EN
Planmeca ProMax 3D Mid
10026635_11
user's manual
2D imaging
TABLE OF CONTENTS
1 INTRODUCTION ..............................................................................................1
2 MAIN PARTS ...................................................................................................2
2.1 Sensors .......................................................................................................................... 2
2.2 Patient supports ............................................................................................................. 3
2.3 Exposure switch .............................................................................................................4
2.4 Emergency stop button .................................................................................................. 5
3 SWITCHING X-RAY UNIT ON .........................................................................5
4 PROGRAMS .....................................................................................................6
4.1 Panoramic programs ...................................................................................................... 8
4.2 Temporomandibular joint (TMJ) programs ................................................................... 10
4.3 Sinus programs ............................................................................................................ 12
5 CONTROL PANEL .........................................................................................14
5.1 General about control panel ......................................................................................... 14
5.2 General settings ........................................................................................................... 15
5.3 Selecting panoramic program ...................................................................................... 18
5.4 Selecting temporomandibular joint (TMJ) program ...................................................... 22
5.5 Selecting sinus program .............................................................................................. 25
6 PATIENT POSITIONING CONTROLS ...........................................................26
7 PREPARATIONS FOR EXPOSURE ..............................................................28
7.1 Attaching and removing sensor ................................................................................... 29
7.2 Preparing patient .......................................................................................................... 31
8 PANORAMIC EXPOSURE .............................................................................32
8.1 Patient positioning ........................................................................................................ 33
8.2 Taking an exposure ..................................................................................................... 38
9 TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE ..................................41
9.1 Double TMJ exposure (lateral, PA or lateral-PA) ......................................................... 41
9.2 Multi-angle TMJ exposure (PA or lateral) .................................................................... 48
10 SINUS EXPOSURE ........................................................................................53
10.1 Patient positioning ........................................................................................................54
10.2 Taking an exposure ..................................................................................................... 56
User’s Manual (2D)
Planmeca ProMax 3D Mid 1
TABLE OF CONTENTS
The manufacturer, assembler, and importer are responsible for the safety, reliability
and performance of the X-ray unit only if:
- installation, calibration, modification and repairs are carried out by qualified
authorized personnel
- electrical installations are carried out according to the appropriate requirements
such as IEC 60364
- equipment is used according to the operating instructions
Planmeca pursues a policy of continual product development. Although every effort is
made to produce up-to-date product documentation this publication should not be
regarded as an infallible guide to current specifications. We reserve the right to make
changes without prior notice.
COPYRIGHT PLANMECA
Released: 7 July 2014
Publication part number: 10026635 revision 11
2 Planmeca ProMax 3D Mid
User’s Manual (2D)
1 INTRODUCTION
INTRODUCTION
This manual describes how to take 2D panoramic
exposures. Make sure that you are fully acquainted with
the appropriate radiation protection measures and these
instructions before you use the X-ray unit.
NOTE The software version is shown briefly on the control
panel when the X-ray unit is switched on. This manual
is valid for software version 2.7.6.0.r or later. This
software version is compatible with Romexis software
version 3.7.0.r or later.
NOTE Refer to the User’s Manual for 3D imaging for details
on information displays and for any general advice
about the X-ray unit.
User’s Manual (2D)
Planmeca ProMax 3D Mid 1
MAIN PARTS
Prof_1.eps
3D Mid ProFace sensor
Mid_85
3D sensor
Dimax sensor
Mid_3D_15x15.eps
2 MAIN PARTS
2.1 Sensors
NOTE Refer to the User’s Manual for 3D imaging for a general
view of the X-ray system.
2 Planmeca ProMax 3D Mid
User’s Manual (2D)
2.2 Patient supports
Bite1.eps
TEMPLE?SUPPORTAI
Chin support
Bite piece
Chin cup
Chin rest
Temple supports
Chin2.eps
Bite2.eps
Chin1.eps
Lip1.eps
Adapter
MAIN PARTS
User’s Manual (2D)
Planmeca ProMax 3D Mid 3
MAIN PARTS
Exposure button with
indicator light
AMBER = EXPOSURE
GREEN = READY
Exposure
indicator light
Exposure
indicator light
Ready
indicator light
(GREEN)
(AMBER)
CONTROL PANEL LIGHTS:
PXR_Dsw._2eps
2.3 Exposure switch
The exposure switch can be mounted on the wall, or it can
be hung from the hook provided on the stationary column
top if a protected area is within reach.
On the exposure button and on the control panel a green
indicator light will come on when the unit is correctly set
up and ready to take an exposure. Additionally, the word
READY will stop flashing on the control panel display.
An amber indicator light will come on on the exposure
switch and on the control panel when you take an
exposure. It indicates that the unit is generating radiation.
You will also hear a radiation warning signal.
4 Planmeca ProMax 3D Mid
When you take an exposure you must press and hold
down the exposure button for the whole duration of the
exposure.
If you remove your thumb from the exposure button
before the exposure cycle is completed radiation will be
interrupted, the C-arm will stop moving and a help
message will appear on the control panel display. Guide
the patient away from the X-ray unit. Then clear the help
message by touching OK.
User’s Manual (2D)
2.4 Emergency stop button
on_off_2.eps
On / off switch
Stationary column top
SWITCHING X-RAY UNIT ON
The emergency stop button is located on the top of the
stationary column. Press the button to stop the X-ray unit
operating in an emergency. When the emergency stop
button is pressed down, all movements of the X-ray unit
are blocked and the unit will not generate radiation. The
up / down movement will stop within a distance of 10 mm
(0.4 in.).
A help message will appear on the control panel display.
Guide the patient away from the X-ray unit. Then release
the emergency stop button. The X-ray unit will
automatically restart.
3 SWITCHING X-RAY UNIT ON
User’s Manual (2D)
The on / off switch is located on the underside of the
stationary column top. When you switch the X-ray unit on
the main display will be shown on the control panel and
the X-ray unit will carry out a self-test which will last a few
seconds.
The X-ray unit is then ready for use.
NOTE To prolong the lifetime of the Planmeca ProMax 3D Mid
X-ray unit, always switch the X-ray unit off when it is
not in active use.
Planmeca ProMax 3D Mid 5
PROGRAMS
4 PROGRAMS
Program package Contents Sensor
3D imaging system
NOTE The images shown in this manual are only examples.
3D Dental programs
(standard with 3D
sensor)
3D ENT programs
(optional with 3D
sensor)
3D Dental programs +
ProFace
(standard with 3D Mid
ProFace sensor)
Tooth
Teeth
Jaw
Face
Horizontal pair
Sinus
Middle ear
Middle ear pair
Temporal bone
Temporal bone pair
Vertebrae
Airways
Tooth (+ Face Scan)
Teeth (+ Face Scan)
Jaw (+ Face Scan)
Face (+ Face Scan)
Horizontal pair (+ Face Scan)
Face Scan
3D
3D
3D Mid ProFace
3D ENT programs +
ProFace
(optional with 3D Mid
ProFace sensor)
3D Model
(optional)
2D imaging system (optional)
Basic panoramic
programs (standard)
Sinus (+ Face Scan)
Middle ear (+ Face Scan)
Middle ear pair (+ Face Scan)
Temporal bone (+ Face Scan)
Temporal bone pair (+ Face Scan)
Vertebrae (+ Face Scan)
Airways (+ Face Scan)
Face Scan
3D Impression scan
3D Plaster cast scan
Standard panoramic
Lateral double TMJ
PA double TMJ
PA rotational sinus
Standard panoramic + TMJ
3D Mid ProFace
3D or
3D Mid ProFace
3D, 3D Mid ProFace
or Dimax
3D or
3D Mid ProFace
6 Planmeca ProMax 3D Mid
User’s Manual (2D)
Program package Contents Sensor
PROGRAMS
Advanced panoramic
programs (optional)
Other panoramic
programs (optional)
Cephalostat
(optional)
Dynamic Exposure
Control (DEC)
(optional)
Horizontal segmenting
Orthogonal panoramic
Interproximal panoramic
Bitewing panoramic
Lateral-PA double TMJ
3 angles PA TMJ
3 angles lateral TMJ
PA non-rotational sinus
Lateral non-rotational sinus
Midsagittal non-rotational sinus
Bitewing panoramic
Horizontal and vertical
segmenting
Scanning Ceph
Planmeca ProCeph
Panoramic DEC
Cephalometric DEC
3D, 3D Mid ProFace
or Dimax
3D, 3D Mid ProFace
or Dimax
Dimax
ProCeph
Dimax
User’s Manual (2D)
Planmeca ProMax 3D Mid 7
PROGRAMS
layer laser beam
1 cm
layer laser beam
1 cm
4.1 Panoramic programs
Standard panoramic program
Orthogonal panoramic program
The standard panoramic program has a traditional path
and angles of the beam.
The basic imaging geometry is the same as in the
standard panoramic program but the X-ray beam is
perpendicular to the jaw.
NOTE This program is optimized for orthogonal imaging and
a shadow of the opposite side teeth may therefore be
visible in the radiograph.
Interproximal panoramic program
The basic imaging geometry is the same as in the
standard panoramic program but the X-ray beam is more
parallel to the interproximal contacts of the teeth.
8 Planmeca ProMax 3D Mid
NOTE This program is optimized for interproximal imaging
and a shadow of the opposite side teeth may therefore
be visible in the radiograph.
User’s Manual (2D)
Bitewing panoramic program
layer laser beam
1 cm
2/2
layer laser beam
1 cm
1/2
1/2
2/2
2/2
This program produces bitewing images from premolar
and molar areas including parts of maxilla, mandible and
rami. The bottom of the maxillary sinus as well as the
mandibular canal and the mental foramen are also visible.
The bitewing program uses interproximal angulation
projection geometry.
In the bitewing program radiation dose is reduced
compared to the standard panoramic program.
PROGRAMS
NOTE This program is optimized for interproximal imaging
and a shadow of the opposite side teeth may therefore
be visible in the radiograph.
Standard + TMJ
Panoramic program Standard + TMJ takes exposures of
teeth and both temporomandibular joints (TMJs). The
program uses optimal and adjustable imaging angles for
TMJ exposures.
The exposure is taken in two stages. Teeth are imaged
during the first exposure (1/2) and both TMJs during the
second exposure (2/2).
User’s Manual (2D)
Planmeca ProMax 3D Mid 9
PROGRAMS
1/2
1/2
2/2
2/2
1 cm
1/2
1/2
2/22/2
4.2 Temporomandibular joint (TMJ) programs
Double lateral
Lateral TMJ exposures of closed (1/2) and open (2/2)
temporomandibular joints. The imaging angle is
adjustable (default angle: 17°).
Double PA
Postero-anterior TMJ exposures of closed (1/2) and open
(2/2) temporomandibular joints. The imaging angle is
adjustable (default angle: 17°).
PA exposures are taken perpendicular to the long axis of
the condyle (90° - 17° = 73°). The condyle angle is shown
as default angle.
10 Planmeca ProMax 3D Mid
User’s Manual (2D)
Double lat-PA
1 cm
1/2
1/2
2/2
2/2
1/3
2/3
3/3
1 cm
1
2
3
1 cm
1 2
3
2/3
3/3
1/3
3 angles PA (L / R)
PROGRAMS
Lateral (1/2) and postero-anterior (2/2) TMJ exposures of
closed or open temporomandibular joints. The imaging
angles (lateral and PA) are adjustable (default angle: 17°).
PA exposures are taken perpendicular to the long axis of
the condyle (90° - 17° = 73°). The condyle angle is shown
as default angle.
3 angles lat (L / R)
Three postero-anterior multi-angle left-hand or right-hand
side TMJ exposures.
The imaging angle for image no. 2 is adjustable (three
imaging angles: 17° ±7° by default). The selected imaging
angle is in image no. 2.
PA exposures are taken perpendicular to the long axis of
the condyle (90° - 17° = 73°). The condyle angle is shown
as default angle.
Three lateral multi-angle left-hand or right-hand side TMJ
exposures.
The imaging angle for image no. 2 is adjustable (three
imaging angles: 17° ±7° by default). The selected imaging
angle is in image no. 2.
User’s Manual (2D)
Planmeca ProMax 3D Mid 11
PROGRAMS
X-ray
1 cm
X-ray
1 cm
X-ray (L)
4.3 Sinus programs
PA rotational
PA non-rotational
Postero-anterior rotational sinus exposure.
Postero-anterior non-rotational sinus exposure.
“Non-rotational” indicates that the C-arm moves linearly
and scans over the head with a linearly moving X-ray
beam.
Lateral non-rotational (L / R)
12 Planmeca ProMax 3D Mid
Lateral non-rotational exposure of the left or right sinus
area.
User’s Manual (2D)
Midsagittal non-rotational (L / R)
1 cm
X-ray (L)
Lateral non-rotational sinus exposure in the middle of the
jaw. Exposure can be taken from the left or right jaw side.
PROGRAMS
User’s Manual (2D)
Planmeca ProMax 3D Mid 13
CONTROL PANEL
Time
5 CONTROL PANEL
5.1 General about control panel
NOTE Never allow patients to touch the display when they
NOTE The contents of the control panel displays depend on
NOTE Refer to the User’s Manual for 3D imaging for details
NOTE Do not use sharp objects to operate the control panel.
are positioned in the X-ray unit. Touching the display
during exposure will stop the imaging process.
the configuration of the X-ray unit.
on information displays.
To make a selection on the control panel, simply touch a
text field or an icon with your finger or a soft stylus. You
will hear a signal tone when a field or an icon is activated.
You can set the X-ray unit so that the current time will be
shown at the bottom of the display. On information display
i210 you can choose in which format (e.g. 13:19) it will be
shown.
On information display i230 you can set the X-ray unit so
that the radiation dose will be shown in a pop-up window
after each exposure. The value shown on the display
indicates the highest radiation dose the patient was
exposed to during the exposure. Note that you will have to
accept the pop-up message by touching OK after each
exposure.
If you are using a Dimax sensor you can set the X-ray unit
so that a preview of the X-ray image will be shown on the
control panel after each 2D exposure (information display
i25.5).
The display will automatically switch to stand-by mode if
you do not touch the display or the exposure button for
more than thirty minutes. In stand-by mode the green
ready lights on the exposure button and control panel
indicate that the X-ray unit is switched on even though the
display is dark. The display will switch on as soon as you
touch it again.
NOTE The control panel display can be adjusted to respond
NOTE You can switch practice mode on if you wish to
NOTE The exposure time indicated on the display (before an
to your individual finger touch (information display
i25.4).
practice or demonstrate the functions of the X-ray unit
without radiation (information display i410).
exposure is taken) is an estimated value. The real
value is shown after the exposure. Variation in
exposure time is caused by mA automation.
14 Planmeca ProMax 3D Mid
User’s Manual (2D)
5.2 General settings
From left to right: Child
Adolescent
Small adult
Average-sized adult
Large adult
5.2.1 Selecting patient size
CONTROL PANEL
Select the patient size by touching the corresponding size
symbol in the Patient size field on the main display.
Select the smallest patient size symbol for a child.
Selecting the smallest patient size symbol will
automatically reduce the exposure area and patient dose.
The jaw shape & size setting will automatically change to
Normal & Narrow.
Select the second patient size symbol for an adolescent.
Select the third patient size symbol for a small adult.
Select the fourth patient size symbol for an average-sized
adult. Selecting any of the patient sizes in the middle will
automatically change the jaw shape and size setting to
Normal & Average.
Select the biggest patient size symbol for a large adult.
Selecting the biggest patient size will automatically
change the jaw shape and size setting to Normal & Wide.
The selected patient size will be highlighted.
NOTE The exposure values (kV and mA) will automatically
NOTE Jaw shape and size selection is not available in sinus
change to correspond with the selected patient size
and exposure program.
programs.
5.2.2 Selecting kilovolt and milliampere values
NOTE The exposure values will automatically change to
correspond with the selected patient size and
exposure program.
The preset exposure values are average values and they
are only meant to guide the user.
To change the preset exposure values, touch the kV / mA
field on the main display.
User’s Manual (2D)
Planmeca ProMax 3D Mid 15
CONTROL PANEL
Quick buttons
The Select kV / mA display appears. Select the required
exposure values by touching the kV and mA values. The
selected values will be highlighted.
Confirm your selection and return to the main display by
touching OK.
The preset exposure values for the selected exposure
program are shown in the quick buttons at the bottom of
the display.
NOTE Selecting kV and mA values manually will override the
automatic quick button setting.
5.2.3 Changing exposure values for quick buttons
The quick button exposure values have been preset at the
factory. If needed, the preset values can be changed by
the user.
To change the preset values of a quick button, first select
the required kV and mA values by touching the
corresponding fields on the parameter display and then
touch and hold the desired quick button at the bottom of
the display until you hear a signal tone. The quick button
will now show the new exposure values.
The quick button values are program-specific, i.e. the
exposure values can be set separately for each program.
NOTE To view the preset exposure values for each program
type, refer to the tables in chapters 8 “PANORAMIC
EXPOSURE” on page 32, 9 “TEMPOROMANDIBULAR
JOINT (TMJ) EXPOSURE” on page 41 and 10 “SINUS
EXPOSURE” on page 53.
Confirm your selection and return to the main display by
touching OK.
16 Planmeca ProMax 3D Mid
User’s Manual (2D)
5.2.4 Setting vertical offset value
Vertical offset 0 mm
Vertical offset 10 mm
(C-arm moves up)
CONTROL PANEL
You can set the X-ray unit so that the C-arm moves up at
the start of all 2D exposures (panoramic, TMJ and sinus).
To do this, first go to information display Set panoramic
imaging vertical offset (i27.3) and adjust the vertical offset
value between 0-20 millimetres (default 0 mm).
5.2.5 Selecting patient entry position
The selected vertical offset (e.g. 10 mm) will be shown on
the main display. The C-arm will now automatically move
up at the start of an exposure, i.e. the image area will be
shifted 10 millimetres upwards.
The X-ray unit offers two patient entry positions: Entry 1
and Entry 2. You can use either of them according to your
individual preference.
Selecting Go Entry 1 will move the C-arm to the back,
away from the patient positioning area. This full view
position allows you to monitor and adjust the patient’s
position freely from all directions.
Selecting Go Entry 2 will position the C-arm around the
temple supports. This is the traditional closed patient
entry position.
User’s Manual (2D)
NOTE If needed, the Go Entry 1 function can be disabled on
information display i230. This might be necessary if
there is no space for the C-arm to move back.
Planmeca ProMax 3D Mid 17
CONTROL PANEL
X-ray units with Dimax sensor:
X-ray units with 3D sensor and SmartPan license:
5.3 Selecting panoramic program
To select a panoramic program, touch the Prog. field on
the main display. The main display is the display that is
shown when the X-ray unit is switched on.
The Select program type display appears. Select program
type Pan.
NOTE The Select program type display will show all the
exposure programs that the X-ray unit features at the
moment. The X-ray unit can be upgraded with new
exposure programs, contact your dealer for further
information.
On the next display, select the panoramic program you
wish to use.
Refer to section 4.1 “Panoramic programs” on page 8 for
a more detailed description of the program types.
18 Planmeca ProMax 3D Mid
NOTE Program type Standard + TMJ is not available for X-ray
units with Dimax sensor.
When you have selected the program the main display
will be shown again.
User’s Manual (2D)
5.3.1 Selecting jaw shape & size in panoramic programs
Jaw size:
Narrow
Average
Wide
Jaw shape:
Normal
V-shaped
Square
This function adjusts the form of the image layer to
accommodate patients with different jaw shapes and
sizes.
NOTE The setting in the jaw field will automatically change to
correspond with the selected patient size.
Selecting the smallest patient size will automatically
change the jaw shape and size setting to Normal &
Narrow.
Selecting any of the three patient sizes in the middle will
automatically change the jaw shape and size setting to
Normal & Average.
Selecting the biggest patient size will automatically
change the jaw shape and size setting to Normal & Wide.
If necessary, you can select the jaw shape and size
manually by touching the Jaw field or jaw icon on the main
display.
CONTROL PANEL
The Select jaw shape & size display appears. The
marking on the jaw icon demonstrates the image layer.
Select the required jaw shape and size by tapping the
corresponding icon. The selected jaw icon will be
highlighted.
NOTE Selecting jaw shape and size manually will override
the automatic setting.
Confirm the selection and return to the main display by
touching OK.
User’s Manual (2D)
Planmeca ProMax 3D Mid 19
CONTROL PANEL
Deselected
sectors -
Sectors
no exposure
to be exposed
Exposure
No exposure
5.3.2 Selecting segmentation in panoramic programs
NOTE Horizontal segmenting is not available for the bitewing
program.
This optional function allows you to take exposures of
different jaw segments. This will reduce the radiation dose
as only diagnostically interesting sections need to be
included in the exposure.
Touch the Segment field or segment icon on the main
display.
The Select segmentation display appears. The display
shows an icon which is divided into three horizontal
sectors (and five vertical sectors, depending on the unit
configuration). The segment numbers on the main display
(1 2 3 4 5) refer to the five vertical sectors.
Touch the corresponding arrow field(s) to deselect the
sector(s) that should not be exposed. The sectors which
will not be exposed will turn dark red. The sectors which
will be exposed remain white.
NOTE It is not possible to expose two separate horizontal
NOTE The image shown on the display is only an example.
sectors.
Touching the arrow of a deselected sector again will
change the sector’s color back to white.
Confirm the selection and return to the main display by
touching OK.
The actual size of the exposed area depends on the
patient’s anatomy.
5.3.3 Dynamic Exposure Control (DEC) in panoramic programs
NOTE Dynamic Exposure Control (DEC) is an optional
NOTE DEC and vertical segmenting can be used
NOTE DEC and horizontal segmenting cannot be used
NOTE If Autofocus is switched on (AF ON), DEC will be
feature for X-ray units with Dimax sensor. DEC has to
be activated on information display i310 before you
can start using it.
simultaneously. However, the right-most vertical
sector (segment 5) cannot be deselected.
simultaneously.
automatically switched off for the first exposure (scout
image).
20 Planmeca ProMax 3D Mid
User’s Manual (2D)
Adjusting DEC density
CONTROL PANEL
Touch the DEC field on top of the main display to switch
Dynamic Exposure Control (DEC) on or off for the
exposure you are going to take.
Dynamic Exposure Control (DEC) automatically provides
optimal exposure values for each patient during exposure.
This function adjusts the exposure values individually for
each patient based on their anatomic structure and bone
density. Switching DEC on improves the image quality as
the function produces images of more consistent
brightness and contrast.
When DEC is switched on the exposure values will be
automatically adjusted during exposure. The kV value will
be adjusted by max ±4 kV and the mA value will be
adjusted by max +4/-3 mA within the available scale.
If the images appear to be too bright or too dark, DEC
density can be adjusted on the DEC Settings display
(i25.1).
To adjust DEC density for panoramic exposures touch
either of the Panoramic density arrow fields. DEC density
is expressed in percentage in comparison to DEC
calibration value. The setting can be adjusted between
20% (lower exposure values -> brighter image) and 200%
(higher exposure values -> darker image). The
recommended setting is 100% (default setting).
User’s Manual (2D)
Planmeca ProMax 3D Mid 21
CONTROL PANEL
X-ray units with Dimax sensor:
X-ray units with 3D sensor and SmartPan license:
5.3.4 Autofocus (AF) in panoramic programs
NOTE Autofocus is an optional feature for X-ray units with
NOTE Autofocus has to be activated on information display
NOTE The layer light is disabled when Autofocus is switched
NOTE If Autofocus is switched on (AF ON), DEC will be
Dimax sensor. It is available for standard,
interproximal and orthogonal panoramic programs.
i310 before you can start using it.
on.
automatically switched off for the first exposure (scout
image).
Touch the Autofocus field on the main display to switch
Autofocus on (AF ON) or off (AF OFF) for the exposure
you are going to take.
Autofocus adjusts the layer position automatically. The
function positions the image layer individually for each
patient based on the position and angle of the apices of
the upper central incisors.
The exposure will be taken in two stages and the C-arm
will move twice.
5.4 Selecting temporomandibular joint (TMJ) program
To select a temporomandibular joint (TMJ) program,
touch the Prog. field on the main display. The main
display is the display that is shown when the X-ray unit is
switched on.
22 Planmeca ProMax 3D Mid
User’s Manual (2D)
CONTROL PANEL
The Select program type display appears. Select program
type TMJ.
NOTE The Select program type display will show all the
exposure programs that the X-ray unit features at the
moment. The X-ray unit can be upgraded with new
exposure programs, contact your dealer for further
information.
On the next display, select the TMJ program you wish to
use. If the program is not shown on the display, you can
use the down arrow to scroll through the list.
Refer to section 4.2 “Temporomandibular joint (TMJ)
programs” on page 10 for a more detailed description of
the program types.
When you have selected the program the main display
will be shown again.
5.4.1 Selecting jaw size and adjusting imaging position & angle in TMJ programs
This function adjusts the image layer (focal through) to
accommodate patients with different jaw sizes.
NOTE The setting in the jaw field will automatically change to
correspond with the selected patient size.
Selecting the smallest patient size will automatically
change the jaw size setting to Narrow.
Selecting any of the three patient sizes in the middle will
automatically change the jaw size setting to Average.
Selecting the biggest patient size will automatically
change the jaw size setting to Wide.
User’s Manual (2D)
If necessary, you can select the jaw size manually by
touching the Jaw field or jaw icon on the main display.
The Select jaw size, adjust position and angle display
appears. The marking on the jaw icon demonstrates the
image layer. Select the required jaw size by tapping the
corresponding icon. The selected jaw icon will be
highlighted.
NOTE Selecting the jaw size manually will override the
automatic setting.
Planmeca ProMax 3D Mid 23
CONTROL PANEL
Symmetric / asymmetric
exposure
To adjust the imaging position or angle, touch the
corresponding arrows on either side of the display. The
imaging position or angle on the other jaw side will
change accordingly if the setting in the top right field is set
to Symmetric.
If the patient’s right and left side are asymmetric you will
need to set the imaging position and angle separately on
the other jaw side. To do this, touch the field for
symmetric / asymmetric setting to select the asymmetric
setting and adjust the other jaw side as required.
Confirm the selection and return to the main display by
touching OK.
NOTE You can set the X-ray unit so that the imaging position
will be automatically moved forwards for the open jaw
exposure (i27.1).
NOTE The default imaging angle (17 degrees for lat and PA)
can be changed (i27.1).
5.4.2 Selecting jaw side in double TMJ programs
This function enables you to select on which side the
exposure(s) will be taken.
On the main display, touch the Segment icon.
The Select side display appears. Touch the arrow field to
deselect the jaw side that should not be exposed. This
side will turn dark red. The jaw side which will be exposed
remains white.
Touching the arrow of a deselected side again will change
the color back to white.
Confirm the selection and return to the main display by
touching OK.
24 Planmeca ProMax 3D Mid
User’s Manual (2D)
5.5 Selecting sinus program
X-ray units with Dimax sensor:
X-ray units with 3D sensor and SmartPan license:
CONTROL PANEL
To select a sinus program, touch the Prog. field on the
main display. The main display is the display that is
shown when the X-ray unit is switched on.
The Select program type display appears. Select program
type Sinus.
NOTE The Select program type display will show all the
exposure programs that the X-ray unit features at the
moment. The X-ray unit can be upgraded with new
exposure programs, contact your dealer for further
information.
On the next display, select the sinus program you wish to
use.
Refer to section 4.3 “Sinus programs” on page 12 for a
more detailed description of the program types.
User’s Manual (2D)
When you have selected the program the main display
will be shown again.
Planmeca ProMax 3D Mid 25
PATIENT POSITIONING CONTROLS
Open / close temple supports (2D imaging)
Move target area up
Move X-ray unit up
Positioning joystick (3D imaging)
Move X-ray unit down
Move target area down
(3D imaging)
(3D imaging)
Down
Up
emergency_stop.eps
Stop plate
6 PATIENT POSITIONING CONTROLS
X-ray unit up / down
Positioning joystick
NOTE Never allow patients to press the positioning controls
NOTE Touching any of the positioning controls (button or
NOTE If for some reason either of the buttons gets stuck
NOTE Be careful that the X-ray unit does not hit the ceiling
NOTE Make sure that there is no object under the telescopic
NOTE The column movement stops automatically if the
NOTE When positioning wheelchair patients always first
when they are positioned in the X-ray unit.
joystick) will switch the patient positioning lights on.
The X-ray unit up and down buttons are used to adjust the
X-ray unit to suit the height of the patient.
The X-ray unit moves slowly at first, then faster.
during operation, you can stop the up / down
movement by pressing any of the other control
buttons or the positioning joystick. This is a safety
measure that guarantees that the up / down movement
can be stopped in an emergency.
when you press the up button. The maximum height
can be adjusted to suit offices with low ceiling, contact
your service technician for help.
column when you press the down button. If something
is in danger of becoming trapped, release the button
immediately to stop the movement.
emergency stop plate at the bottom is pressed
upwards. Clear any obstruction before moving the
column again.
move the X-ray unit down before you position the
patient in the unit.
The positioning joystick is used for horizontal fineadjustment of the target area in 3D imaging. It is used
when the patient is positioned in the X-ray unit.
26 Planmeca ProMax 3D Mid
User’s Manual (2D)
Target area up / down
Down
Up
Open / close temple supports
PATIENT POSITIONING CONTROLS
The target area up and down buttons are used for vertical
fine-adjustment of the target area in 3D imaging. The
buttons are used when the patient is positioned in the Xray unit.
The X-ray unit moves slowly when you press the up /
down button. The height of the patient support table is not
changed, i.e. the patient remains in the same position.
Press the temple support button to open the temple
supports in 2D imaging. The temple supports can be
closed by pressing the temple support button again.
User’s Manual (2D)
Planmeca ProMax 3D Mid 27
PREPARATIONS FOR EXPOSURE
7 PREPARATIONS FOR EXPOSURE
NOTE The available sensors are shown in section 2.1
“Sensors” on page 2.
NOTE If a movable Dimax sensor is attached to the
NOTE If the X-ray unit has a SmartPan license and a Dimax
cephalostat (optional), the sensor must be moved to
the C-arm if you wish to use it for taking panoramic
exposures.
sensor, you can
- use a 3D sensor to take 3D and SmartPan (SmartPan,
SmartTMJ, SmartSinus) exposures OR
- use a 3D sensor to take 3D exposures and a Dimax
sensor to take panoramic exposures. This option has
to be selected on information display i230
(Behavioural preferences -> Use Dimax sensor for
panoramic).
28 Planmeca ProMax 3D Mid
User’s Manual (2D)
7.1 Attaching and removing sensor
Glass windows
ProFace sensor
Shock
indicator
Dimax
sensor
Sensor
Locking knob
NOTE FOR PROFACE SENSOR:
Do not touch the glass windows when you hold the
sensor. Fingerprints or other stains on the glass
surface destroy image quality.
CAUTION Do not drop the sensor. Planmeca limited
warranty does not cover damage which is
due to misuse, e.g. dropping the sensor,
neglect, or any cause other than ordinary
use.
Do not use the sensor if the shock indicator
is red - contact your service technician for
help.
If you have any reason to believe that the
sensor might be faulty, take a test exposure
before taking a patient exposure.
PREPARATIONS FOR EXPOSURE
Attaching sensor to C-arm
Push the sensor onto the connector on the C-arm.
Turn the locking knob over the fastening mechanism. This
will secure the sensor in position.
User’s Manual (2D)
Planmeca ProMax 3D Mid 29
PREPARATIONS FOR EXPOSURE
Mid_84.eps
C-arm electrical
connector button
C-arm
electrical
connector
Sensor
Locking
knob
Detaching sensor from C-arm
Push in the C-arm electrical connector button on the other
side. This will make the electrical connection between the
sensor and C-arm.
NOTE Do not remove the sensor during imaging process.
Push in the C-arm electrical connector. This will
disconnect the electrical connection between the sensor
and C-arm.
The locking knob can now be turned 180 degrees. This
will release the locking mechanism.
Carefully pull the sensor out.
30 Planmeca ProMax 3D Mid
User’s Manual (2D)
7.2 Preparing patient
PREPARATIONS FOR EXPOSURE
Ask the patient to remove any spectacles, hearing aids,
dentures, hairpins, and personal jewellery such as
earrings, necklaces and piercings as these can produce
shadows or reflections in the image. The patient should
also remove any loose items of clothing (e.g. scarf, tie)
that might get caught in the arms of the X-ray unit.
NOTE High contrast objects, such as gold teeth or amalgam,
may cause artefacts in the image.
Place a protective lead apron over the patient’s back if
required.
User’s Manual (2D)
Planmeca ProMax 3D Mid 31
PANORAMIC EXPOSURE
Bite2.eps
Bite1.eps
Adapter
Chin rest
Bite piece
Chin2.eps
Chin1.eps
Chin cup
Chin
support
Lip1.eps
8 PANORAMIC EXPOSURE
Insert the chin rest and a bite piece into the adapter.
Insert the adapter into the holes in the patient support
table.
For edentulous patients or for patients who are unable to
use the bite piece you can use the chin cup or the chin
support.
NOTE We recommend that you use the chin support when
taking bitewing exposures.
Select the panoramic program you wish to use (see
section 5.3 “Selecting panoramic program” on page 18).
Select the patient size (see section 5.2.1 “Selecting
patient size” on page 15).
The exposure values will automatically change to
correspond with the selected exposure program and
patient size. The preset exposure values are shown in the
following table. The preset exposure values are average
values and they are only meant to guide the user. If
necessary, you can change the preset values as
described in section 5.2.2 “Selecting kilovolt and
milliampere values” on page 15.
NOTE FOR X-RAY UNITS WITH DIMAX SENSOR:
The preset exposure values are optimized for taking
exposures at enhanced resolution (Romexis setting).
You can use lower exposure values when taking
exposures at normal resolution.
NOTE Always try to minimize the radiation dose to the
patient.
32 Planmeca ProMax 3D Mid
The setting in the jaw field will automatically change to
correspond with the selected patient size. You can select
the jaw shape and size manually as described in section
5.3.1 “Selecting jaw shape & size in panoramic programs”
on page 19.
You can take a segment exposure by selecting only
certain vertical or horizontal segments of the jaw, refer to
section 5.3.2 “Selecting segmentation in panoramic
programs” on page 20.
User’s Manual (2D)
PANORAMIC EXPOSURE
Temple
support
button
Height adjusting
buttons
If you are taking a combined exposure (Standard + TMJ),
select the jaw size and image position parameters (target
position, imaging angle, symmetric / asymmetric setting)
as described in section 5.4.1 “Selecting jaw size and
adjusting imaging position & angle in TMJ programs” on
page 23.
Panoramic exposure values
PATIENT kV VALUE mA VALUE
Child 62 5
Adolescent 64 6
Small adult 66 8
Average-sized adult 68 10
Large adult 70 13
8.1 Patient positioning
Move the C-arm to the patient entry position if it is not
already there. Refer to section 5.2.5 “Selecting patient
entry position” on page 17 for differences between the two
positions.
Prepare the patient for the exposure as described in
section 7.2 “Preparing patient” on page 31.
Press the temple support button to open the temple
supports if they are not already open.
Guide the patient to the unit so that they are facing the
chin rest.
To adjust the height of the unit, press either of the height
adjusting buttons until the chin rest is on the level of the
patient’s chin.
User’s Manual (2D)
The X-ray unit moves slowly at first, then faster.
Planmeca ProMax 3D Mid 33
PANORAMIC EXPOSURE
Bite piece
Patient position with
chin support
3DMid_lights1.eps
Frankfort
Midsagittal
plane light
Layer light
plane light
Ask the patient to step forward, grasp the patient handles,
stretch and straighten their back and neck, and bite the
bite piece. The incisal edges of the maxillary and
mandibular teeth must be in the groove in the bite piece.
NOTE If you are using the chin support, position the patient
so that the chin, just below the lower lip, touches the
top bar.
NOTE If you are using the chin cup or chin support, use for
example a cotton roll to ensure that the patient’s upper
and lower incisors do not overlap.
The following positioning lights will come on:
34 Planmeca ProMax 3D Mid
User’s Manual (2D)
PANORAMIC EXPOSURE
patposlights3.eps
Thumb wheel
Patient support table
Positioning
controls
Midsagittal
plane light
Frankfort plane light
Note that the positioning lights will automatically switch off
after two minutes. If the lights go out before you have
positioned the patient, switch them on by touching the
thumb wheel on the underside of the patient support table
or by pressing any of the positioning controls (button or
joystick).
Position the patient’s head so that the midsagittal plane
coincides with the midsagittal plane light beam.
Position the patient’s head so that the Frankfort plane
coincides with the Frankfort plane light beam. Adjust the
tilt of the patient’s head by raising or lowering the unit with
the height adjusting buttons. The patient’s back and neck
should be straight.
The Frankfort plane is a plane which joins the infra-orbital
point to the superior border of the external auditory
meatus.
User’s Manual (2D)
Planmeca ProMax 3D Mid 35
PANORAMIC EXPOSURE
Frankfort
plane
light
Thumb
wheel
Canine
Apices of upper
central incisors
Layer light
Second
incisor
Layer light
Thumb
wheel
The Frankfort plane light, which is located on the side of
the column, can be moved up or down. This is done by
rotating the thumb wheel below the light slot.
Position the apices of the patient’s upper central incisors
within the image layer of the unit.
To do this, rotate the thumb wheel located on the
underside of the patient support table to move the layer
light until it falls between the second incisor and the
canine. For an average patient, this procedure will place
the apices of the upper central incisors within the image
layer.
patposlights3.eps
NOTE The layer light is disabled when Autofocus is switched
on (AF ON).
36 Planmeca ProMax 3D Mid
Check that the Frankfort plane light and the midsagittal
plane light are still correctly positioned. Reposition them if
necessary.
User’s Manual (2D)
Panoramic program Standard + TMJ
Imaging position: Ruler measurement
Layer light
Imaging angle: Submento-vertex exposure
If you are taking a combined exposure, the TMJ imaging
position and angle must be checked when the patient is
positioned in the X-ray unit:
Touch the Jaw field on the main display, or alternatively,
tap the jaw icon on the right side of the display. The Select
jaw size, adjust position and angle display will appear.
Imaging position:
between the layer light and the patient’s temporomandibular joint to determine the exact imaging position.
Adjust the imaging position with the left / right arrows
according to your measurement.
Imaging angle:
projection) to determine the exact imaging angle. Adjust
the imaging angle with the left / right arrows according to
your measurement.
PANORAMIC EXPOSURE
Use a ruler to measure the distance
Take a submento-vertex exposure (axial
User’s Manual (2D)
NOTE The ruler measurement depends on the position of the
layer light. On retakes always use a ruler to measure
the position. Do not rely on numeric position values.
Planmeca ProMax 3D Mid 37
PANORAMIC EXPOSURE
Exp_sw_wall6_2.eps
Green ready
indicator light
Amber exposure
indicator light
8.2 Taking an exposure
NOTE Make sure that you have selected the right patient and
the panoramic exposure mode in the Planmeca
Romexis program before you take an exposure. Refer
to the Romexis User’s Manual.
When you are ready to take an exposure touch the Ready
field on the main display. The X-ray unit will move to the
ready position and the temple supports will automatically
close.
On the exposure button and on the control panel a green
indicator light will come on. Additionally, the word READY
will be shown on the control panel display. The Romexis
program will show the Waiting for Ready message on the
computer screen.
The green indicator lights and the word READY will flash
while the unit moves to the ready position. They will stop
flashing when the unit has reached the ready position.
The Romexis program will now show the Waiting for
Exposure message on the computer screen.
Ask the patient to close their lips on the bite piece,
swallow, place their tongue flat against the roof of the
mouth, breathe normally, and stand as still as possible.
Move to a protected area.
NOTE Maintain audio and visual contact with the patient and
unit during exposure. If the C-arm stops moving
during exposure, or moves in an erratic way, release
the exposure button immediately.
Standard, interproximal, orthogonal and bitewing panoramic programs
Press and hold down the exposure button for the duration
of the exposure. The C-arm will move once around the
patient’s head. The radiation warning lights on the
exposure switch and on the control panel will come on
and you will hear a radiation warning tone. When the Carm has completed the exposure cycle the temple
supports will automatically open. You can now guide the
patient from the unit.
38 Planmeca ProMax 3D Mid
When you have taken the exposure the image will be
shown on the computer screen. Note that you must
accept the image in the Planmeca Romexis program only accepted images will be stored in the database.
Refer to the Romexis User’s Manual.
User’s Manual (2D)
Panoramic program Standard + TMJ
Amber exposure
indicator light
Exposure 1
(scout image)
The exposure will be taken in two stages and the C-arm
will move twice. The teeth area is imaged during the first
exposure and the temporomandibular joints (TMJs) during
the second exposure. The C-arm is automatically moved
upwards between the exposures. You will hear a warning
tone when the C-arm moves up.
Press and hold down the exposure button for the duration
of both exposures.
NOTE Do not release the exposure button before the end of
the second exposure.
During the exposures the radiation warning light on the
exposure switch and on the display will come on and you
will hear a radiation warning tone.
When the C-arm has completed the second exposure
cycle the temple supports will automatically open. You
can now guide the patient from the unit.
PANORAMIC EXPOSURE
When you have taken the exposure the image will be
shown on the computer screen. Note that you must
accept the image in the Planmeca Romexis program only accepted images will be stored in the database.
Refer to the Romexis User’s Manual.
Standard, interproximal and orthogonal panoramic programs using
Autofocus (X-ray units with Dimax sensor)
Autofocus adjusts the layer position automatically. The
function positions the image layer individually for each
patient based on the position and angle of the apices of
the upper central incisors.
The exposure will be taken in two stages and the C-arm
will move twice.
Press and hold down the exposure button for the duration
of the first exposure. The first exposure is a short, lowdose exposure during which the optimal position for the
image layer will be calculated.
The radiation warning lights on the exposure switch and
on the control panel will come on and you will hear a
radiation warning tone.
User’s Manual (2D)
Planmeca ProMax 3D Mid 39
PANORAMIC EXPOSURE
Move layer position
Distance from center
Back to main display
Calculated
position =
white line
Position
selected
by user =
red line
Exposure 2
(final image)
The following display will appear on the control panel and
computer screen.
The calculated layer position will be shown with a white
line on the image.
If necessary, you can adjust the layer position by touching
the plus/minus (+/-) fields on the control panel display.
Touching the plus field will move the layer forwards and
touching the minus field will move the layer backwards.
The new position will be shown with a red line on the
control panel display. The movement range is from +15
mm to -15 mm. The distance from the center point will be
shown at the bottom of the display (e.g. 2 mm).
NOTE Make sure the patient does not move between
exposures.
Press and hold down the exposure button again to take
the second exposure. The second exposure will produce
the actual image and the C-arm will now move through
one complete exposure cycle.
NOTE Alternatively, you can touch the OK field on the Auto
focus layer definition display and then press the
exposure button.
The radiation warning lights on the exposure switch and
on the control panel will come on and you will hear a
radiation warning tone.
When you have taken the exposure the image will be
shown on the computer screen. Note that you must
accept the image in the Planmeca Romexis program only accepted images will be stored in the database.
Refer to the Romexis User’s Manual.
NOTE If the imaging process is cancelled from the Romexis
program, Autofocus has to be switched off (AF OFF)
and back on (AF ON) again before the next Autofocus
exposure can be taken.
40 Planmeca ProMax 3D Mid
User’s Manual (2D)
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Bite1.eps
Lip1.eps
Chin support
Adapter
9 TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
9.1 Double TMJ exposure (lateral, PA or lateral-PA)
This exposure will produce closed and open views of the
left and right temporomandibular joints.
9.1.1 First exposure - jaw closed
NOTE You can set the X-ray unit so that the imaging position
will be automatically moved forwards for the open jaw
exposure (information display i27.1).
Insert the chin support into the adapter. Insert the adapter
into the holes in the patient support table.
Select the double TMJ program you wish to use (see
section 5.4 “Selecting temporomandibular joint (TMJ)
program” on page 22).
Select the patient size (see section 5.2.1 “Selecting
patient size” on page 15).
Select the image position parameters (target position,
imaging angle, symmetric / asymmetric setting, left / right
side exposure) as described in sections 5.4.1 “Selecting
jaw size and adjusting imaging position & angle in TMJ
programs” on page 23 and 5.4.2 “Selecting jaw side in
double TMJ programs” on page 24.
User’s Manual (2D)
The exposure values will automatically change to
correspond with the selected exposure program and
patient size. The preset exposure values are shown in the
following tables. The preset exposure values are average
values and they are only meant to guide the user. If
necessary, you can change the preset values as
described in section 5.2.2 “Selecting kilovolt and
milliampere values” on page 15.
NOTE Always try to minimize the radiation dose to the
patient.
Planmeca ProMax 3D Mid 41
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Temple
support
button
Height adjusting
buttons
Exposure values for TMJ program “Double lateral”
PATIENT kV VALUE mA VALUE
Child 64 7
Adolescent 66 8
Small adult 68 9
Average-sized adult 70 10
Large adult 72 11
Exposure values for TMJ programs “Double PA” and “Double lat-PA”
PATIENT kV VALUE mA VALUE
Child 66 7
Adolescent 68 8
Small adult 70 9
Average-sized adult 72 10
Large adult 74 11
9.1.2 Patient positioning
Move the C-arm to the patient entry position if it is not
already there. Refer to section 5.2.5 “Selecting patient
entry position” on page 17 for differences between the two
positions.
Prepare the patient for the exposure as described in
section 7.2 “Preparing patient” on page 31.
Press the temple support button to open the temple
supports if they are not already open.
Guide the patient to the unit so that they are facing the
chin support. Explain to the patient that you will take a
double exposure and that the unit will rotate twice.
42 Planmeca ProMax 3D Mid
To adjust the height of the unit, press either of the height
adjusting buttons until the opening in the chin support is
approximately level with the patient’s mouth.
The X-ray unit moves slowly at first, then faster.
User’s Manual (2D)
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
patposlights3.eps
Thumb wheel
Patient support table
Positioning
controls
Midsagittal
plane light
Ask the patient to step forward, grasp the patient handles,
stretch and straighten their back and neck, and press their
lips against the chin support. The patient's nose must rest
on top of the support and their mouth must be closed, and
their teeth must be together.
The positioning lights for the midsagittal plane, Frankfort
plane and layer position will come on. Note that they will
automatically switch off after two minutes. If the lights go
out before you have positioned the patient, switch them
on by touching the thumb wheel on the underside of the
patient support table or by pressing any of the positioning
controls (button or joystick).
User’s Manual (2D)
Position the patient’s head so that the midsagittal plane
coincides with the midsagittal plane light beam.
Planmeca ProMax 3D Mid 43
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Frankfort plane
5°
Frankfort plane light
Frankfort
plane
light
Thumb
wheel
Position the patient’s head so that the Frankfort plane is
tilted down five degrees. To do this support the back of
the patient’s head with your hand and, using the Frankfort
plane light as a reference line, adjust the position of the
patient’s head by raising or lowering the unit with the
height adjusting buttons. Make sure the patient’s back
and neck are straight.
The Frankfort plane light, which is located on the side of
the column, can be moved up or down. This is done by
rotating the thumb wheel below the light slot.
The imaging position and angle must be checked when
the patient is positioned in the X-ray unit:
Touch the Jaw field on the main display, or alternatively,
tap the jaw icon on the right side of the display. The Select
jaw size, adjust position and angle display will appear.
Imaging position:
between the layer light and the patient’s temporomandibular joint to determine the exact imaging position.
Adjust the imaging position with the left / right arrows
according to your measurement.
Imaging angle:
projection) to determine the exact imaging angle. Adjust
the imaging angle with the left / right arrows according to
your measurement.
Use a ruler to measure the distance
Take a submento-vertex exposure (axial
44 Planmeca ProMax 3D Mid
User’s Manual (2D)
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Imaging position: Ruler measurement
Imaging angle: Submento-vertex exposure
Layer light
Green ready
indicator light
NOTE The ruler measurement depends on the position of the
layer light. On retakes always use a ruler to measure
the position. Do not rely on numeric position values.
NOTE Make sure that you have selected the right patient and
the panoramic exposure mode in the Planmeca
Romexis program before you take an exposure. Refer
to the Romexis User’s Manual.
When you are ready to take an exposure touch the Ready
field on the main display. The X-ray unit will move to the
ready position and the temple supports will automatically
close.
On the exposure button and on the control panel a green
indicator light will come on. Additionally, the word READY
will be shown on the control panel display. The Romexis
program will show the Waiting for Ready message on the
computer screen.
User’s Manual (2D)
Planmeca ProMax 3D Mid 45
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Amber exposure
indicator light
Green ready
indicator light
The green indicator lights and the word READY will flash
while the unit moves to the ready position. They will stop
flashing when the unit has reached the ready position.
The Romexis program will now show the Waiting for
Exposure message on the computer screen.
Ask the patient to stand as still as possible.
Move to a protected area.
Press and hold down the exposure button for the duration
of the exposure. The C-arm will move through one
complete exposure cycle and then automatically return to
the ready position. The temple supports will remain closed
and hold the patient in position for the second exposure.
During the exposure cycle the radiation warning lights on
the exposure switch and on the control panel will come on
and you will hear a radiation warning tone.
NOTE Maintain audio and visual contact with the patient and
unit during exposure. If the C-arm stops moving
during exposure, or moves in an erratic way, release
the exposure button immediately.
9.1.3 Second exposure - jaw open
Ask the patient to open their mouth as wide as possible.
Make sure that the patient’s upper lip is still touching the
chin support.
When you are ready to take the second exposure touch
the Ready field on the main display.
On the exposure button and on the control panel a green
indicator light will come on. Additionally, the word READY
will be shown on the control panel display. The Romexis
program will show the Waiting for Exposure message on
the computer screen.
Ask the patient to stand as still as possible.
46 Planmeca ProMax 3D Mid
Move to a protected area.
User’s Manual (2D)
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Amber exposure
indicator light
1/2
1/2
2/2
2/2
Press and hold down the exposure button for the duration
of the second exposure. During the exposure cycle the
radiation warning lights on the exposure switch and on the
control panel will come on and you will hear a radiation
warning tone. When the C-arm has completed the second
exposure cycle the temple supports will automatically
open. You can now guide the patient from the unit.
NOTE Maintain audio and visual contact with the patient and
unit during exposure. If the C-arm stops moving
during exposure, or moves in an erratic way, release
the exposure button immediately.
When you have taken the exposure the image will be
shown on the computer screen. Note that you must
accept the image in the Planmeca Romexis program only accepted images will be stored in the database.
Refer to the Romexis User’s Manual.
User’s Manual (2D)
Planmeca ProMax 3D Mid 47
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Bite1.eps
Lip1.eps
Chin support
Adapter
9.2 Multi-angle TMJ exposure (PA or lateral)
This exposure will produce three exposures with different
angles from the left or right temporomandibular joint.
Note that the C-arm will move through three exposure
cycles.
Insert the chin support into the adapter. Insert the adapter
into the holes in the patient support table.
Select the multi-angle TMJ program you wish to use (see
section 5.4 “Selecting temporomandibular joint (TMJ)
program” on page 22).
Select the patient size (see section 5.2.1 “Selecting
patient size” on page 15).
Select the image position parameters (target position and
imaging angle) as described in section 5.4.1 “Selecting
jaw size and adjusting imaging position & angle in TMJ
programs” on page 23.
The exposure values will automatically change to
correspond with the selected exposure program and
patient size. The preset exposure values are shown in the
following tables. The preset exposure values are average
values and they are only meant to guide the user. If
necessary, you can change the preset values as
described in section 5.2.2 “Selecting kilovolt and
milliampere values” on page 15.
NOTE Always try to minimize the radiation dose to the
patient.
Exposure values for multi-angle lateral TMJ programs
PATIENT kV VALUE mA VALUE
Child 64 7
Adolescent 66 8
Small adult 68 9
Average-sized adult 70 10
Large adult 72 11
Exposure values for multi-angle PA TMJ programs
PATIENT kV VALUE mA VALUE
Child 66 7
Adolescent 68 8
Small adult 70 9
Average-sized adult 72 10
Large adult 74 11
48 Planmeca ProMax 3D Mid
User’s Manual (2D)
9.2.1 Patient positioning
Temple
support
button
Height adjusting
buttons
patposlights3.eps
Thumb wheel
Patient support table
Positioning
controls
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Move the C-arm to the patient entry position if it is not
already there. Refer to section 5.2.5 “Selecting patient
entry position” on page 17 for differences between the two
positions.
Prepare the patient for the exposure as described in
section 7.2 “Preparing patient” on page 31.
Press the temple support button to open the temple
supports if they are not already open.
Guide the patient to the unit so that they are facing the
chin support. Explain to the patient that you will take a
multi-angle exposure and that the C-arm will move
through three exposure cycles.
To adjust the height of the unit, press either of the height
adjusting buttons until the opening in the chin support is
approximately level with the patient’s mouth.
The X-ray unit moves slowly at first, then faster.
Ask the patient to step forward, grasp the patient handles,
stretch and straighten their back and neck, and press their
lips against the chin support. The patient's nose must rest
on top of the support and their mouth must be closed, and
their teeth must be together.
The positioning lights for the midsagittal plane, Frankfort
plane and layer position will come on. Note that they will
automatically switch off after two minutes. If the lights go
out before you have positioned the patient, switch them
on by touching the thumb wheel on the underside of the
patient support table or by pressing any of the positioning
controls (button or joystick).
User’s Manual (2D)
Planmeca ProMax 3D Mid 49
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Midsagittal
plane light
Frankfort plane
5°
Frankfort plane light
Frankfort
plane
light
Thumb
wheel
Position the patient’s head so that the midsagittal plane
coincides with the midsagittal plane light beam.
Position the patient’s head so that the Frankfort plane is
tilted down five degrees. To do this support the back of
the patient’s head with your hand and, using the Frankfort
plane light as a reference line, adjust the position of the
patient’s head by raising or lowering the unit with the
height adjusting buttons. Make sure the patient’s back is
straight.
50 Planmeca ProMax 3D Mid
The Frankfort plane light, which is located on the side of
the column, can be moved up or down. This is done by
rotating the thumb wheel that is below the light slot.
The imaging position and angle must be checked when
the patient is positioned in the X-ray unit:
Touch the Jaw field on the main display, or alternatively,
tap the jaw icon on the right side of the display. The Select
jaw shape and size display will appear.
Imaging position:
between the layer light and the patient’s temporomandibular joint to determine the exact imaging position.
Adjust the imaging position with the left / right arrows
according to your measurement.
Use a ruler to measure the distance
User’s Manual (2D)
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Imaging position: Ruler measurement
Imaging angle: Submento-vertex exposure
Layer light
Imaging angle: Take a submento-vertex exposure (axial
projection) to determine the exact imaging angle. Adjust
the imaging angle with the left / right arrows according to
your measurement.
9.2.2 Taking an exposure
User’s Manual (2D)
NOTE The ruler measurement depends on the position of the
layer light. On retakes always use a ruler to measure
the position. Do not rely on numeric position values.
NOTE Make sure that you have selected the right patient and
the panoramic exposure mode in the Planmeca
Romexis program before you take an exposure. Refer
to the Romexis User’s Manual.
When you are ready to take an exposure touch the Ready
field on the main display. The X-ray unit will move to the
ready position and the temple supports will automatically
close.
Planmeca ProMax 3D Mid 51
TEMPOROMANDIBULAR JOINT (TMJ) EXPOSURE
Green ready
indicator light
Amber exposure
indicator light
1/32/3
3/3
On the exposure button and control panel a green
indicator light will come on. Additionally, the word READY
will be shown on the control panel display. The Romexis
program will show the Waiting for Ready message on the
computer screen.
The green indicator lights and the word READY will flash
while the unit moves to the ready position. They will stop
flashing when the unit has reached the ready position.
The Romexis program will now show the Waiting for
Exposure message on the computer screen.
Ask the patient to stand as still as possible.
Move to a protected area.
Press and hold down the exposure button for the duration
of the exposure. The C-arm will move through three
exposure cycles. The radiation warning lights on the
exposure switch and on the control panel will come on
and you will hear a radiation warning tone.
When the C-arm has completed the third exposure cycle
the temple supports will automatically open. You can now
guide the patient from the unit.
NOTE Maintain audio and visual contact with the patient and
unit during exposure. If the C-arm stops moving
during exposure, or moves in an erratic way, release
the exposure button immediately.
When you have taken the exposure the image will be
shown on the computer screen. Note that you must
accept the image in the Planmeca Romexis program only accepted images will be stored in the database.
Refer to the Romexis User’s Manual.
52 Planmeca ProMax 3D Mid
User’s Manual (2D)
10 SINUS EXPOSURE
Bite1.eps
Lip1.eps
Chin support
Adapter
Exposure values for sinus program “PA rotational”
SINUS EXPOSURE
This procedure will produce an exposure of the maxillary
sinus along the selected plane.
Insert the chin support into the adapter. Insert the adapter
into the holes in the patient support table.
Select the sinus program you wish to use (see section 5.5
“Selecting sinus program” on page 25). Select the patient
size (see section 5.2.1 “Selecting patient size” on page
15).
The exposure values will automatically change to
correspond with the selected exposure program and
patient size. The preset exposure values are shown in the
following tables. The preset exposure values are average
values and they are only meant to guide the user. If
necessary, you can change the preset values as
described in section 5.2.2 “Selecting kilovolt and
milliampere values” on page 15.
PATIENT kV VALUE mA VALUE
Child 74 8
Adolescent 76 9
Small adult 78 10
Average-sized adult 80 11
Large adult 82 12
Exposure values for sinus program “PA non-rotational”
PATIENT kV VALUE mA VALUE
Child 74 7
Adolescent 76 8
Small adult 78 9
Average-sized adult 80 10
Large adult 82 11
Exposure values for sinus programs
“Lateral non-rotational” and “Midsagittal non-rotational”
Child 62 6
Adolescent 64 6
Small adult 66 6
Average-sized adult 68 7
Large adult 70 7
User’s Manual (2D)
PATIENT kV VALUE mA VALUE
Planmeca ProMax 3D Mid 53
SINUS EXPOSURE
Temple
support
button
Height adjusting
buttons
Thumb wheel
Patient support table
Positioning
controls
10.1 Patient positioning
NOTE Always try to minimize the radiation dose to the
patient.
Move the C-arm to the patient entry position if it is not
already there. Refer to section 5.2.5 “Selecting patient
entry position” on page 17 for differences between the two
positions.
Prepare the patient for the exposure as described in
section 7.2 “Preparing patient” on page 31.
Press the temple support button to open the temple
supports if they are not already open.
Guide the patient towards the unit so that they are facing
the chin support.
To adjust the height of the unit, press either of the height
adjusting buttons until the opening in the chin support is
approximately level with the patient’s mouth.
patposlights3.eps
The X-ray unit moves slowly at first, then faster.
Ask the patient to step forward, grasp the patient handles,
stretch and straighten their back and neck, and press their
lips against the chin support. The patient's nose must rest
on top of the support and their mouth must be closed.
The positioning lights for the midsagittal plane, Frankfort
plane and layer position will come on. Note that they will
automatically switch off after two minutes. If the lights go
out before you have positioned the patient, switch them
on by touching the thumb wheel on the underside of the
patient support table or by pressing any of the positioning
controls (button or joystick).
54 Planmeca ProMax 3D Mid
User’s Manual (2D)
SINUS EXPOSURE
Midsagittal
plane light
Frankfort plane light
Frankfort
30°
plane
Frankfort
plane
light
Thumb
wheel
Position the patient’s head so that the midsagittal plane
coincides with the midsagittal light beam.
Position the patient’s head so that the Frankfort plane is
tilted up between 0 and 30 degrees depending on the
build of the patient. To do this support the back of the
patient’s head with your hand and, using the Frankfort
plane light as a reference line, adjust the tilt of the
patient’s head by raising or lowering the unit with the
height adjusting buttons. The patient’s back and neck
should be straight.
User’s Manual (2D)
The Frankfort plane light, which is located on the side of
the column, can be moved up or down. This is done by
rotating the thumb wheel below the light slot.
NOTE Make sure that you have selected the right patient and
the panoramic exposure mode in the Planmeca
Romexis program before you take an exposure. Refer
to the Romexis User’s Manual.
Planmeca ProMax 3D Mid 55
SINUS EXPOSURE
Green ready
indicator light
Amber exposure
indicator light
10.2 Taking an exposure
When you are ready to take an exposure touch the Ready
field on the main display. The X-ray unit will move to the
ready position and the temple supports will automatically
close.
On the exposure button and on the control panel a green
indicator light will come on. Additionally, the word READY
will be shown on the control panel display. The Romexis
program will show the Waiting for Ready message on the
computer screen.
The green indicator lights and the word READY will flash
while the unit moves to the ready position. They will stop
flashing when the unit has reached the ready position.
The Romexis program will now show the Waiting for
Exposure message on the computer screen.
Ask the patient to swallow and stand as still as possible.
Move to a protected area.
Press and hold down the exposure button for the duration
of the exposure. The C-arm will move through one
complete exposure cycle. During the exposure cycle the
radiation warning lights on the exposure switch and on the
control panel will come on and you will hear a radiation
warning tone. When the C-arm has completed the
exposure cycle the temple supports will automatically
open. You can now guide the patient from the unit.
NOTE Maintain audio and visual contact with the patient and
unit during exposure. If the C-arm stops moving
during exposure, or moves in an erratic way, release
the exposure button immediately.
When you have taken the exposure the image will be
shown on the computer screen. Note that you must
accept the image in the Planmeca Romexis program only accepted images will be stored in the database.
Refer to the Romexis User’s Manual.
56 Planmeca ProMax 3D Mid
User’s Manual (2D)
Planmeca Oy | Asentajankatu 6 | 00880 Helsinki | Finland
tel. +358 20 7795 500 | fax +358 20 7795 555 | sales@planmeca.com | www.planmeca.com
Loading...