Broken Xray Sensors – Why They Break
This post about broken xray sensors is a response to a Dr’s question about why sensors break, whether or not new sensor cables on Schicks will be more durable and whether or not sensors in general are affordable.
To understand broken xray sensors we have to think about how xray sensors are made. It makes you realize that broken xray sensors aren’t that surprising. The thing is that the new cable will have all the problems that the old broken xray sensor cable has. The problem is pretty simple: the broken xray sensor has copper wires that are of a very small gauge. It is necessary for a xray sensor to have small guage wires so that they can make the cable thin and flexible. To compare for you, a network cable has 24GA wires in it or .511 mm diameter wires, most xray sensors use 34GA wires or .16mm diameter wires. These are very thin wires and they are fairly long with significant flex points. As the wire flexes about 12,000 times a year the individual copper strands in the cable break down and sometimes disconnect all together, causing a broken xray sensor. The connections between the broken xray sensor and the wire are also very tiny and the solder points themselves sometimes fail.
The problem broken xray sensors have is that although copper is flexible, when it gets that thin and gets moved that much it will inherently fail.
So why not do wireless? Well, Schick wireless xray sensors have several problems, one stuffing the wireless circuitry and a battery onto the back of the sensor. Not a lot of space there and transmission makes heat. The battery has to be very durable if you want it to last all day, durable and compact equals expensive. The whole rig has to be waterproof as well, which isn’t hard, but it certainly adds to the size. Size is a huge issue, especially with your staff already complaining about the size of the sensors and placement vs film xrays.
Why not do a thicker cable? We use a replacement cable with 30GA wires, it adds 25% thickness to the overall xray sensor wire which still keeps it very flexible but thicker than most modern xray sensor wires, about the same thickness as old Trophy sensor cables(which lasted forever).
Why not make the broken xray sensor cable replaceable. Schick did this as well trying to deal with the cable issue, but it has several problems. The connector they had to design to make the cable replaceable is pretty cool but also incredibly prone to failure and corrosion. They should have used Gold connectors, sadly they didn’t. Corrosion, even if not visible to the naked eye, can really screw up a low voltage signal. Their second problem was how that connector locks to the xray sensor. They used a metal housing with very tiny screws to accomplish this, but this combined with the special contacts makes it a very expensive cable, not to mention it is just expensive to have custom cable manufacturing done when you need a connector that is used only for their purposes. Because when you are building blow mold and stamping systems on a small scale, (Schick is a small scale compared to for instance how many USB plugs 3M makes and sells a year. 10,000 compared to millions)
So their replaceable cable is more likely to fail because of how it has to be connected and because it still has the same failure points as their regular cable.
With the advent of CMOS sensors direct to USB like Dexis, E2V(XDR, QuickRay, Dentimax), Gendex and others there are now less wires in the cable heading to the sensor and theoretically the cable should be more durable, but there is a whole new downside. There is a lot of data processing that is now taking place right on the back of the sensor as well as the information that needs to be processed by the sensor to interface with the computer. All of this packed into the sensor housing and all very susceptible to voltage and amperage. AKA these babies are easy to burn out from minor voltage irregularities in a USB port. Personally I think every USB sensor especially Dexis sensor should only be plugged into power regulated USB ports. Meaning not only should the USB port be on a powered hub separate from the computer, but that powered hub shouldn’t be plugged into wall AC. Here is why. You wall AC can come out anywhere within 10% of 110Volts AC and still be acceptable to the power company so your computer could be getting 100-120 VAC which gets translated to your USB ports as 4.5VDC to 5.5VDC. This can damage fine circuitry. Most devices can deal with minor power fluctuations without damage but if the circuitry is small enough and there is no gate to let off extra voltage because there isn’t space for one then maybe it burns out the part of the sensor that talks to the computer.
We see a lot of Dexis Platinum’s that have this issue where they no longer tell the computer a sensor serial number. Dexis Platinum’s have to have the correct calibration files installed for the sensor you are using otherwise you get an error that says no calibration file is installed, but even with the utility that is supposed to fix this I saw 19 Dexis Platinum’s last year that were under 3 years old that had this issue and I cannot find a solution for it.
The biggest problem with Dental technology across the board is that dental companies and manufactures that sell the technology want to do their best to control every angle of it. Building in roadblocks to repairing and servicing their technology. I believe the goal of Schein, Benco, and Patterson is for there to be no aftermarket for this type of equipment. They don’t want service centers for sensors, cerecs, and expensive lasers. If they can prevent the equipment from being able to be repaired or serviced it is a huge advantage for them , because unlike the auto industry they will never have to worry about fighting a significant used dental technology market. People will pay a good price for a used car because it can be certified and it can be repaired, but buying a used cerec isn’t like that. If you buy a used Cerec and it fails there is no one who can fix it for you and Cerec will punish you for buying a used Cerec by telling you have to pay thousands of dollars in back support fees and an ownership change over before they will even provide you an estimate for servicing the unit.
If you control the servicing of the units (broken xray sensors included) you can control the whole after market for them.
So my advice is simple. Buy a sensor that is reasonable if it fails in 4 years. (What exactly is reasonable, well let’s just say the cost of processing film) I’m going to calculate it out over 3 Life Cycles aka 12 Years and I’m not doing this to sell you, but maybe just to make what you have invested come into a less painful light.
So let’s put you on a 4 year life cycle
4 years of 2 Hygiene rooms and 3 Ops and you throw away broken xray sensors and computers every 4 years (Which isn’t far fetched, 5 year old computers are usually terrible and slow with all kinds of problems)
Two size #2’s plus one size #1 for a total of 3 sensors which we discount 10% if you buy 3 at a time. So $12,586.50 in sensors
Apteryx and 10 licenses – Lifetime no re purchase and free updates. $3,370 (Apteryx software you can upgrade for free forever with no service contract so it’s like a film processor, buy it once and it will last a good long time. Dexis and other softwares are not like this, they require support contracts.)
Xray sensors and software = $15,956 (QuickRay Sensors Paired with Apteryx XrayVision)
You’ll need a computer and Monitor in Each Op and someone to install it. (Not counting front desk computers because let’s face it, you need those with or without digital XRay
5 computer and 5 22″ LCDs with installation = $6,000
Not including the server either because you need that for your front desk as well, but let’s say you did we charge 1995$ for a server and 22″ LCD with installation included in that price.
So let’s say over 3 cycles Meaning 3 cycles of computers and 3 cycles of sensors (12 Years) You would spend
Computers(12 Years-3 sets of computers and servers all installed professionally) =$23,985
3 Cycles of sensors (6 size 2s and 3 size 1s) = $37,759.50
One Time Purchase of Apteryx = $3,370
Total 12 Year cost of computers, servers, sensors getting tossed every 4 years = $65,114
That is a big old hunk of change but let’s just look at film in that time and I’ll be generous
1 Film Processor – $4,800 (you got a great deal on a PA only processor let’s say, Like a new Peri Pro)
2 Hygiene Rooms Worth of Bitewings (2 Rooms X 8 Patients/day X 4BWs/Patient X 4 Days/Week X 46 Weeks Per Year X 12 Years) = 141,312 BWs
I’ll throw in your water, processing fluid and all the PAs you take in your Doctors OP for free to match up with the cost of barrier shields for your sensors and holders, plus IT services. Heck I’ll even throw in the 35000 Bitewing holders you would have used in that time at least $.50 a piece.
So just the BWs you would take in Hygiene and just the cost of the film processor ignoring all the other costs is $61,324
So going digital on a 4 year turnaround is 4K$ more expensive over 12 years. And I think if you consider the costs of processing fluids, and those plastic BW holders you use to keep the x-rays organized into the chart you could see another 20K$ in possible costs on the film side which would give you $140 a month to put towards IT expenses which would be very low if none of your equipment is older than 4 years.
So on this plan you probably are not saving a dime over using film, but you get digital X-Ray, you get the space back that your film processor was stealing from you, you get to not have jugs of chemicals, you also could be paperless at this price reclaiming you a lot of space being used on storing charts.
I guess what I am saying is that the right sensor and computer system can be very comparable compared to film.
But here is where the equation changes. If you are buying Schick for instance?
about 8K$ a sensor chucking them ever 4 years and 120$ a month just in software support fees so you can keep updated with your imaging software it gets our cost of digital up to $89,280 + the computer cost ($23,985) = $113,265
So you can see that your choice of sensor system and software can really change your cost analysis vs. film
So a recap on the 12 years
Film = $61,324
Schick+ES Image =$113,265
I’m only talking numbers here. If you really like the Schick sensors, an extra $4,000 a year in cost may be completely reasonable for you and I would understand that as a business owner.
My point of this is not to say digital is inexpensive or that it is going to save you money over film. Maybe if you consider time of employees and such it just might. My point is that it is not that unreasonable what it costs if you pick the right system.
I also want to finish this post by saying Sirona (Schick) makes an excellent sensor and they are a good company. I think you will have the same excellent experience with QuickRay and Apteryx working with us.
I don’t know if this takes the sting out at all, but it might. Also you can see how the price can change if you can get that 5th year out of your systems. For instance sensors, don’t throw them out after 4 years but toss them when they fail. Computers on the other hand have a planned replacement because if you wait till they fail it could cut into your production being down a room, plus you tend to spend more over time if you are paying for added tech fees stretching the life out of computers or trying to get them overnighted in when you are down.