panoura 18s - imageworks · 2015-04-13 · panoura 18s operation manual 1 introduction welcome to...

This “Operation Manual” describes information on how to operate “PANOURA 18S”, a digital panorama tomographic X-ray diagnostic apparatus for dental use, and precaustions for use.• To avoid any unexpected accident, failure, or

damage to the system, read this “Operation Manual” prior to system installation.

• Be sure to keep this manual after having read through it.

PANOURA 18S

Operation Manual

1PANOURA 18S Operation Manual

Introduction

Welcome to PANOURA 18S.This product, classified as a medical equipment, is provided only after stringent quality control and product inspection have been carried out on it. Should any failure or malfunction occurs, please feel free to contact your dealer.• A symbol used in this manual alerts the user to possible dangers to the human body

or possible damage to the equipment. To avoid these unexpected accidents, read carefully and adhere to the instructions following the symbol.

• Be sure to read through the manual prior to use to take full advantage of the equipment and use it effectively for many years to come. To avoid any unexpected accident, failure, or damage, once you have read the manual, keep it in a prominent place near the equip-ment.

• If you have any question or opinion about the manual, feel free to contact your dealer . Should any nonconsecutive numbering or page missing is found, the defective manual will be replaced with a new one.

• Reproduction or reprint of part or all of the manual without prior written permission is strictly prohibited.

• Modifications may be made to the manual at any time without prior notice

DisclaimerWe will not be liable for any failure, damage, and condition occurring in PANOURA 18S at-tributable to:• Installation, relocation, maintenance, and/or repair by us any other subcontractor than

those we nominated.• Any other product than those we delivered.• Maintenance and/or repair using any other repair parts than those we designated.• Negligence of precautions/instructions and the correct operating procedure described in

the manual.• Ambient environment departing from the operating conditions (power supply, installation

environment, etc.) for the equipment defined in the manual.• Natural disasters such as fire, earthquake, flood, and lighting.

2 PANOURA 18S Operation Manual

Table of contents

Introduction ............................................................................................................................... 1Safety precautions in using PANOURA 18S ............................................................................ 7Precautions for Use .................................................................................................................. 8Responsibilities for equipment management attributable to the user ..................................... 11Required Maintenance and Inspection ................................................................................... 11Durable period ........................................................................................................................ 11Repair functional part supply period ....................................................................................... 11Actions to be taken in case of an accident ............................................................................. 11Signage used in the manual ................................................................................................... 12EMC compatibility symbol ...................................................................................................... 12Precautions for Storage Location and Operating Environment of X-ray Equipment .............. 13Precautions for Installation and Relocation ............................................................................ 14

1 Before Using this Product 171.1 Intended Use ................................................................................................................. 171.2 Main label sealing ......................................................................................................... 171.3 Names and functions of units and their parts ................................................................ 21

1.3.1 Main body .....................................................................................................................211.3.2 Names and functions of control panel switches and indicators (1) ..............................231.3.3 Names and functions of control panel switches and indicators (2) ..............................251.3.4 Names and functions of hand-switch box indicators and switches ..............................261.3.5 Head support unit .........................................................................................................271.3.6 Positioning beams ........................................................................................................281.3.7 Sensor unit (detachable) ..............................................................................................291.3.8 Cephalo unit (*) ............................................................................................................301.3.9 Laser beam allocation ..................................................................................................31

1.4 Materials of applied parts .............................................................................................. 321.5 Principle of Operation .................................................................................................... 33

1.5.1 X-ray generating mechanism .......................................................................................331.5.2 Operating principle ......................................................................................................331.5.3 Principle of Photography ..............................................................................................34

1.6 Photographic functions .................................................................................................. 351.6.1 Functions of radiation modes .......................................................................................351.6.2 Selecting Radiation status ...........................................................................................361.6.3 Names of arm unit positions .........................................................................................37


1.7 X-ray photographic cycles ............................................................................................. 39

2 Directions for Use 412.1 Pre-/post-operational procedures .................................................................................. 412.2 Emergency stop ............................................................................................................ 422.3 Procedure for X-ray image acquisition .......................................................................... 43

2.3.1 Turning the power switch on ........................................................................................432.3.2 Activating Image Creator from the Viewer ....................................................................442.3.3 Setting the radiation mode ...........................................................................................452.3.4 Introducing the patient inside the equipment ................................................................502.3.5 Positioning in Panoramic mode ....................................................................................532.3.6 Positioning in TMJ mode ..............................................................................................592.3.7 X-ray radiation ..............................................................................................................622.3.8 Withdrawing the patient from the equipment ................................................................652.3.9 Image Transfer .............................................................................................................652.3.10 Shutting off the power supply .......................................................................................66

2.4 Procedures of Cephalometric Radiography .................................................................. 672.4.1 Turning the power switch on ........................................................................................672.4.2 Activating Image Creator from the Viewer ....................................................................672.4.3 Setting the Image Acquisition Mode .............................................................................672.4.4 Patient Introduction and Positioning .............................................................................682.4.5 X-Ray Photography ......................................................................................................712.4.6 Patient’s Exit .................................................................................................................732.4.7 Image Transfer .............................................................................................................732.4.8 2.4.8 Turning Off the Equipment ..................................................................................74

3 Directions for Use of Image Creator 753.1 Installing Image Creator ................................................................................................ 75

3.1.1 Installation procedure ...................................................................................................753.1.2 Installing Image Creator ...............................................................................................77

3.2 Installing AJAT .............................................................................................................. 803.2.1 Preparation for Installation ...........................................................................................803.2.2 Installation ....................................................................................................................82

3.3 Starting up Image Creator ............................................................................................. 843.4 Confirming program versions ........................................................................................ 843.5 Image Creator Screen ................................................................................................... 853.6 Saving and Loading of Acquired Data (RAW Data) ...................................................... 87


3.7 Tomotgraphic Adjustment ............................................................................................. 873.8 Display Adjustment ....................................................................................................... 893.9 Image Export ................................................................................................................. 90

4 User Program Mode 91

5 Directions for Use of PANOURA18S ControlManager 955.1 Installing PANOURA18S ControlManager .................................................................... 95

5.1.1 Installation procedure ...................................................................................................955.1.2 Installing ControlManager ............................................................................................97

5.2 Starting up PANOURA18S ControlManager ................................................................. 995.3 Descriptions of Main Menu .......................................................................................... 1005.4 Descriptions of “Setup” screen .................................................................................... 1005.5 Confirming program versions ...................................................................................... 1015.6 Configuring a communication port(s) .......................................................................... 103

6 Recovering from failures 1056.1 Problems and their corrective measures ..................................................................... 105

6.1.1 Problems with image acquisition ................................................................................1056.1.2 Problems associated error messages displayed on the screen .................................107

6.2 Making contact with your dealer. ................................................................................. 108

7 Maintenance services 1097.1 Cleaning ...................................................................................................................... 1097.2 Regular checks ........................................................................................................... 1107.3 Regular check services ............................................................................................... 111

7.3.1 Outsourcing the regular check services .....................................................................1117.3.2 Archiving records on regular check services ..............................................................111

7.4 Performing check services .......................................................................................... 112


8 Disposal specification 115

9 Accessories 117

10 List of time-change components and consumable stores 11910.1 Time-change components ........................................................................................... 11910.2 Consumable stores ..................................................................................................... 119

11 Main specification 12111.1 Specification ................................................................................................................ 12111.2 Filter Specifications ..................................................................................................... 12311.3 Dimensional drawing ................................................................................................... 124

11.3.1 Standing position wall-mount: Panorama type ...........................................................12411.3.2 Standing position wall-mount short type: Panorama type ..........................................12511.3.3 Standing position wall-mount long type: Panorama type ...........................................12611.3.4 Standing position base-mount (with an optional base):Panorama type .....................12711.3.5 Standing position base-mount short type (optional base):Panorama type .................12811.3.6 Standing position base-mount long type (optional base):Panorama type ..................129

11.3.7 Standing position base-mount (with an optional wide base):Panorama type .............130

11.3.8 Standing position base mount short type

(with an optional wide base): Panorama type ............................................................131

11.3.9 Standing position base mount long type

(with an optional wide base): Panorama type ............................................................13211.3.10 Standing position wall-mount: Cephalo-attached type ...............................................13311.3.11 Standing position wall-mount short type: Cephalo-attached type ..............................13411.3.12 Standing position wall-mount long type: Cephalo-attached type ................................13511.3.13 Standing position base-mount (with and optional base):Cephalo-attached type .......13611.3.14 Standing position base-mount short type (optional base):Cephalo-attached type .....13711.3.15 Standing position base-mount long type (optional base):Cephalo-attached type ......13811.3.16 Standing position base-mount (with an optional wide base): Cephalo-attached type 13911.3.17 Standing position base-mount short type

(with and optional wide base): Cephalo-attached type ...............................................14011.3.18 Standing position base-mount long type

(with and optional wide base): Cephalo-attached type ...............................................141

11.4 Circuit block diagram ................................................................................................... 14211.5 Circuit block diagram (Cephalo-attached type) ........................................................... 143


11.6 Spatial resolution (MTF) .............................................................................................. 14411.7 Anode cooling curve and heat content of X-ray tubeassembly ................................... 145

12 Qualification Assurance (QA) Procedure 14712.1 Structure of the phantom ............................................................................................. 14712.2 QA Procedure ............................................................................................................. 148


Safety precautions in using PANOURA 18S

Meaning of symbolsA symbol and its variations used in the manual and attached to the equipment have the meanings described below. To avoid any possible danger, be sure to adhere to the instruc-tions following these symbols.

: Informs the user of any general caution, warning, or danger.

DANGER : Alerts the user to a direct danger, which may lead to severe injury or death, serious damage to the equipment and its surrounding proprietary (e.g. totally-lost machine), or fire.

WARNING : This is used to indicate an indirect (or potential) danger that could cause death or serious injury, severe property damage such as complete failure of the equipment, or a fire.

Following is an example of indirect danger. Example: Ignoring a warning label and opening a cover and touching a

high-voltage terminal could result in death.

CAUTION : Alerts the user to a risk of any accident, which may lead to mildly to moderately injured human body, partially-destructed machine, or lost computer data.


Precautions for Use

WarningCARELESS OR IMPROPER USE OF X-RAY EQUIPMENT CAN BE EXTERMELY HAZ-ARDOUS.1. Be sure to operate the equipment in a radiation-controlled area.2. A patient, if moves, may be caught by a rotating arm unit during image acquisition.

To avoid this accident, monitor a patient every minute and if you detect any possible danger, immediately stop image acquisition.

3. A patient, if moves, may be caught by a rotating arm unit during positioning or image acquisition. To avoid this accident, ask the patient to remain still.

4. Turn the power switch OFF (a ○ symbol will appear) if you don’t intend to operate the equipment for a long period.

5. Any one other than the qualified service persons should not remove the cover, other-wise a failure, accident, discoloration/color-fading, or malfunction may occur.

6. Electromagnetic waveAn electromagnetic wave, if any, may interfere with this medical equipment in your clinic office, causing malfunction. Avoid this problem, be sure to turn off the power switches of the electric apparatuses; a cell phone, PHS, transceiver, or radio-controlled transmitter.

7. Be sure to plug a medical ground cable into a ground outlet prior to use of PANOURA 18S. Don’t plug the cable into any other kind of outlet than that for exclusive use.

8. Don’t connect any other device than specified ones to the equipment. Don’t install unspecified software on the PC connected to the system.

9. Don’t connect a developing apparatus with the equipment in the same X-ray room. A gas generated by the developing apparatus may erode the equipment, leading to seri-ous damage.

10. Never gaze directly at positioning beams, though their power outputs (Class 2) are enough to avoid adverse effects on your eyes by aversive behavior by winking.

11. Don’t apply any heavy load or shock on the equipment, e.g. suspending from the chin rest or sliding mechanism, otherwise the equipment may be damaged.

12. Never allow infants and children to approach this product except when used for medi-cal care.

13. Do not give high impact or excessive external load to this product. Otherwise it may cause malfunction.

14. Do not hang down from or apply force on the Cephalo unit (including the Cephalo-arm). Otherwise the equipment may fall or be damaged.

15. Be careful not to let infants and children hang down from or apply force on the Cephalo unit (including the Cephalo-arm).


Caution1. Only the qualified person can be take X-ray photographs. Any unqualified person is

banned by law to take X-ray photographs.2. Usually, turning the power switch on moves the arm unit automatically to the patient

positioning point. To avoid damage to surrounding physical assets, don't place any-thing within a movable range of the arm unit.

3. Be sure to press the correct switches, such as the Up and Down switches, during positioning, otherwise the patient may be injured.

4. Be sure to carefully open or close the head support by gripping its base without apply-ing excessive force, otherwise the patient may be injured.

5. Don’t wipe off the plastic or coated surfaces of the equipment with cloth dampened with any solution containing chemicals, e.g. paint thinner, benzene, and alcohol. Other-wise the surfaces may get decolorized, color-faded, or malfunctioned.

6. Carefully read "Safety Precautions in Using Medical Electric Equipment".7. Ask the adult patient to wear a X-ray protective apron and the child patient to ware

both the X-ray protective apron and a thyroid gland protective cloth.8. Don’t take X-ray photographs of pregnant women or possibly pregnant women.9. Don’t use any other accessory than those we designated.10. Keep the patient out from the equipment until the arm unit of the equipment has re-

turned to its start position. Otherwise, the patient may be caught by the arm unit, being injured.

11. Be careful not to irradiate the positioning laser beams into patient’s eyes. Ask the patient not to gaze directly at these beams.

12. To ensure stable behavior, operate the equipment only in the operating environment defined in “11.1 Specification”.

13. Take great care in turning on the heater. A sudden rise in temperature of the cold X-ray room may form dew condensation, causing malfunction of the equipment.

14. To minimize the X-ray dose irradiated on the patient, be sure to position the patient correctly prior to image acquisition.

15. To prevent the patient from infection, be sure to use a new bite block for each patient and wipe off it with alcohol-dampened cotton prior to use for keeping clean.

16. Correctly connect the PC protective earth terminal to ground.17. Don't rotate the arm unit manually, otherwise the patient body may be caught by the

arm unit or a failure may occur in the equipment.18. Once the arm unit has been positioned, be sure to return the positioning mirror to its

original position.19. Be careful not to get your fingers caught in the equipment during the operation, such

as rotating, opening and closing, moving back and forth, of the ear rod and nose sup-port of the Cephalo unit.


Caution20. Do not touch the Sensor unit and the Second Slit unit while the Cephalo Sensor is in

operation. Otherwise, your fingers or hands may get caught in the units and may get injured.

21. Do not apply force to the Sensor unit. Otherwise it may cause failure in the equipment.22. Be sure to open or close the ear rod of the Cephalo unit by holding its knob without

applying excessive force. Otherwise the patient may be injured.23. Be sure to connect the additional protective earth conductor of the equipment.24. Be careful not to hit the patient's face when moving the nose support of the Cephalo

unit up, down, back or forth.25. Advise the patient to stay still while an image is being acquired. If the patient moves, it

causes image blurring and degrades the image quality.26. Set up the monitor in position so as to avoid any direct light reflection from any lighting

inside or outside thus ensuring the best image quality and viewability.27. Do not operate this equipment when there is a possibility of earthquake occurrence.

After an earthquake, check to see if the equipment operates properly. Otherwise, the patient may be injured.

28. Do not place anything inside the X-ray field of the equipment.29. When attaching and detaching the sensor, hold the sensor knob tightly so as not to

drop it. Dropping the sensor may cause failure of the equipment.

CautionDo not modify this equipment.• Changing the specifications of this product done by the user is regarded as the modifica-

tion of medical equipments.


Responsibilities for equipment management attributable to the user

Each state has different requirements to operate this equipment. The user of the equipment has to get familiar and comply with all the relevant laws before operating the equipment. In addition, this equipment can only be used by legally certified individuals. The user is also responsible to use and maintain this equipment as described in this manual.

Required Maintenance and Inspection

Maintenance and inspection are needed to ensure safe use of the equipment.

Durable period

The usable life is 10 years from the date of manufacture as long as the equipment is properly maintained and inspected. *Based on Company data.

Repair functional part supply period

Supply of the replacement performance parts for this product (parts required to maintain the function of the product) is guaranteed by the Company for 10 years from the date of manu-facture.

Actions to be taken in case of an accident

1. In the event an accident occurs, immediately stop the equipment by pressing the emer-gency button and ensure the safety of the persons involved in the accident.

2. Provide appropriate first aid as required by the accident conditions.3. If necessary, turn off the power of the computer and then turn off the equipment’s scan-

ner switch and system main switch.4. Immediately contact the dealer where the equipment was purchased.5. Use the contact information provided at the end of this manual.


Warning• Never use the equipment until the measure for preventing from possible dangers have

be taken and it has been confirmed that safety is ensured in the dental office.

Signage used in the manual

The following signage is used throughout the manual.

NOTE : Provides general information on operations independent of safety precautions.

Suppl. : Provides supplementary information on operations and functions independent of safety precautions.

See also :Indicates the title to be quoted or page.

EMC compatibility symbol

• Complied Specification Number and Publication Year: IEC 60601-1-2:2001, A1:2004• Compliance Wordings: This product complies with EMC Standard IEC 60601-1-2: 2001,

A1: 2004• Classification: CISPR11 Group 1 Class A


Electromagnetic Compatibility

Guidance and manufacturer's declaration - electromagnetic emissions

The Panoura18S is intended for use in the electromagnetic environment specified below.The customer or the user of the Panoura18S should assure that it is used in such an environment.

Emissions test Compliance Electromagnetic environment – guidance

RF emissionsCISPR 11 Group 1

The Panoura18S uses RF energy only for its internal function. There-fore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment.

RF emissionsCISPR 11 Class A

The Panoura18S is suitable for use in all establishments other than domestic, and may be used in domestic establishments and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes, provided the following warning is heeded:

Warning: This equipment/system is intended for use by healthcare professionals only. This equipment/system may cause radio interfer-ence or may disrupt the operation of nearby equipment. It may be necessary to take mitigation measures, such as re-orienting or relocating the Panoura18S or shielding the location.

Harmonic emissionsIEC 61000-3-2 Class A

Voltage fluctuations/flicker emissionsIEC 61000-3-3

Complies

TABLE: Guidance and manufacturer's declaration - electromagnetic immunity

The Panoura18S is intended for use in the electromagnetic environment specified below. The customer or the user of the Panoura18S should assure that is used in such an environment.

Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment - guidance

Electrostaticdischarge(ESD)IEC 61000-4-2

±6 kV contact±8 kV air

±6 kV contact±8 kV air

Floors should be wood, concrete, or ceramic tile.If floors are covered with synthetic material the relative humidity should be at least 30%.

Electrical fasttransient / burstIEC 61000-4-4

±2 kV for power supply lines±1 kV for input/output lines

±2 kV±1 kV

Mains power quality should be that of a typical commercial or hospital environment.

SurgeIEC 61000-4-5

±1 kV differential mode±2 kV common mode

±1kV±2kV

Mains power quality should be that of a typical commercial or hospital environment.

Voltage dips, short interruptions and voltage variations on power supply input linesIEC 61000-4-11

<5% UT(>95% dip in UT) for 0,5 cycles40% UT(60% dip in UT) for 5 cycles70% UT(30% dip in UT) for 25 cycles<5% UT(>95% dip in UT) for 5 sec

Functions InterruptionFunctions InterruptionFunctions InterruptionFunctions Interruption

Mains power quality should be that of a typical commercial or hospital environment. If the user of the Panoura18S requires continued operation during power main inter-ruptions, it is recommended that the Panoura18S be powered from an uninterruptible power supply or a battery.

Power frequency(50/60Hz)magnetic fieldIEC 61000-4-8

3 A/m Complies

Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environ-ment.

NOTE UT is the a.c. mains voltae prior to application of the test level.


TABLE: Guidance and manufacturer's declaration - electromagnetic immunity

The Panoura18S is intended for use in the electromagnetic environment specified below. The customer or the user of the Panoura18S should assure that is used in such an environment.

Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment - guidance

Conducted RFIEC 61000-4-6

3 Vrms150 kHz to 80 MHz 3 V

Portable and mobile RF communications equipment should be used no closer to any part of the Panoura18S, including cables, than the recommendedseparation distance calculated from the equation applicable to the frequency of the transmitter.

Recommended separation distanced = 1.2 √Pd = 1.2 √P 80 MHz to 800 MHzd = 2.3 √P 800 MHz to 2.5 GHz

where P is the maximum output power rating of the transmitter in watts (W) ac-cording to the transmitter manufacturer and d is the recommended separation distance in meters(m).

Fields strengths from fixed RF transmit-ters, as determined by an electromagnetic site surveya, should be less than the com-pliance level in each frequency rangeb.

Interference may occur in the vicinity of equipment marked with the following symbol:Radiated RF

IEC 61000-4-3 3 V/m

80 MHz to 2.5 GHz 3 V/m

NOTE 1 At 80 MHz and 800MHz, the higher frequency range appliesNOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by ab-

sorption and reflection from structures,objects and people.

a: Field strengths from fixed transmitters, such as base stations for radio (celular/cordless), telephones and land mobile radios, amateur radio,AM and FM radio broadcast, and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the Panoura18S is used exceeds the applicable RF compliance level above, the Panoura18S should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the Panoura18S

b: Over the frequency range 150 kHz to 80 MHz, field strhgths should be less than 3 V/m.


TABLE: Recommended separation distances between portable and mobile RF communications equipment and the equipment

The Panoura18S is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the Panoura18S can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment and the Panou-ra18S as recommended below, according to the maximum output power of the communication equipment.

Rated maximum output power of transmitter

W

Separation distance according to frequency of transmitterm

150 kHz to 80 MHzd = 1.2√P

80 MHz to 800 MHzd = 1.2√P

800 MHz to 2.5 GHzd = 2.3√P

0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73

1 1.2 1.2 2.3

10 3.8 3.8 7.3

100 12 12 23

For transmitter rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.

NOTE 1 At 80 MHz and 800MHz, the separation distance for the higher frequency range appliesNOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by

absorption and reflection from structures, objects and people.

WARNING:Use of accessories, transducers, and cables other than those specified may result in degraded electromag-netic compatibility performance of this device!


Precautions for Storage Location and Operat-ing Environment of X-ray Equipment

Don’t operate or store the equipment in the environment as described below. If you need to operate or store it in such an environment, contact the manufacturer of the equipment or your dealer prior to use or storage.

1. In areas with a temperature range that exceeds the values stated in the specifications.2. Areas where the air pressure is less than 700 hPa or over 1060 hPa.3. Areas subject to harmful gases.4. Areas with excessive humidity (30 to 75%, no condensation).5. Areas subject to steam.6. Areas subject to water drops.7. Areas with much dust or sand.8. Areas with much oil vapor.9. Areas subject to salty air.10. Areas containing explosive gases or dust.11. Areas subject to excessive vibration or shock.12. Areas with a noticeable slope.13. Areas where the power voltage fluctuates abnormally.14. Areas where the power voltage drops excessively when a load is applied.15. Areas subject to direct sunlight.16. Areas where chemical products are stored.17. Areas where developer units are installed.18. Areas exposed to intense noise.

See also : For information regarding Storage and Usage Environment Precautions of the computer, refer to the Product Information Guide included with the computer at delivery.


Precautions for Installation and Relocation1. Installation Areas

(1) Install in the X-ray room.(2) The size of the installation area should be at least 1,350 mm (W) x 1,350 mm (D) x

2,400 mm (H) or 54” (W) x 54” (D) x 95” (H), to allow the patients to be put in and taken out, the equipment to be operated, the equipment to be used correctly such as allowing for daily inspections, and to perform work to maintain equipment perfor-mance.

If installed alongside other pieces of equipment, be sure not to place them within the range of the arm unit’s movement.

The installation area size differs depending on the room shape, door locations, etc. For details contact the dealer where the equipment was purchased.(3) Rapidly warming a cool X-ray room results in condensation inside the equipment that

causes problems. When heating a room, do so slowly. The environmental range for using this equipment in good condition is as follows. Temperature: 10 to 40ºC (50 to 95°F) Relative humidity: 30 to 75% (no condensation) Air pressure: 700 to 1060 hPa(4) Install in the area equipped with light fixture to ensure the product’s operability, X-ray

image quality and its viewability. Set the monitor to the area where is unaffected by the light reflection from indoors and outdoors.

2. Power(1) Prepare a medical grade outlet (grounding is required) of your area’s power voltage

and dedicate it for PANOURA 18S 100V: More than AC100V, 20.0A 110V: More than AC110V, 18.1A 120V: More than AC120V, 16.6A 220V: More than AC220V, 9.09A 230V: More than AC230V, 8.69A 240V: More than AC240V, 8.33A(2) Absolutely do not use an extension cord or plug multiple cords into one outlet.(3) Wipe off dust that has accumulated on the power plug and outlet. Leaving the dust

on them could allow a minute electrical current to flow due to humidity, etc., and result in overheating or a fire.

(4) Do not impair, damage, or modify the power cord. In addition, do not place heavy objects on it, pull on it, or bend it excessively as these could damage the power cord and cause a fire or electrical shock.


3. GroundingThis product is grounded by plugging the medical grade plug into a medical grade outlet.

4. Movement and TransportTo move or transport this equipment, contact the dealer where the equipment was pur-chased.

Before Using this Product


1 Before Using this Product

Caution• To ensure safe use of this product, be sure to completely read this "Safety precautions

in using PANOURA 18S" P.7 Information before using this product.• Do not use this product for other than its intended use. • Perform only the operations described in this manual.• Always following the instructions in the labels affixed to this product.

1.1 Intended UseThis equipment is to perform oral and maxillofacial panoramic radiography and cephalometric radiography (*) for diagnosis in the dental field.

1.2 Main label sealing

M N

KL

R J E

QABCDGHP



*For a Cephalo-attached equipment

R

E

L

K

N M

O

ABCDEGHP

Q ST



1.3 Names and functions of units and their parts

1.3.1 Main body

1

2

3

4

618

7

10

13

11

16

14

98

17

5

12

15

19

22

23


2021



Name Function1 Driving unit Contains the driving mechanism of the arm unit.

2 Arm unit Supports the X-ray head and the sensor and is rotated by the internal driving mechanism.

3 Head unit

Contains the X-ray generator and slits to generate the X-ray beam necessary for image acquisition.*For a Cephalo-attached equipment, internal drive switches the inner slits according to the image acquisition mode selected.

4 Head support unit Supports and makes immobile the patient's head in X-ray image acquisition.

5 Chin rest base The chin rest block and bite block are attached in the Panoramic modes and the TMJ adaptor is attached in the TMJ * mode.

6 Sensor unit(Detachable)

Converts X-ray absorption data into electronic data in response to the signals from the controller during image acquisition to output to the PC.It also has a movable structure. For panoramic image acquisition, attach the sensor unit to the docking station unit (Panorama).

7 Docking station unit(Panorama)

For panoramic image acquisition, attach the Panorama/Cephalo-combined sensor here.

8 Chin rest unit Supports the chin rest base. Equipped with an emergency stop switch at its bottom.

9 Handle Grasped by the patients to keep postual safety during image acquisition.

10 Bite block Bited by the patient to align between the homographic areas of the maxillary and mandible front teeth.

11 Sliding bodySupports the driving unit mounting the arm and the chin rest unit and moves up or down when the Up or Down switches are pressed. Equipped with a positioning mirror on the front a cover and the power switch at the bottom.

12 Control panel Enables the operator to set any of radiation modes, irradiate the positioning beams, reset the arm unit, and move the arm unit up/ or back/forth.

13 Wall fixing bracket Fixes the equipment on the wall by means of coach screws.14 Positioning mirror Enables the operator to check the patients face for any inclination.

15 Hand switch boxFixed on the wall outside of the X-ray room and equipped with the irradiation switch. Pressing the radiation switch irradiates X-ray and the arm rotates for image acquisition.

16 Column unit The sliding mechanism being moved up and down to align to the patient's target level by means of an electric actuator.

17 Power switch Supplies power to PANOURA 18S (ON: power supplied, OFF: no power sup-plied.)

18 Emergency stop switch When pressed in case of emergency, PANOURA 18S stops.

19 Base unit (optional) May be used depending on the strength of the floor, on which the equipment is installed.

20

Cephalo unit (*)

Equipped with a head-positioning device (patient-positioning unit) necessary for cephalometric radiography. This unit converts the X-ray absorbed data into electronic data by the signal from the control device and exports the image to the computer unit.

Docking station unit(Cephalo) (*)

For panoramic image acquisition, attach the Panorama/Cephalo-combined sensor here. Moves during image acquisition.

PC Enables image information management and processing via the keyboard and mouse.

Monitor Displays Panoramic images and others acquired to use for radiogram interpre-tation.

* For a Cephalo-attached equipment* TMJ (Temporomandibular Joint) mode: mandibular images



See also : Slide elevation mechanism The elevation mechanism of the equipment is driven by an electric motor to

achieve 800 mm of stroke. Accordingly, the equipment may generate larger noise overall or only in the limited area; don’t worry about such a noise because of no failure occurring.

1.3.2 Names and functions of control panel switches and indicators (1)Each of the control panel switches executes its own function assigned; moves the sliding mechanism up or down, moves the arm unit forward or backward, specifies photographing settings, irradiates the positioning beam, and the like.

2

1

3

6

98

4

5

7

10

Name Function

1 Mode switch

When pressed, toggles between "Adult", "Child", "TMJ", and Single to select any of these four radiation modes. The LED associated with selected mode will go on.

Panorama Single

TMJChild

* : For a Cephalo-attached equipment, it toggles between "Panorama", "Child", "TMJ", "Single", "Cephalo Anteroposterior image", "Cephalo Lateral image" and "Carpus image".See also : "1.3.2 Names and functions

of control panel switches and indicators (1)" P.25

Panorama

Single

TMJChild

CephaloAnteroposteriorimage

CephaloLateralimage

Carpusimage

2 Select switch

Toggles between "AUTO" and "MAN-UAL". In the MANUAL status, values for "Tube voltage", "Tube current", and "Radiation time" may be specified.

ManualAuto

3 Confirm switch

Used to confirm any value for "Tube voltage", "Tube current", and "Ra-diation time" in the MANUAL status. Confirming the value for "Radiation time" confirms other values

Shifting to new setting for tube current

Shifting to new setting for tube voltage Settings confirmed

Shifting to new setting for irradiation time



Name Function

4 "+" and "-" switch

"Used to specify any value for "Tube voltage", "Tube current", and ""Radiation time"". ""+"" increases the current value by one level and "-" decreases by one level.For more information on the allowable ranges of tube voltage, tube current, and radiation time, see "Parameter settings table" P.26 ."

5 Reset switch

Rotates the arm up to the start point for each radiation mode. Also used to release the error message.Pressing this switch for 3 seconds rotates the arm to the sensor detachable position.

6 Positioning beam switch

Positions the patient by means of positioning beams. When pressed, moves the arm unit to the positioning point and turn on the positioning beams associ-ated with "Meadina line", "oculoauricular", and "Front tooth topographic area". The beams will go off 60 seconds after automatically. When pressed again during the beam on, the beam will go off.

7 Up switch When pressed and held down, moves the sliding mechanism up to adjust the chin rest level. When released, stops sliding movement.

8 Down switch When pressed and held down, moves the sliding mechanism down to adjust the chin rest level. When released, stops sliding movement.

9 Forward switchWhen pressed and held down, moves the arm unit forward (toward the column) to adjust the patient position for acquiring topographic images of front teeth. When released, stops sliding movement.

10 Back switchWhen pressed and held down, moves the arm unit backward (toward the opposite side of the column) to adjust the patient position for acquiring topo-graphic images of front teeth. When released, stops sliding movement.

* Pressing the positioning beam switch causes the positioning beam to remain activated for 60 seconds.

Parameter settings tableParameter Settings

Tube voltage [kV]58 60 63 65 68 71 7376 79 82

Tube current [mA]2.0 2.5 3.2 4.0 5.0 6.4 8.010

Radiation time [sec]

PanoramicAdult 8 14 16Child 6.4 11.2 12.8

TMJ 8(*1)

Single0.10 0.12 0.16 0.20 0.25 0.32 0.400.50 0.63 0.80 1.00 1.20 1.60 2.002.50 3.20

Cephalo* PA, Carpus 8.0Carpus* LA 10.0

*For a Cephalo-attached equipment*Radiation time for TMJ image acquisition is 4 seconds x 2. When acquiring images of both mouth opening and closing positions, it will be two acquisitions of 4 seconds x 2 each.



1.3.3 Names and functions of control panel switches and indicators (2)

4

5

6

4

2

3

Name Function1 Radiation mode indicator Adult panoramic : Adult LED goes on, if selected.

Child panoramic : Child LED goes on, if selected.TMJ : TMJ LED goes on if selected.Single : Adult LED, Child LED and TMJ LED goes on if selected.Cephalo :Adult LED, Child LED and TMJ LED goes on if selected.

2 Radiation status indicator AUTO : Auto LED goes on, if selected.MANUAL : Manual LED goes on, if selected.

3 Tube voltage indicator Indicates the current setting for Tube voltage.Single :Displays SnGL on Tube voltage and Tube current indica-

tor.

Cephalo* :Displays CEPH on Tube voltage and Tube current indicator.

Tube current indicator Indicates the current setting for Tube current.4 Radiation time indicator Indicates the radiation time usually; the remaining time during image acqui-

sition; the remaining waiting time during cooling down.Single :Displays SHOT.Cephalo* :Displays PA/LA/CArP.(PA:Cephalo Anteroposterior, LA: Cephalo Lateral, CArP: Carpus)

5 Confirm switch Confirm switch Blinks during modification to the value for Tube voltage or current. Goes on when pressed to confirm the modifica-tion.

6 Reset LED Blinks while the equipment (e.g. the rotating arm) is operating; goes on when it has returned to its reset point in each radiation mode; goes off when it leaves the reset point. Blinks while the arm is moving to the positioning beam radiation point; goes off when it has reached the point.

* For a Cephalo-attached equipment



1.3.4 Names and functions of hand-switch box indicators and switches

2

3

4

1

5

Name Function1 X-ray LED Keeps on during X-ray radiation with a continual acoustic alarm.

2 Ready LED

Blinks while the equipment (e.g. the rotating arm) is operating; goes on when it has returned to its reset point in each radiation mode; goes off when it leaves the reset point. Blinks while the arm is moving to the positioning beam radiation point; goes off when it has reached the point.

3 Cooling LED Keeps on during cooling time after X-ray radiation; goes off when the cooling time has expired.

4 Power LED Keep on while power is being supplied.

5 X-ray radiation switch Pressed and held down in the Ready for radiation state (Ready LED on) to irradiate X-ray for a specified time period.

*In case of an error, X-ray Ready LED/Cooling LED blinks. When the problem is fixed, The LED goes off.



1.3.5 Head support unitThe head support unit supports and makes the patient’s head immovable at the give position during X-ray photographic image acquisition

1

2

Name Function

1 Forehead support Supports the patient's forehead to avoid back and forth movement of the patient's head.

2 Lateral head support

Supports and makes the patient's head immovable.When image acquisition status is set to "AUTO", it automatically sets the ap-propriate irradiance condition by measuring the head thickness of the patient.(*)(For automatic setting of irradiance condition, see "Irradiance condition for image acquisition set to AUTO" P.29

*1 For Cephalo image acquisition, when image acquisition status is set to "AUTO", it will be set to the default irradiance condition of each image acquisition mode.

Irradiance condition for image acquisition set to AUTO

Image acquisition mode Head thicknessIrradiance condition

Head support

Head thickness

Tube voltage Tube currentAdult panoramic Less than 170mm 73kV 8.0mAChild panoramic 170mm and above 79kV 8.0mA

TMJLess than 170mm 73kV 10mA170mm and above 79kV 10mA

PA 82kV 10mALA 79kV 10mACarpus 63kV 10mA

Caution• Don’t open and close the head support by force without gripping its base, otherwise the

patient may be injured.



1.3.6 Positioning beams

Positioning for Panoramic Image AcquisitionPressing any of the positioning beam switches activates its associated positioning beam (at the same time, the arm unit moves to the positioning point). These positioning beams can be used to make the patient’s head immovable at the position appropriate for image acquisition.

12

3

Name Function

1 Median beam Used to adjust any horizontally inclined patient's face by aligning to the patient's midsagittal.

2 Oculoauricular beam Used to adjust any anteroposteriorly inclined patient's face by align-ing to the patient's reference face plane (Frankfurt or Camper plane).

3 Front-tooth tomographic beamUsed to adjust the patient's front tooth row and the X-ray radiation point by aligning the beam to the tops of front tooth roots (around the middle of the mandibular third tooth).

Warning• Don’t gaze directly at the positioning beams, though their power outputs (Class 2) are

enough low to avoid adverse effects on eyes by aversive behavior, e.g. winking.

Caution• Take care not to irradiate the laser positioning beams into the patient’s eyes. Ask the

patients not to gaze at these beams.

Suppl. : The positioning beams automatically go off about 60 seconds after activation. If the positioning beams have gone off before positioning is successfully finished, retry pressing the beam switches to turn the positioning beams on?



1.3.7 Sensor unit (detachable)

1

2

Name Function1 Handle When detaching the sensor, hold the handle to retain it.2 Knob for detaching Rotate the knob to fix the sensor to the docking station.

Locking/unlocking position of the knob for detaching

When locking When unlocking

Caution• Be sure to hold the handle when detaching the sensor. The sensor may drop if you hold

other parts. Dropping the sensor may cause failure.



1.3.8 Cephalo unit (*)

1

2

3

4

5

Name Function1 Ear rod Adjusts to the patient’s porus acusticus and fixes the head.2 Nose support Adjusts to the center of patient’s eyebrows and fixes the head.

3 Cephalo sensor

This unit converts the X-ray absorbed data into electronic data by the signal from the control device and exports the image to the computer unit.Uses Panorama/Cephalo-combined sensor.

4 Docking station (Cephalo) For Cephalo image acquisition, attach the Panorama/Cephalo-combined sensor here. Moves during image acquisition.

5 Cephalo arm Supports Cephalo sensor.


Detaching nose supportAs shown on the picture on the right, pull the release pin of the nose support for detachment.

Carpus support



1.3.9 Laser beam allocationPanoura 18S equips with a laser beam allocated in the position shown below.

Laser beam



1.4 Materials of applied partsThe applied parts coming in contact with the patient have been made of the materials de-scribed below.

2

4

1

3

6

5

Name Function1 Chin rest bloc ABS resin, PC resin (adaptor for edentulous jaw)2 Head support ABS resin3 Handle ABS resin4 Bite block ABS resin5 Ear rod PC resin6 Nose support PC resin




1.5 Principle of Operation

1.5.1 X-ray generating mechanismA X-ray beam is generated by part of kinetic energy converted when electrons rapidly spin-ning decelerate in the material. To accelerate the thermoelectrons of the X-ray beam emitted by a X-ray tube, several tens kilo voltages of high DC voltage is required. To this require-ment, an internal high-voltage transformer increases the voltage by several hundreds voltage. The quality of the X-ray beam varies with the level of the voltage applied to the X-ray tube (X-ray tube voltage). With higher X-ray tube voltage applied, a higher transmission power of X-ray beam is generated. The X-ray dose depends on the magnitude of a current flowing through the X-ray tube (X-ray tube current).

1.5.2 Operating principle

This equipment is equipped with an X-ray generator and a Sensor unit at an Arm unit sup-ported by a Column unit and a sliding body unit. While rotating around the patient's teeth and jaw, the equipment irradiates X-ray and detects X-ray absorbed data at the Sensor unit multiple times. Detected multiple data are transferred to an image processing unit and the data are superimposed with appropriate shift value according to the X-ray moving speed by the arm rotation to acquire panoramic image or the image of jaw joint.To acquire Cephalo image and Carpus image, attach the Panorama/Cephalo-combined CMOS sensor to the Cephalo unit and the equipment irradiates X-ray to head, teeth, jaw and hand, and detect X-ray absorbed data at the Sensor unit. (*)Images will be displayed on the Indicator and image data will be recorded in the memory of magnetic disk and so on.



1.5.3 Principle of Photography

Panoramic modesKeep pressing the X-ray radiation switch to rotate the arm unit. The X-ray tube assembly that irradiates a narrow beam is suspended to the arm unit. The arm unit rotates at a specified speed around the stationary patient. During the arm unit rotation, data will be acquired by the Sensor unit multiple times. In the image processing unit, data acquired in the Sensor unit are superimposed with the shift value according to the desired tomographic area to acquire tomographic view.

TMJ modeIn the same manner as that in the panoramic mode, the patient can be positioned within the field of photography to acquire only the images of left and right joint areas necessary for diagnosis.

Cephalometric radiography (*)A plain radiographic image with stable magnification percentage of the properly positioned patient's head, between the broad beam irradiating X-ray generator and the Cephalo sensor which is the optical receiver, can be acquired.

Carpus radiography (*)A plain radiographic image with stable magnification percentage of the properly positioned patient's hand, between the broad beam irradiating X-ray generator and the Cephalo sensor which is the optical receiver, can be acquired.

Caution• Errors may be observed when measurement is made on 2D images acquired in the

panoramic mode.




1.6 Photographic functions

1.6.1 Functions of radiation modes

Adult panoramicPanoramic images of the patient’s tooth row may be acquired in a normal radiation time (about 16 seconds).

Child panoramicFor child and small female patients, the child panoramic mode can be used to acquire images in a shorter radiation time (normal: about 12.8 seconds).

TMJ modeSplit images of the patient’s temporoman-dibular joint can be acquired in a radiation time of four seconds/stage.

Standard panoramic mode trajectory

Child panoramic-mode trajectory

TMJ-mode trajectory



Cephalometric radiography (*)Choose between anteroposterior image (PA) and lateral image (LA). Image acquisition time for an anteroposterior and a lateral image is eight seconds and ten seconds respectively.

PA LA

Carpus radiography (*)Image acquisition time for a carpus image is eight seconds.


1.6.2 Selecting Radiation status You may select either radiation status of AUTO or MANUAL.

Radiation statusAUTO : The tube voltage, tube current, and radiation time are automatically set appro-

priately for the size of the patient’s tooth row. In case of Cephalo radiography and Carpus radiography, tube voltage, tube

current and radiation time are set to default of each image acquisition mode.(*)MANUAL : The tube voltage, tube current, and radiation time may be arbitrarily modified.*For a Cephalo-attached equipment

Carpus



1.6.3 Names of arm unit positions

Start/reset point

Positioning point

Patient introduction point

Patient withdrawal point



Cephalo radiography position (*)

Sensor detachment position


74°

90°



1.7 X-ray photographic cyclesThe equipment has incorporated a variable-cooling time function. X-ray photography may be repeated consecutively two or three times after it has not been used for a long time; however, the X-ray head, once reaching a given temperature, should be cooled for a given time de-pending on the photographic conditions as shown in the following table.The X-ray photographic cycles of the equipment are as described in the following table.

X-ray photographic cycles - Panoramic mode

Tube Voltage [kV] Tube Current [mA] Irr. Time [sec] Cool. Time [sec] Max. radiations/hr[No. of times]

Con.1 73 8 16 368 9Con.2 73 8 14 322 10Con.3 79 8 16 400 8Con.4 79 8 14 350 9

X-ray photographic cycles - TMJ mode


Con.1 73 10 8 232 15Con.2 79 10 8 256 13

X-ray photographic cycles – Cephalo radiography (*)


Con.1 82 10 8.0 320 12Con.2 79 10 10.0 385 10Con.3 63 10 8.0 244 16


Directions for Use


2 Directions for Use

Caution• To assure the operator’s and patient’s safety, be sure to read through this section prior

to use of the equipment.

2.1 Pre-/post-operational procedures

Pre-operational procedurePlug the power cable of the equipment into the medical ground outlet.Check the area surrounding the equipment to see if there exists nothing disturbing X-ray photography.Be sure to check the equipment in reference to "7.2 Regular checks" P.112 and "Regular check list" P.112 prior to use.

Post-operational procedureAfter use, turn off (a ○ symbol will appear) the power switch of the equipment and then un-plug the power cable from the medical ground outlet.

Caution• Don’t put anything within the movable range of the arm unit, otherwise the equipment or

its surrounding physical proprietaries may be damaged.

NOTE : Be sure to clean and sterilize the equipment.

See also : "7.1 Cleaning" P.111

Directions for Use


2.2 Emergency stopIn case of an emergency, one of two steps described below can be followed to immediately stop the equipment.

Emergency stop switch

1 Release the X-ray Radiation switch during image acquisition. X-ray radiation and image acquisition will immediately stop with E r08 displayed on the control panel.

See also : "6.1.2 Problems associated error messages displayed on the screen" P.109

2 Pressing the Emergency Stop switch shuts off power supply to the main body, causing X-ray radiation and image acquisition to stop.All the functions will be stop because of power shutdown. After emergency stop, be sure to evacuate the patient to any safe area. Then, turn off the power switch or unplug the power cable from the power outlet.Finally, fix the problem involved in emergency stop. To activate the equipment, turn the Emergency Stop switch clockwise to release.

Directions for Use


2.3 Procedure for X-ray image acquisition

2.3.1 Turning the power switch on

1 Turn the computer’s power switch on.

2 Turn the power switch on (a | symbol will appear) on the equipment to check that the power LED (green) has gone on (also, check that the Emergency Stop switch has been released).

At power-on, the arm unit will move automatically to the patient introduction point (The set-tings for automatic motion may be modified in the program mode. See “Table 4 Descriptions of user program mode” of the section “4 User program mode”).

Caution• At power-on, usually the arm unit will move automatically to the patient introduction

point. Don’t put anything within the movable range of the arm unit, otherwise its sur-rounding physical proprietaries may be damaged.

• Ask the patient to keep off the equipment until the arm unit returns to its reset point.• If the equipment is not used for a long time, turn off the power switch (a O symbol will

appear)- Properly ground the computer.- Before image acquisition, make sure that the sensor (detachable) is installed and

locked at the docking station (panoramic).

3 Wait for a while until the link between the internal sensor and the computer has been established.

NOTE : If the link between the sensor and the computer is not established for more than one minute, turn off the equipment and turn it on once again.

Directions for Use


2.3.2 Activating Image Creator from the Viewer

Caution• Use a viewer compatible with TWAIN Version 2.1.

See also : Regarding detailed operations of the viewer, refer to the instruction manual of the viewer in use.

1 Operate the computer and activate the viewer.

2 Select “Insert an image from the scan-ner or camera (Twain)” from the viewer.

3 Select PANOURA18S as the source of image to be inserted.

4 Press the button to insert the image.The main screen of Image Creator is displayed.

Directions for Use


2.3.3 Setting the radiation mode

From the control panel:To set the radiation mode:

1 Press the Mode switch and then any of “Adult”, “Child”, “TMJ” and “Single” switches to select your desired mode. The LED associated with the selected mode will go on.* For a Cephalo-attached equipment, it

toggles between "Panorama", "Child", "TMJ", "Single", "Cephalo Anteroposterior image", "Cephalo Lateral image" and "Carpus image"

The LED of the selected image acquisi-tion mode turns on.

* When in the Cephalo image acquisition mode, the three LEDs turn on.

Radiation Mode Function To which the mode is switched when Mode switch is pressed

Adult Panoramic Acquires panoramic images of the patient's tooth row in radiation time, normally 16 sec.

Panorama Single

TMJChild

Child PanoramicAcquires panoramic images of the child patient's tooth row in radiation time, normally 12.8 sec.

TMJAcquires two-or four-fractioned images of patient's mandibular joint in radiation time, 4 sec./stage.

Single Acquires an image of the size of the pan-oramic sensor without moving the arm.

Cephalo Acquires “Anteroposterior image (PA)”, “Lat-eral image (LA)”, and “Carpus image (CarP)”.

Panorama

Single

TMJChild

CephaloAnteroposteriorimage

CephaloLateralimage

Carpusimage

2 Press the Select switch and then one of“Auto” and “Manual”switches to select the desired mode. The LED associated with the selected mode will go on.

Directions for Use


Radiation status Function To which mode is switched when Select switch is pressed

AUTOSpecifies automatically the values for Tube voltage and Radiation time appropriate for the patient's tooth row size. ManualAuto

MANUALAllows the operator to modify arbitrarily the value for Tube voltage, Tube current, or Radiation time.

3 In the Manual status, press the Fix switch, select “Tube voltage”, “Tube current”, and “acquisition time”, and use the “+” and “-” switches to modify the settings.

To which mode is switched when Confirm switch is pressed

Shifting to new setting for tube current

Shifting to new setting for tube voltage Settings confirmed

Shifting to new setting for irradiation time

See also : "Parameter settings table" P.26

4 In the main screen of Image Creator, set up the tooth alignment size and tooth alignment shape according to the patient. Set the tomographic position at 0.

5 Click “New” in the main screen of Image Creator and Image Acquisition Condi-tion Setting screen is displayed.Make sure that the settings in the screen match with the settings made on the Control Panel, and press “OK”.

Directions for Use


Software can be used to set the radiation mode on the PC.Set up the image acquisition mode using the software Image Creator on the computer.

1 In the main screen of Image Creator, set up the tooth alignment size and tooth alignment shape according to the patient. Also, set the tomographic position at 0.

2 Click “New” in the main screen of Image Creator, and Image Acquisition Condi-tion Setting screen is displayed.

3 In order to switch between Panoramic Acquisition Mode and Cephalometric Acquisition Mode, press the “Mode Change” button.* For a Cephalo-attached equipment

4 In the “Image Acquisition Condition Setting”screen, select mode, status and parameters (tube voltage, tube current, radiation time) of the image acquisition, and press “OK”. The setting informa-tion is transferred to the main equip-ment.

Directions for Use


5 Press “OK”.

Suppl. : Once having confirmed the modification by clicking “Set”, you con not restore the previ-ous setting(s) even through clicking “Cancel”.

Suppl. : The value set on either of the control panel and the PC is reflected.

Checking the chin rest blockCheck that the chin rest block appropriate for the selected radiation mode has been selected.

Panoramic mode TMJ mode

Caution• Use the chin rest block appropriate for the selected radiation mode. Otherwise, no cor-

rect image can be obtained.

Directions for Use


Preparation for using an adaptorInsert an adaptor appropriate for the selected radiation mode into the chin rest block.

1 Insert the bite block (2)into the chin rest block (1).

2 To acquire the images of the patient with edentulous jaw or with no front teeth, insert the adaptor for edentulous jaw into the chin rest block.

3 Remove the chin rest and attach the TMJ adaptor to the chin rest block base.Use the TMJ adaptor (CHILD) for the child patient to acquire the highest qual-ity of images of the temporomandibular joint.

Caution• Be sure to use the adaptor appropriate for the radiation conditions. With a wrong adap-

tor, high quality of images cannot be acquired.• Use a new bite block for each patient to prevent infectious diseases. Wipe off the bite

block with alcohol-dampened cloth to keep clean prior to use.• Use the chin rest block, adaptor for the patient with edentulous jaw, and TMJ adaptor

after cleaning for each patient.

Panoramic mode

2

1

Panoramic mode(Patient with edentulous jaw

TMJ mode

Directions for Use


2.3.4 Introducing the patient inside the equipment

Caution• Be sure to ask the patient to wear a X-ray protective apron and the child patient to wear

both the X-ray protective apron and a thyroid gland-protective cloth prior to X-ray radia-tion.

• Ask the patient to remove eye glasses and accessories prior to X-ray radiation, other-wise they may be reflected on the images.

• If the patient puts up in a ponytail, be sure to check that it does not come in contact with the equipment.

• Otherwise, the patient may be injured.• Ask the patient to keep off the equipment until the arm unit of the equipment has been

reset. Otherwise, the patient may be caught by the arm unit, being injured.• Don’t turn the arm unit manually, otherwise the patient may be caught by the arm unit,

being injured or a failure may occur in the equipment.

Adjusting the chin rest heightPrior to introducing the patient inside the equipment, adjust the chin rest close to the patient’s height. Press the Up/Down switch on the control panel to move the chin rest up or down.

Panoramic mode (child) TMJ mode

Panoramic mode (child) : Panoramic mode chin rest block adjusted close to the Patient’s jaw height

TMJ mode : TMJ adaptor adjusted close to the patient’s subnasal point.

Caution• Ask the patient to keep off the equipment until the height of the equipment has been

successfully adjusted. Otherwise, the patient may be hit by the equipment, being injured.

Directions for Use


Introducing the patient inside the equipment

Open the head support while gripping its base and then introduce the patient inside the equipment. Ask the patient to grasp the grooved handle of the bite block with ramrod-straight posture.

Warning• Don’t apply heavy load or shock on the equipment, e.g. suspending from the chin rest or

handle. Otherwise, the equipment may be damaged.

If the sensor comes in contact with the patient’s shoulder, ask the patient to grasp the handle with his/her arms crossed to lower the position of the shoulder.

Caution• If no image can be acquired with ramrod-straight posture, the white shadow of the cervi-

cal vertebra may hide the front teeth, resulting in invalid images.• Don’t open and close the head support by force without gripping its base, otherwise the

patient may be injured.• Be sure to press the correct switches, e.g. the Up or Down switch, for positioning, other-

wise, the patient may be injured.

(Panoramic)

(Panoramic)

Directions for Use


Suppl. : Patient on a wheelchairIntroduce the patient on a wheelchair into close to the column with the ramrod-straight posture to position at a predetermined point.

When an optional normal base is used, introduce the wheelchair so that its front wheels may sit just inside the central space of the base, taking care not to hit the rear wheel(s) against the base.

When an optional wide base is used, fold up the foot rests of the wheelchair if necessary to introduce the wheelchair into close to the column.

Caution• The images of the patient on a standard wheel chair may be acquired. The wheelchair

with a longer backrest or custom-made wheelchair may disturb image acquisition by the equipment.

• Check that the wheelchair does not disturb the equipment prior to image acquisition.• Be careful not to hit the patient’s legs against the column while introducing the patient on

a wheelchair with the foot rests folded close to the column.• For the patient on a wheelchair, the patient’s shoulder may come in contact with the

equipment without ramrod-straight posture.• To avoid this problem, ask the patient to straighten his/her spine in positioning and then

acquire images.

Directions for Use


2.3.5 Positioning in Panoramic mode

Warning• Don’t gaze directly at positioning beams, even though their power outputs (Class 2) are

enough low to avoid adverse effects by operator’s and patient’s aversive behavior .

Caution• Don’t irradiate the laser positioning beams into the patient’s eyes. Ask the patient not to

gaze at the beams.• To minimize the X-ray dose irradiated on the patient, be sure to position the patient cor-

rectly.• If the rotating arm is deviated from its correct position, e.g. when the patient shoulder

hits against it, positioning may not be appropriately performed. To avoid this problem, be sure to return the arm to its reset point and then retry.

Aligning the median beamOnce the patient has been introduced inside the equipment, press the Posi-tioning beam switch. The rotating arm unit will move to the positioning point and the beam goes on.Then, align the median beam to the patient’s midsagittal line. Monitor the patient in the mirror to check that the beam focuses on the patient’s midsagit-tal line. (The correct line runs through the middle point between the left and right incisors and the nose ridge.)

Suppl. : The positioning beam automatically goes off about 60 seconds after activation. If the beam has gone off before positioning is successfully finished, press the Beam switch to activate the positioning beam.

Median beam

Directions for Use


Suppl. : Wrong median beam alignment may affect the images as described below.1. Inclined patient’s face

Problems• Prominent difference between the tops of

left and right temporomandibular joints.• Distorted image with a difference in size

between left and right mandibular angles.Possible causes• Inclined patient’s face toward either of

the left and right sides.Corrective measure• Align the reference median line (vertical

line) to the patient’s midsagittal line.2. One half of the patient’ face enlarged and the other reduced

Problems• One half of the patient’s face is enlarged

and the other reduced.• A difference in size between the tops of

left and right temporomandibular joints.Possible causes• The patient does not face front, deflecting

toward either of the left and right sides.• Inclined patient’s face toward either of

the left and right sides.Corrective measure• Align the reference median line (vertical

line) to the patient's midsagittal line.

Directions for Use


Aligning the oculoauricular beamMove the sliding mechanism up or down so that the oculoauricular beam may be positioned parallel to the pa-tient’s Frankfurt plane.

Warning• Don’t apply heavy load or shock on the equipment, e.g. suspending from the chin rest or


Caution• Be sure to press the correct switches, such as the Up and Down switches, in position-

ing. Otherwise, the patient may be injured.

Suppl. : The positioning beam automatically goes off 60 seconds after activation. If the positioning beam has gone off before positioning has been successfully finished, press the Beam switch to activate the beam.

Suppl. : Wrong lateral positioning may affect the images as described below.1. The patient's face inclined downward

Problems• Blur root apexes of mandibular front

teeth.• Patient's hyoid bone overlapped on the

mandibular front teeth.Possible causes• The patient's face inclined downward.• The patient's forehead inclined anteriorly.Corrective measure• Align the reference facial plane to the

horizontal reference line (horizontal line).

Oculoauricular beam

Directions for Use


2. The patient's face inclined upwardProblems• Blur maxillary front teeth.• Patient'ss hard palate overlapped on the

root apexes on the maxillary tooth row.Possible causes• The patient's face inclined upward.• The patient's mandible inclined anteriorly.Corrective measure• Align the reference facial plane to the

horizontal reference line (horizontal line)

Aligning tomographic front-tooth beamMove the arm unit forward or backward using the Forward or Backward switch on the control panel to align the tomo-graphic front-tooth beam to the root apexes of the front teeth (in the vicinity of the middle point of the mandibular third tooth).At the end of positioning, check that all the beams have focused on their cor-rect points.* The positioning switch, once pressed,

turns on with its associated beam acti-vated for 60 seconds.

When the positioning beam goes off, press the Positioning switch to activate.

Suppl. : To align the beam to the middle point of the mandibu-lar third tooth, ask the patient to: Pronounce “Yi”. Open the mouse so that the canine teeth are exposed.

Caution• Press the correct positioning switches, e.g. the Forward and Backward switches, in

positioning. Otherwise, the patient may be injured.

Suppl. : The positioning beam automatically goes off about 60 seconds after activation. If the beam has gone off before positioning is successfully finished, press the Beam switch to activate the beam.

Tomographicfront-tooth beam

Directions for Use


Suppl. : Wrong beam positioning on the mandibular third tooth may affect as described below.1. The patient's face inclined downward

Problems• Blur root apexes of mandibular front

teeth.• Patient's hyoid bone overlapped on the

mandibular front teeth.Possible causes• The patient's face inclined downward.• The patient's forehead inclined anteriorly.Corrective measure• Align the reference facial plane to the

horizontal reference line (horizontal line).2. The patient's face inclined upward

Problems• Blur maxillary front teeth.• Patient'ss hard palate overlapped on the

root apexes on the maxillary tooth row.Possible causes• The patient's face inclined upward.• The patient's mandible inclined anteriorly.Corrective measure• Align the reference facial plane to the

horizontal reference line (horizontal line)

Adjusting the head supportSlide the head support toward the pa-tient’s forehead while gripping its base to make the head immovable stably.

Caution• Don’t force the head support open or close without gripping its base. Otherwise, the


Directions for Use


Adjusting the head supportSlide the head support in contact with the patient’s head while gripping its base and then close it. With the Auto setting, the tube voltage appropriate for the patient will be automatically set.At the end of adjustment, try to turn on the positioning beams to check that they focus on their correct positions.



Turning off the positioning beamsPress the Beam switch to turn off the positioning beam. Return the positioning mirror to its original position.

Caution• Once positioning has been successfully finished, be sure to return the positioning mirror

to its original position.

Directions for Use


2.3.6 Positioning in TMJ mode

Caution• If the rotating arm unit deviates from its correct position, e.g. when it hits against the

patient’s shoulder, positioning may not be correctly performed. To avoid this problem, be sure to return the arm unit to its reset point and then retry.

Adjusting the chin rest heightAlign the chin rest to the height of the patient’s head. Introduce the patient inside the equipment and moves the sliding mechanism up or down on the control panel so that the TMJ adap-tor may be positioned at the patient subnasal point with the ramrod-straight posture. Then, press the Beam switch to activate the positioning beam.

Caution• Press the correct Positioning switches, such as the UP and Down switches, in position-

ing. Otherwise, the patient may be injured.• Don’t apply heavy load or shock on the equipment, e.g. suspending from the chin rest or


Aligning the median beamAfter introducing the patient inside the equipment, press the Beam switch. The rotating arm unit moves to the position-ing point and the positioning beam activates.Next, align the median beam to the patient’s midsagittal line. Monitor the patient in the positioning mirror to check that the beam focuses on the patient’s center line. (The correct line runs through the middle between the left and right incisors and the nose ridge.)

Caution• Ask the patient not to gaze at the positioning laser beams.

median beam

Directions for Use


Warning• Don’t irradiate the positioning beams into the patient’s eyes, even though their power

outputs are enough low (Class 2) to avoid adverse effect on the patient eyes by aversive behavior, e.g. winking.

Suppl. : The positioning beam goes off about 60 seconds automatically after activation. If the beam has gone off before positioning is successfully finished, press the Beam switch to activate the beam.

Aligning oculoauricular beam Align the horizontal line of the head support parallel to the camper plane on patient’s head. Moves the sliding mechanism up or down to adjust the chin rest height so that the TMJ adap-tor may be positioned at the subnasal point. Then, make a fine-adjustment to align the oculoauricular beam to the camper plane on the patient’s head.

Adjusting the head supportSlide the head support toward the pa-tient’s forehead, while gripping its base, to make the head immovable stably.



oculoauricular beam

Directions for Use


Adjusting the temporal supportSlide the temporal support in contact with the patient’s head while gripping its base and then close it. With the Auto setting, the tube voltage appropriate for the patient is automatically set.At the end of adjustment, turn on the positioning beam to check it focuses on the correct point.



Turning off positioning beamPress the Beam switch to turn off the positioning beam.Return the positioning mirror or its original position.

Caution• Press the correct switches, such as the Up and Down switches, in positioning. Other-

wise, the patient may be injured.• Ask the patient not to gaze at the positioning laser beams.

Warning• Don’t gaze at the positioning beams, even though their power outputs are enough low

(Class 2) to avoid adverse effects on the patient’s eyes by aversive behavior, e.g. wink-ing.

Directions for Use


2.3.7 X-ray radiation

Warning• Ask the patient not to move during image acquisition, otherwise the patient may be

caught by the rotating arm. Monitor the patient throughout image acquisition and in case of an emergency, immediately stop the equipment.

Caution• Only the qualified person can take X-ray photographs. Any unqualified person is banned

by law to take X-ray photographs.• To minimize the X-ray dose irradiated on the patient, be sure to perform correct position-

ing prior to taking photographs.

Starting X-ray radiation

1 After the operations described in "2.3.3 Setting the radiation mode" P.47 , make sure that Image Creator is displaying its image acquisition standby screen.

2 Press the X-ray radiation switch to start image acquisition.Holding down this switch activates X-ray radiation during the specified radiation time.During X-ray radiation, the orange X-ray LED is on in the hand switch box with a consecutive audible alarm.An audible alarm also sounds at the control panel.

To stop X-ray radiation and image acquisition by the equipment during the process, only release your finger from the X-ray radiation switch because of switches being of deadman type.

Directions for Use


* Deadman type switch: Simply pressing and holding down this type of switch allows the apparatus to operate during a given time period.

Caution• Releasing the X-ray radiation switch causes the X-ray radiation and image acquisition to

stop with an error, increasing the X-ray dose irradiated on the patient due to retry. Don’t release the X-ray radiation switch for any purpose other than emergency stop.

- Evacuate the controlled area while X-ray is irradiated.

Photography in TMJ mode

Caution• To minimize the X-ray dose irradiated on the patient, be sure to perform correct position-

ing prior to taking photographs.

● Photography at mouth closing positionAsk the patient to close the mouth gently.Check that the patient has closed the mouse and then press and hold down the X-ray radiation switch until image acquisition is successfully finished.To take images of left and right tem-poromandibular joints, four-second X-ray radiation is executed on both the joints, amounting to eight seconds. After X-ray photography, release your finger from the X-ray radiation switch.

Directions for Use


● Photography at mouse opening positionAsk the patient to open the mouse with the TMJ adaptor attached to the subnasal point.Check that the patient has opened the mouse and then press and hold down the X-ray radiation switch until image acquisition is successfully finished.To take images of left and right tem-poromandibular joints, four-second X-ray radiation is executed on both the joints, amounting to eight seconds. After X-ray photography, release your finger from the X-ray radiation switch.

Caution• During data acquisition in the TMJ mode, X-ray radiation stops with X-ray radiation LED

off and an audible alarm silenced in any other area than temporomandibular joints. Note that the X-ray radiation switch must be pressed and held down until the arm unit stops.

• Don’t release your finger from the X-ray radiation switch during radiation. Otherwise, X-ray radiation and image acquisition may stop with an error, causing an increase in X-ray dose irradiated to the patient due to taking images again.

- Evacuate the controlled area while X-ray is irradiated.

Image Acquisition PreviewOnce an X-ray image acquisition commences, Image Creator displays the acquisition screen instead of the standby screen. In the acquisition screen, how the panoramic image is being formulated is displayed simulta-neously with the acquisition progress.

Directions for Use


2.3.8 Withdrawing the patient from the equipment

Open the head support. Ask the patient to move backward carefully.

Caution• To withdraw the patient from the equipment, be sure to escort the patient, while stepping

back, to the safe area. Otherwise, the patient may be injured by an accident, e.g. top-pling down.

2.3.9 Image Transfer

1 Once the X-ray irradiation terminates, the image data starts being transferred from the main equipment to the com-puter (Image Creator). After the image transfer is complete, Image Creator formulates and displays the panoramic image.

Directions for Use


2 Image is transferred to the original viewer that activated Image Creator by pressing “OK”.

NOTE : When measurement is made on the acquired Panoramic images, errors may be observed because of they being 2D images.

See also : For detailed operations of Image Creator, refer to "3 Directions for Use of Image Creator" P.77

See also : Regarding detailed opera-tions of the viewer, refer to the instruction manual of the viewer in use.

Caution• Be sure to handle the hard disk correctly, otherwise all the important data and programs

may be lost due to a failure or improper formatting. Be sure to back up the data stored on the hard disk in any auxiliary memory using, e.g. a program enabling backup copy operation. We are not liable in case of data loss due to a failure or wrong operation.

2.3.10 Shutting off the power supplyTurn off the power switch (○) and check that the green Power LED has gone off.

Directions for Use


2.4 Procedures of Cephalometric Radiography

2.4.1 Turning the power switch onSee also : "2.3.1 Turning the power switch on" P.45

2.4.2 Activating Image Creator from the ViewerSee also : "2.3.2 Activating Image Creator from the Viewer" P.46

2.4.3 Setting the Image Acquisition Mode

Setting the image acquisition mode using the control panelSee also :"From the control panel:" in "2.3.3 Setting the radiation mode" P.47 .

Setting the image acquisition mode using Image CreatorSee also : "Software can be used to set the radiation mode on the PC." in "2.3.3 Setting the

radiation mode" P.47

Setting of the Cephalo UnitTurn the ear rod and nose support of the Cephalo Unit to the appropriate position according to the desired image acquisition mode, namely “Anteroposte-rior Image (PA)” or “Lateral Image (LA)”. (The arrow indicates the direction of the patient's face.) * When performing a carpus image acquisi-

tion, the PA (anteroposterior) positions are used.

Caution• Before initiating the image acquisition, make sure that the sensor unit (detachable) is

attached and locked to the docking station unit (cephalo).• Clean the ear rod and nose support after each patient.• Before positioning the patient, make sure that the image acquisition mode and the rota-

tion points of the ear rod and nose support match with each other.• Beware not to have your finger or other objects caught when rotating, opening, closing,

or moving back and forth the ear rod or nose support on the cephalo unit.

LA

PA

Directions for Use


2.4.4 Patient Introduction and Positioning

Caution• Cover the patient with an X-ray protective apron. In case of a child patient, additionally

put on a thyroid protective clothing.• Instruct the patient to remove his/her glasses, accessories, etc. before performing the

image acquisition. Otherwise, the glasses, accessories, etc. will intervene with the im-age to be acquired.

• When the patient has trussed hair such as in ponytail, make sure that the hair does not interfere with the operation of the equipment. If it does, it might cause accidents or injuries.

• Do not allow the patient to approach the equipment until movements of the arm unit to reset or to the cephalo image acquisition position are complete. Otherwise, the patient might have his/her body caught in the arm unit and might cause accident or injuries.

• Do not rotate the arm unit by hand. Otherwise, the patient might have his/her body caught in the arm unit and might cause accidents or injuries. It may also cause failure of the equipment.

Preparation for Patient Introduction and Positioning

Press the Reset Switch on the Control Panel. The arm unit and sensor unit automatically move to the cephalo im-age acquisition position, and the slits in the head unit automatically switch.

Before inviting the patient in, move the ear rod to an approximate position of his/her height. Press the Up/Down switch on the Control Panel to move the equipment upward or downward.

Directions for Use


Caution• Do not allow the patient to approach the equipment until the height adjustments on the

equipment are complete. Otherwise, the patient might collide with the equipment and cause an accident.

• If an object is placed within the range of the arm unit’s movement or underneath the cephalo unit, it might cause damage to the object or malfunction to the equipment.

• If the patient touches the ear rod when being introduced to or leaving the equipment, he/she might get injured or the ear rod might be dislocated. Invite the patient in such a way that he/she would not touch the ear rod.

Directions for Use


Introducing and Positioning the PatientAfter introducing the patient, move the ear rods upward or downward to match the heights of patient’s porus acusticus. Insert the ear rod into the porus acusticus on one side and close the ear rod. Then gently insert the ear rod on the other side. When inserting the ear rod, make sure that the patient’s eye-ear plane is placed horizontally.

When acquiring a lateral (LA) image, adjust the height of the nose support at the center between the patient’s eyebrows, and gently press it to fix. (Remove the nose support when acquiring an anteroposterior (PA) image or a carpus image.) Instruct the patient to close his/her mouth with some appropriate tension.

Hold the bottoms of both ear rods and slide them in order to open or close the ear rods.Open the ear rods to the maximum when acquiring a carpus image

LA

LA

PA

PA

Carpus

Carpus

When acquiring a carpus image, stand the patient at the side of the equipment. Instruct the patient to open his/her hands completely and place them in front of the carpus support.

Directions for Use


Caution• In order to minimize X-ray exposure to the patient, make sure that the image acquisition

is done with a correct positioning.• Hold the bottoms of both ear rods and slide them in order to open or close the ear rods.

The patient might get injured if excessive force is applied to move the ear rods. • Be cautious not to hit the patient’s face or other body parts when moving the nose sup-

port up/down or forward/backward.• If such switches as Up/Down Switch are wrongly pressed when positioning, the patient

might get injured. Be cautious as to avoid erroneous operations.• Do not move the equipment up/down or forward/backward while the ear rods are in the

patient’s porus acusticus. The patient might get injured.

2.4.5 X-Ray Photography

Caution• X-ray photography is to be taken only by a qualified person. X-ray photography by an

unqualified person is strictly prohibited by law.• In order to minimize X-ray exposure to the patient, make sure that the image acquisition

is done with a correct positioning.

Initiating X-Ray Photography

1 After the operation described in "2.4.3 Setting the Image Acquisition Mode" P.69 , make sure that Image Creator is dis-playing the “Image Acquisition Standby” Screen.

Directions for Use


2 Press the X-ray radiation switch to begin the X-ray photography. By hold-ing the X-ray radiation switch pressed down, X-ray is irradiated according to the acquisition time specified. While X-ray is being irradiated, the X-ray LED (orange) on the hand-switch box is lit and buzzer sounds continuously. Buzzer also sounds from the Control Panel.The equipment employs a dead man’s switch*. If the finger is removed from the X-ray radiation switch, the X-ray irradiation and image acquisition opera-tion stop.* Dead man’s switch: A system which oper-

ates only when the operator applies force to the equipment.

Caution• If the finger is removed from the X-ray radiation switch while X-ray is being irradiated,

the X-ray irradiation and image acquisition operation stop. The image acquisition ends up in an error. Re-acquisition will cause increase in the X-ray exposure to the patient. Unless for an emergency stop, do not remove your finger from the X-ray radiation switch until the image acquisition is completed.

• Beware not to touch the equipment while the docking station unit (Cephalo) or sensor unit is in motion. The finger or hand might get caught and injured.

• Evacuate the controlled area while X-ray is being irradiated.

Acquisition PreviewOnce an X-ray acquisition com-mences, Image Creator displays the acquisition screen instead of the standby screen. In the acquisition screen, how the pan-oramic image is being formulated is displayed simultaneously with the acquisition progress.

Directions for Use


2.4.6 Patient’s ExitOpen the ear rods and instruct the patient to move away from the equipment.

Caution• When the patient makes his/her exit, make sure to escort and lead the way. Since the

patient needs to move backward when removing him/herself from the equipment, the patient might trip over or cause similar accidents.

2.4.7 Image Transfer

1 When X-ray irradiation is initiated, the equipment starts transferring the image data to the computer (Image Creator). Once the transfer is complete, Image Creator starts formulating and display-ing the cephalo image.

2 Press “OK” to activate Image Creator and transfer the image data to the original viewer.

NOTE : Since a panoramic image has been converted into a two-dimensional image, some errors may be ob-served when a measurement is taken on the acquired image.

See also :For detailed operations of Image Creator, refer to "3 Directions for Use of Image Creator" P.77

See also :For detailed operations of the viewer, refer to the operation manual of the viewer in use.

Directions for Use


Caution• Malfunctions or erroneous operations such as unintended formatting on the hard disk

drive might render important data or programs inoperative. Use a backup program etc. to copy the contents of the hard disk drive into an auxiliary storage device. Please note that we are not liable for the loss of data because of a malfunction or erroneous opera-tion.

2.4.8 2.4.8 Turning Off the EquipmentTurn the power switch off (indicated by ○) and make sure the power indicator (green) is unlit.

Directions for Use of Image Creator


3 Directions for Use of Image Creator

Using Image Creator in order to set up the image acquisition mode, acquire images, formu-late panoramic images, adjust the tomographic setting of panoramic images, and transfer images to the viewer.

3.1 Installing Image Creator

3.1.1 Installation procedureNOTE : Only the operator with the administrative right assigned can install Image Creator.

If you have no administrative right assigned, contact your system administrator.

NOTE : Prior to installing Image Creator, check that PANOURA18S ControlManager has been installed. If PANOURA18S ControlManager has not been installed, install PANOURA18S ControlManager and then Image Creator.

1 Insert the “PANOURA18S” installation disk into the CD drive of the PC.

2 Click “Start” and select “Run”.

3 The “Run” dialog will open. Click “Browse......”.



4 The “Browse......” dialog will open. From “Look in”, select the CD drive as a directory path.

5 The files in “Image Creator” directory will be listed. Select “setup.exe”.

6 Click “Open”.

7 Return to the “Run” dialog. Click “OK”. The installer will activate.



3.1.2 Installing Image Creator

1 The right-hand dialog will open.

2 Then, another right-hand dialog will open. Click “Next”.

3 The “License Agreement” dialog will open. Read the description of the software license agreement and if you agree with it, check in “I accept.....” and click “Next”.



4 The “Location” dialog will open. Check the file location and click “Next”.

5 The right-hand dialog will open. Click “Install”.

6 During installation, the right-hand dialog will remain open.



7 Once installation has finished, another right-hand dialog will open.



3.2 Installing AJAT

3.2.1 Preparation for Installation

Caution• Administrative right is required for installation. If you have no administrative right as-

signed, contact your system administrator.• Before activating Image Creator, make sure that AJAT software is installed.

In case AJAT software is not installed, follow the instructions below and install it.


2 Press “Start” and select “Run”.

3 The “Run” dialog box open is displayed. Press “Browse......”.

4 The “Browse......” dialog box is dis-played. From “Look in”, select the CD drive.



5 Double-click and open the “Image Creator” folder. Select “AJAT_DEN-TAL_IMAGING.exe”.

6 Press “Open”.

7 Return to the “Run” dialog box. Click “OK”. The installer begins its operation.



3.2.2 Installation

1 A dialog box as in the figure on the right is displayed. Click “Next”.

2 A dialog box appears prompting for installation destination. Check the installation destination and click “Next”.

3 A dialog box as in the figure on the right is displayed. Select “Full installation with hardware support” and click “Next”.The “License Agreement” is displayed in the dialog box. Read the description of the software license agreement and if you agree with it, check in the “I accept.....” box and click “Next”.



7 A dialog box as in the figure on the right is displayed while the installation is in progress.

8 When the installation is completed, a dialog box as in the figure on the right is displayed. Click “Finish” and restart the computer. After the computer is restarted, the Windows service of AJAT software is automatically activated and takes up about 1GB of internal memory.

3.3 Starting up Image CreatorWhen the computer is restarted after the installation, Image Creator is automatically activated in the background. From next time onward when the computer is turned on, Image Creator is automatically activated in the background. While Image Creator is active, is displayed on the task tray.

3.4 Confirming program versions

1 Right-click the icon displayed on the task tray. Select About from the pop-up menu displayed.

2 The “Program Version Confirmation” screen will open.



3.5 Image Creator Screen

Image Creator Main Screen (without panoramic images)

③

⑥ ⑦

⑲

⑧ ⑨

④ ⑤ ⑪

②

Image Creator Main Screen (with panoramic images)

③

⑥ ⑦

⑮ ⑯ ⑰ ⑱ ⑲

⑧ ⑨⑩ ⑭

④ ⑤ ⑪ ⑫ ⑬

①



Name Function1 Image Display Area Displays acquired image.

2 “Call Back Last Image”Button

Loads the RAW data, the last image acquired. Such operations can be done on the loaded RAW data as reformulation and readjustment of tomographic setting on the panoramic or cephalometric radiographic images.

3 “New” ButtonAcquires a new image from the patient. Such operations can be done on the loaded RAW data as reformulation and readjustment of tomographic setting on the panoramic or cephalometric radiographic image.

4 “Select” ButtonLoads a previously acquired RAW data. Such operations can be done on the loaded RAW data as reformulation and readjustment of tomographic setting on the panoramic or cephalometric radiographic image.

5 “Settings” ButtonDisplays the Settings screen of the User Program Mode. In the User Pro-gram Mode, the main equipment can be set up. For details, refer to "4 User Program Mode" P.93 .

6 Tooth Alignment Size Group

When acquiring a new image, the size of tomographic trajectory is selected for the panoramic image displayed in the preview and the panoramic image to be newly created. After the image acquisition, the size of tomographic trajectory is selected for the panoramic image to be reformulated when the “Preview” Button is pressed. Select one from Small / Normal / Large.

7 Tooth Alignment Shape Group

When acquiring a new image, the shape of tomographic trajectory is selected for the panoramic image displayed in the preview and the panoramic image to be newly created. After the image acquisition, the shape of tomographic trajectory is selected for the panoramic image to be reformulated when the “Preview” Button is pressed. Select one from Narrow / Normal / Wide.

8 Tomographic Position Group

When acquiring a new image, the position of tomographic trajectory is se-lected for the panoramic image displayed in the preview and the panoramic image to be newly created. After the image acquisition, the position of to-mographic trajectory is selected for the panoramic image to be reformulated when the “Preview” Button is pressed. Select a position within the range between -10.0mm and +10.0mm.

9 “ASC” CheckboxWhen this box is checked, the cervical spine adjustment function is activated when formulating the panoramic image. This function can be used for previ-ously acquired images as well.

10 “Preview” Button Using a previously acquired image, reformulates the panoramic image using the settings in the items 6-9 above.

11 “Auto-Focus” Button Automatically focuses on the rectangular domain specified at the Image Display Area.

12 Display Adjustment Buttons Adjusts the image display of the Image Display Area. The left-drag function of the mouse changes according to the button pressed.

13 Coordinates Display

When the mouse cursor is on the Image Display area, the coordinates and values of the pixel pointed at by the cursor are displayed. When a rectan-gular domain is set, the starting and ending coordinates and the mean pixel value of the selected area are displayed.

14 Image AcquisitionInformation Display Displays the information of the image at the Image Display area.

15 Progress DisplayWhen a time-consuming process, such as reformulation of panoramic or cephalometric radiographic image is in progress, the processing progress is displayed.

16 Operation and Status Display Displays the status of Image Creator and simple operation instructions.

17 “OK” Button Transfers the image newly acquired or formulated by tomographic adjust-ment to the viewer and closes the screen of Image Creator.

18 “Export” Button Exports the image newly acquired or formulated by tomographic adjustment as a file in the TIFF format. Names and exports the loaded data (RAW data).

19 “Cancel” Button Closes the screen of Image Creator without transferring the image to the viewer.



3.6 Saving and Loading of Acquired Data (RAW Data)

Call back Last ImageImage Creator automatically saves one image data after acquisition. The “Call Back Last Image” function loads this acquired data with ease.

NOTE : If the computer is turned off or restarted after the data is acquired, it takes a while for the data to be called back as the acquired data is loaded from the file.

NOTE : If another data is loaded after the data is acquired, it takes some time for the data to be called back as the acquired data is loaded from the file.

Select and ExportBy pressing “Export” Button, the acquired data can be named and saved. By pressing “Se-lect” Button, a file from the saved data can be selected and loaded.

NOTE : The file size of an acquired data is about 900MB. When saving the file using the Export function, beware of the free space on the destination drive.

NOTE : Since the file size of an acquired data is about 900MB, it takes a while for the acquired data to be loaded.

3.7 Tomotgraphic Adjustment

Manual AdjustmentWhen “Preview” is pressed after the Tooth Alignment Size, Tooth Alignment Shape, and To-mographic Position are set, the panoramic image is reformulated according to the parameters set.

Tooth Alignment SizeName Small Normal Large

Image

Tooth Alignment ShapeName Narrow Normal Wide

Image



Tomographic ImagePosition -10mm … +10mm

Image

Auto-FocusBy selecting a rectangular domain on the panoramic image and pressing “Auto-Focus”, the panoramic image is reformulated by the selected domain being focused and the tomographic domain being automatically readjusted.

NOTE : When a tomographic domain is adjusted using Auto-Focus, the tomographic domain of upper and lower of the selected rectangular domain are also relocated.



3.8 Display AdjustmentBy operating the Display Adjustment Buttons, the left-drag function of the mouse for the Im-age Display area can be chosen.

Domain ButtonDomain Button is used when defining a rectangular domain on the image shown at the Image Display area. A rectangular domain is defined by the mouse’s left-drag-ging from the starting coordinates to the ending coordinates. Only one rectangular domain can be set for the displayed image.

Window Level ButtonWindow Level Button is used when adjusting the window level of the image shown at the Image Display area. Adjustment can be done with the mouse’s left-dragging.

Horizontal Movement ButtonHorizontal Movement Button is used when moving the image shown at the Image Display area horizontally. Horizontal movemnet is done by the mouse’s left-dragging.

Zoom ButtonZoom Button is used when enlarging or reducing the image shown at the Image Display area. The image is enlarged or reduced by the mouse’s left-dragging.

Reset ButtonIf pressed when Domain Button is selected, the domain defined becomes unselected. If pressed when Window Level Button is selected, the window level returns to the default value. If pressed when either Horizontal Movement Button or Zoom Button is selected, the image fits into the Image Display area.

Display adjustments can also be done with mouse movements only without using these but-tons.Window Level Adjustment : Dragging the mouse while both right and left buttons pressed.Horizontal Movement : Mouse’s right-dragZoom : Wheel movementsWindow Level Reset : Mouse’s left double-clickPosition and Zoom Reset : Mouse’s right double-click



3.9 Image ExportThe image shown at the Image Display area can be transferred to the viewer or exported as a file in the TIFF format.

Transfer to the viewerWhen Image Creator is activated from the viewer using TWAIN, press “OK” to transfer the image shown at the Image Display area to the viewer.For viewers capable of handing 16 bpp grayscale images, the formulated image is transferred as it is.For viewers only capable of handling 8 bpp grayscale images, the image is transferred after the subtractive color process according to the Window Level shown at the Image Display area.

Exporting a file in the TIFF formatWhen Export Button is pressed while an image is shown at the Image Display area, the image is named and exported into a file. The file can be exported either in the TIFF 8 bpp grayscale format or in the TIFF 16 bpp grayscale format.

User Program Mode


4 User Program Mode

In User Program Mode, various settings can be made so that this equipment can be operated more easily. The settings can be made in “Image Creator” or “Panoura18S Control Manager” software installed on the computer. Refer to "Descriptions of User Program Mode" P.95 for the program number and display contents.

Operation through Image CreatorActivate “User Program Mode” by pressing Setting Button on Image Creator.

Operation through PANOURA18S Control Manager

1 Activate “User Program Mode” by pressing “Setting” Tab on PANOU-RA18S Control Manager.

User Program Mode


2 Click and select the User Program Number that needs adjustment.

3 Press the button of the setting value needing adjustment.

4 A dialog box as in the figure on the right is displayed and the setting is completed.

User Program Mode


Descriptions of User Program ModeProgram No. Description Setting Default

Prog No.02

Specifies whether an audible alarm sounds when any button is pressed on the touch panel.

Audible alarm

OnOn : an alarm sounds Off : no alarm sounds

Prog No.03

Specifies whether the arm automatically moves to the patient positioning point after image acquisition.

Patient positioning point (after acquisition)

OnOn : specified Off : not specified

Prog No.04 Specifies power-on behavior

Power-on behaviorEntrOff : no auto

behaviorEntr : patient posi-

tioning pointRest : auto reset

point

Prog No.05

Specifies the correc-tion level of cervical spine for image acquisition

Cervical spine correction

LoOff : no correction Hi : step 2 Lo : step 1

Prog No.06

Specifies whether a service maintenance message appears once 2,000th radia-tion has finished.

Service maintenance message

NoYes : no message appears No : message appears

Prog No.07Resets the settings in memory to their defaults.

User program settingsNo

Yes : resets to defaults No : existing settings retained

Prog No.09Stores the initial state in memory at power-on.

Initialization at power-onNo

Yes : Initialization at power-on No : not stored in memory

Prog No.11

Specifies whether an audible alarm sounds when an error oc-curs.

Audible alarm sound

OnOn : an alarm sounds Off : no alarm sounds

Suppl. : During setting the mode in the User Program Mode, any operation from the radia-tion switch or control panel is inactivated.

See also :For more information on how to use PANOURA18S ControlManager, see "5 Direc-tions for Use of PANOURA18S ControlManager" P.97 .

Directions for Use of PANOURA18S ControlManager


5 Directions for Use of PANOURA18S Control-Manager

5.1 Installing PANOURA18S ControlManager

5.1.1 Installation procedureNOTE : Only the operator with the administrative right assigned can install Image Creator.

If you have no administrative right assigned, contact your system administrator.

NOTE : Prior to installing Image Creator, check that PANOURA18S ControlManager has been installed. If PANOURA18S ControlManager has not been installed, install PANOURA18S ControlManager and then Image Creator.


2 Click “Start” and select “Run”.

3 The “Run” dialog will open. Click “Browse......”.

4 The “Browse......” dialog will open. From “Look in”, select the CD drive as a directory path.



5 When the contents of the CD drive are displayed, open “ControlManager” by double-clicking it. Select “ControlMan-ager”.

6 Click “Open”.

7 Return to the “Run” dialog. Click “OK”. The installer will activate.



5.1.2 Installing ControlManager

1 The right-hand dialog will open.

2 Then, another right-hand dialog will open. Click “Next”.

3 The “License Agreement” dialog will open. Read the description of the software license agreement and if you agree with it, check in “I accept.....” and click “Next”.



4 The “Location” dialog will open. Check the file location and click “Next”.

5 The right-hand dialog will open. Click “Install”.

6 During installation, the right-hand dialog will remain open.



7 Once installation has finished, another right-hand dialog will open.

5.2 Starting up PANOURA18S ControlManagerWhen the computer is restarted after the installation is complete, PANOURA18S ControlMan-ager is automatically activated in the background.From next time onward when the computer is turned on, PANOURA18S ControlManager is automatically activated in the background.While PANOURA18S ControlManager is active, is displayed on the task tray.

Configuring a communication port(s).

1 To configure your desired communica-tion port(s) (hereafter, called the port (s)):* Only at initial start-up.In response to the message in the right-hand dialog , click “OK”.(For more information on the commutation ports, see "5.6 Configuring a communica-tion port(s)" P.105 .)

2 The “Port Setup” screen will open.From a pulldown menu (1), select your desired port and then click “OK”(2).

1

2



5.3 Descriptions of Main MenuClicking “Main” brings up “Main Menu”on the PC screen.On the “Main Menu” screen, these data will be indicated.

1 Tube voltage2 Tube current3 Radiation time4 Radiation mode5 Radiation status

5.4 Descriptions of “Setup” screenSoftware “PANOURA18S ControlManager” can be used to configure User Program Mode on the PC. For more information on program numbers and their descriptions, see "Descriptions of User Program Mode" P.95 of "4 User Program Mode" P.93 .

1 Click “Setup”

2 Click the program number of the pro-gram to be modified to select.

1 2 3

45



3 Click the button associated with the setting to be modified.

4 The right-hand dialog will open. To confirm the modification, click “OK”.

Suppl. : In the User Program Mode, any operation from the radiation switch or the control panel is not activated.

5.5 Confirming program versions

1 Click “About” in “Main Menu”.



2 The “Program Version Confirmation” screen will open.

3 Program versions are listed as shown in the following screen.

1234

5

1. Main program version2. Control panel program version3. Hand Switch Box program version4. Cephalo control relay board program version (*)5. PANOURA18S ControlManager version*Only for a Cephalo-attached equipment.

Suppl. : The version numbers in the above figure are for reference only. The actual num-bers may vary.



5.6 Configuring a communication port(s)

1 Click “About” in “Main Menu”.

2 The “Version Confirmation” screen will open.Click “Port Setting”.

3 The “Port Setup” dialog will open.

4 From the pulldown menu, sele ct your desired port(s) and then click “OK”. You will return to the “System Setup” screen.



Suppl. : About “communication ports”

1 The equipment has incorporated “serial type” of communication ports.A set of serial ports are arranged as shown in the right-hand photograph.The rear panel of the PC has one or more receptacles labeled “IOIOI” as shown in the photograph.

2 ach of these serial ports (hereafter, called ports) has a designation assigned on the PC.e.g.: COM3 COM6(The assigned numbers are not always serial numbers.)

3 With more than one port incorporated in the equipment, you need to indicate (configure) which port is connected to the PC via cabling.PANOURA18S ControlManager can be used to select your desired port(s) from a port list for easy configuration.

4 Selecting any wrong port will bring up an error message; “Please check the proper connection of the cable and the power being turned on”. In response to this message, select a correct port(s).

Recovering from failures


6 Recovering from failures

6.1 Problems and their corrective measures

6.1.1 Problems with image acquisitionThese problems should be appropriately addressed according to the corrective measures described in "Corrective measures for problems with image acquisition".

Corrective measures for problems with image acquisitionSymptom Possible cause Action

Enlarged and blur front tooth area

Images are enlarged and blur. The front tooth area has been shifted at the back of the front tooth tomographic area and the distance between the sensor and the patient is too long.

Sift the sensor several millimeters back-ward using the Back switch in positioning.

Reduced and blur front tooth area

Images are enlarged and blur. The front tooth area has been shifted at the front of the front tooth tomographic area and the distance between the sensor and the patient is too short.

Sift the sensor several millimeters forward using the Forward switch in positioning.

Blur left or right molar tooth

The center of the chin rest block does not agree the patient's midsagittal line.

Align the center of the chin rest block with the patient's midsagittal line.

The head does not face front. Ask the patient to face front.

Whitish and blur front tooth area

With the oblique cervical spine, X-ray is absorbed leading to a shadow formed on the front tooth area.

Ask the patient to hold up his/her head.

A white horizontal line appears on the apexes of the maxillary tooth roots, disturbing observation.

The image of the plate bone overlaps the image of tooth roots.

Ask the patient to incline slightly the face forward until the oculoauricular plane is positioned horizontally.

Several fine linesappear on the image.

Insufficient dose Increase the dose to acquire correct images.

The X-ray beam deviates from the given path. Contact your dealer.

No image has been acquired

Image Creator is not in Acquisition standby mode.

Switch Image Creator to Acquisition standby mode.

The data cable has not been correctly connected to the PC. Connect the cable correctly to the PC.

Failed unit Contact your dealer.

No operation activated

No power is supplied to the unit. Plug in the power cable into the outlet.The circuit breaker has blown. Reset the breaker.The power switch has been turned off (a O symbol will appear).

Turn the power switch on (a | symbol will appear).

Failed unit Contact your dealer.With the power switch on (a | symbol being indicated), X-ray cannot be irradiated.


The emergency stop switch has been pressed.

Turn the emergency stop switch clockwise to release the switch.



Symptom Possible cause Action

Abnormal noise sounds during X-ray radiation.

The X ray tube has been shorted out or a gas has been generated in it.

Contact your dealer.The high-voltage transformer coil has been shorted out.

No reaction to opera-tion from the PC

The mouse keyboard has not been cor-rectly connected to the PC.

Connect the mouse keyboard connector to the PC.

No power is supplied to the PC.

The power cable has not been connected to the PC.

Plug in the power cable firmly into both the PC and the outlet.

None appears on the monitor screen.

The cable has not been correctly con-nected between the monitor and the PC. Connect correctly the cable to the PC.

The power cable has not been connected to the monitor.

Plug in the power cable firmly into both the monitor the outlet.

The PC has been activated but the power switch of the monitor has not been turned on.

Check that the power button of the monitor has been pressed and power is supplied (ON).

"Check that power is supplied to the main body or the cable has been correctly connect-ed to the PC" message has appeared.

The PC connection cable has not been correctly connected to the PC. Connect correctly the cable to the PC.

The PC communication port has not been configured.

Configure the communication port (see "Configuring a communication port(s)." P.101 ).

No power is supplied to the unit. Turn the main switch on (a | symbol will appear).


Troubleshooting of Image acquisition (For a Cephalo-attached equipment only)

Symptom Possible cause ActionThe equipment does not switch to Cephalo image acquisition mode.

Arm does not move to Cephalo image acquisition position. Contact your dealer if it happens fre-

quently.CCD sensor unit does not move to Cephalo image acquisition position,

Some parts of the Cephalo image is missing (radiation field is off).

Slit position or Cephalo sensor position is not adjusted properly. Contact your dealer.

Cephalo image is blurred.

Patient may have moved during the image acquisition.

Fix the patient properly and advise him not to move during image acquisition.

Right and left ear rods position for the Cephalo lateral image (LA) is off from the original position.

Something may have hit the ear rod. Contact your dealer.



6.1.2 Problems associated error messages displayed on the screenIf an error message appears on the control panel, follow the corrective measures described in "Error message code list" to fix.

Error message code listError code Description Action

Er08 The X-ray radiation switch has been released during image acquisition.

Press the Reset switch on the con-trol panel to recover from the error. Retry.

Er09 The rotating arm has rotated faster than the given speed.If this error persists, contact your dealer.Er10 The rotating arm has rotated slower than the given speed.

Er27 FLASH memory writing errorEr28 X-ray cannot be irradiated at the specified strength

Immediately contact your dealer.Er29 X-ray cannot be irradiated at the specified dose.

Er30 X-ray head temperature has exceeded the given value. If this error persists, contact your dealer.

Er31 Failure in the X-ray head

Immediately contact your dealer.Er34 Failure in arm sensor AREr39 Failure in arm sensor AL

Er44 Two or more arm driving sensors including the arm sensor have been activated at the same time.

Er46 Communication error between CPU circuit board and touch panel

If this error persists, contact your dealer.

Er50 At main power-on, the X-ray radiation switch has been pressed in the hand switch box. Press the Reset switch on the

control panel to recover from the error. If this error persists, contact your dealer.

Er54 The arm unit movement does not finish within the given time period.

Er56 The back-and-forth driving motor movement does not finish within the given time period.

Er57Failure in back-and-force driving sensor. A wrong combina-tions of arm driving sensors have been activated at the same time.

Immediately contact your dealer.

Er59 Motor control error. Image acquisition control has abnor-mally terminated.

If this error persists, contact dealer.Er60 Arm unit driving control error. Arm unit driving motor control has abnormally terminated.

Er62 Back-end-forth driving motor error. Back-and-forth driving motor control has abnormally terminated.

Er67A major difference has observed between the arm unit driving pulse and the value detected by the arm position detector.

Press the Reset switch on the control panel to recover from the error. If this error persists, contact your dealer.

Er68 The value detected by the arm position detector has ex-ceeded the normal range of operation due to running idle.

Er69The timing between the back-and-forth driving motor pulse and the toggling of back-and-forth driving sensor ON and OFF has exceeded the normal range.

Er71 X-ray head control errorEr72 The type of the X-ray head has not correctly specified. Immediately contact your dealer.

Er73 Communication error between CPU circuit board and hand switch box




Error code Description ActionEr75 (*) Cephalo relay board communication error


Er80 (*) Collimator switching limit sensor errorEr81 (*) Collimator switching position error

Er82 While in panoramic image acquisition, Ready signal of the sensor is not turned On.

Er83 (*) While in Cephalo image acquisition, Ready signal of the sensor is not turned On.

Er84 (*) Motor movement of the Cephalo unit did not complete properly.

*Only for a Cephalo-attached equipment

Warning message code listWarning Code Description Action

Fi01 Notice of service maintenance services. Total No. of radiation has exceeded 2,000.

It is recommended that you will perform regular checks. Contact your dealer.

Fi02 The radiation switch has been pressed dur-ing selecting radiation conditions.

It will be cancelled by the reset switch on the Control panel. Contact your dealer if it hap-pens frequently.

Fi03 The radiation switch has been pressed dur-ing X-ray cooling time period.

6.2 Making contact with your dealer.If any problem persists even though the appropriate corrective measure described above has been taken, contact your dealer and provide information on:

1. Product name (PANOURA 18S) and its manufacturing number (**-****).2. Operation, which might cause the failure (as detail as possible).3. Current condition

e.g.: An error message indicating ○○ is displayed. The arm unit or sliding mechanism has stopped with .......

4. See the contacts described at the end of the manual.

Maintenance services


7 Maintenance services

PANOURA 18S has been designed so that the user may take full use of it reliably and satis-factorily over many years to come. To assure the operator’s and the patient’s safety in using the equipment, the user is responsible for performing preventive maintenance services.To perform the preventive maintenance services, follow the instructions in "7.2 Regular checks" P.112 and "7.3 Regular check services" P.113 . If you desire to outsource the regular checks, feel free to contact your dealer. It should be noted that if you outsource these check services, they are not always performed just as described in the regular check list.

Caution• To assure the operator’s and the patient’s safety in using the equipment, be sure to read

through this section and the page "Safety precautions in using PANOURA 18S" P.7 .

7.1 Cleaning1. Cleaning coated surfaces

Wipe out dirt stuck on the coated surfaces of the equipment with a water-dampened soft cloth and then wipe away remaining moisture with a dry cloth.

2. Cleaning plated surfacesWipe out dirt stuck on the plated surfaces of the equipment with a water-dampened soft cloth and then wipe away remaining moisture with a dry cloth.

3. Cleaning casing cover surfacesWipe out dirt stuck on the cover surfaces with a mild detergent-dampened soft cloth, after being wrung, and then wipe away remaining moisture with a dry cloth.

4. Cleaning the chin rest block and adaptorWipe out dirt stuck on the chin rest and adaptors for edentulous jaw and TMJ with a mild detergent-dampened soft cloth, after being wrung, and then wipe away remaining moisture with a dry cloth.

5. Cleaning the head supportPull the head and temporal head supports directly downward out from the head support unit. Wipe out dirt (e.g. hair dressing) stuck on the chin rest and adaptors for edentulous jaw and TMJ with a mild detergent-dampened soft cloth, after being wrung, and then wipe away remaining moisture with a dry cloth.

6. Cleaning the PCConsult the Instruction Manual supplied with your PC to follow the appropriate cleaning procedure.



7. Cleaning the ear rod and nose support (*)Dampen a soft cloth with mild detergent, wring well and wipe out dirt from the ear rod and nose support. Wipe away moisture with a dry cloth.

8. Cleaning the X-ray irradiator (Head unit) and the image reception area (Sensor unit)Dampen a soft cloth with mild detergent, wring well and wipe out dirt. Wipe away mois-ture with a dry cloth. Make sure that there is no dust remained after cleaning.*For a Cephalo-attached equipment

Caution• Wiping the plastic and painted surface with chemicals such as thinner, benzene and

alcohol may cause change or loss of color and/or equipment failure. Use a soft cloth dampened with water to clean the equipment.

7.2 Regular checks

Regular check listNo. Check that: Timing Remarks

1 The power cable has been firmly inserted in the outlet. pre-operation

2 No crack or scratch is found on the power cable. pre-operation

3The unit has sit on the floor stably with no rattle.(For more information, see Step 1 of "7.4 Performing check services" P.114 )

pre-operation

4

"The unit moves up and down normally with no abnormal noise.(For more information, see Step 2 of "7.4 Performing check services" P.114 )

pre-operation

5 The power plug has not generated excessive heat. as needed

6 Nothing disturbing image acquisition is found around the unit. each time

7 The power switch has been turned off after image acquisition. each time

8The head support moves normally.(For more information, see Step 3 of "7.4 Performing check services" P.114 )

each time

9The unit acquires images normally.(For more information, see Step 4 of "7.4 Performing check services" P.114 )

each time

10 The power cable has been unplugged from the outlet after image acquisition. post-operation

11X-ray irradiator (Head unit) and the image reception area (Sensor unit) are clean with no dent, dirt or dust.

pre-operation

The user is responsible for performing the regular checks listed above.For more information on how to perform regular checks, see "7.4 Performing check services" P.114 .



7.3 Regular check servicesThe regular checks listed below are required on the equipment.

Regular check listNo. Check that: Timing Remarks

1 Supply power (input power: 90-132V or 198-264 V) is supplied. every 6 months

2 The protective earth line is correctly connected to ground. every 6 months

The user is responsible for performing the regular checks listed above.For more information on how to perform regular checks, see "7.4 Performing check services" P.114 .

7.3.1 Outsourcing the regular check servicesThe regular check services may be outsourced to your subcontractor. The recommended main check services to be performed by the subcontractor are as described in the following table. For more information, the maintenance checking sheet supplied with the equipment.

List of regular check services by subcontractorNo. Check that: Timing Remarks

1 Supply power (input power: 90-132V or 198-264 V) is supplied. every 6 months

2 The protective earth line has been connected to ground. every 6 months

3 X-ray output is normal. every 6 months4 Operational safety, e.g., in arm rotating, is assured. every 6 months5 All the sensors operate normally. every 12 months6 Electrical safety is assured. every 12 months

7.3.2 Archiving records on regular check servicesTo ensure the reliability and safety of PANOURA18S, be sure to archive the result records on regular check and scheduled check services.



7.4 Performing check services1. Installation: The equipment shall stand on the base or floor firmly.

Check that the equipment has been stably installed with no rattle.2. Column’s up and down movement:

Move the column up and down to check that it moves normally up and down with no abnormal noise.

3. Head support movement:(1) Open and close the head support while gripping its base.(2) Check that the head support opens and closes normally without any major trouble or

abnormal noise.*For a Cephalo-attached equipment

(3) Slide the ear rod knob to perform open and close movement, back and forth/up and down movement of nose support, and rotating movement of ear rod and nose sup-port.

(4) Check if there is no major trouble such as difficulty in the above movements or abnor-mal noise.

4. Image acquisition:(1) Acquire images in the Panoramic mode in the empty X-ray room for 16 seconds.(2) Check that the images have been imported in the PC. Observe the machine behavior during image acquisition to check that the equipment

moves normally as described below. 1. The arm unit rotates smoothly. 2. The arm rotates normally with no abnormal noise.


(3) Perform Cephalo lateral image acquisition (LA) in a completely desolated X-ray room.(4) Check that the images have been imported to the PC.(5) Check if it causes error when image acquisition mode and head positioning do not

match.5. Power supply: Source voltage (input power source)

Use a voltmeter to check that the equipment has been correctly connected to an appro-priate power outlet as described below.(1) Voltage range AC 90 ~ AC 132 V (with load*1) AC 198 ~ AC 264 V (with load*1)(2) Accuracy of a voltmeter (tester) AC Voltage ± (0.7% 2 digits) or its equivalents(3) Tester type Voltmeter for effective voltage measurement



(4) Procedure 1. Set the measurement range of the tester to AC (measurable range 0 ~300 V). 2. Connect the tester probe between both the polarities (L (line) - N (neutral) of the

power outlet.*1 : “with load” indicates such a condition that the elevating motor or rotating arm is

activated and/or X-ray is being irradiated.6. Ground Protective earth

Check that the equipment has been connected to the correctly-grounded power outlet.(1) Accuracy of a voltmeter (tester) AC Voltage±(0.7% + 2 digits) or its equivalents(2) Tester type Voltmeter for effective voltage measurement(3) Recommended testers 1. Fluke 87 V (Fluke) 2. PC510 (SANWA) 3. 3802 (HIOKI) or their equivalents(4) Procedure 1. Set the measurement range of the tester to AC (measurable range 0 ~ 300 V). 2. Connect the tester probe to L (line) or N (neutral) of the power outlet. 3. Check that the results described below have been obtained. (i) L-G (ground) voltage : AC 90 ~ AC 132 V or AC 198 ~ AC 264 V

Caution• To avoid a danger of electric shock, be sure to read the instruction manual supplied with

the tester carefully prior to use.

Disposal specification


8 Disposal specification

This product cannot be disposed of as regular industrial waste. The customer is responsible for the proper disposal of this product with following the each countries'/local governments' regulation/code. For more information, please contact to your dealer.

WEEE Directive(2002/96/EC)

Accessories


9 AccessoriesAccessory list

No. Item Name Quantity1 Instructions Manual (this document) 12 Guarantee card 13 Test results report 1

4 Maintenance and inspection card (X-ray) 1

5 PANOURA18S CD-ROM 16 Chin rest block 17 Adaptor for edentulous jaw 18 TMJ adaptor (ADULT) 19 TMJ adaptor (CHILD) 110 Data cable 111 PC connection cable 112 Fixing-to-column/-wall coach screws 813 Fixing-to-column anchor screws 414 Hexagon socket head bolts for anchor screws 415 Adjusting shims 516 Tapping screws for fixing the hand switch box 217 Beam adjustment jig 118 Bite block (consumable) 119 Tapping screws for hand switch mounting tabs 220 Hexagon socket head bolts for fixing the driving unit 421 Hexagon socket head bolts for fixing the chin rest unit 422 QA phantom 123 Protective ground line (earth line) 123 Spiral tube 1


Caution• Don’t use any part other than those listed in the above table.

List of time-change components and consumable stores


10 List of time-change components and consumable stores

10.1 Time-change componentsThe equipment contains no time-change component.

10.2 Consumable storesThe equipment contains consumable stores listed in the following table.If you need to acquire any one of these consumable stores, contact your dealer described at the end of this manual to provide information on your order (product name, part No. , and quantity).

Consumable store listNo. Item Name Remarks1 Bite block

Main specification


11 Main specification

11.1 SpecificationItem Specifications

Equipment type Digital panoramic x-ray equipmentProduct name PANOURA18SModel XP73Operable mode Uninterrupted operation of intermittent loadHigh-voltage generator DC rectificationX-ray generating equipment type MIR-100X-ray tube focal point 0.5 mm×0.5 mmX-ray tube cooling method Oil coolingNominal maximum electric power (combination of X-ray tube voltage and tube current at maximum output)

0.82kW (82kV, 10mA)

Tube voltage 58, 60, 63, 65, 68, 71, 73, 76, 79, 82kVTube current 2.0, 2.5, 3.2, 4.0, 5.0, 6.3, 8.0, 10mA

Radiation time

PanoramicAdult 8, 14, 16Child 6.4, 11.2, 12.8

TMJ 8

Single0.10, 0.12, 0.16, 0.20, 0.25, 0.32, 0.40, 0.50, 0.63, 0.80, 1.00, 1.20, 1.60, 2.00, 2.50, 3.20

8.0 – 10.0 seconds (Cephalo / Carpus image acquisition) (*)

Electric power supply resistance Maximum 0.2 Ω or lessPhotographing direction Panorama, TMJ Clockwise / Counter Clockwise

Image magnification percentage1.2 – 1.29 (Panoramic image acquisition, TMJ image acquisition)1.39 (Single image acquisition)1.10 (Cephalo / Carpus image acquisition) (*)

Filter typeAdd Filter 1.5mmAlRadiation orifice plate 0.17mmAlCriteria : Tube Voltage / Current = 85kV / 12mA

Total filtration 2.5mmAl equivalent or overLeakage dose 1.0 mGy/h or lessLeakage dose calculation standards Tube voltage 82kV, tube current 10mA, Duty1:40Duty cycle 1:40Linearity of X-ray output ±5%

Pixel100 μm isotropic/pixelMatrix 64 x 1510 (Panoramic) 64 x 2266 (Cephalo)

SID/SOD (Panorama) 485mm / 350mmSID/SOD (Cephalo) 1650mm / 1500mm

Image magnification Panoramic 1.2 to 1.29TMJ 1.2 to 1.29Single 1.39

Emergency stop method Deadman-type / emergency stop switch

Main specification


Item Specifications

Rated power

Number of phases Single phaseFrequency 50 Hz/60 HzVoltage AC100V – 120V / AC220V - 240VInput 2.0kVAApparent Resistance Of Supply Mains R ≤0.3Ω

Wiring circuit breaker (fuse) type and capacity 20A (over-current release)

Classification Class I, Type B Usable life 10 years (when prescribed maintenance and inspections are performed)Up-and-down stroke 800 mm (short type: 400 mm)

Weight

125kg Standing position wall mount120kg Standing position wall mount (short type)150 kg (with an optional base)145kg Standing position base mount short type (with an optional base) *1190kg Standing position wall mount (with Cephalo)185kg Standing position wall mount short type (with Cephalo)215kg Standing position base mount (with Cephalo and optional base)210kg Standing position base mount short type (with Cephalo and optional base) *1

Operating environmentTemperature 10 to 40°C (50 to 104°F)Relative humidity 30 to 75% (no condensation)Atmospheric pressure 700 to 1060hPa

Required storing and shipping condi-tion

Temperature 5 to 45°C (41 to 113°F) Humidity 50 to 75% (no condensation)Atmospheric pressure 700 to 1060hPa

Operational mode Continuous operation with intermittent load

*For a Cephalo-attached equipment*1 Additional 5kg for wide baseThis product complies with the EMC standard IEC 60601-1-2: 2001,A1:2004.

Main specification


11.2 Filter Specifications

Aperture cover 0.2mmAl (PC 1.0mm)

Acrylic filter 0.3mmAl (Acryl 3.0mm)

Aluminum filter 1.5mmAl (Aluminum 1.5mm)

X-ray tube(Focal spot)Inherent filtration of X-ray tube 0.4mmAl

Inherent filtration 2.7mmAl

Total filtration : more than 2.5mmAl / 76kV

Main specification


11.3 Dimensional drawing

11.3.1 Standing position wall-mount: Panorama typeUnit: mm

(1 inch = 25.4 mm)

Main specification


11.3.2 Standing position wall-mount short type: Panorama typeUnit: mm

(1 inch = 25.4 mm)

Main specification


11.3.3 Standing position wall-mount long type: Panorama typeUnit: mm

(1 inch = 25.4 mm)

Main specification


11.3.4 Standing position base-mount (with an optional base):Panorama type

Unit: mm(1 inch = 25.4 mm)

Main specification


11.3.5 Standing position base-mount short type (optional base):Panorama type


Main specification


11.3.6 Standing position base-mount long type (optional base):Panorama type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.7 Standing position base-mount (with an optional wide base):Panorama type


Main specification


11.3.8 Standing position base mount short type(with an optional wide base): Panorama type


Main specification


11.3.9 Standing position base mount long type(with an optional wide base): Panorama type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.10 Standing position wall-mount: Cephalo-attached typeUnit: mm

(1 inch = 25.4 mm)

Main specification


11.3.11 Standing position wall-mount short type: Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.12 Standing position wall-mount long type: Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.13 Standing position base-mount (with and optional base):Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.14 Standing position base-mount short type (optional base):Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.15 Standing position base-mount long type (optional base):Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.16 Standing position base-mount (with an optional wide base): Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.17 Standing position base-mount short type(with and optional wide base): Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.3.18 Standing position base-mount long type(with and optional wide base): Cephalo-attached type

Unit: mm

(1 inch = 25.4 mm)

Main specification


11.4 Circuit block diagram

4※

CP

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X-Ray Generator

Pressor

Circuit

Head Thickness Sensor

X-Axis Positioning Sensor

Arm Rotation Positioning Sensor

Pulse Interface Unit

Class 2 Laser

Positioning Beam

Irradiation Display Unit

Arm Rotation Stepping Motor

X-Axis Driving Stepping Motor

Drive Circuit

Lifting Switch

Main Control Circuit

Operating Unit

Power Circuit

Emergency

Stop Switch

Noise Filter

Power Switch

Over-Current

Release

Over-Current

Release

Primary Circuit

X-Ray Control

Circuit Board

Secondary

Circuit

Protective

Grounding

Protective

Grounding

(Medical Grade 3P

　　　Power Plug)

Lifting Motor

Hand Switch

Hand Switch Box Unit

Lifting Positioning Sensor

Lifting Control

Circuit

Externally Installed

Main specification


11.5 Circuit block diagram (Cephalo-attached type)

1※

2※

3※

3※

3※

3※

1※

4※

▼

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3※ BGR CP

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Sensor Unit (Panorama)

Can be used or detached / attached

Class 2 Laser

Positioning Beam

Irradiation Display Unit

Operating Unit

Main Control Circuit

Lifting Switch

Drive Circuit

Drive Circuit

(Option)

Arm Rotation Stepping Motor

X-Axis Driving Stepping Motor

Collimator Stepping Motor

Hand Switch Box Unit

Hand Switch

Lifting Positioning Sensor

Lifting Control

Circuit

Lifting Motor

Power Circuit

Emergency

Stop Switch

Noise Filter

Power Switch

Over-Current

Release

Over-Current

Release

Protective

Grounding

Protective

Grounding

(Medical Grade 3P

　　　Power Plug)

4※


4※


Sensor Attachment

Control Circuit

Cephalo Positioning Sensor

Drive

Circuit

Cephalo Control

Circuit

X-Ray Generator

Pressor

Circuit

Switching Hub

Head Thickness Sensor

X-Axis Positioning Sensor

Arm Rotation Positioning Sensor

Collimator Slide Positioning Sensor

Sensor Slide Positioning Sensor

(Option)

(Option)

Primary Circuit

Secondary

Circuit

X-Ray Control

Circuit Board

Sensor Unit (Cephalo)

Can be used or detached / attached

Cephalo Sensor Slide

Stepping Motor

Main specification


11.6 Spatial resolution (MTF)

0 2 4 6

0.2

0.4

0.6

0.8

1

Spatial Frequency [LP/mm]

MTF

Main specification


11.7 Anode cooling curve and heat content of X-ray tube assembly

0 100 200 300 400

30

40

50

60

Time [min]

Tem

p [℃

]

0 100 200 300 4000

100

200

300

Time [min]

Hea

t [kJ

]

Qualification Assurance (QA) Procedure


12 Qualification Assurance (QA) Procedure

12.1 Structure of the phantom



12.2 QA ProcedureNOTE : Perform an inspection according to following steps on each half of year and save

the result.

1 Attach the QA phantom to the chin rest block base.

phantom

Chin rest base

2 Acquire image of the QA phantom under the following conditions.

Image acquisition mode setting

Image acquisition mode Standard panoramaImage acquisition status ManualTube voltage 58kVTube current 2mARadiation time 16sec

User program mode setting Cervical spine correction OFF

Image Creator setting

Tooth alignment size NormalTooth alignment shape NormalTomographic position 0mmCervical spine correction OFF

NOTE : For the above image acquisitions, do not move the arm position. If you have moved the arm position using the forward/back switch, press the reset switch to return the arm to the original position before acquiring images.



3 Check the following from the acquired panoramic images.

1. Check the circularity of the steel ball in the center.Radius of the X-direction should be within ±19% of the radius of Y-direction.

X-direction

Y-direction

See also : For measurement functions, see the viewer manual.2. Check the distance from the steel ball in the center to the steel balls in the right/left

end.For the measurement values A and B below, it should be |(A-B)/(A+B)|≦0.035.

A B

See also : For measurement functions, see the viewer manual.

Please be sure to fill your information in:

Contact

PANOURA 18SOperation ManualIssue date : xxxx, 2010 (1’st version)

European Authorized Representative:Emergo EuropeMolenstraat 15, 2513 BH, The Hague,The Netherlands

Manufactured by:The Yoshida Dental MFG. Co., Ltd.1-3-6, kotobashi, sumida-ku, Tokyo, Japan

Document No. M3M 10-xxx

panoura 18s - imageworks · 2015-04-13 · panoura 18s operation manual 1 introduction welcome to...

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