Planmeca Romexis. quick guide. Viewer EN _2

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1 Planmeca Romexis Viewer quick guide EN _2

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3 TABLE OF CONTENTS 1 START-UP OF PLANMECA ROMEXIS VIEWER Selecting the interface language Selecting images Starting the Planmeca Romexis Viewer Selecting other images via Viewer launcher when the Viewer is already running USING THE 2D IMAGE BROWSER Opening an image Filtering images according to the exposure date SETTING THE LAYOUT CLOSING ALL OPEN IMAGES PRINTING IMAGES USING THE VIEWING, MEASUREMENT AND ANNOTATION TOOLS Viewing tools Measuring and annotating images D MODULE Opening a 3D volume D Explorer Saving and printing 2D snapshots Adjusting levels Measuring length Measuring angle Adjusting contrast, brightness and sharpness D rendering D overlays PANORAMIC TAB Toggle zoom Define data range (area of interest) Drawing panoramic curve IMPLANT / CROSS SECTIONS TAB Adjusting cross sectional slices Adjusting axial / panoramic slices Drawing nerves Implant tools TMJ TAB Drawing PA line Quick Guide Planmeca Romexis Viewer TOC-1

4 TABLE OF CONTENTS The manufacturer, assembler, and importer are responsible for the safety, reliability and performance of the unit only if: - installation, calibration, modification and repairs are carried out by qualified authorized personnel - electrical installations are carried out according to the appropriate requirements such as IEC equipment is used according to the operating instructions. Planmeca pursues a policy of continual product development. Although every effort is made to produce up-to-date product documentation this publication should not be regarded as an infallible guide to current specifications. We reserve the right to make changes without prior notice. COPYRIGHT PLANMECA Publication number Revision 2 Released 03 April 2014 TOC - 2 Planmeca Romexis Quick Guide

5 START-UP OF PLANMECA ROMEXIS VIEWER 1 START-UP OF PLANMECA ROMEXIS VIEWER With Windows operating system Insert the Planmeca Romexis Viewer CD into the CD drive. The Planmeca Romexis Viewer Launcher starts up automatically (if Windows autorun is enabled). The Viewer Launcher can also be started by double-clicking the Romexis_Viewer.exe file found from the root of the CD. With Mac operating system Insert the Planmeca Romexis Viewer CD into the CD drive and start the Viewer Launcher application by double-clicking the Romexis_Viewer.app file. 1.1 Selecting the interface language Select the interface language from the drop-down menu on the upper right corner of the screen Selecting images The images are listed according to the name of the patient, capture date and image type. Select the images by clicking them on the list. To select multiple images hold down the Ctrl button on your keyboard. Quick quide Planmeca Romexis Viewer 1

6 USING THE 2D IMAGE BROWSER 1.3 Starting the Planmeca Romexis Viewer To run the program from CD click Start Viewer. OR: To copy the program and images to the local hard disk and run the viewer from there select Install. 1.4 Selecting other images via Viewer launcher when the Viewer is already running 1. Close Planmeca Romexis Viewer from the File Menu by selecting Exit. OR: Click the red cross button on the top right corner of the Romexis Viewer window. The Viewer launcher appears on top of the screen. 2. Select the images you want to view from the list. 2 USING THE 2D IMAGE BROWSER The Image Browser shows all images of the patient grouped according to the image type (panoramic, CBCT, cephalometric, intraoral images and photos). 2.1 Opening an image Double-click the preview thumbnail of the image you want to view. OR: Click the thumbnails of the image(s) you want to view and click View Selected. 2 Planmeca Romexis Viewer Quick quide

7 USING THE 2D IMAGE BROWSER Browsing images in different browsing modes The following browsing modes are available: All image types Displays thumbnails of all image types. Image list Displays a list of all patient images. All Images Displays an overview of all patient images. Grid Displays images of the selected image type in grid format. In the grid browsing mode the maximum number of images are shown simultaneously. Film-strip Displays images from left to right in film-strip format. Carousel Displays images from left to right in a 3D carousel. 2.2 Filtering images according to the exposure date To filter /select images according to the exposure date tick the appropriate boxes in the Date field. To view all images tick the All Dates box. Quick quide Planmeca Romexis Viewer 3

8 SETTING THE LAYOUT 3 SETTING THE LAYOUT Click this button to set the layout for the displayed images. In the following window select the desired layout or create a customized one by selecting the desired number of columns and rows from the drop-down menus. 4 CLOSING ALL OPEN IMAGES To close all open images click this button. 5 PRINTING IMAGES To set the window scale for intraoral images, the margins and the page orientation click this button. In the opening window enter the appropriate values in the fields and click OK. To print currently open images click this button. The images will be printed as displayed in the layout. 4 Planmeca Romexis Viewer Quick quide

9 USING THE VIEWING, MEASUREMENT AND ANNOTATION TOOLS 6 USING THE VIEWING, MEASUREMENT AND ANNOTATION TOOLS 1. To select and activate the desired tool, click it with your mouse. 2. Click on the image in the area where you want to use the tool or for the marking to begin. 3. Keep the mouse button pressed down while moving the mouse until satisfied with the marking. 4. To deactivate the tool re-click the currently selected button or click another button. 6.1 Viewing tools Zoom in Use this button to zoom in the desired area in the image. Zoom out Use this button to zoom out in the desired area in the image. Zoom to fit Click on this button to fit open images to the window. Actual pixels Shows the image in its actual size. One image pixel equals one screen pixel. Uniform scaling Shows all images in equal size. Show overview Use this button to pan images on the screen. Flashlight Allows regional filter for gamma, contrast & brightness, invert, equalize, sharpen, and emboss. To adjust the size of the filter area or the radio buttons use the mouse wheel. To switch between different filters use the right mouse button. Flashlight setup Allows setting of gamma, contrast & brightness values. These settings are image specific. To adjust the size of the filter area or the radio buttons, use the mouse wheel. To switch between different filters use the right mouse button. Quick quide Planmeca Romexis Viewer 5

10 USING THE VIEWING, MEASUREMENT AND ANNOTATION TOOLS Magnify To take a closer look on a desired area of interest move the magnifier freely over the image. Pan (move) Move the image on the screen by clicking and dragging the selected image. Adjust contrast and brightness Click this button to open the sliders for contrast and brightness adjustment. Adjust values by moving the sliders up / down. Adjust region of interest Use this button to define the area of effect for image processing buttons and certain measurements. When defining multiple regions the active region is marked in green and the inactive regions in blue. To delete the selected region click the Delete key. 6.2 Measuring and annotating images Measure To draw a measurement line press the mouse button and hold it down while moving the mouse. To finish the line release the button. Draw arrow Click and hold down the mouse button while drawing. To finish the arrow release the mouse button. Draw rectangle Click and hold down the mouse button while drawing. To finish the rectangle release the mouse button. Draw ellipse Click on the image where you want to draw an ellipse. Hold down the mouse button while moving the mouse. To finish the ellipse release the mouse button. Draw text Click on the image where you want add a text annotation. Type the desired text in the field and click OK or press Enter on your keyboard. 6 Planmeca Romexis Viewer Quick quide

11 3D MODULE Hide annotations Click this button to hide all annotations added on the image. To re-show the annotations re-click it. Move annotations Use this button to click and drag the annotation to the desired area on the image. Delete annotations Use this button to select and delete annotations with your mouse. 7 3D MODULE 7.1 Opening a 3D volume To open a 3D volume click on the 3D module button and double-click the volume line D Explorer In the Explorer tab the 3D volume is displayed simultaneously in four different views: Sagittal (red), Coronal (green), Axial (blue) and 3D rendered view. The red, blue and green lines across the views indicate the slicing planes. To adjust the position of the volume hold down the left mouse button and move the mouse in the view. NOTE These adjustments affect all the other views except for the rendered view and are automatically adjusted correspondingly. To rotate the viewing angle hold down the right mouse button while moving the mouse. Quick quide Planmeca Romexis Viewer 7

12 3D MODULE Navigating 3D volume data in MPR slice views There are 2 modes for navigating 3D volumes described below. Enable this button for volume navigation and disable it for plane navigation. Volume navigation You can move and rotate volumes so that the orthogonal planes remain at right angles while moving/rotating the volume. This way the volume can be positioned so that the point of interest shows in other MPR views. To move the volume use the left mouse button. To rotate the volume use the right mouse button. Plane navigation With plane navigation the volume remains static while the orthogonal planes are moved and rotated inside the volume. This can be used for arbitrary oblique slicing without moving the actual anatomy. The orthogonal planes can be reoriented as follows: To move the intersection of planes click and drag on a MPR slice using the left mouse button. This way the intersection of the orthogonal planes can be positioned so that the point of interest shows in the other MPR views. To rotate around their intersection the 2 planes perpendicular to the current slice click and drag the planes on a MPR slice using the right mouse button. (In the example below the 2 planes are shown on the current slice.) 8 Planmeca Romexis Viewer Quick quide

13 3D MODULE This tool can be used for placing the planar intersection along the axis of a tooth and to rotate the planes in the Axial view while observing the tooth s anatomy in Coronal and Sagittal views. Axial Coronal Sagittal Reset orientation Resets orientation of orthognal planes to default without affecting other settings. 7.3 Saving and printing 2D snapshots 1. Click the Save 2D view button. 2. In the opening window select the appropriate options and click OK. The software will automatically generate a 2D snapshot image of the selected views and the snapshot image will open in the 2D module. 3. Next, click the Print images button. A print preview opens. 4. To print the images click the Print button at the bottom of the window. 7.4 Adjusting levels See section Adjusting levels on page Measuring length Use this button to measure length of an object in an image. 1. Click in the image where you want the measurement to begin. 2. Drag and release the mouse button where you want the measurement to end. Quick quide Planmeca Romexis Viewer 9

14 3D MODULE 7.6 Measuring angle 1. Click in the image where you want the angle to begin. 2. Drag and then release the mouse button where you want the angle to end. 7.7 Adjusting contrast, brightness and sharpness To adjust the contrast, brightness and sharpness of the coronal, sagittal and axial view use these sliders D rendering The 3D Rendering tools can be used to adjust the rendered volume. To move the rendered volume press the mouse wheel or hold down the left and right mouse buttons while dragging the image. To re-centre the rendering right-click on the new centre point Setting 3D rendering options To set rendering options click this button. The following options are available. Table 1:Rendering presets 1. MIP (Maximum Intensity Projection) 2. X-ray 3. X-ray shaded (default) 4. Shaded 5. Shiny 6. Surface 7. Black & White X-ray 8. Soft tissue To set the current rendering setting as a new custom pre-set click the Add button. The currently selected option will be shown in the thumbnail circled with white line. To delete the current custom pre-set click the Del button. To select a new default rendering, right-click on the desired mode and select Set as Default Preset. 10 Planmeca Romexis Viewer Quick quide

15 3D MODULE Setting 3D rendering contrast, brightness, cut-off threshold and transparency To adjust 3D rendering contrast, brightness, cut-off threshold and transparency move the 3D rendering sliders. Contrast Brightness Cut-off threshold Transparency Adjusting levels Click this button to adjust the levels. The opening histogram is a graphic representation of the intensity distribution in the volume. To adjust the gamma curve move the green line in the histogram. To adjust contrast and brightness move the red lines on both sides of the histogram. To scale the histogram up or down use these arrows. To restore the original scale click this button. Threshold The black line increases or decreases the threshold and consequently has the same function than the slider Set 3D Rendering Cutoff Threshold. Pseudo Colour modification The buttons left and right of the gamma value, named F and R, modify the pseudo colours. To alter and allocate the colour selection automatically for different tissues based on the curve of the histogram click the button. To modify the position and range of the specific colour manually, drag the rectangles above the histogram left or right. Quick quide Planmeca Romexis Viewer 11

16 3D MODULE To change the colours for an individual selection double-click the rectangle. To reset the pseudo colours settings click this button. From the arrow button readily available colour maps can be selected. Show/hide orientation lines Shows/hides orientation lines and measurements in rendered view only. Show/hide planes Sagittal plane (red) Coronal plane (green) Axial plane (blue) All planes The following options are also available: Show/hide volume boundaries: Show linear perspective in 3D Rendering Smoothing Applies a smoothing filter on the 3D rendering 12 Planmeca Romexis Viewer Quick quide

17 3D MODULE 7.9 3D overlays The 3D overlays menu can be used for adjusting the settings of objects superimposed to the CBCT volume. All ProFace and soft tissue objects of the patient are listed below the 3D Overlays drop-down menu. Each item has separate tools for adjusting the settings such as visibility in different views, transparency and colour. The menu can also be used to add or edit comment on the objects. If the patient has several overlay images you can scroll the list of overlays up and down using the mouse wheel to view all the overlays. To add and edit comments in the images click on the Add Comment field under the sliders and enter the comment. The comments added in the object browser will become visible in the Volumes tab list. Planmeca ProFace overlay All the ProFace overlays of the patient are by default shown in the overlay list. The ProFace overlays are listed based on their date and a thumbnail image of the ProFace image is shown. 2 - Toggles the visibility of ProFace profile lines in 2D Slice views 3 -Toggles the visibility of ProFace images in 3D rendered view Colour Sets colour for ProFace profile line in 2D Slice views Quick quide Planmeca Romexis Viewer 13

18 PANORAMIC TAB 8 PANORAMIC TAB In the 3D Panoramic tab panoramic images (also called curved reformatting) can be generated from the 3D volume data. The generated panoramic image can be adjusted and processed in multiple ways. The image range and thickness can be defined as well as the selection of the appropriate curve for the construction of the panoramic view. The displayed view can also be exported, see section 7.3 Saving and printing 2D snapshots on page 9. The images can also be printed. The Panoramic tab contains four views: Sagittal view, where the sagittal orientation of the 3D volume can be rotated. Axial view, where the axial orientation of the volume can be rotated and where the panoramic curve is defined and shown. Panoramic view, where one or more panoramic images, including 3D rendered panoramic views are shown. Moving the scroll bar on the right edge of a panoramic view adjusts the radius of the panoramic curve showing immediately in the axial view by the panoramic curve moving in or out in relation to the patient s anatomy. As the slider is released, the new layer is automatically updated to the panoramic view. 3D Rendered view NOTE To scroll through the image layers including panoramic, sagittal and axial using the mouse wheel deactivate the Zoom Mode, see section 8.1 Toggle zoom on page Planmeca Romexis Viewer Quick quide

19 PANORAMIC TAB 8.1 Toggle zoom When the Toggle Zoom button is activated the sliced views can be scaled up and down. Move the mouse pointer over the desired view and turn the mouse wheel into the appropriate direction (up to zoom in, down to zoom out). NOTE When Toggle Zoom is deactivated, scrolling the mouse wheel over a view will scroll through the image layers as do the Layer Scroll Bars on each view s right side. NOTE The rendered volume can be zoomed regardless Toggle Zoom activation. 8.2 Define data range (area of interest) To define the area of interest for a panoramic image click this button. Use the left slider to adjust the data range for the upper jaw and the right slider for the lower jaw Panoramic autofocus tool This tool automatically identifies anatomy in CBCT image and shapes the panoramic layer so that it follows anatomy in all three dimensions. This results in a clear overview of the whole denture. When used in combination with the Panoramic autofit tool, a detailed panoramic view can be easily generated. Without autofocus With autofocus NOTE When using panoramic autofocus tool the neighboring panoramic slices may seem identical. Quick quide Planmeca Romexis Viewer 15

20 PANORAMIC TAB Panoramic autofit tool Click on the Panoramic Autofit button. A panoramic curve (focal layer) is automatically placed on the volume. The occlusal level in the volume is automatically identified and the panoramic curve (focal layer) is placed on the dental arch. This tool works best with volumes where dental arch is present. The Panoramic Autofit tool also adjusts the maxillary and mandibular ranges of the panoramic view so that they resemble typical panoramic image dimensions. (For manual adjustment see section 8.2 Define data range (area of interest) on page 15). 8.3 Drawing panoramic curve To define a new curve, click this button. To draw the curve use the left mouse button. When finished click the right mouse button. The new panoramic view will be automatically calculated. To edit the curve, click this button. To move single points in the curve or the whole curve grab the green line of the curve with left mouse button. When finished re-click the button. To delete currently displayed panoramic curve click this button. The standard curves are not deleted. To display a list of all saved panoramic curves click this button. All draws curves are saved and named according to the date and time of creation. To recall and apply a curve click the desired entry in the list. 16 Planmeca Romexis Viewer Quick quide

21 IMPLANT / CROSS SECTIONS TAB 9 IMPLANT / CROSS SECTIONS TAB In the 3D Cross Sections / Implant tab cross sectional slices, axial slices and panoramic images can be created from the 3D data. The Cross Sections / Implant tab contains four views: Axial views Panoramic view Cross sectional slices view 3D rendered view Axial view Panoramic view Cross-sectional slices view 3D rendered view The views can be expanded by clicking the small dual arrows in the ends of the view dividers or maximized by clicking the Maximize button. Quick quide Planmeca Romexis Viewer 17

22 IMPLANT / CROSS SECTIONS TAB 9.1 Adjusting cross sectional slices To mirror the cross section click this button in the upper right corner of the cross sections view To edit the properties of the cross sections click this button in the upper right corner of the cross sections view. In the opening dialogue the distance between the slices, the width, the thickness and the number of slices can be defined. To adjust the values move the sliders up and down. Using the cross sectional scroll bar To move the cross sections move the scroll bar to the right or left. Moving the scroll bar shifts the visible slices along with the panoramic curve to the same direction. If the Cross section lines option is activated the visible slices will also shift to the axial and panoramic views. The middle section is indicated by a bright red line and ruler in the cross sections view. To move in cross sections voxel by voxel click on the arrows on both ends of the scroll bar. To move freely around cross sections drag the scroll cursor. To move in cross sections in increments of the distance between the slices, click between the scroll box and end arrows. 18 Planmeca Romexis Viewer Quick quide

23 IMPLANT / CROSS SECTIONS TAB 9.2 Adjusting axial / panoramic slices To adjust axial / panoramic slices click this button in the upper right corner of the axial view. In the opening window the distance between the slices, the thickness and the number of slices can be defined. 9.3 Drawing nerves 1. Click this button to draw a new nerve channel. 2. Select either panoramic or the cross sectional view 3. Use the left mouse button to place points for a curve depicting the nerve channel of the patient. 4. When finished click the right mouse button. The nerve channel will be displayed as a coloured line in the panoramic view and with coloured dots in the cross sectional views. To delete the currently selected nerve channel click this button. To adjust the properties of a nerve channel, select the nerve channel you want to modify and click this button. The nerve can also be opened from the Nerves list. In the opening window opens where you can name the nerve and modify its colour and diameter. Quick quide Planmeca Romexis Viewer 19

24 IMPLANT / CROSS SECTIONS TAB To display a list of all visible nerves click this button. In the opening window nerves can be deleted or their properties can be modified. To delete a nerve from the list (and the cross sectional tab), select the nerve and click the Delete button. To change the properties of a nerve, select a nerve and click the Properties button. The Nerve Properties window will appear. 9.4 Implant tools To place a pre-selected default implant into the plan click this button. The default implant can be defined in the Implant library. To draw an approximation of the implant s width and height, using the patient s anatomy as a reference for sizing click this button. Next, search the nearest matching real implant from the Implant library. To place an implant directly from the Implant Library click this button. Select the appropriate implant and press Add to add it into the plan. To delete the selected implant from the plan click this button. To display the properties of the selected implant click this button. To set the length, diameter, and colour for the selected implant enter the appropriate value on the corresponding field or select the desired colour by clicking the colour map next to the Color field. 20 Planmeca Romexis Viewer Quick quide

25 IMPLANT / CROSS SECTIONS TAB To adjust the rotation angle of the selected implant drag the Rotation Angle slider. To display a list of all implants in the current plan click this button. The name, colour, length, and diameter of the listed implants can be modified. Quick quide Planmeca Romexis Viewer 21

26 TMJ TAB 10 TMJ TAB 10.1 Drawing PA line 1. Verify alignment of the volume using the Axial view. Use the slider on its right edge to bring condyles into view. 2. Draw right posterior anterior (PA) line using this button. 3. Click and hold down the left mouse button in the middle of the condyle. 4. Draw the PA line by dragging with your mouse. Romexis will automatically display the opposite half of the line and round its total length to nearest millimeter. 5. To finish the line, release the left button and Romexis will automatically populate the slice views. 6. To draw the left PA line click this button. 7. Repeat the steps as described above starting from step Use the View settings dialogue to adjust the number, width and spacing of the PA and lateral slices similar to other 3D modules. 9. To adjust the position of the PA lines verify that the Move / rotate volume button is disabled. 10.Use the left mouse button to move a PA line or the right mouse button to rotate. 11.To adjust the width of the slices (length of the PA line) either use the slice specific settings menu or redraw the line. 22 Planmeca Romexis Viewer Quick quide

27 TMJ TAB Draw right PA line Use to draw and define the posterior-anterior PA line for the right side slices. Draw left PA line Use to draw and define the posterior-anterior PA line for the left side slices. Synchronise sides To enable / disable synchronisation of the left PA line with the right PA line click this button. When synchronisation is enabled (default) the length of the second PA line will be automatically constrained to match the length of the first drawn line. When synchronisation is disabled each PA line can be individually defined. Quick quide Planmeca Romexis Viewer 23

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