKEN LINE DISTANCE
(“New Broken Line Distance”) Select to trace a distance with broken line
(NOT AVAILABLE FOR VIEWER VERSION)
For more details on these features, please refer to the relevant “Annexes” to this manual

5.5.3.2. LINE AND ARROW TOOLS

NEW DISTANCE
Select to trace a line
(“New Distance”)

NEW ARROW
Select to trace an arrow
(“New Arrow”)

5.5.3.3. TOOLS OF LINES AND ARROWS WITH TEXT

NEW LINE WITH TEXT

Select to trace a new line with text
(“New Line + Text”)

NEW ARROW WITH TEXT

Select to trace an arrow with text
(“New Arrow + text”)

34 USER MANUAL EN
5.5.3.4. MARKER TOOLS

NEW SMALL MARKER

Select to trace a small marker
(“New Small Marker”)

NEW MEDIUM MARKER

Select to trace a medium marker
(“New Medium Marker”)

NEW LARGE MARKER

Select to trace a large marker
(“New Large Marker”)
MARKER SET-UP Select to open the marker set-up window. This
(“Marker setup”) command allows modifying marker thickness.
In the “Marker Setup” window it is possible to:

- Modify marker thickness.

- Define the marker tracing modes.

(Static: marker not modifiable, Dynamic: marker modifiable after tracing with the “Edit” button).

5.5.3.5. TEXT TOOLS

NEW TEXT
Select to add text
(“New single line string”)

EN USER MANUAL 35
 NEW MULTILINE TEXT
Select to add a new multiline text
(“New multiline text”)

5.5.3.6. ANGLE TOOLS

NEW ANGLE
Select to trace a new angle
(“New Angle”)

NEW ANGLE WITHOUT VERTEX

Select to trace a new angle without vertex
(“New Angle Without Vertex”)

NEW CIRCLE
Select to trace a circle
(“New Circle”)

5.5.3.7. PROFILE TOOLS

The profiles indicate the value in Hounsfield units

NOTE:
Accuracy of Hounsfield unit (HU) measurement has intrinsic limitations in CBCT technique, as
broadly debated in scientific literature. Among others, see: "Deriving Hounsfield units using grey
levels" - DMFR (2010) 39, p.323; "Influence of anatomical location on CT numbers" - OOOO Vol.
115 4 April 2013 p.558; "Prospects and challenges of rendering tissue density in Hounsfield units"
- OOOO Vol. 116 1 July 2013 p.105.

The program will show this message

NEW PROFILE
Select to trace a profile
(“Trace Profile”)

NEW REGION
Select to trace a focus area
(“Trace region”)
DISPLAY DENSITY Select to display the density level (in HU scale) in
(“Display density”) the area indicated by the cursor inside the image
(The region can be set from the Graphic Options
window of the File menu)

36 USER MANUAL EN
5.5.3.8. IMPLANT TOOLS

NOTE:
DISCLAIMER OF LIABILITY

CEFLA s.c. shall not be liable for any incidental or consequential loss, damage or expense,
directly or indirectly arising from the use of the implant simulation feature, neither assumes nor
authorises any other person to assume for it any other or additional liability or responsibility in
connection with these features. Implant simulation should only be used by surgeons having
received proper training.

Implants are portrayed in a simplified shape, or template, faithfully replicating the outer dimension
of the implants according to catalogues and datasheets of their respective manufacturers. As
technical data is subject to change without notice, make sure that the dimensions of the implant
template being used do reflect the actual implant size, according to current specifications from the
chosen implant manufacturer.

All company and/or product names may be trade names, trademarks and/or registered
trademarks of the respective owners with which they are associated.

NOTE:
The implant-related functions within the program are for communication purposes.
Please refer to a specific third-party software if you need an optimized implant planning.

NOTE:
Due to the complexity of the computation, if a large number of implants are entered, it will be
possible to notice a slowdown in the scrolling of the images.

To speed up the response of the program user interface it is possible to:

- hide the implant overlays when they are not necessary;

- reduce the thickness of the panoramic images;
- hide the panoramic image.

NEW IMPLANT
Select to add a new implant
(“New implant”)

SHOW IMPLANT IN MPR VIEW

Select to view an implant in the MPR view
(“New implant”)

NEW REGION
Select to align the implants present
(“Trace region”)

EN USER MANUAL 37
Selecting “New implant”, the implant selection window will be shown:
The functions of the window are described below:
Red Tabs
List of the manufacturers and the relative models contained
in the database.
“Used implant(s)” tab
It displays the implants currently used in the document (the
implants are displayed after selecting the implant with the
“Select implant” button.
"Select implant" button
It allows selecting the desired implant so that it can
subsequently be added to the document. After clicking this
button, the selected implant will be shown in the green
“Used implant(s)” tab.
"Exit" button
It allows closing the window and returning to the original
document.

After selecting the implant, the insert/edit window will be displayed:

The functions of the window are described below:
Implant display window:
In this window you can edit the size and shape of the
implant by:
1) Changing the red nodes in the image, dragging
them both vertically and horizontally to the desired
position with the mouse.
2) Adding new points (diameters) by double-clicking
the desired point or right-clicking and selecting “Add
diameter” / “Remove diameter”.
Colours window:
It allows changing the implant display colour.
Steps window:
It allows dragging the red nodes in steps of 0.05mm,
0.1mm or 0.5mm.
Vertical and Diameter position fields:
They indicate the measurements of the various parts of the
implant. You can edit the measurement by entering a new
value from the keyboard.
"Add" / "Remove" buttons
Add/remove a diameter in position 0mm.
"Insert implant" button
It allows adding the previously selected implant to the
document.

"Unselect implant" button

It allows deselecting the previously selected implant and
returning to the previous window.

"Exit" button
It allows closing the window and returning to the original
document.

38 USER MANUAL EN
 Once the implant has been positioned, you can obtain
information on HU values by right-clicking on the implant
and selecting the command “Show implant info”.
A window will open, as shown in the figure, indicating the
HU and Misch scale values. The red diagram indicates the
values of volume densities occupied by the implant, the
blue diagram indicates the values of volume density
outside the implant (up to 1mm distance).

Right-click to select “Apply implant description” button. It

allows positioning the implant description on the image.

EN USER MANUAL 39
“Edit implants database” button

This button is used to manage the addition/display of implant producers from the Implant editor window.

1) Add producer
It allows you to add a new implant producer that will be displayed in the window by means of a blue tab.

2) Manage producer
It allows you to manage the display of desired producers in the window. Each selected producer will be
displayed by means of a red tab.

40 USER MANUAL EN
“Align implants” button

With two or more implants, use this button to align them.

The command divides all implants in two groups: implants facing upwards and implants facing downwards.
In each group the inclination of all implants will be changed to be aligned and all inclinations will be connected.

When a group is created, all implants are aligned with the first implant used of the same group.

In a group of aligned implants, when an implant is rotated, all implants of the same group are rotated.

When an implant is added to the volume the "Prosthesis alignment" command is reset, then all implants will be free
to rotate without changing the inclination of other implants.

To add a new implant both to the upwards or downwards group, it is necessary to manually align the new implant as
well as the implants of the desired group, then select "Align implants".

Implants before alignment (LH) and after alignment (RH)

Implant replacement and info display

Right-clicking on the implant, after positioning it, will allow selecting some commands, such as displaying information
on the type, or replacing the implant with another model or deleting it

EN USER MANUAL 41
5.5.3.9. VOLUME TOOLS

NEW VOLUME
Select to create a new volume
(“New volume”)
By selecting “New volume” the following window will be displayed allowing you to divide into segments a volume
defined by a set density (or density threshold).

After clicking on the images from the MPR view (axial (A) / coronal (B) / sagittal (C) section) and after selecting the
volume to be divided into segments, the following options, described in detail here below, will be available:

The buttons relevant to the axes (1) are displayed in the middle

NOTE:
Accuracy of Hounsfield unit (HU)
measurement has intrinsic limitations in
CBCT technique, as broadly debated in
scientific literature. Among others, see:
"Deriving Hounsfield units using grey levels" -
DMFR (2010) 39, p.323; "Influence of
anatomical location on CT numbers" - OOOO
Vol. 115 4 April 2013 p.558; "Prospects and
challenges of rendering tissue density in
Hounsfield units" - OOOO Vol. 116 1 July
2013 p.105.

COLOUR AREA
It defines the colour representation of the segmented
volume.

42 USER MANUAL EN
 SPEED / RESOLUTION BAR
Based on the selection made, either the calculation
speed or the best resolution will be preferred.
With wide regions, it is recommended to prefer the high
speed setting.

THRESHOLD (HU)
It defines the range (lower and higher threshold) of
density to be divided into segments

The buttons relevant to the axes (2) are displayed in the

middle

Click on “Axis Reset” to set the axes back to the default

conditions

Click on “Show axis intersections” to show / hide the

axes intersection on the image

The panel of the buttons for the creation of the regions

to be segmented (3) is at the bottom left side of the
window

Click on “Next” (or click with the right button of the

mouse) to calculate the volume and the relevant
statistics

Click on “Back” to go back to the previous window

Click on “Cancel” to quit the window and go back to the

main page

Click on “Save current settings” to save current settings

Click on “Next” (or click with the right button of the mouse) to calculate the volume to be segmented. The result can
be later saved and displayed on the MPR page by clicking on the button “Save results”.

EN USER MANUAL 43
44 USER MANUAL EN
5.5.3.10. OBJECT PROPERTIES

After positioning an object (measurement, line, text, marker etc.), by clicking on it inside the image, it is possible to:

- Drag the object inside the image

- Enlarge / resize it by clicking on the dots present on it
- Delete it by clicking directly on the “canc” button of the control panel

It is also possible to delete the overlays from inside the selected image or to delete them all (in case of
implants) by selecting the button on the left in the “Tools” group

EN USER MANUAL 45
5.5.4. “3D COMMANDS” GROUP

It includes commands required for the rotation, activation / deactivation of the relevant overlays and for the selection
of the presets related to the 3D views.

Click on “Show preset list” to view the default view presets.

For further information on these functions, please refer to the relevant “Annex”.

5.5.5. “REPORT” GROUP

It includes commands required to create reports (entry of images, notes, etc.).

For a detailed description of the available tools refer to the paragraph “Fast report”.

46 USER MANUAL EN
5.6. VIEW IMAGE SERIES

You can scroll through the previously created images using the specific keys on the toolbar

Arrow keys: to move between the different image series.

5.7. ENLARGED AND FULL-SCREEN IMAGE MODE

In order to manage image display in the best possible way, the images present in the various views can be
maximised and displayed in full screen mode.

In the first case, the image size will be adapted to the software
display window. To perform such operation, move the mouse
cursor to the desired image and click on the box at the top right
corner
It is also possible to perform the same operation by right-clicking
and selecting Maximized from the menu.

To restore the image size, go back to the previous view, click on

the double box placed at the top right corner or move the mouse
cursor to the desired image, right-click and select Restore from
the menu.

NOTE:
If the image is maximised, the zoom and change view commands cannot be used. However, you
can enter measures, edit the image palette, etc.

To display an image in full screen mode, move the cursor to the

desired image, right-click and select Fullscreen image from the
menu.

A new window will open displaying the image in full screen mode:
in every case, except for 3D rendering display, it is possible to
zoom in/out by means of the mouse wheel and move the zoomed
image by keeping the left button pressed.

In case of 3D rendering, you can use the same commands used in the 3D box of the view to move, zoom in/out and
turn the 3D model.

EN USER MANUAL 47
 NOTE:
Except for the 3D rendering, if the image is in full screen mode, you cannot perform any editing.

48 USER MANUAL EN
5.8. RESTORING IMAGE FACTORY POSITION

Each view allows editing the image display area by means of the vertical or horizontal separators. Just move the
cursor to one of them and keep the left button pressed while dragging. If you want to put the separators back to their
factory position, just move the cursor to an image, right-click and select the Reset images layout item from the menu.
5.9. SENDING THE IMAGES VIA EMAIL

If a personal email box has been set in the program to send

emails (see par. 8.9), you can send the images as an email
attachment. Move the cursor to the desired image, right-click and
select Send image via email. A window will be displayed, which
allows specifying a name and format for the image. Clicking on
OK, a window will be displayed, where to enter the addressee
email address, the subject and a message (optional).

NOTE:
Such function is available not only for Volumetric data, but also for 2D images. In the latter case, if
many images are selected simultaneously, all of them will be attached to the email.

NOTE:
Forwarding times may extend in case of big files.

WARNING:
Check the right configuration of the email box. Make sure that the total size of the attachments
does not exceed the maximum limit allowed by the provider/domain of the email address used.

Moreover, you can send an image via email to the technical

support service. Move the cursor to the desired image, right-click
and select Send image via email to support . A window is
displayed where you can enter a message (optional); the
addressee and Subject fields are already filled out.

NOTE:
In case of 2D images, you can send all the selected images in TIFF format.

WARNING:
This option must be used if required by the technical service. Any image sent without the explicit
request by the technical service does not trigger any support procedure.

EN USER MANUAL 49
5.10. SAVING IMAGES IN THE 2D DOCUMENT

An image can be selected inside a 3D document and a copy can be sent to the 2D document.
To do this, select File → Save image as and left-click with the mouse on the desired image: select “Save in 2D
images document” from the file saving window that will appear.

From the 2D document you can now go back to the 3D document, from where the image was sent, by right-clicking
on the desired image and selecting "Open 3D document".

50 USER MANUAL EN
6. DICOM IMAGES

The DICOM (Digital Image and Communication in Medicine) is the file format that aids the distribution and the
viewing of medical images. The program allows exporting and subsequently importing the images in DICOM format.

2D DATA ONLY

2D images can be saved in DICOM format (as well as PNG, TIFF and JPEG) with the “ORIGINAL”, “DEFAULT” and
“TREATED” options. The “ORIGINAL” option allows obtaining RAW images, the “DEFAULT” option allows obtaining
an unchanged/not reprocessed version of the images, while the “TREATED” version contains all processing/post-
processing applied by the user.
As the “TREATED” format is a reprocessed version, it is deliberately marked so that no other processing filter can be
applied if it is reimported in the software.
Information mentioned above applies to Export, Store, Send data to, etc.

CBCT DATA ONLY

For both the Export and the Store functions, you can save the DICOM images in “DEFAULT” and in “TREATED”
format; the “DEFAULT” format is the unchanged/not reprocessed version of the images, while the “TREATED” format
contains all processing/post-processing applied by the user.
As the “TREATED” format is a reprocessed version, it is deliberately marked so that it cannot be used by third-party
software to generate new images or sections (e.g. in case of axial images), as any cut produced on the treated
dataset may generate images with altered diagnostic content.

WARNING:
All the images saved in DICOM format with the “TREATED” option (by means of the Export,
Store, Save, Send data to, etc. commands) CANNOT be reloaded (via Import, Retrieve, etc.) to
the program.

6.1. EXPORTING IMAGES IN DICOM FORMAT

CBCT DATA ONLY

WARNING:
Only the original axial images (not reformatted) exported in DICOM format can be reimported (via
Import, Retrieve, etc.) to the software. No other type of CBCT image can be reimported, except
for scout images in case of Retrieve.

EN USER MANUAL 51
6.1.1. SAVING "AXIAL SEQUENCES"

To save a complete axial images sequence, select File → Export → Save in DICOM format → Sequence of original
Axial images.
The “Browse for folder” window will be displayed on the screen. Select the directory to which you wish to export the
images, then press “OK”. The export will start immediately.
NOTE:
When saving “Sequence of original Axial images” in the selected folder, a new one will be created
with the following path: ..\Surname_Name_YYYYMMDD.
This folder will contain the DICOMSET.

To save a customized axial sequence, select File → Export → Save in

DICOM format → Sequence of customized Axial images.
The axial images will be exported according to the settings in the
dialog Export settings → Save in DICOM format.

6.1.2. SAVING "ALL IMAGES"

After opening a CBCT document, select File → Export → Save in

DICOM format → All Images to save in Dicom format (.dcm) different
types of secondary images, if available in the document (scout, axial,
cross, multiplanar etc.).
A window will be displayed, where it is possible to select the image
types available in the document and after confirming with the button
“Send”, a second window called “Browse for folder” will appear,
allowing to choose the folder in which you want to export images.
Press the “OK” button to start the export.

52 USER MANUAL EN
6.1.3. SAVING FROM AXIAL AND MPR VIEW

Right-click on the 2D images to open the menu that allows you to

choose to save images in DICOM format.
The selections shown vary depending on the displayed view.
“Image group” allows saving the whole series of images on which
you clicked.
“Scout + Axial + Coronal + Saggital” allows saving the whole series
of images present on all the 2D views currently displayed.

NOTE:
Images exported in DICOM format using the just-described mode may not be reimported in the
Software

EN USER MANUAL 53
6.1.4. SAVING SINGLE IMAGES

It is possible to save single axial images in DICOM format

from volumetric or study document.

To save an image:

1) Select File → Save Image As

2) Left-click on the desired image

3) The saving window is displayed, where it is possible to

choose between Treated or Default DICOM image

54 USER MANUAL EN
6.2. IMPORTING IMAGES IN DICOM FORMAT

CBCT DATA ONLY

WARNING:
It is possible to import DICOM datasets only if compatible: the manufacturer reserves the right to
check a dataset manufactured by third parties before declaring it importable

NOT AVAILABLE FOR VIEWER VERSION

Select File → Import → Import DICOM dataset

A window labelled “Load DICOM Dataset”, from where it is possible to select the DICOM files to import, will be
displayed.
To import a multi-file DICOMSET select one of the dataset files.
Then, system asks whether the document must be imported as a Volumetric Data or a Study document.
Imported documents and documents created from them (e.g. Studies, Reports, etc.) cannot
- be filed in PACS (File → DICOM Storage (Study) and File → DICOM Storage (Report))
- be exported in DICOM format (File → Export → Save in DICOM format…)
- printed with DICOM printers

In these cases the following error message with the number 01.238.0059 "Unexpected manufactured model name”
will be displayed

EN USER MANUAL 55
6.2.1. LIMITATIONS TO IMAGE IMPORT IN DICOM FORMAT IN THE SOFTWARE

In order to allow the Software to recognise DICOM images they must have the features indicated in the table below.

Dicom Tag Tag Name 2D images 3D images

// // Standard Dicom 3 Standard Dicom 3

[0002; 0010] Transfer Syntax 1.2.840.10008.1.2 Implicit VR 1.2.840.10008.1.2 Implicit VR

UID – Little Endian – Little Endian

1.2.840.10008.1.2.1 Explicit VR 1.2.840.10008.1.2.1 Explicit VR

– Little Endian – Little Endian

1.2.840.10008.1.2.4.70 1.2.840.10008.1.2.4.70
Explicit VR – Little Endian – Explicit VR – Little Endian –
JPEG Lossless, Non-hierarchical, JPEG Lossless, Non-hierarchical,
First-Order Prediction First-Order Prediction

[0008; 0005] Specific Character ISO IR_100 ISO IR_100

Set ISO IR_192 ISO IR_192

[0002; 0002] Media Storage 1.2.840.10008.5.1.4.1.1.1.1 1.2.840.10008.5.1.4.1.1.2 CT

SOP Class UID DX Image Storage Image Storage

1.2.840.10008.5.1.4.1.1.1.3
IO Image Storage

1.2.840.10008.5.1.4.1.1.7
Secondary Capture Image Storage

[0008; 0008] Image Type // original\primary\axial

derived\primary\axial

56 USER MANUAL EN
6.3. SAVING 2D IMAGES IN DICOM FORMAT

Each image can be saved in DICOM format.

From inside the document select File → Save Image As...
The cursor will change its appearance to reflect the selected
command.
Left-click on the image you wish to save.

The “Save As” window will appear with a suggested file name. Browse for the directory where you want to save the
file.
Click on the “Save” button to save the file. After the file has been saved, the “Save image as…” command is still
active and it is possible to save other images. Right-click to deactivate it.

6.4. IMAGE STORING ON PACS

NOT AVAILABLE FOR VIEWER VERSION

If the “NNTDicom” function is enabled, you can send images in DICOM format to a PACS.
To do this, after opening the program document containing the images to send, select the command File → DICOM
Storage
6.5. EXPORT SETTINGS

NOT AVAILABLE FOR VIEWER VERSION

Using the Tools → Export Settings… command, you can display

the general export configuration window of the program.
Inside there are some tabs detailed here below:

EN USER MANUAL 57
6.5.1. GLOBAL DICOM

Select the Global DICOM tab to set:

1) INSTITUTION NAME and STATION NAME: names used during file export.

2) CHARACTER SET: The character set used during export. It is possible to select between:
• ISO_IR 192 (Unicode): "Unicode" character set.
• ISO_IR 100 (Ascii): “Ascii” character set.

3) “EXPORT AXIAL DATASET AS HORIZONTAL” option: it forces the axial images export, ignoring the inclination
with respect to the patient system. It applies when exporting only axial images, not when exporting all images.
When forwarding Dicom dataset to third-party software, this option is ignored if all image export is active.

58 USER MANUAL EN
6.5.2. NNTDICOM

Select the NNTDicom tab to set:

1) STORAGE: it displays the list of active storage paths.

2) FORCE STORAGE OF ALL 2D IMAGES: For every storage (Store) on PACS it forces the storage of all 2D
images of the patient, not only the new images not sent to PACS yet.

3) SAVE AXIALS IN 512 x 512 pixels: it transforms axial images into 512 x 512 pixels format.

4) ENABLE IMAGE COMPRESSION: All DICOM format images are compressed in lossless mode before being
sent or stored.

5) OVERLAYS: adds the overlays in a dedicated plane.

EN USER MANUAL 59
6.5.3. SAVING IN DICOM FORMAT

Select the Save in DICOM format tab to set:

1) 3D EXPORTED IMAGES TYPE

2) ENABLE IMAGE COMPRESSION:

All DICOM format images are compressed in lossless mode before being sent or stored.

3) OVERLAYS: adds the overlays in a dedicated plane.

4) ANONYMIZE EXPORT:
if enabled, it allows making anonymous the exported images.
After opening a volumetric or study document, the command is also available from the menu File → Export →
Anonymize export.

5) SAVE AXIALS IN 512 x 512 pixels: it transforms axial images into 512 x 512 pixels format.

6) CREATE A SINGLE DICOM DATASET FILE

It determines the type of dataset to create. Two different types of dataset are available:
• Multiple files DICOM dataset: DICOM multiple files (one for each axial image).
• Single-file DICOM dataset: DICOM single file containing all the axial images.

7) VOXEL SIZE (MINIMUM): it allows setting the voxel size of the customized axial series

8) AXIAL’S THICKNESS (MINIMUM): it allows setting the thickness of the axial images of the customized axial
series.

9) AXIAL’S DISTANCE (MINIMUM): it allows setting the distance between the axial images of the customized axial
series, if it is equal to the thickness a checkbox is displayed.

10) SHOW THE VOLUME ORIENTATION…: if enabled, it shows the volume orientation dialog when running the File
→ Export → Save in DICOM format → Sequence of customized Axial images command.

11) SHOW THE SAVE IN DICOM FORMAT OPTIONS…: if enabled, it shows this setting dialog when running the
File → Export → Save in DICOM format → Sequence of customized Axial images command.

60 USER MANUAL EN
7. REPORT TEMPLATES

NOT AVAILABLE FOR VIEWER VERSION

7.1. FOREWORD

Templates are required to create a report. This template represents the layout with which header, patient data, notes
and images will be included in the report.
Several templates can be created, customising them according to the type of printer, the type of paper used,
or simply the type of report you want to create.
There are two main types of templates: single-page templates and multi-page templates.
Two single-page factory templates called F0 and F1 are pre-installed on the software. Such templates are required to
print single 2D images in portrait (F1) or landscape (F0) format.
7.2. CREATING A NEW SINGLE-PAGE TEMPLATE

Select File → Template Setup → Single page layout → New….

Select the printer from the list of printers, the paper type and orientation which will be used for the report, then click
on the “OK” button.
The template layout will appear inside a dialog box. It
contains 5 predefined fields:

Comments: it defines the comment associated with the

template.
Header: report header area.
Patient: patient data area.
Notes: report comments area.
Logo: Manufacturer and software logo area (cannot be
changed by the user)
Img1: area reserved to the first report image.

Use the “Comment” field to describe the template being

created
(Example: Maxillary implant study)

Left-click on the “Img1” box. The box will be highlighted and

the cursor will change depending on the area where it is.
Each box can be adjusted in two different ways:
1) Using the mouse: click inside the box and drag the
mouse to change the box position. Click on the edges
of the box to resize it.
2) Using control buttons: click on the single buttons to
modify the position, size and scale of the box.
NOTE:
Changing the scale from 100% will cause the
report images to lose the 1:1 scale.

EN USER MANUAL 61
 Click on the “Add” button to add a new image box.
Continue adding new image boxes until the template is
defined.
Click on the “Remove” button to delete the highlighted box.
At the end click on the “OK” button.
You will be prompted to confirm before saving the new
template. Select “OK”.

7.3. MODIFYING AN EXISTING SINGLE-PAGE TEMPLATE

Select File → Template Setup → Single page layout → Open….

The “Open report page layout” window will appear on screen. Select the template to modify and click on the “OK”
button.
The selected template will open. After modifying the template, click on the “OK” button.
7.4. DELETING A SINGLE-PAGE TEMPLATE

Select File → Template Setup → Single page layout → Delete….

The “Delete report page layout ” window will appear on screen. Select the template to delete and click on the “OK”
button. You will be prompted to confirm before deleting the template.

7.5. CONVERTING A SINGLE-PAGE TEMPLATE

Converting a template means adapting an existing template to a printer different from the one used during the
template creation. After the conversion the original template will be overwritten by the new one.
Select File → Template Setup → Single page layout → Convert….
The “Convert template” window will appear on screen. Select the template to be converted and click on the “OK”
button.
Select the type of printer you wish to use for the conversion (“ Windows Standard” or “Digital / DICOM”).
From “Print Setup” select the printer to use for the conversion, then press “OK”.
You will be prompted to choose if you want to keep a copy of the original template (select “No”) or if you want to
overwrite it (select “Yes”).

7.6. COPYING A SINGLE-PAGE TEMPLATE

Copying a template means creating a copy of a template. This command is useful if you want to create similar
templates. After copying it, each template can be modified according to your needs.
Select File → Template Setup → Single page layout → Copy….
The “Copy template” window will appear on screen. Select the template to be converted and click on the “OK” button.
The selected template will open. Perform the modification you wish and click “OK”.
You will be prompted to confirm before saving the template. Click on the “OK” button.

62 USER MANUAL EN
7.7. MULTI-PAGE TEMPLATES

Select File → Template Setup → Multiple pages layout

The Edit template window will open, where various operations can be performed

Add: It creates a new template and adds it to the list of the multi-page templates.

Delete: It creates an existing template and deletes it from the list of the multi-page templates.
Add Page: It adds a page to the selected template. The pages that can be added are the
previously created single-page templates. To create a new page with a new layout, first create the
single-page template with the desired layout.
Delete Page: It deletes a page of the selected template.

Move Up: It swaps the selected page with the previous one.

Move Down: It swaps the selected page with the following one.

Ok: It confirms and saves the editing just performed on the templates and closes the window.

Cancel: It cancels the editing just performed on the templates and closes the window.

EN USER MANUAL 63
8. REPORT
8.1. STANDARD REPORT

A document with images must be opened in order to create a report.

8.1.1. SELECTING THE TEMPLATE

After opening a document with images, select Report → New…

The “Open report page layout” window will appear on screen. For each template, ID comment, associated printer,
rank showing how often the template has been used and a preview image are shown.
Select the template to be converted and click on the “OK” button. The template will open.
The new report based on the selected template appears on the screen near the document images. At the same time
the “Open Report Page Layout” window is displayed again. Select a new template and click the “ OK” button if you
wish to add a new page to the report, otherwise press the “Cancel” button.
Please find below a brief description of the report fields:
1) Report header
2) Patient data
3) Empty image fields
4) Comment field

Note that the patient data and header are automatically introduced
by the software.

64 USER MANUAL EN
8.1.2. INSERTING IMAGES IN THE REPORT

Left-click in the first box destined to contain an image. The green box
will turn yellow.
Left-click on the image to insert.
If the image is too large to fit in the report, on the image is displayed
the area of the image that may be inserted. The area that cannot be
inserted is darkened.
Adjust the frame location inside the image to delimit the area to be
inserted.
Right-click to copy the image inside the report. The image frame will
be copied into the report.
Repeat the previous steps to insert additional images in the report.

At the end the report is complete with all the images.

EN USER MANUAL 65
8.1.3. INSERTING IMAGES IN AUTOMATED MODE

Use the automatic mode to speed up the operation of adding images to a report. This mode allows the user to select
the images to add to the report in sequence without enabling the report boxes every time.
Here below is a brief description of this sequence.
Open an empty report page (Report → New…).
Hold down the F1 button of the control panel to select an image to be added to the report, repeat this operation for all
the images you want to add.
If you wish to know in advance the position of the added images, select “Report → Report Wizard”.
The boxes inside the report page will be identified by progressive
numbers.
At the same time the first box will be automatically highlighted.
Select the image you wish to add in the selected area.
After the image has been added, the following box will be highlighted.
Repeat this procedure until all boxes have been filled in.

8.1.4. REMOVING IMAGES FROM A REPORT

To delete an image from a report, right click on the image. A pop-up menu will appear. Click on the “ Remove” menu
item.
A red cross will be drawn on the selected image. You will be prompted to confirm before deleting the image. Click on
"Yes" to delete the image.

8.1.5. INSERTING NOTES IN THE REPORT

Make sure a note field has been designated within the report.
Left-click on the report. Select Edit → Report New…
The “Text editor” window will appear.
Type the text you wish to insert. It is possible to change font size,
style and colour.
When you have finished select the “OK” button. The notes will appear
inside the report.

66 USER MANUAL EN
8.1.6. REMOVING NOTES FROM THE REPORT

To remove notes from the report select Edit → Empty Report Notes…
NOTE:
In case the report comprises more than one page, you will be prompted to select the page from
which you wish to remove the notes.

8.1.7. REPORT TEXT DATABASE

NOT AVAILABLE FOR VIEWER VERSION

It is possible to create a database of the most common comments used in the report notes field; this database can be
opened by selecting Edit → Show report notes texts database…
A window with the list of the existing comments will appear.
Select a text line and click on “Select”, then click on “Apply” to apply it
to the report.

8.1.8. ADDING PAGES TO A REPORT

To add new pages to the report select Edit → Add report page…
The “Open Report Page Layout” window will appear, displaying the list of all the available templates. Select a
template and click on the “OK” button. The template will open.
At this time it is possible to modify the template layout before using it. At the end click on the “OK” button.
A new empty page will appear below the first page of the report.
In the “Open Report Page Layout” click the “Cancel” button to start inserting images into the new page, or select
another template and press the “OK” button to add another page to the report.

8.1.9. REMOVING PAGES FROM A REPORT

If the report has more than one page, it is possible to remove single pages.
Select Edit → Remove Report Page…
From the drop down list select the page you want to remove. You will be prompted to confirm before removing the
page from the report. Click on the “Yes” button to remove the page.

EN USER MANUAL 67
8.1.10. MODIFYING TEMPLATE OF REPORT PAGE

Select Edit → Report Page Layout…

If the report contains more than one page, you will be prompted to choose the page layout you wish to modify. This is
possible through the “Select the report page ” dialogue. The template corresponding to the selected page will e open.
If images have already been inserted in the page, it is only possible to change the position of the images, without
modifying their size and scale. Make the changes in the same manner as when creating a new template. After
making the changes, click on the “OK” button.
The report page will be automatically updated.
8.1.11. MODIFYING VISUALIZATION OF REPORT IMAGES

It is possible to modify the visualization of an image already copied into a report.

Right-click on the image of the report you wish to modify. Select “ Change Palette…” from the menu displayed. The
“Visualization Window” will appear, showing the selected image.
For a detailed explanation of this window, please refer to paragraph 3.1
At the end press the “Apply” button to apply the modifications to the image.
8.1.12. USE OF “DRAW ONLY ON REFERENCE IMAGE” COMMAND

CBCT DATA ONLY

The “Draw Only On Reference Image” flag appears in the pop-up menu after right-clicking on an image in the report.
If the flag is checked the selected image will display its reference lines only inside the axial image from which it has
been created.
Otherwise, reference lines will be drawn on all of the axial images of the report.

Axial image without reference lines Axial image with reference lines

68 USER MANUAL EN
8.1.13. USE OF “HIGHLIGHT CROSSES ON PANORAMICS” CONTROL

CBCT DATA ONLY

The “Highlight crosses on panorex” flag appears in the pop-up menu after right clicking on a single transaxial or
sequence of transaxial images in a report.
If the command is enabled, each transaxial view will draw a complete reference line on each panoramic image of the
report.
Otherwise, if the command is disabled, only a partial reference will be displayed on the panoramic images.

At the first command selection the reference At the second command selection the At the third command selection the reference
lines are complete. reference lines are partially coloured. lines are disabled and only minimum
references are drawn.

8.1.14. PERFORMING MEASURES OF DISTANCES OR ANGLES

On the images of the report it is possible to measure distances or angles as it is done on the images of the study
(see chapter 3.5).
Right-click on the image of the report you wish to modify.
From the menu displayed move the mouse to “ Distances…” to open the distance measurement menu and to
“Angles…” to open the angle measurement menu.

8.1.15. INSERTING EXAM/PATIENT DATA IN THE REPORT

It is possible to include additional data related to the patient and to the exam in the Patient area.
On this matter, please refer to paragraph 8.3.3.

8.1.16. PRINTING A REPORT

To print a report select Report → Print…

8.1.17. SAVING THE REPORT

To print a report select Report → Print…

EN USER MANUAL 69
8.1.18. SAVING IN PDF FORMAT

NOT AVAILABLE FOR VIEWER VERSION

Select File → Save report in PDF format… Choose the

desired path and file name

Now set the PDF quality (150, 300 or 600 DPI) and, as
for Printing, the interested page range.
The PDF document is then generated and subsequently
opened.

8.1.19. SAVING IN DICOM FORMAT

Select File → Save report in DICOM format… Choose the

desired path and file name.

70 USER MANUAL EN
8.1.20. OPENING A REPORT

Select File → Open… “Choose document” window will be displayed. Click the “Report” button.
On the “Report List” window, select the patient and click
“OK”.
NOTE:
If the patient does not appear on the upper part
of the list, search it by entering the surname
initials in the field on the top left corner of the
window (see image at the side, item 1).
Furthermore, it is possible to search by
applying a filter by dates (item 2) located on
the top right corner of the window.

8.1.21. MODIFYING PATIENT DATA

Select Edit → Report Patient Data… The software will open the “Patient File” dialogue.
After you have finished click on the “OK” button.

EN USER MANUAL 71
8.2. FAST REPORT

NOTE:
AVAILABLE FOR MEDICAL AND VETERINARY APPLICATIONS ONLY

A document with images must be opened in order to create a report.

8.2.1. SELECTING THE TEMPLATE

After opening a document with images, select Report → New (fast)…

The “Open template” window will appear on screen. For each template, ID comment, associated printer, rank
showing how often the template has been used and a preview image are shown.

Please find below a brief description of the report fields:

H = Report header
P = Patient data
I = Empty image fields
N = Comment field

Note that the patient data and header are automatically

introduced by the software.

Select the template to open and click on the “OK” button. The template will open.

The new report based on the selected template appears on the screen near the document images.
The window will show the summary panel of the images and pages in the report and the buttons to add images /
pages (1) and for report preview (2)

72 USER MANUAL EN
 The “Report” panel of the available tools (containing also
the summary of the no. of images and pages present in
the report) is displayed at bottom left side of the window

• Layout editing buttons (1)

• Buttons to add images (2)
• Buttons to add notes (3)

Layout editing button (1)

Use this button to define the grid of the images to add
inside the report (from a 1x1 grid to a 8x8 grid).
It is also possible to define a customised grid by editing
the fields below.

Button to add images (2)

Use this button to add images to the template. For
further details refer to the following paragraph.

EN USER MANUAL 73
8.2.2. INSERTING IMAGES IN THE REPORT

Click on the left button or hold CTRL key pressed on the

keyboard and left-click inside the image you want to
add.

The image grid area that will be filled, is highlighted in

blue in the report preview image.
If the image is too large to fit in the report, on the image
is displayed the area of the image that may be inserted.
The area that cannot be inserted is darkened.

Adjust the frame location inside the image to delimit the

area to be inserted.
Right-click to copy the image inside the report. The
image frame will be copied into the report.

Repeat the previous steps to insert additional images in

the report.

74 USER MANUAL EN
 At the end of the operation, the report is complete with
all images and it will be possible to save it (with Report
→ Save) and print it (with File → Print).

NOTE:
The report can be completed adding less images than those provided in the template by clicking

on the completion button

EN USER MANUAL 75
8.2.3. REMOVING IMAGES FROM A REPORT

To delete an image from a report, right click on the

image. A pop-up menu will appear. Click on the
“Remove” menu item.

A red cross will be drawn on the selected image. You will

be prompted to confirm before deleting the image.

Click on "Yes" to delete the image.

76 USER MANUAL EN
8.2.4. INSERTING NOTES IN THE REPORT

Make sure a note field has been designated within the report.

Select the command Report → Report page notes (or the icon from the Report panel).

The “Text editor” window will appear.

Type the text you wish to insert. It is possible to change
font size, style and colour.
When you have finished select the “OK” button. The
notes will appear inside the report.

8.2.5. REMOVING NOTES FROM THE REPORT

To remove notes from the report select Report → Empty report notes… (or the icon from the Report panel).

NOTE:
In case the report comprises more than one page, you will be prompted to select the page from
which you wish to remove the notes.

8.2.6. REPORT TEXT DATABASE

NOT AVAILABLE FOR VIEWER VERSION

It is possible to create a database of the most common comments used in the report notes field; this database can be

opened by selecting Report → Show report notes texts database… menu (or the icon from the Report panel).

A window with the list of the existing comments will

appear.

Select a text line and click on “Select”, then click on

“Apply” to apply it to the report.

EN USER MANUAL 77
8.2.7. ADDING PAGES TO A REPORT

Should the number of images to be

added to the report exceed the
number of images of the preset grid,
additional pages will be added
automatically. A new empty page will
appear below the first page of the
report.

In any case, it is still possible to edit

the layout of the preset grid by
means of the Layout editing button
(see previous par.)

8.2.8. REMOVING PAGES FROM A REPORT

If the report has more than one page, it is possible to remove single pages.
Select Report → Remove report page…
From the drop down list select the page you want to remove. You will be prompted to confirm before removing the
page from the report. Click on the “Yes” button to remove the page.

78 USER MANUAL EN
8.2.9. SAVING THE REPORT

Select Report → Save to save the report.

8.2.10. PRINTING A REPORT

To print a report select File → Print…

8.2.11. SAVING IN PDF FORMAT

NOT AVAILABLE FOR VIEWER VERSION

Select File → Save report in PDF format… Choose the desired path and file name.

Now set the PDF quality (150, 300 or 600 DPI) and, as
for Printing, the interested page range.

The PDF document is then generated and subsequently

opened.

8.2.12. SAVING IN DICOM FORMAT

Select File → Save report in DICOM format… Choose the desired path and file name.

8.2.13. OPENING A REPORT

Select File → Open… “Choose document” window will be displayed. Click the “Report” button.

On the “Report List” window, select the patient and click

“OK”.

NOTE:
If the patient does not appear on the upper
part of the list, search it by entering the
surname initials in the field on the top left
corner of the window (see image at the side,
item 1).
Furthermore, it is possible to search by
applying a filter by dates (item 2) located on
the top right corner of the window.

8.2.14. MODIFYING PATIENT DATA

Select Edit → Edit patient record… The software will open the “Patient record” dialog.
After you have finished click on the “OK” button.

EN USER MANUAL 79
9. MANAGING DOCUMENTS

NOT AVAILABLE FOR VIEWER VERSION

9.1. IMPORT

Importing a document means copying it from an external medium (CD, network, etc.) to the program work directory.
There are two different ways to import documents: by patient or by document.
It is also possible to import DICOM datasets selecting the menu File → Import → Import DICOM dataset…, the
description of this procedure is available in paragraph 4.2.

9.1.1. IMPORTING BY DOCUMENT

Select File → Import → Import by Document… The “Choose Document” window will appear. Select the type of
document you wish to import.
The “Import/Export path setup” dialogue will appear. The “Current path” field displays the location from where the
software will import the documents. Select the “Change path” button to change the directory.
When completed select the “Browse” button to display the list of documents stored in the directory.
Select the document(s) you want to import. Use the “Select all” button to select all the listed documents.
Check the “Delete Source file” flag to delete the file from the original location after the import procedure is terminated
(if the device allows that). Use the “Print” button to print the list of patients.
Once the documents have been selected click on the “OK” button.
At the end of the import process a dialogue box will appear. Press “OK”.

9.1.2. IMPORTING BY PATIENT

This function allows the recovery of a determined document using the LABEL typed during Export, (for example to
know on which number of CD in your archive it is stored).
Select File → Import → Import by Patient… The “Patient List” window will appear. To select a patient type the
surname initials, part or the entire surname, then click on the “Update list” button. Highlight the desired patient and
then press “OK” button.
The list of not on-line documents of the selected patient will appear. The Labels typed during Export will be shown in
the “Notes” column. Highlight the desired document and click on the “OK” button
The “Import/Export path setup” dialogue will appear.
Insert the correct path of the document to import. Click on “BROWSE” button. If the path is correct it will begin the
copy of the files.
At the end of the import process a dialogue box will appear. Press “OK”.

80 USER MANUAL EN
9.2. EXPORT

Exporting a document means copying it from the program work directory to an external medium (CD, network etc.).
There are two different ways to export documents: by patient or by document.

9.2.1. EXPORTING BY PATIENT

Select File → Export → Export by Patient… “Import/Export path setup” dialogue will be displayed.
The “Current path” field displays the location where the software will export the documents. Select the “Change path”
button to change the directory. In the “New Folder” field enter the name of the a directory, which is created by
selecting the “Add Folder” button.
NOTE:
In the added folder another one will be created, named: ..\Surname_Name_YYYYMMDDOfBirth.
Such folder will store the DICOM images.

At the end press the “Go on” button. The “Patient List” window will appear. To select a patient type the surname
initials, part or the entire surname, then click on the “Update list” button.
The window will be updated with all the patients that match the criteria used for the search. Highlight the patient to be
exported and select the “OK” button.
The “Document list - Export” dialogue will appear, showing all the available documents for the selected patient.
Select the document(s) you want to export. Use the “Select all” button to select all the documents. Check the “Delete
Source file” flag to delete the file from the original location after the import procedure is terminated.
At the end click on the “OK” button. The “Insert label” window will appear. Type the path or the name of the disk
where you are exporting. This is necessary in order to use the “Import by Patient” function.
At the end click on “OK”. At the end of the import process a dialogue box will appear. Press “OK”.

9.2.2. EXPORTING BY DOCUMENT

Select File → Export → Export by Document… from the “Choose Document” window. Select the document you wish
to import.
The “Import/Export path setup” window will appear. The “Current path” field displays the location where the software
will export the documents. Select the “Change path” button to change the directory. In the “ New Folder” field enter
the name of the a directory, which is created by selecting the “Add Folder” button.
NOTE:
In the added folder another one will be created, named: ..\Surname_Name_YYYYMMDDOfBirth.
Such folder will store the DICOM images.

Once done, press the “Go on” button. The selected document export list will appear. Select the patient(s) you want to
export. Use the “Select all” button to select all the documents. Check the “Delete Source file” flag to delete the file
from the original location after the import procedure is terminated.
At the end click on the “OK” button. The “Insert label” window will appear. Type a distinguishing comment related to
this export process.This identifies the different export operations completed. At the end click on “OK”.
At the end of the import process a dialogue box will appear. Press “OK”.

In case of “Maxillofacial Surgery” application mode, select File → Export → Export current patient’s documents… or
Export all patient’s documents…

It is also possible to export in DICOM format several documents of the same patient by selecting File → Export →
Save in DICOM format current patient’s documents

EN USER MANUAL 81
9.2.3. ANONYMISATION OF THE PATIENT

If you wish to export documents with anonymous patient data, select

the command File → Export → Anonymize export

82 USER MANUAL EN
9.3. DELETING DOCUMENTS

Select File → Delete by Document… from the “Choose Document” window. Select the document you wish to import.
Select the document(s) you want to delete from the document list. Use the “Select all” button to select all the
documents.
At the end click on the “OK” button.
It is also possible to delete documents relevant to a patient. To do this select File → Delete by Patient…
The Autodelete button will also be enabled only in case RawData (CBCT DATA ONLY) are being deleted.
When pressing the Autodelete button, the “Autodelete configuration”
dialog box will appear.

This allows the user to disable the automatic RawData deletion or to

enable only for RawData with dates before the set days. In this case,
at the software start up the user will be prompted to confirm the old
document deletion.
Click the OK button to store the changes.

In case of “Maxillofacial Surgery” application mode, select File → Delete → Delete current patient’s documents… or
Delete all patient’s documents…

EN USER MANUAL 83
9.4. USING SEVERAL ARCHIVES

If the program is appropriately configured (contact technical support for more information), you can use several
working archives, for example, for separate patient and/or document management.
If more than one archive is present, the "Archive selection button"
will appear on the main toolbar: by clicking on this button, you can
select the desired archive.
NOTE:
Archive 1 is the general default archive of the program.

NOTE:
If during configuration you set a password to access
the secondary archive, you will be asked to enter it
after selection.
If during configuration you set a password to enable document
deletion, you will be asked to enter it when you attempt to delete a
document.

9.5. BURNING CDs AND DVDs

CDs or DVDs can be created in order to save documents, distribute them to third parties or create a free viewer: a
version of the software not requiring installation and through which the user may enjoy most of the functions available
to analyse the Studies included in the same CD/DVD.

84 USER MANUAL EN
9.5.1. BURNING A DISC BY DOCUMENT

Select File → Disc burning (CD/DVD) → Burn a disc by Document… If an old compilation is present, the user will be
asked whether to clear it or to cancel the command. Choose the document type that you need on the disc
If another same-type compilation is present, the program asks whether to continue or create a new one.
Select the documents to add and at the end press Start
burning session to start the burning session.
The window displays the selected documents dimension
and the compilation total dimension (horizontal progress
bar) for a comparison with the CD’s and DVD’s capacity
A more precise data quantity control will be performed by
the burning software.

EN USER MANUAL 85
9.5.2. BURNING A DISC BY PATIENT

Select File → Disc burning (CD/DVD) → Burn a disc by Patient… If an old compilation is present, the user will be
asked whether to clear it or to cancel the command.
Choose the Patient by making a surname search. Select the documents to add and at the end press Start burning
session to start the burning session. The window displays the selected documents dimension and the compilation
total dimension (horizontal progress bar) for a comparison with the CD’s and DVD’s capacity.
A more precise data quantity control will be performed by the burning

9.5.3. CREATING A VIEWER

Select File → Disc burning (CD/DVD) → Burn a viewer disc…

If an old compilation is present, you are asked whether to empty it or cancel the command.
Choose the Patient by making a surname search. Select the documents to add and at the end press Start burning
session to start the burning session. The window displays the selected documents dimension and the compilation
total dimension (horizontal progress bar) for a comparison with the CD’s and DVD’s capacity.
A more precise data quantity control will be performed by the burning

The Viewer is a version of the program not requiring installation, it can be executed directly from CD/DVD and does
not save any files on the computer. Nonetheless, it contains many functions of the complete program.
The Viewer allows the user to open only those documents included in the same disk, and no documents can be
saved. Nonetheless, the created Reports can be printed.

86 USER MANUAL EN
9.5.4. BURNING SOFTWARE

NNT Burner, the CD/DVD burning software integrated into the program, is launched automatically during the
procedures described in paragraph 7.5. In addition, it may be launched at any time by selecting File → Disc burning
(CD/DVD) → Show burning windows…

In field 1 it is possible to add the title of the disc.

Field 2 lists all documents that will be added to the disc.
The box 3 is used to give information to the user.
The progress bar 4 represents the compilation size with respect to the disc capacity.
When a rewritable disc is inserted in the CD/DVD burning device the Erase button is activated; press it to view a
window where it is possible to choose how to delete a rewritable support: select Fast to logically erase the disc (data
are not physically removed) and this operation takes only a couple of minutes, with Complete, instead, the
information on the disc is physically removed but the erasing time is much longer, about 20 minutes.
By pressing Options all the other available options are also displayed:
The possible options are:
1. Choose the burner to use. It is not possible to use several devices at the same time.
2. Choose the burning speed (it depends on the selected burning device and on the disc available).
3. Choose the number of copies.
4. Choose whether you wish to perform the data check at the end of the burning process.
5. Choose whether you wish to perform a burning process simulation (the disc is not written).
6. Finalize the disc or allow the possibility to add other data in the future
7. Information about the software.
Once your standard options are set, it is possible to save them by pressing the Save Options button, so in the
following burning processes the saved options will be used, if possible.
The Remove button deletes the selected documents, while Remove all deletes all documents present in the
compilation.
The Save files… button saves in a folder defined by the user the files that the program would burn on the disc.
To close the program use the Exit button, whereas to start the burning process press the Burn! button.
Before starting the burning process the program makes a local copy of the data, this could take several minutes if the
documents are over the network.
The inserted disk will not be burned if it already contains other data.

EN USER MANUAL 87
Burner during the burning process:

During the burning process two progress bars appear, they represent:
1. Buffer of the burner (YELLOW).
2. Process progress (GREEN).
All the controls are invalidated and the Stop button is activated; this button, when pressed, stops the data copying,
starts the finalizing process and cancel the data control if previously set.
This is the only procedure to stop the burning process, do not ever close the program during the disc’s copy or disc’s
erasing.
Once data copying on the disc is complete, the program starts the finalization or the lead-out of the CD/DVD and
checks the just-written data.
When the program is closed, the user is asked whether the compilation’s changes have to be saved and if the just-
burned documents have to be deleted from the compilation.

88 USER MANUAL EN
9.5.5. BURNING A VIEWER DISC WITH OR WITHOUT DICOM FILE

In addition to the previously described modes, you can create a

Viewer disc for the current patient. After opening a patient
document, you will be able to choose one of the following creation
modes:

Burn a viewer disc

If you want to burn a classic viewer

Burn a viewer disk + DICOM axial dataset…

If you want to create a viewer disc containing a folder with the
DICOM files of the current patient. It is possible to include the
DICOM files of the axial images.

Burn a viewer disc + all DICOM images

it is possible to choose which groups of images (e.g. Panoramic
X-rays, radiographic images through Teleradiography, etc.) you
want to attach to the viewer disc in DICOM format.

Burn DICOM files only

If you want to burn only the DICOM files of the open document

Burn a viewer disc with selected images

In case of a 2D document you can choose this mode to burn only
the selected images

EN USER MANUAL 89
9.6. TRANSFERRING DOCUMENTS OR PATIENTS BETWEEN ARCHIVES

To transfer documents between archives, select File →

Transfer to another archive → Transfer by Document…;
select the type of document to be transferred and then
choose a document from the list; clicking on OK, a
window is displayed showing all the archives that can be
used as destination; select the desired archive and wait
for the data to be transferred.

WARNING:
Such operation transfers the data from an
archive to another one. Therefore, the
document is deleted from the source archive
and it is copied to the destination/target
archive.

To transfer patients between archives, select File → Transfer to another archive → Transfer by Patient…; select the
patient to be transferred and click OK; a window is displayed showing all the archives that can be used as
destination; select the desired archive and wait for the data to be transferred.

WARNING:
Such operation transfers the patient and the corresponding data from an archive to another one.
Therefore, the patient is deleted from the source archive and it is copied to the destination/target
archive.
NOTE:
Both procedures allow selecting more than one document or more than one patient
keeping the CTRL button pressed.

90 USER MANUAL EN
10. OTHER FUNCTIONS

NOT AVAILABLE FOR VIEWER VERSION

10.1. 3M & DICOM PRINTERS

If a 3M printer (printers using a 3M interface card) or a DICOM printer is used, it will require unique considerations in
its setup.
The setup of the printer is performed at a service level by the technician. To display the configuration of the printer
follow these steps.
Select File → Print setup… The “Select printer” window will be displayed. Select the “Digital & DICOM” button and
then “OK”.
The “Digital & DICOM printer setup” dialog will be displayed. Choose the print page size (if more than one option is
available).
Refer to customer support for further information about your settings.

10.2. SYSTEM FILES BACKUP

The system back up procedure consists of saving the program setup files.
In case of MAIN WORKSTATION the scanner setup files are also saved.

It is recommended to make a backup copy of these files at least once a week. Please find below the procedure:

1. From the main menu bar select File → Settings Backup.

2. The “Import/Export path setup” window will appear. The “ Current path” field defines the directory where the
backup of the system file will be stored. Select the “Change path” button to change the directory.
In the “New Folder” field enter the name of the a directory, which is created by selecting the “Add Folder” button.
3. At the end press the “Go on” button.
4. The backup process will start in background. At the end a message will appear informing that the process is
finished.

EN USER MANUAL 91
10.3. PROGRAM INTEGRATION WITH THIRD-PARTY SOFTWARE (PARTNERING SOFTWARE)

CBCT DATA ONLY

After that a Study or a Volumetric Data is opened select File → Send data to, then choose one of the available
programs (such as InVivoDental and SimPlant).
The program will export the required images and start the selected software.
NOTE:
The Send data to command is available only if at least one third-party software is installed and
available with the program.
NOTE:
The third-party software may be set in the program through the dialog that will open with the Tools
→ Export settings command after pressing the “Add” button.

For more details on this feature, please refer to the document “Application vs Third-party
Software”.

92 USER MANUAL EN
10.4. SELECTING AND ACQUIRING FROM TWAIN SOURCES

You can select and acquire images from external TWAIN devices,
for example, intraoral cameras.
To set the acquisition from a specific TWAIN device, after
connecting it, you must select it by choosing from the main
window of the program File → Select TWAIN source...
A window will be shown listing the TWAIN devices available from
which you can select the desired one.

To acquire images from the selected TWAIN device, select the command File → Acquire from TWAIN source from
the main window of the program.
Refer to the device manual for further details on acquisition.

10.5. COMPATIBILITY WITH VDDS PROTOCOL

The program supports stages 1,2,3,4 and 5 of VDDS standard, ver. 1.4, as IPS.
Some optional fields may not be implemented (e.g. DATE field modifier: SELECT).
For further information, refer to "VDDS Media 1.4 Monitor.pdf", available in the installation disc.

10.6. DOSE BOOK TOOL

NOT AVAILABLE FOR VIEWER VERSION

NOTE:
The Dose Book Tool is not available in “VET” mode.

The software contains the Dose Book Tool, an application allowing to quickly consult the examinations of all the
patients included in the archive used. In addition to examination generic data, the tool aims at showing X-ray
parameters and calculating the total dose (DAP) for each patient.

In order to make this information available, in case of previous installations, you have to convert the database used
following the procedure below.

EN USER MANUAL 93
10.6.1. CONVERTING A DATABASE

The conversion procedure allows converting the documents included in the archive to a version compatible with the
Dose Book Tool. Conversion duration varies and could even take many hours depending on the size of the archive
used. To begin database conversion procedure, select Tools → Convert db data to last version... and click on OK
(after reading the warning message).

WARNING:
During conversion, make sure that no other workstation is using the archive you want to convert.

A progress bar and, at the end of the conversion, a success message will be displayed. As already mentioned, the
conversion process may take a lot of time, but it can be interrupted at any time, saving the current progresses.
After interruption, the conversion of the remaining documents can be resumed at any time. If conversion duration is
particularly long, perform it overnight.

NOTE:
The conversion procedure is applied to documents created with a software version earlier than
7.0. New documents do not need to be converted as they are already created in the new version.

10.6.2. STARTING THE DOSE BOOK TOOL

To start the Dose Book Tool, select Tool → Start Dose Book Tool.... The following page will be displayed.
In addition to a menu bar (1), there is a button bar (2)
featuring Search for one or more patients, Search for all
patients, Print Report and Information functions

The central part of the main window (3) includes the list of
the examinations of the requested patients, which can be
exported through a report in CSV or PDF format (4).

The examination list may also be filtered by examination

date (5) and image type (6). The columns of the
examination list may be customised by means of the
corresponding button (7).

94 USER MANUAL EN
10.6.3. REQUESTING ONE OR MORE PATIENTS

The Selection → Select patient... command allows displaying the list of the patients included in the currently selected
archive of the software. Such list allows selecting one or more patients (you can select a patient clicking on the
corresponding line or select many patients clicking on the corresponding lines and keeping the CTRL button on the
keyboard pressed). To confirm the selection, click on OK: all the examinations concerning the selected patients are
displayed.
NOTE:
Required time varies according to the number
of patients included in the archive. The request
can be interrupted at any time; the partial result
of the research is displayed.

A page will display all the examinations of the selected

patients and the results can be filtered entering patient
name (1).

NOTE:
If allowed by the software application mode
selected, in case of many CBCT documents of
the same examination (e.g., RawData +
Volumetric Data, etc.), only one document is
considered in order to calculate the total dose.

10.6.4. REQUESTING ALL PATIENTS

The Selection → Select all patients... command allows displaying the examination list of all the patients included in
the currently selected archive and date range.
NOTE:
Required time varies according to the number of patients included in the archive. The request can
be interrupted at any time; the partial result of the research is displayed.

10.6.5. CONSULTING DATA

After performing the request described in the previous

paragraphs, a list will be displayed containing all the
information about the examinations: in case of many
examinations for the same patient, they are displayed in
different lines one beneath the other.

Clicking on any examination of a patient, a summary

indicating the total dose value (Total DAP) of the patient
is displayed at the bottom, i.e. the total of the dose
value for each examination relating to the selected
patient is calculated.

EN USER MANUAL 95
10.6.6. CREATING A REPORT

CSV format
A report in CSV format of the patients’ examination list and of the summary can be created by clicking on the
corresponding button (4) or selecting the File → Create CSV… item; then choosing where to save the file to.
NOTE:
The only character selected to separate the fields is “ ; ” (semicolon).

PDF format
A report in PDF format of the patients’ examination list and of the summary can be created by clicking on the
corresponding button (5) or selecting the File → Create PDF... item; the default paper size is A4, horizontally
oriented; if the number of columns of the list (and the relevant information) exceeds the length of an A4 page, you will
be prompted to choose between a PDF file in Single-page or Multi-page format.

• The Single-page format compresses column width so that they are contained in the length of a single A4
paper; the information contained is compressed too.
• The Multi-page format allows creating a PDF report featuring columns characterised by the size necessary to
contain all the information; if the A4 paper length is not enough to contain all the columns, another page will
be added on the right of the first one.

Once the PDF has been created, the document will be displayed by means of the default PDF reader of the
computer.

10.6.7. PRINTING A REPORT

You can directly print the currently displayed examination list by means of the corresponding Print report button. As
for PDF report creation, upon printing, if need be, you will be prompted to choose between Single-page or Multi-page
format.

96 USER MANUAL EN
10.6.8. FILTERING THE EXAMINATION LIST

In order to easily consult the examination list, you can apply filters as far as the examination date and/or the image
type are concerned.

To use the examination date filter, enable it by means of the box in “Exam Date filter” section (6) and enter a From/To
date range. The date can be entered through the keyboard or chosen by means of the calendar widget; after
choosing the date, the list will be filtered automatically.

NOTE:
When disabling the filter, the initial examination list is
restored.

To use the filter according to the image type, choose the desired
image type from the drop-down menu shown in the example on the
left. The list will be filtered automatically according to the selected
image type; select “All” to restore the list.

10.6.9. SENDING THE REPORT VIA EMAIL

The CSV or PDF report can be sent via email. Select File → Send report using email... → CSV (or PDF); if the
software is set to Web-based (SMTP) forwarding mode, a window will be displayed where to enter the addressee
email address and, optional, the subject and the email message. If the software is set to Windows Default Client
mode, the default email management program is used; the CSV or PDF report is attached to the email.
NOTE:
The email parameters used are set in the software through the File → E-mail setup… menu

EN USER MANUAL 97
10.7. METAL ARTEFACT REDUCTION (MAR) ALGORITHM

NOT AVAILABLE FOR VIEWER VERSION

WARNING:
The metal artefact reduction "MAR" algorithm is an aesthetic function optimizing the displaying of
the volumetric datum through the reduction of the artefact visual disturbance, but not ensuring the
information content integrity of the resulting volume.
For the detailed examination and correct diagnosis of the clinical case, always refer to the original
volumetric datum.

WARNING:
The metal artefact reduction "MAR" algorithm is designed and optimized for dental purposes.

WARNING:
When using imported DICOM documents, the MAR functionality is not optimised and the following
warning message will be displayed

10.7.1. FOREWORD

The metal artefact reduction “MAR” algorithm is an automatic procedure that can be used on volumetric images and
that identifies and reduces artefacts due to radiopaque materials.

98 USER MANUAL EN
10.7.2. USAGE

You can run the procedure by means of the corresponding button (see
image) or through the Edit → MAR Correction menu. The current
document is closed prompting you to save any modification applied.

NOTE:
The “MAR” algorithm cannot be executed on a document containing a volume corrected by the
same algorithm.

The “Metal artefacts correction” progress window is displayed during the

procedure.
You can click on the “Cancel” button at any time to stop the procedure.
Clicking on the “Cancel” button, the original document is opened again.

NOTE:
The time necessary to complete the procedure depends on the FOV associated with the volume,
on the resolution and on the quantity of metal artefacts present in the image.

When the "MAR" algorithm will be completed, a new volumetric document, associated to the same patient of the
original document, and which can be identified by the wording “[Metal artifacts reduction]” inside the note field, will be
created. The new document will include all secondary images present inside the original document.

EN USER MANUAL 99
10.8. HEADREST STICK REMOVAL FUNCTION

NOT AVAILABLE FOR VIEWER VERSION

In case of scanning with devices featuring a headrest support equipped with sticks, it is possible to use this function
to remove them from volumetric data.

Open the desired volumetric data and select Edit → Automatic

hide headrest sticks or → Manual hide headrest sticks command.

or by directly selecting the Show/hide headrest sticks button in the

toolbar.

Confirm document closing and reopening with OK key.

In case of manual mode, it is necessary to select the point where

sticks are present on the axial image.

Position the points over the sticks and confirm with OK.

100 USER MANUAL EN

 The images will be recalculated with sticks hidden.

EN USER MANUAL 101

10.9. DATA BACKUP

NOT AVAILABLE FOR VIEWER VERSION

WARNING:
The software does not perform the data backup automatically. Therefore, it is recommended to
follow the manual procedure listed below if you need to perform a backup on mobile (hard disk,
USB pendrive, etc.) or network (NAS, server, etc.) support.

To perform a manual data backup, open the program and select the Help → About menu

It will be necessary to copy the following folders listed inside the window

In particular:
- Copy the shared folder “..\Shared\” (that may contain the database of the data) (A)
- Copy the folder containing the RawData “..\RawData\” (B)
- Copy the folder containing volumetric data, studies, reports, etc. “..\Document\”.
If the folders containing these data are part of the same path (e.g. B - C – D - E) simply copy the folder once

NOTE:
With secondary archives and/or network archives it will be necessary to copy the folders listed
above that are in the set customised paths

102 USER MANUAL EN

10.10. MULTIROOM SCANNER SYSTEM

NOT AVAILABLE FOR VIEWER VERSION

If the Multiroom scanner system is enabled, it is possible to start it

through the File → Send data to → Book PSP Scanner Multiroom
command (in case of open patient tab and document)

or by directly selecting the Send data to button from the toolbar (in
case of open patient tab and closed documents).
For further information on use, refer to the iCapture manual.

EN USER MANUAL 103

11. TROUBLESHOOTING

NOT AVAILABLE FOR VIEWER VERSION

11.1. WARNING TO RESTART PC

If the PC is not turned off/restarted for more than 3 days, when you
open the program a warning will be shown on the screen indicating
that it is necessary to restart the PC in order to ensure proper
functioning of the system.
After clicking OK to close the warning window, the main functions of
the program (opening documents, scanning, etc.) will be disabled
until the PC is restarted.

11.2. ERRORS GUIDE

To easily solve any issues that may occur when using the program, please refer to the enclosed Errors Guide, that
includes a list of possible error codes, as well as their description and the possible solutions.
The Errors Guide document is available in the setup disk.

104 USER MANUAL EN

11.3. LOG ERROR

To facilitate troubleshooting during program use, you

can refer to log data containing any software fault and
problem
Log data can be consulted through the specific error
viewer that can be accessed from the program through
the Tools → Start log error viewer menu.

Click on the relevant button on the toolbar or select File

→ Open to view the data. Select the desired log file

It is now possible to view the event list: click on the relevant column to sort the events, while use the buttons
"Search" and Config" to search key words and view / hide some information (e.g., workstation name, IDThread, etc.)

Click on the desired event in the lower box of the window to view the event detailed information:

EN USER MANUAL 105

11.3.1. SEND DATA VIA E-MAIL
Log data can be compressed and exported to be sent to the Technical Support.

From the program through the Tools → Send log file via e-mail
menu it is possible to send data to the Technical Support via e-mail
address.

NOTE:
Proper forwarding of log data via e-mail is subject to the presence of an Internet connection
allowing external SMTP connections to the program.

11.3.2. SENDING INFORMATION / ERRORS VIA CLOUD

NOTE:
Proper forwarding of information / errors via cloud is subject to the presence of an Internet
connection allowing external connections to the program.
For more information on the requirements for proper operation, refer to annex “ Minimum and
recommended system requirements”.

It is possible to automatically send software and device errors to the Technical Support via Cloud service.

DEVICE ERRORS
The service will work if the device serial number is properly set in the software (or automatically recognised by the
software).

SOFTWARE ERRORS
The service will work if the control workstation serial number is properly set in the software.

If the above mentioned serial numbers are not properly set, the software shows the following screen.

106 USER MANUAL EN

11.4. REMOTE SUPPORT

To have remote support on your computer, after ensuring that it is connected to a network that allows internet
access, select Help → Remote Support… from the home screen.
The Remote Support program will be launched.
Do not close the program and communicate to Service the ID and the
Password displayed in the appropriate fields.
If a connection is not available, please contact your network
administrator and ask for
Remote Support (TeamViewer) to work properly.

WARNING:
Do not use Remote Support (TeamViewer) with the following operations: “ Daily Check”, “Blank
acquisition” and “2D/3D Scan of patient or denture”.
For further information refer to the enclosed document “Acquisition Operations with...”

EN USER MANUAL 107

12. IEC61223: ACCEPTANCE TEST

CBCT DATA ONLY

NOT AVAILABLE FOR VIEWER VERSION

This chapter describes specific software procedures to be performed to facilitate the execution of the acceptance
tests prescribed by the IEC61223-3-5 standard. For each test, the relevant paragraph of the reference standard is
specified.
12.1. POSITIONING OF THE PATIENT SUPPORT [PARAGRAPH 5.1]

No specific procedure was implemented for this purpose.

108 USER MANUAL EN

12.2. PATIENT POSITIONING ACCURACY [PARAGRAPH 5.2]
12.2.1. AXIAL PATIENT POSITIONING ACCURACY [PARAGRAPH 5.2.1]

See paragraph 12.2.2.

12.2.2. SAGITTAL AND CORONAL PATIENT POSITIONING LIGHT [PARAGRAPH 5.2.2]

This paragraph describes the procedure for the calibration of the positioning lasers used for positioning the patient.
These procedures allow the Axial, Sagittal and Coronal centring; for the calibration of the machine use only the ones
that the model needs.
The procedure for verifying patient centring is as follows:
1. Run a scan of a centred object by using the provided centring systems (see USER MANUAL).
2. Perform a Primary Reconstruction, if it is not made automatically.
3. Once the scan Volumetric is shown, enter in the MPR view by pressing the MPR Tab

4. Select the point illuminated by the lasers using AXIALS, SAGITTALS and CORONALS indicators to move the
image.
(Typically the lasers identify only 2 out of 3 possible dimensions, so one of the three views is not useful for this
purpose)
5. Select Tools → IEC 61223-3-5 test→ Patient positioning accuracy test from the menu
6. Rules appear, allowing to measure the laser offsets, the distance between two small lines is 1mm, while the
distance between two big lines is 5mm.
In the example the two directions defined by the lasers are the Axial and the Sagittal ones while the Coronal one
is not defined. As shown by the upper-right image the laser offset is 4mm both on the Axial plane and on the
Sagittal one.

EN USER MANUAL 109

12.3. TOMOGRAPHIC SECTION THICKNESS [PARAGRAPH 5.3]
12.3.1. TOMOGRAPHIC SECTION THICKNESS FOR AXIAL SCANNING [PARAGRAPH 5.3.1]

1. Set the application mode “Imaging Center, Maxillofacial” from Tools → General settings → Application mode
2. Take a scan of a test device as described in the standard (it should contain one or more ramps with known and
opposite angle, the use of phantom Catphan 500 is suggested), for each FOV.
3. Perform the primary reconstruction using the preferred voxel option (e.g. isometric voxel);
4. At the end of the reconstruction, select Study Reconstruction → Study Reconstruction.
5. Press the 100% button on the toolbar to enlarge the reconstruction ROI to the maximum.

6. Set the slice thickness to 0.5, 1 or 5mm

7. Move the ROIs until the maximum width area is included (if Catphan 500 is used, frame the ramp area), then
press “start” to start the study reconstruction.
8. Open the study and visualize the axial images. Set the single axial mode (Axial tab) and browse the images till
the ramp will appear.
9. Select Tools → IEC 61223-3-5 test → Tomographic Slice thickness test
10. Trace a line (press the left button of the mouse, move it and at the end press the left button again to define the
line end), as parallel as possible to the white bar displayed on the axial (see following picture).

11. The window of the density profile is displayed. Move the mouse inside the graph until half of background
disappears (half of the image is white and half is black). Press the left button of the mouse to fix the background
value.

110 USER MANUAL EN

12. Move the mouse inside the graph and fix (with the left button of the mouse) the new line to the maximum
grayscale.
13. The software will calculate the FWHM value, shown in the box under the graph. Multiply said value by the angle
tangent that the acquired ramp forms with the axial plane to obtain the slice thickness.

12.3.2. TOMOGRAPHIC SECTION THICKNESS FOR HELICAL SCANNING [PARAGRAPH 5.3.2]

No specific procedure was implemented for this purpose.

12.4. DOSE [PARAGRAPH 5.4]

No specific procedure was implemented for this purpose.

EN USER MANUAL 111

12.5. NOISE, MEAN CT NUMBER AND UNIFORMITY [PARAGRAPH 5.5]

1. Set the application mode “Imaging Center, Maxillofacial” from Tools → General settings → Application mode
2. Take a scan of a test device as described in the standard (the use of phantom Catphan 500 or a container with
16 cm of water is suggested).
3. Perform the primary reconstruction using the preferred voxel option (e.g. isometric voxel);
4. At the end of the reconstruction, select Study Reconstruction → Study Reconstruction.
5. Press the 100% button on the toolbar to enlarge the reconstruction ROI to the maximum.

6. Set the slice thickness to 0.5mm.

7. Move the ROIs until the maximum width area is included (if Catphan 500 is used, frame the uniformity area), then
press “start” to start the study reconstruction.

112 USER MANUAL EN

8. Open the study and visualize the axial images. Set the single axial mode (Axial tab) and browse the images till
the desired one is shown (usually in the upper part of the scanned volume).
9. Select Tools → IEC 61223-3-5 test → Noise and Uniformity test.
10. A small ROI will appear. Enlarge it to the edge of the test device.

EN USER MANUAL 113

11. At the end, press the right button of the mouse to get the results. The software will create 5 ROIs as described in
the standard (the central ROI with size equal to 40% of the scanned object, and four ROIs placed at 3, 6, 9 and
12 o’clock position with size equal to 10% of the scanned object).

The shown results are the Mean CT value of each ROI and the standard deviation of the central ROI (as required
by the standard).

Refer to the document “Dose declaration and acceptance test” of your device to verify the results obtained

114 USER MANUAL EN

12.6. SPATIAL RESOLUTION [PARAGRAPH 5.6]

1. Set the application mode “Imaging Center, Maxillofacial” from Tools → General settings → Application mode
2. Take a scan of the test device (the tungsten carbide bead of phantom Catphan 500 was used as an example).
3. Perform the primary reconstruction using the preferred voxel option (e.g. isometric voxel);
4. At the end of the reconstruction, select Study Reconstruction → Study Reconstruction.
5. Press the 100% button on the toolbar to enlarge the reconstruction ROI to the maximum.

6. Set the slice thickness to 0.5mm.

7. Open the study and visualize the axial images. Set the single axial mode (Axial tab) and browse the images till a
section with the scanned object is shown.
8. Select Tools → IEC 61223-3-5 test → Spatial resolution test.
9. A ROI will appear. Move it (holding down the left button of the mouse) over the white point indicating the wire or
micro-bead

EN USER MANUAL 115

10. Press the right button of the mouse to get the results. MTF50 and MTF10 values (lp/cm) are shown.
Refer to the document “Dose declaration and acceptance test” of your device to verify the results obtained.

116 USER MANUAL EN

12.7. "CONTRAST SCALE” TEST

1. Set the application mode “Imaging Center, Maxillofacial” from Tools → General settings → Application mode
2. Take a scan of a test device as described in the standard (it should contain one or more ramps with known and
opposite angle, the use of phantom Catphan 500 is suggested), for each FOV.
3. Perform the primary reconstruction using the preferred voxel option (e.g. isometric voxel);
4. At the end of the reconstruction, select Study Reconstruction → Study Reconstruction.
5. Press the 100% button on the toolbar to enlarge the reconstruction ROI to the maximum.

6. Set the slice thickness to 0.5, 1 or 5mm

7. Move the ROIs until the maximum width area is included (if Catphan 500 is used, frame the area containing the
beads of different material), then press “start” to start the study reconstruction.
8. Open the study and visualize the axial images. Set the single axial mode (Axial tab) and browse the images till
the beads of different material (e.g. if Catphan 500 is used: air, Teflon, acrylic, LDPE).

Example of bead positioning with Catphan 500

EN USER MANUAL 117

9. Enlarge the bead area and use the “Trace Region” tool to trace a region within the bead so as to calculate the
corresponding value in HU. Repeat for all the 4 beads.

Refer to the phantom manual (Catphan 500) or the document “Dose declaration and acceptance test” of your
device to verify the results obtained

118 USER MANUAL EN