Mastering Basic Skills Eases Conversion to Rectangular Collimation Switching to Rectangular Collimation: First Know the Basics

During my dental training, I was taught intraoral radiography using only rectangular collimation. Once out of the dental school in 1993, I realized that not many practices used rectangular collimators. Often-heard reasons for not using a rectangular collimator are cone-cutting errors and the fact that it is easier to aim with a circular collimator. Later, during my training as a dental and maxillofacial radiologist at King’s College London in the United Kingdom, I was also using rectangular collimators for intraoral imaging. In every one of my lectures and classes, I have talked about the use of collimators in dental radiology, but I realize that not many practitioners are fond of them. However, we should be using rectangular collimators in dental radiography because they make a big difference for the patient and the quality of images. Switching Over: In the spring of 2013, one of the quality improvement initiatives in Dr Jonathon Lee's office was the adoption of long cone rectangular collimation for bitewing and traditional periapical x-rays. The process of switching to rectangular collimators went smoothly because of a quality improvement initiative undertaken in 2008 when the office went "hard sensor digital." The office uses the Carestream Dental (formerly KodakTM Health) digital intraoral sensors, which have a true pedo size 0 sensor and sizes 1 and 2 sensors. Before going digital in 2008, Dr Lee reintroduced a "Radiology Back-to-Basics" workshop for the staff for a couple months in 2007. They used the Rinn® XCP kit holders to relearn proper technique with film. There was a no-bending film policy in place. This allowed the staff to master the technique before going digital. Eventually, staff members were able to visualize proper placement of the sensor and tube placement so that they needed only the Rinn XCP sensor holder and no longer needed the ring and the rod. From this experience, Dr Lee learned that his staff and patients had an easier time when digital sensors were used rather than film when taking x-rays. Patient comfort was his office's major concern. To patients, the sensors were like sucking on a xylitol lollipop because these sensors have rounded corners: there are no longer the sharp pokes that were common with film. In addition, compared to regular x-ray film, the images consistently were of higher quality, and fewer retakes were required with digital imaging. After mastering the basics, switching to the rectangular collimation was simple. (Reviewer-).