Romexis en

Planmeca Romexis ®
user’s manual
EN
10014593_18
TABLE OF CONTENTS
Chapter A GENERAL
1 INTRODUCTION TO PLANMECA ROMEXIS IMAGING SOFTWARE A-1

1.1 Introduction to digital imaging ............................................................................A-2
1.2 Securing the image data ....................................................................................A-2
1.3 Image acquisition ...............................................................................................A-3
1.4 Settings ..............................................................................................................A-3
1.5 Archiving ............................................................................................................A-3
1.6 Processing and restoring images ......................................................................A-5
1.7 Measuring images .............................................................................................A-6
1.8 Annotating images .............................................................................................A-6
1.9 Printing ...............................................................................................................A-6
1.10 DICOM support ..................................................................................................A-7
1.11 Disclaimer ..........................................................................................................A-8
2 STARTING PLANMECA ROMEXIS ..................................................... A-9

3 PLANMECA ROMEXIS MODULES ................................................... A-10
4 PLANMECA ROMEXIS SHORT CUT COMMANDS ......................... A-11
Chapter B PATIENTS & FILES MODULES
1 ALL PATIENTS .................................................................................... B-1

1.1 Searching patients .............................................................................................B-1
1.2 Searching assigned patients ..............................................................................B-2
1.3 Sorting patients ..................................................................................................B-3
1.4 Selecting and opening patients ..........................................................................B-3
1.5 Adding patients ..................................................................................................B-5
1.6 Assigning patients ..............................................................................................B-6
1.7 Inactivating patients ...........................................................................................B-7
2 DICOM WORKLIST SEARCH .............................................................. B-8

3 DICOM QUERY / RETRIEVE (OPTIONAL) ......................................... B-8
4 FIND BY IMAGE ................................................................................... B-9
5 CLOUD MANAGEMENT .................................................................... B-10
5.1 Downloading cases from the Cloud server ......................................................B-10
5.2 Managing cases ...............................................................................................B-11
5.3 Planmeca Romexis Cloud users and requirements .........................................B-12
5.4 System configuration for Planmeca Romexis Cloud ........................................B-13
User’s Manual Planmeca Romexis 1

TABLE OF CONTENTS
6 DEMOGRAPHICS .............................................................................. B-14

6.1 Editing patients ................................................................................................B-14
Chapter C 2D IMAGING MODULE
1 PANORAMIC IMAGES ......................................................................... C-2

1.1 Capturing panoramic images ............................................................................ C-2
1.2 Capturing SmartPan panoramic images ........................................................... C-3
1.3 Opening and viewing SmartPan images ........................................................... C-4
1.4 Processing SmartPan stack images ................................................................. C-5
1.5 Moving and inactivating SmartPan images ....................................................... C-6
1.6 Adding SmartPan images to studies ................................................................. C-6
1.7 Importing and exporting SmartPan images ...................................................... C-6
1.8 Printing SmartPan images ................................................................................ C-6
2 CAPTURING CEPHALOMETRIC IMAGES ......................................... C-7

3 CAPTURING INTRAORAL IMAGES ................................................... C-9
3.1 Capturing intraoral images into a study ............................................................ C-9
3.2 Capturing single intraoral images ................................................................... C-11
4 CAPTURING INTRAORAL IMAGES ................................................. C-12

4.1 Capturing images with Planmeca ProSensor ................................................. C-12
5 CAPTURING INTRAORAL IMAGES WITH PLANMECA

PROSCANNER .................................................................................. C-15
5.1 Standalone Planmeca ProScanner ................................................................. C-15
5.2 Planmeca ProScanner with Planmeca ProID reader ...................................... C-19
5.3 ProScanner image recovery ........................................................................... C-24
6 CAPTURING INTRAORAL CAMERA IMAGES ................................ C-24

7 SEARCHING IMAGES IN CASE SERVER CONNECTION IS LOST C-25
7.1 2D images ....................................................................................................... C-25
7.2 3D images ....................................................................................................... C-26
8 TWAIN SETUP ................................................................................... C-27

8.1 TWAIN settings ............................................................................................... C-27
8.2 TWAIN image preprocessing .......................................................................... C-29
8.3 TWAIN auto recovery ..................................................................................... C-29
9 TWAIN CAPTURE .............................................................................. C-30

10 IMPORTING IMAGES ........................................................................ C-31
2 Planmeca Romexis User’s Manual

TABLE OF CONTENTS
11 DICOM IMPORT ................................................................................. C-32

11.1 DICOM import with patient data ...................................................................... C-32
12 DICOMDIR IMPORT ........................................................................... C-33

13 NEW STUDY ...................................................................................... C-35
14 IMAGE BROWSER ............................................................................ C-36
14.1 Browser tab ..................................................................................................... C-36
14.2 Study tab ......................................................................................................... C-45
14.3 Findings tab .................................................................................................... C-48
14.4 Attachments .................................................................................................... C-54
15 SETTING THE LAYOUT .................................................................... C-57

16 CLOSING ALL OPEN IMAGES ......................................................... C-57
17 DICOMDIR MEDIA STORAGE .......................................................... C-57
18 EXPORTING IMAGES ........................................................................ C-58
19 EXPORTING IMAGES USING DICOM EXPORT .............................. C-60
20 DICOMDIR EXPORT .......................................................................... C-61
21 PRINTING IMAGES / PRINT EDITOR ............................................... C-65
21.1 Creating print pages ....................................................................................... C-66
21.2 Print editor tool bar ......................................................................................... C-67
21.3 Vertical toolbar ................................................................................................ C-70
22 DICOM PRINT (OPTIONAL) .............................................................. C-75

23 DICOM STORAGE & STORAGE COMMITMENT (OPTIONAL) ....... C-76
24 LAUNCH EXTERNAL APPLICATIONS ............................................. C-76
25 CLOUD EXPORT ............................................................................... C-77
25.1 Sending cases using the Planmeca Romexis Cloud service .......................... C-78
26 PLANMECA ROMEXIS CEPHALOMETRIC ANALYSIS

(CEPH) MODULE ............................................................................... C-80
27 VIEW ADJUSTMENT TOOLS ............................................................ C-81
28 MEASURING IMAGES ....................................................................... C-83
29 DRAWING TOOLS ............................................................................. C-85
30 2D IMPLANT LIBRARY (OPTIONAL) ............................................... C-87
30.1 Adding and managing implants in the plan ..................................................... C-88

TABLE OF CONTENTS
31 IMAGE SPECIFIC TOOLS ................................................................. C-90

31.1 Image processing tools ................................................................................... C-91
32 IMAGE PROPERTIES ........................................................................ C-94

32.1 Show properties .............................................................................................. C-94
32.2 Alignments ...................................................................................................... C-97
32.3 Copy to clipboard ............................................................................................ C-98
32.4 Moving to other patient ................................................................................... C-98
32.5 Assign as face photo ..................................................................................... C-99
32.6 Inactivate ........................................................................................................ C-99
Chapter D 3D IMAGING MODULE
1 INTRODUCTION .................................................................................. D-1

2 VOLUMES TAB .................................................................................... D-3
2.1 Opening and viewing 3D volumes .................................................................... D-3
2.2 Show properties ................................................................................................ D-3
2.3 Moving volume to other patient ......................................................................... D-4
2.4 Inactivate .......................................................................................................... D-5
3 EXPLORER TAB .................................................................................. D-6

3.1 Short description of the 3D module main toolbar .............................................. D-6
3.2 3D capture ...................................................................................................... D-10
3.3 3D model capture ........................................................................................... D-12
3.4 Artefact removal .............................................................................................. D-14
3.5 Stitch volumes ................................................................................................ D-16
3.6 Importing 3D Images ...................................................................................... D-20
3.7 Importing Intra oral scans ............................................................................... D-21
3.8 Scanning with PlanScan scanner ................................................................... D-25
3.9 Exporting 3D Images ...................................................................................... D-25
3.10 Exporting surface models in ProFace tab ....................................................... D-29
3.11 Exporting CBVT volumes in STL (surface model) format ............................... D-30
3.12 Save 2D view .................................................................................................. D-33
3.13 Creating virtual cephalometric images ............................................................ D-38
3.14 Print editor ...................................................................................................... D-40
3.15 DICOM Print ................................................................................................... D-45
3.16 DICOM Storage .............................................................................................. D-46
3.17 Cloud export ................................................................................................... D-47
3.18 Launch external applications .......................................................................... D-47

TABLE OF CONTENTS
3.19 Adjust levels (contrast & brightness) .............................................................. D-48

3.20 Measure angle ................................................................................................ D-49
3.21 Measure length ............................................................................................... D-49
3.22 Save view ....................................................................................................... D-49
3.23 Select view ...................................................................................................... D-49
3.24 Delete view ..................................................................................................... D-50
3.25 Reset view ...................................................................................................... D-50
3.26 Toggle zoom ................................................................................................... D-50
3.27 Findings .......................................................................................................... D-51
3.28 Image properties ............................................................................................. D-52
3.29 Inactivate image .............................................................................................. D-52
3.30 Views .............................................................................................................. D-52
3.31 Slice specific tools .......................................................................................... D-54
3.32 Volume adjustment tools ................................................................................ D-56
3.33 Annotations ..................................................................................................... D-63
3.34 3D rendering ................................................................................................... D-70
3.35 3D overlays ..................................................................................................... D-73
3.36 Soft tissue overlay .......................................................................................... D-74
4 PANORAMIC (PAN) TAB .................................................................. D-78

4.1 Adjusting panoramic layer settings ................................................................. D-79
4.2 Using panoramic tools ................................................................................... D-80
5 3D CROSS SECTIONS TAB .............................................................. D-84

5.1 Adjusting slices in cross sections views ......................................................... D-85
5.2 Full arc mode .................................................................................................. D-86
5.3 Adjusting axial slices ....................................................................................... D-88
5.4 Adjusting panoramic slices ............................................................................. D-88
5.5 Cross sectional scroll bar ................................................................................ D-88
5.6 Nerve tools ...................................................................................................... D-89
6 IMPLANT TAB .................................................................................... D-91

6.1 Implant tools .................................................................................................. D-91
6.2 Placing implants .............................................................................................. D-93
6.3 Managing implants using the implant library ................................................... D-94
6.4 Using crown library ......................................................................................... D-98
6.5 3D implant verification tool .............................................................................. D-99
7 TMJ TAB .......................................................................................... D-102

7.1 TMJ Tools ..................................................................................................... D-102

TABLE OF CONTENTS
8 PROFACE TAB ................................................................................ D-105

8.1 Planmeca ProFace rendering view ............................................................... D-105
8.2 3D overlays ................................................................................................... D-106
8.3 CBVT rendering view .................................................................................... D-106
8.4 Planmeca ProFace image adjustment tools ................................................. D-106
8.5 Comparing ProFace images before and after treatment .............................. D-115
8.6 Alternative method for comparing images before and after treatment .......... D-120
8.7 Fitting Planmeca ProFace image to CBVT volume ...................................... D-122
8.8 Fitting surface models ................................................................................... D-125
8.9 Adjusting ProPace rendering overlay offset manually .................................. D-129
8.10 Creating a set of Planmeca ProFace 2D snaphots ....................................... D-130
8.11 Taking Planmeca ProFace quickshots ......................................................... D-131
8.12 Importing Planmeca ProFace images ........................................................... D-133
8.13 Exporting Planmeca ProFace images .......................................................... D-134
9 FILE MENU ....................................................................................... D-137

9.1 About ............................................................................................................ D-137
9.2 ROI reconstructions ...................................................................................... D-137
9.3 Recovering 3D volumes ................................................................................ D-139
Chapter E CAD/CAM MODULE
1 INTRODUCTION .................................................................................. E-1

1.1 Scan & design new restorations ........................................................................E-2
1.2 Import 3D models ..............................................................................................E-2
1.3 Export 3D models ..............................................................................................E-4
1.4 Patient’s case files .............................................................................................E-4
1.5 Scans and restorations in 3D module ................................................................E-6
Chapter F CLINIC MODULE
1 INTRODUCTION .................................................................................. F-1

2 CLINIC MONITORING .......................................................................... F-1
2.1 Operatories ........................................................................................................F-2
2.2 Searching dental units, operatories and users ..................................................F-3
2.3 Configuring clinic layout .....................................................................................F-4
2.4 Update firmware (centralized update of Planmeca dental unit software) ..........F-6

TABLE OF CONTENTS
3 UNIT MONITORING ............................................................................. F-7

3.1 User and patient data ........................................................................................F-7
3.2 Dental unit control panel ....................................................................................F-8
3.3 Storing and restoring dental unit settings ..........................................................F-8
3.4 Short cuts ...........................................................................................................F-9
3.5 Error messages ...............................................................................................F-10
3.6 Instrument console ..........................................................................................F-10
3.7 Chair position ...................................................................................................F-11
3.8 Graphic display ................................................................................................F-11
4 DIAGNOSTIC LOG ............................................................................. F-13

4.1 Reviewing dental unit events ...........................................................................F-14
5 DEVICE SUMMARY ........................................................................... F-15

5.1 Unit .................................................................................................................F-16
5.2 Instruments ......................................................................................................F-17
5.3 Latest cleaning procedures ..............................................................................F-17
5.4 Service history .................................................................................................F-18
5.5 Viewing events in diagnostic log ......................................................................F-20
6 INFO ................................................................................................... F-21
Chapter G ADMIN MODULE
1 RESOURCE ..........................................................................................G-1
1.1 Groups tab ........................................................................................................ G-1
1.2 Users ................................................................................................................ G-5
2 DEVICE ALERTS .................................................................................G-8

2.1 Configure device alerts ..................................................................................... G-8
3 DENTAL RECORD .............................................................................G-11

3.1 Materials ......................................................................................................... G-11
4 IMAGING ............................................................................................G-13
4.1 Templates ....................................................................................................... G-13
4.2 DICOM Configuration ..................................................................................... G-17
5 LOCAL SETTINGS .............................................................................G-28

5.1 Set as global defaults ..................................................................................... G-28
5.2 3D ................................................................................................................... G-29
5.3 Reconstruction Server .................................................................................... G-30
5.4 2D ................................................................................................................... G-30

TABLE OF CONTENTS
5.5 External applications ....................................................................................... G-32

5.6 Dental unit interface (PlanLink) ....................................................................... G-34
5.7 Intraoral video camera Serial Connection (CamComm) ................................. G-34
5.8 Practice management software interface (PMBRIDGE) ................................. G-34
5.9 CD recording device ....................................................................................... G-34
5.10 DICOM ............................................................................................................ G-34
Chapter H REPORT MODULE
1 REPORT GENERATION ...................................................................... H-2

1.1 Image Link ........................................................................................................ H-2
1.2 Patient link ........................................................................................................ H-2
1.3 Refresh ............................................................................................................. H-2
1.4 Print .................................................................................................................. H-2
2 IMAGE VIEW ........................................................................................ H-3
Chapter I PLANMECA ROMEXIS CONFIGURATION APPLICATION
1 ENTERING THE APPLICATION ............................................................I-1

1.1 Changing password ............................................................................................ I-2
2 GENERAL SETTINGS ...........................................................................I-3

2.1 Resources ........................................................................................................... I-3
3 IMAGING ..............................................................................................I-12
3.1 Panoramic ......................................................................................................... I-12
3.2 Cephalometric ................................................................................................... I-15
3.3 Intraoral ............................................................................................................. I-17
3.4 CBVT ................................................................................................................ I-20
3.5 Display .............................................................................................................. I-21
3.6 Dental record .................................................................................................... I-23
3.7 PlanLink & Diagnostics ..................................................................................... I-25
3.8 Print .................................................................................................................. I-27
3.9 Cloud ................................................................................................................ I-28
3.10 DDX dental ....................................................................................................... I-29
4 IMAGE & DATA MANAGEMENT ........................................................I-31

4.1 Data folders ...................................................................................................... I-31
4.2 Trash ................................................................................................................. I-32
4.3 Long Term Archive ........................................................................................... I-33

TABLE OF CONTENTS
5 START-UP ............................................................................................I-34
5.1 Client parameters ............................................................................................. I-34
5.2 Romexis Service ............................................................................................... I-36
6 SERVER PARAMETERS .....................................................................I-39

6.1 Server ............................................................................................................... I-39
6.2 Database .......................................................................................................... I-41
6.3 External communication ................................................................................... I-43
APPENDIX A: ORDER SERVICES .........................................APPENDIX A-1

1 PLANMECA PROMODEL .................................................APPENDIX A-1
1.1 Placing an order .................................................................................Appendix A-1
2 ORDERING SURGIGUIDE® DRILL GUIDES WITH

PLANMECA ROMEXIS .....................................................APPENDIX A-6
3 3D DIAGNOSTIX ORDER SERVICES ..............................APPENDIX A-8
3.1 Radiology report order .......................................................................Appendix A-8
3.2 Treatment plan and guide order ......................................................Appendix A-11
APPENDIX B: PLANMECA ROMEXIS VIEWER .....................APPENDIX B-1

1 OPENING IMAGES ...........................................................APPENDIX B-1
2 VIEWING 3D IMAGES .......................................................APPENDIX B-3
APPENDIX C: PLANMECA iROMEXIS ...................................APPENDIX C-1

1 INTRODUCTION ...............................................................APPENDIX C-1
2 CONNECTING PLANMECA iROMEXIS TO SERVER .....APPENDIX C-2
3 ADJUSTING USER INTERFACE AND DATABASE
SETTINGS .........................................................................APPENDIX C-5
4 VIEWING AND BROWSING IMAGES ..............................APPENDIX C-6

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 60364
- equipment is used according to the operating instructions
Planmeca pursues a policy of continual product development. Although every

effort is made to produce up-to-date product documentation this publication
should not be regarded as an infallible guide to current specifications. We
reserve the right to make changes without prior notice.
COPYRIGHT PLANMECA
Publication number 10014593 Revision 18
Released 19 December 2013

Chapter
A GENERAL
1 INTRODUCTION TO PLANMECA ROMEXIS

IMAGING SOFTWARE
The Planmeca RomexisTM imaging software is intended for viewing,

enhancing and archiving images. It can be used to take exposures with all the
present and future Planmeca digital imaging devices and video cameras. This
manual describes how to use the software.
NOTE Read this manual carefully before using the system.
NOTE The Planmeca ProMax 3D X-ray units, other digital X-ray units and
intraoral video cameras have separate manuals, which should be used
in conjunction with this manual.
NOTE This manual is valid for the following software revisions:

Planmeca Romexis 3.4.0.R.
Please see X-ray unit manuals for availability of specific features.
NOTE Planmeca Romexis can be used with Microsoft Windows 8, 7, XP, Vista
Business, Windows 2003 and Windows 2008 Server operating systems.
Planmeca Romexis conforms to Windows user interface standards. Mac
OS operating systems are supported with certain limitations.
NOTE User organization must take care of protecting the computer and the
network by using up-to-date virus and malware protection software and
fire wall.
The operation of the Planmeca Romexis system is made as simple as

possible. However, no computer system can be operated continuously and
successfully without competent software and hardware. Especially in mission
critical applications, such as archiving of patient images, continuous operation
of the system must be assured. This includes, but is not limited to, making
sure that hardware and software support is available, phone help and user
training as well as backing up of patient data has been arranged. It is
recommended to engage a competent system integrator service for this
purpose.
Planmeca Romexis is a registered trademark of Planmeca company.
Planmeca Romexis imaging software fulfils the requirements of Directive 93/

42/EEC.
User’s Manual Planmeca Romexis A-1

INTRODUCTION TO PLANMECA ROMEXIS IMAGING SOFTWARE
1.1 Introduction to digital imaging
Digital images are composed of small dots called pixels. Similarly the 3D
images are composed of voxels, three dimensional pixels. The size of each
pixel sets an absolute upper limit on what can be observed. Refer your X-ray
unit’s documentation for detailed information on maximum resolution, image
dimensions and exposure times.
Each pixel in an image is represented by a numerical value in the computer

memory. Because of the numerical (non-physical) nature of the image, the
brightness and contrast of the image can be altered and various image
enhancements can be performed. It is necessary to take into account the
effects of image enhancement when using manipulated images for diagnosis.
The numerical nature of the image sets an upper limit to the detectability of
contrast differences (e.g. in radio translucency) in digital images. This contrast
resolution is expressed in terms of number of bits used in capturing and
storing the image or in number of grey levels that the system can record. See
below for values of Planmeca equipment:
Device Number of bits Gray levels
Dimax (all modes) 12 4096
Promax 3D (all modes) 12 (15 bit raw processing) 4096
Most computer screens can display 256 (8 bit) grey levels or less and it has
been shown that the human eye can barely differentiate contrast differences
in the order of 1/32 - 1/64 (5/6 bits). However, the eye automatically adapts to
the lighting conditions, and this together with proper use of the light box
makes it possible to detect smaller variations in film contrast. It is therefore
necessary to capture and record images at a higher contrast resolution than
256 grey levels (8 bits). More contrast latitude also allows more variations in
exposure factors (kV/mA).
NOTE IMPORTANT SAFETY NOTICE!

Image processing can significantly alter the visibility of both large and
small structures (i.e. bone loss and caries), which may result in either
too many false positive or false negative findings, if care is not taken.
1.2 Securing the image data
Planmeca Romexis uses database system for storing patient data and image
meta information. Image data is stored into the file system as individual files.
Both the database and the image data in the file systems need to be backed
up and stored securely.
A-2 Planmeca Romexis User’s Manual

NOTE Planmeca claims no responsibility for the end users’ data security or for
any malfunction in the computer system that may lead to loss of data.
1.3 Image acquisition
The system is designed to automate the acquisition of images with minimum

intervention from the user. Provided that the user has selected the correct
patient in Planmeca Romexis software, the acquisition procedure and
archiving of the image(s) is almost exactly the same as with conventional film
based imaging systems, except that archiving is fully automated and no film
processing is required. The employed exposure technique is automatically
stored with each image.
1.4 Settings
Planmeca Romexis provides various user settings. A range of parameters

and other options can be set to permit control over the main procedures. The
default settings have been chosen for a typical Planmeca Romexis
environment. If required, they can be easily modified in the Planmeca
Romexis Configuration application, see chapter I “PLANMECA ROMEXIS
CONFIGURATION APPLICATION”.
1.5 Archiving
The archiving of images in Planmeca Romexis is organized under patient

names. The image data is stored in the file system. The exposure values and
basic patient data are stored in the database. Multiple users can store and
retrieve images to and from the system simultaneously.
Long term archive
Long Term Archive (LTA) allows old images to be moved to a more

permanent storage based on the date of acquisition. For more information on
Planmeca Romexis Long Term Archive see section 4.3 “Long Term Archive”
on page I-30.
NOTE The Long Term Archive is not a backup system and appropriate
backups should be maintained in addition to LTA media.

Disk space requirements for 2D images
The approximate disk space requirements for different image formats are the
following:
Format Without compression

With JPEG1
Dimax2/3 normal resolution,

panoramic 5.0 MB 0.8 MB
Dimax2/3 normal resolution,

cephalometric 7.0 MB 0.95 MB
Dimax2/3 enhanced resolution2,

panoramic 8.9 MB 1.1 MB
Dimax2/3 enhanced resolution2,

cephalometric 12.5 MB 1.9 MB
Dimax2/3 high resolution2,

panoramic 20 MB 2.2 MB
Dixi2/3 B0 normal resolution 560 kB 180 kB
Dixi2/3 B1 normal resolution 940 kB 310 kB
Dixi2/3 B2 normal resolution 1.3 MB 430 kB
Dixi2 B0 high resolution2 2.2 MB 720 kB
Dixi2/3 B1 high resolution2 3.8 MB 1.2 MB
Dixi2/3 B2 high resolution2 5.2 MB 1.7 MB
ProSensor S0 normal resolution 1,0 MB
1. The actual achievable values depend on the individual image.

2. Because of the extensive disk space requirements and the additional X-ray radiation necessary for
achieving the same (low) level of noise (quantum mottle), the user should carefully evaluate the
advantages of using the enhanced/high resolution mode.


JPEG conversion is a so called lossy compression, the use of which can
lead to loss of details in an image. Therefore it cannot be guaranteed
that the diagnostic value of the compressed image is equivalent to the
value in the original image. While several studies (see e.g. IADMFR/
CMI´97 Advances in Maxillofacial Imaging: The loss of image quality in
panoramic radiography using image compression, C.G.H Sanderink et
al.) indicate that the loss of data may be insignificant, Planmeca cannot
guarantee that it is safe to use compressed image data for diagnostic
purposes.
Disk space requirements for 3D images
3D X-ray Unit File Format Maximum File Size

ProMax 3D s DICOM 3.0 270 MB
(multi frame)
Promax 3D DICOM 3.0 250 MB
(multi frame)
ProMax 3D Max DICOM 3.0 430 MB
(multi frame)
ProMax 3D Mid DICOM 3.0 977 MB
(multi frame
Note! For stitched volumes the disk space
requirement is double the maximum file size as
the original volumes are stored in addition to the
stitched final volume
1.6 Processing and restoring images
Image processing may radically alter the appearance and possibly the
diagnostic value of the image. However, it is always possible to restore the
image to its original state or undo modifications one by one.

1.7 Measuring images
The measurement tools allow both geometric and relative intensity (i.e.
radiotranslucency or brightness/contrast) measurements.
When performing geometric measurements it should be noted that image

processing (even mere brightness/contrast adjustment) can alter the apparent
geometry of the objects in the image. Also because of the normal distortions
(most notably varying magnification) associated with normal projection X-ray
imaging the measurements must be based on known reference objects in the
image. For this purpose a calibration tool is provided in the Planmeca
Romexis software.
When performing intensity measurements it should be noted that after certain

image processing the relative intensities of the objects may be affected by
their neighbouring objects, which may affect the reliability of e.g. bone density
measurements with the help of a calibration step wedge. The only image
processing procedures guaranteed not to change the relative intensities so
that measurements are independent of the measurement position, are the
brightness/contrast and level adjustment. No guarantee can be given between
the intensity measurements of two different images.
1.8 Annotating images
Images can be annotated with markers and text. These annotations appear as
an overlay on the image and can thus be turned on and off as desired. The
annotations do not affect the actual image.
1.9 Printing
Planmeca Romexis supports DICOM and Windows compatible printers.

1.10 DICOM support
Planmeca Romexis supports the following DICOM (Digital Imaging and

Communications in Medicine) services:
• DICOM Storage SCU (optional),

see chapter C “2D IMAGING MODULE”, section 23 “DICOM STORAGE & STORAGE
COMMITMENT (OPTIONAL)” on page C-73.
• DICOM Storage Commitment SCU (optional),

see chapter C “2D IMAGING MODULE”, section 23 “DICOM STORAGE & STORAGE
COMMITMENT (OPTIONAL)” on page C-73.
• DICOM Query Retrieve SCU (optional),

see chapter B “PATIENTS & FILES MODULES” section 3 “DICOM QUERY / RETRIEVE
(OPTIONAL)” on page B-7.
• DICOM Worklist SCU (optional),

see chapter B “PATIENTS & FILES MODULES”, section 2 “DICOM WORKLIST SEARCH”
on page B-7.
• DICOM Modality performed procedure step MPPS SCU (optional),

see chapter G “ADMIN MODULE”, section 4.2.4 “DICOM Modality performed procedure step
(MPPS)” on page G-22.
• DICOM Print SCU (optional), see chapter C “2D IMAGING MODULE”, section 22 “DICOM
PRINT (OPTIONAL)” on page C-72.
• DICOM Import, single and multi-frame, see chapter C “2D IMAGING MODULE”, section 11
“DICOM IMPORT” on page C-30.
• DICOM Export, single and multi-frame, see chapter C “2D IMAGING MODULE”, section 19
“EXPORTING IMAGES USING DICOM EXPORT” on page C-58.
• DICOMDIR Media Storage, see chapter C “2D IMAGING MODULE”, section 17 “DICOMDIR
MEDIA STORAGE” on page C-55.

1.11 Disclaimer

Planmeca claims no responsibility for the end user’s data security or for
any malfunction in the computer system that may lead to data loss.
Since image processing and digital subtraction radiography can

significantly alter the visibility of both large and small structures (i.e.
bone loss and caries), which may result in either too many false positive
or false negative findings, Planmeca claims no responsibility for the
software use, actions or diagnoses made by the end-user.
The qualities of the monitor can strongly affect image quality. The
monitor qualities change as it gets older.
To correct under/overexposed images adjust gamma and/or contrast/

brightness levels. Only in case these adjustments do not improve the
image take a new image with different exposure values.
Cone beam computed tomography (CBCT) imaging is based on complex

mathematical algorithms that produce high fidelity images. However
various sources may cause imaging artifacts that may lead to incorrect
diagnoses if not properly interpreted. Image interpretation should only
be done by trained professional familiar with CBCT imaging as well as
limitations and artifacts of the Planmeca ProMax 3D X-ray units.
NOTE Please note that as a generic viewing application Planmeca iRomexis

Mobile is not approved for diagnostic use and shall not be used as such.

STARTING PLANMECA ROMEXIS
2 STARTING PLANMECA ROMEXIS
1. Click this icon on your desktop.
A login window opens.
NOTE The appearance of the Login window may differ from the view below
depending on the settings configured by your administrator, see section
2.1.3 “Security” on page I-6.
2. Type your user name and password and click OK.
The Planmeca Romexis application opens in Patient module.
The name of the current user is shown in the title bar.
To login as different user click this icon.
To logout click this icon. All currently opened files will be closed.
NOTE If you are trying to log in while another user is currently logged in, all
patient records are closed but the current views will be stored and
shown when the patient is next accessed by the user. This allows
authorized personnel to view and modify patient status using their own
credentials. If you logout no views will be stored and the patient data will
be opened with default view when accessed next time.

PLANMECA ROMEXIS MODULES
3 PLANMECA ROMEXIS MODULES
The Planmeca Romexis software consists of several software modules.
To access the modules click the module icons on the left side of the screen.
1. Patient module for patient selection and management
2. Files module for managing patient information
3. Record module (optional)
4. Imaging module for X-ray and other imaging
5. 3D module for ProMax 3D images (optional)
6. Clinic module (optional)
7. Report module
8. Admin module
NOTE The visibility of the modules and their functions are controlled by
license and user rights. Depending on the installed license and user
rights the functions described in this manual can vary.

PLANMECA ROMEXIS SHORT CUT COMMANDS
4 PLANMECA ROMEXIS SHORT CUT COMMANDS
The following abbreviations are used in the short cut commands table:
LMB = Left mouse button, RMB = Right mouse button, MMB = Middle mouse
button
On Mac operating systems Ctrl + mouse commands are interpreted as right

mouse click. Therefore, to perform the Windows Ctrl + Shift + mouse
command on Mac, use the command Ctrl + Shift +fn + instead.
Alternatively the MacOS mouse commands can be changed to equivalent of

those on Windows in MacOS System Preferences.
GENERIC SHORTCUTS
All text fields
Windows OS Mac OS Comments
Copy Ctrl + C Ctrl + C
Paste Ctrl + V Ctrl + V
Cut Ctrl + X Ctrl + X
OK / Cancel & Yes / No prompt dialogues
OK Enter Enter
Cancel Esc Esc
Lists & scrollable tables
Move Cursor keys & Cursor keys &
PageUp / PageUp /
PageDown PageDown
Annotations
Delete selected Delete (or Del) fn + Backspace
annotation
3D MODULE
Slice views
Open short-cut RMB click RMB click
menu
3D rendering
Rotate CBVT LMB + hold LMB + hold
volume

Move object Ctrl + Shift + Ctrl + Shift + Fn Moving of

(implant, crown, hold + LMB hold + RMB selected objects
IO Scan) can be
Alt+Shift + hold prevented from
+ LMB the right-click
menu.
Move rendered LMB + Alt + hold LMB + Alt + hold
volume
Increase/ Alt + hold + Alt + hold
decrease the mouse wheel mouse wheel
size of the Paint
ROI to trim tool
Rotate image Alt + hold + LMB Alt + hold + LMB
while Paint ROI
to trim tool is
selected
Drag to crop RMB + hold RMB + hold
volume
Recentre volume RMB click RMB click
on a new point
(surface
rendering only)
Pan/move CBVT MMB Mouse button 3
volume Alt + LMB + hold
Alt + LBM /
cmd + LMB
Zoom in/out Mouse wheel Mouse wheel
scroll scroll
Implant slice views
Drag horizontally RMB + hold RMB + hold
to rotate implant
/ crown
IO-scan import
CBVT volume
Drag to pan/
move surface
model
Pan/move CBVT MMB + hold MMB + hold
volume
Rotate CBVT LMB + hold LMB + hold
volume
Zoom in/out Mouse wheel Mouse wheel
scroll scroll

Virtual ceph
Tilt volume Ctrl + RMB Ctrl + RMB
Adjust contrast & Ctrl + LMB Ctrl + Mouse
brightness button 3
volume
Pan/move Alt + LMB Mouse button 3
MMB + Hold /
Alt + LBM /
cmd + LMB


Chapter
B PATIENTS & FILES MODULES

In this section you can manage patients including searching, editing,
assigning patient to a specific user (group), and inactivating patients.
All patient information is managed in the Files module.
1 ALL PATIENTS
1.1 Searching patients
Patients can be searched by ID or by name.
Search patients by ID
1. Select the option Find by Person ID from the drop-down menu.
2. Enter the patient ID in the text field and click the Find button.
User’s Manual Planmeca Romexis B-1

ALL PATIENTS
Search patients by name
1. Select Find by name from the drop-down (see image above).
2. Enter the patient’s name in Last name, First name format into the search
field and touch the Enter key or click Find to make matching patients appear
in the patient list.
To view all patients saved in the database use the * sign as the search term.
If a partial name is entered all patients whose last name begins with that
partial string will be shown. To search patients by their first name replace the
last name with the wild card *.
Examples:
Doe, John all patients whose last name is Doe and first name
John
S all patients whose last name starts with the letter S
Smi all patients whose last name starts with ‘Smi’, e.g.
Smith and Smiley
Van Gogh all patients with the last name Van Gogh
*, Paul all patients whose first name is Paul
To search patients by a captured image, see section 4 “FIND BY IMAGE” on

page B-9.
To reactivate or permanently delete a patient from the database see section

4.2.1 “Reactivate and empty trash” on page I-29.
1.2 Searching assigned patients
To retrieve all patients assigned to the current user click the Find assigned.
B-2 Planmeca Romexis User’s Manual

ALL PATIENTS
1.3 Sorting patients
Patients in the patient list can be sorted by ID, last name, first name, birth
date, age, gender, phone number, the number of assigned providers and type
(for virtual and template patients) as well as by assignments.
To sort patients click the respective column title.
1.4 Selecting and opening patients
1. Click the patient name in the patient list.
2. Click the Select button (or double-click the patient name).
3. In the opening dialogue select the reason for opening the patient record and
click OK.

ALL PATIENTS
NOTE This request can be set optional in the Planmeca Romexis Configuration
application.
Planmeca Romexis automatically opens the Files module.
The reason for opening a patient record is saved and displayed in the dental
record under the patient case history.
The name of the active patient is always visible in the upper right corner of the
screen. Several patient records can be open at a time but only one of the
open records is active at a time.

ALL PATIENTS
To close the active patient click the Close Patient button.
To view all open patients click the arrow of the drop-down menu.
To select and modify another open patient select the name from the drop-
down menu.
1.5 Adding patients
1. To create a new patient click the Add Patient button.
The Files module opens
2. Enter the necessary information and add a face photo if desired.
The obligatory fields are Person ID, First name and Last name.
3. To save the patient into the database click the Save Patient button.
NOTE The changes are not saved unless Save Patient button is used.
To view the newly created patient on the list perform new patient search.

ALL PATIENTS
1.5.1 Template and virtual patients
For educational purposes template and virtual patients can be created. The
template patients are not real patients but simulate the possible patient cases
that can then be copied into virtual patients for the students to work on.
The supervisors can create template patients with specific medical/dental

history with images included for the students to practice on in a simulation
laboratory.
For the students to work on a patient, the template needs to be copied into
virtual patients which can then be assigned to individual students. That way
each student has his/her own virtual patient(s) to work on but with shared
clinical case.
Creating template patients
Click the Add template button.
To distinguish virtual patients from the actual patients in the patient list
“Template” can be added in the Type column.
Creating virtual patients
1. Select the template patient from the patient list.
2. Click the Add virtual button.
You can name each virtual patient so that the name of the student is included
in the name e.g. Jane’s Child Patient.
To distinguish virtual patients from actual patients “Virtual” can be added in

the Type column.
1.6 Assigning patients
1. Select the patient you want to assign from the patient list and click the Assign
patient button.

ALL PATIENTS
2. Choose the provider you want to assign the patient to. Click OK.
A patient can have one primary provider and several secondary providers. In
case a patient already has one provider and the Assign patient button is
clicked again the following dialogue appears.
• To reassign the patient to a new primary provider click Reassign Primary

button.
• To assign the patient to a secondary provider click Assign Secondary button.
To see the provider(s) assigned to the patient click this button.
The providers assigned appear in the patient list.
1.7 Inactivating patients
To remove a patient form the patient list click the Inactivate button. All patient
information with images are preserved in the Planmeca Romexis database.
To reactivate or permanently delete a patient from the database see section


DICOM WORKLIST SEARCH
2 DICOM WORKLIST SEARCH
The Dicom worklist search can be used to search and retrieve patients from a
central patient archive.
Searches can be filtered by patient information, DICOM parameters such as

accession number or modality or date range.
When selected, a patient is automatically added to the Planmeca Romexis

database if not already registered. If a near match exists in the database the
user will be asked on how to proceed.
3 DICOM QUERY / RETRIEVE (OPTIONAL)
The DICOM Query Retrieve SCU (Q/R) service is used for retrieving images
from DICOM PACS servers. The images can first be queried and then
selected for retrieval to the local storage.
Once retrieved the images can be processed independently of the remote

server.
To send processed images back to the DICOM PACS server use DICOM
Storage, see section 23 “DICOM STORAGE & STORAGE COMMITMENT
(OPTIONAL)” on page C-73 for more information.
To list images for a patient, use the Query or Retrieve button.
To retrieve the selected images, use the Study button.

FIND BY IMAGE
4 FIND BY IMAGE
Patients can be searched by the image type, date and image comments.
To search patients by image define the appropriate search criteria and click
the Find button.
The patients that match the search criteria appear in the list.
To open the found patient select the patient and click Select or double-click
the patient.

CLOUD MANAGEMENT
5 CLOUD MANAGEMENT
To use the cloud management you need a cloud user account. On how to
setup an account see section 1.2.2 “Cloud (User account setup)” on page G-
7.
5.1 Downloading cases from the Cloud server
1. Browse to the Cloud Management tab under Patient module.
2. In the Active Cases list select the case you want to view and click Download.
You can monitor the download progress in the Cloud Management tab. While
the case is being downloaded you can continue working in Planmeca
Romexis but do NOT close it during download. If you try to close Romexis
while the download is in progress you will be prompted to confirm closing
Romexis.
Once the case has been downloaded and saved to Romexis server you will
be prompted if you want to open the image.

CLOUD MANAGEMENT
3. To open the case at a later time select it in Cloud Management tab and click
Open.
5.2 Managing cases
Sent and received cases can be managed in the Cloud Management tab.
You can view the status of all the sent (Case History) and received (Active
Cases) cases and also delete any sent cases.

CLOUD MANAGEMENT
5.3 Planmeca Romexis Cloud users and requirements
NOTE The information regarding cloud users and requirements are subject to
change. For latest information see Planmeca Online website.
Planmeca Romexis Cloud subscriber
Customers who have Planmeca Romexis wanting to both send and receive
images and documents (referrals, reports etc):
• Planmeca Romexis 3.1.0.R or newer
• Planmeca Online account (free)
• Planmeca Romexis Cloud subscription (monthly fee)
Planmeca Online account holder
Customers who have Planmeca Romexis but only want to receive images and
document:
• Planmeca Romexis 3.1.0.R or newer
• Planmeca Online account (free)
Users who do not have Planmeca Romexis
Users wanting occasionally to receive cases from Planmeca over the internet
instead of via Planmeca Romexis Viewer DVDs:
• E-mail address and internet access to receive download links for Planmeca
Romexis
• Planmeca Romexis Viewer + image packages.
Planmeca Romexis Cloud subscribers
Users wanting to receive cases over the internet instead of receiving

Planmeca Romexis Viewer DVDs:
• E-mail address and internet access to receive download links for Planmeca
Romexis

CLOUD MANAGEMENT
• Planmeca Romexis Viewer + image packages.

Table 1: Planmeca Romexis Cloud users and use cases
Planmeca
Planmeca
Casual Online
Romexis Cloud
user account
subscriber
holder
Internet access and e-mail
X X X
address required
Download Planmeca Viewer +
image packages from e-mail X X X
links
Replace DVDs with online
X X X
transfers
Secure transfer and storage of
X X X
patient data in the Cloud
Automatic notifications of new
X X X
cases by e-mail.
Free Planmeca Online account X X
Planmeca Romexis 3.1.0.R or
X X
newer
Download cases directly in
X X
Planmeca Romexis
Manage received cases in
X X
Planmeca Romexis
Subscription to Planmeca
Romexis Cloud (monthly fee, X X
credit card required)
Send cases (images +
documents) to other users X
directly in Planmeca Romexis
Manage sent cases in Planmeca
X
Romexis
5.4 System configuration for Planmeca Romexis Cloud
In cases where the Planmeca Romexis Client workstation is behind a firewall,

a firewall proxy server IP and port can be configured in the Planmeca
Romexis Configuration application under General Settings > Cloud > Servers,
see section 3.9 “Cloud” on page I-25.

DEMOGRAPHICS
6 DEMOGRAPHICS
The Demographics tab sheet in the Files module contains all patient
information and is automatically selected when creating a new patient or
editing an existing one.
6.1 Editing patients
1. Select the patient you want to edit and click the Edit Patient button.
2. Edit the information as necessary.
3. Click the Save Patient button.

Chapter
C 2D IMAGING MODULE
This module is intended for capturing, processing, and storing of X-ray images
and photographs.
NOTE To access the Imaging module a patient must be selected.
The 2D Imaging module consists of the following parts:
1. Image browser: displays thumbnails of all images of the currently selected

patient
2. Main toolbar: contains the tools for capturing, lay-outing and for exporting/
importing images.
3. Image processing toolbar: contains tools for processing, measuring and

annotating images
4. Image specific toolbar: contains tool for adjusting the specific image.
Main toolbar
Image
processing
toolbar
Image specific toolbar
Image browser
User’s Manual Planmeca Romexis C-1

PANORAMIC IMAGES
1 PANORAMIC IMAGES
1.1 Capturing panoramic images
NOTE In case the user does not have the right to capture images without an
approval of the supervisor the capture buttons are disabled until an
image acquisition request for the current user/active patient/image type
combination has been approved. (On how to define user rights see
section 1.2 “Users” on page G-6).
1. Click this icon.
The Panoramic Exposure window appears.
When the X-ray unit is in the ready state the message Waiting for Ready
appears.
2. Prepare the patient for exposure and select the exposure parameters.
3. Drive the X-ray unit to the ready position.
NOTE The L sign denotes the left side of the patient.
When the panoramic unit is in ready position the message Waiting for
Exposure appears.
4. Take an exposure.
The message Saving the image appears and the image is automatically
stored into the database.
5. When all exposures have been taken click Done to return to the 2D Imaging
module.
C-2 Planmeca Romexis User’s Manual

PANORAMIC IMAGES
1.2 Capturing SmartPan panoramic images
Certain Planmeca Promax 3D model X-ray units can take both 3D and 2D
images using the same sensor. The available 2D imaging modes include
panoramic, bite-wing and sinus exposure modes. SmartPan images will be
stored in Planmeca Romexis as an image stack consisting of one auto focus
panoramic image and 9 panoramic images each with a different panoramic
focal layer. The 9 layers allow for viewing different focal layers in the image at
a later time. The layers can also be rejected in preference of the autofocus
image. The SmartPan Autofocus image is automatically generated using the
sharpest layer in each segment of the exposure. The Autofocus image
combines the layers into one optimum image.
For the 2D images acquired with SmartPan, only the pixel size 127µm is
available.
To capture SmartPan panoramic images:
1. Click this icon.
The Panoramic Exposure window appears.
When the X-ray unit is in ready state the message Waiting for Ready appears.
2. Prepare the patient for exposure and select the exposure parameters.
3. Drive the X-ray unit to the ready position. Refer to your Planmeca panoramic
X-ray unit’s User’s manual if uncertain.
When the X-ray unit is in the ready position the message Waiting for Exposure
appears.
After exposure the message Saving the image appears and the image is
automatically stored into the database.
5. When all the exposures have been taken click Done to return to the Imaging
module.

PANORAMIC IMAGES
1.3 Opening and viewing SmartPan images
The SmartPan panoramic images are stored in Planmeca Romexis as a stack

of 10 images that show as a single item with a stack symbol.
The SmartPan images can be opened as a single image or moved between

panoramic focal layer. Normally the 10/10 layer is an Autofocus layer where
the sharpest vertical segments in each layer have been combined into one
overall sharp image.
To open the SmartPan image:
1. Double-click the image in the image browser.
2. Select whether to open the image as a stack or as single images.
NOTE After exposure SmartPan image is automatically opened as a stack

image.
When the image is opened as a stack a scroll bar will appear on the right side
of the image that allows for browsing between panoramic focal layers.
Scroll
bar
The image title bar will read SmartPan indicating the layer currently shown
(e.g. 5/9).
To move the focal layer towards anterior scroll down the image.
To move the focal layer towards posterior scroll up the image.
To navigate between layers use the mouse wheel.
NOTE If any of the single panoramic images in a SmartPan stack are open the
SmartPan stack image will be opened as read only.
1.3.1 Opening SmartPan images in Planmeca Romexis Viewer
SmartPan images can be opened as a stack in Planmeca Romexis Viewer if

they have been exported using DICOMDIR export.

PANORAMIC IMAGES
1.4 Processing SmartPan stack images
In general the processing (viewing, measurement and drawing) is applied to

all images in the stack. For example zooming in and out will zoom all images
in the SmartPan stack even the ones that are not currently shown. The
exceptions to this rule are listed below:
NOTE If a SmartPan stack is opened as separate image(s) all processing will

be applied to opened images only.
Table 2: Summary of processing applied to stack or single image
Processing that apply to stack Processing that affect single

image only
ROI
Zoom
It is not possible to set a Region of
Interest (ROI) on SmartPan images
Calibration
Pan
Each image in the stack must be
calibrated individually.
Magnifier Measurements
Specific to each image.
Line Profile
Overview
Shows the profile for the images
currently showing in the stack
Histogram
Flashlight Displays the histogram of the
images currently showing in the
stack
Contrast/Brightness Annotations
Specific to each image.
Show Annotations Select Annotation
Delete Annotation
Exceptions to Image Specific tools on the vertical image processing toolbar:
• SmartPan layer cannot be modified while the toolbar is shown. Close the tool-
bar to modify the layer.
• Image processing history shows the history of the currently shown image, not
the one of the whole stack.
• Image Properties: comments and diagnosis are uniformly applied to the whole
stack while rotating and mirroring are not possible.

PANORAMIC IMAGES
1.5 Moving and inactivating SmartPan images
By selecting Move To Other Patient you will be will prompted to choose

whether to move the whole SmartPan stack or only the current/open stack
image.
By inactivating stack imageyou will be will prompted to choose whether to

inactivate single image in the stack or the whole stack.
1.6 Adding SmartPan images to studies
The SmartPan stack images can be added to studies containing free

panoramic slot(s). When added to studies, individual stack images can be
moved to different slots as any other images. Also single images can be
removed from layout. Dragging and deleting, however, is limited to the
topmost images in the stack.
1.7 Importing and exporting SmartPan images
• DICOM / DICOMDIR Import: It is possible to import SmartPan images as

stack using DICOMDIR import of a SmartPan stack that has been exported
using DICOMDIR. It is also possible to import multiple SmartPan stack
images using DICOM Import which will automatically add them to a stack if
they originally belong to the same SmartPan exposure.
• DICOM / DICOMDIR Export: When using DICOM export, only the currently
shown stack image is exported. In case of DICOMDIR all stack images are
added to the DICOMDIR fileset by default.
• Bitmap Export: When basic export is used only the currently shown stack
image will be exported to a bitmap file.
1.8 Printing SmartPan images
By default the currently shown stack image will be automatically added into
the layout in the print editor.
To print all layers first open the stack as individual images, or add them in the
print editor using the Image Browser.

CAPTURING CEPHALOMETRIC IMAGES
2 CAPTURING CEPHALOMETRIC IMAGES
1. To capture a cephalometric image click this icon.
The Cephalometric Exposure window appears. When the X-ray unit is in

ready state the message Waiting for Ready appears.
2. Prepare the patient for exposure and select exposure parameters.
3. Drive the X-ray unit to ready position. Refer to your Planmeca cephalometric
X-ray unit’s user’s manual for more information.
When the X-ray unit is in the ready position the message Waiting for Exposure
appears.
5. When all exposures have been taken click Done to return to the Imaging
module.
When the panoramic unit is in ready position the message Waiting for
Exposure appears. You can now expose the X-ray as normal.

CAPTURING CEPHALOMETRIC IMAGES
SmartPan capture window will show the middle layer as preview and
automatically store all layers into Planmeca Romexis for later viewing and
processing.

CAPTURING INTRAORAL IMAGES
3 CAPTURING INTRAORAL IMAGES
Intraoral images can be captured either as a study into a template or as single

images. For single image capture see section 3.2 “Capturing single intraoral
images” on page C-11.
3.1 Capturing intraoral images into a study
1. Click this icon.
2. Select the desired study template from the list.
At the beginning of the list there are empty templates and at the bottom of the
list there are previous studies arranged by date.
While capturing images into a study Planmeca Romexis browses through the
template in a predefined order, denoting the current image to be captured by a
blue border around the slot.

3. Follow the tooth numbering and sensor orientation as shown on the top, also
predefined in the template.
To cancel the exposure click Cancel. The captured images are saved and the
incomplete study is preserved for later use.
4. When all images have been captured click Done.

3.2 Capturing single intraoral images
1. Click this icon.
The Intraoral Exposure Window appears. When the X-ray unit is in ready state
the message Waiting for exposure appears on top of the window.
NOTE For more information see Planmeca Intra X-ray unit’s user’s manual.
3. Take an exposure as usual.
4. Define the tooth numbers and sensor orientation and take the next exposure.
module.

4 CAPTURING INTRAORAL IMAGES
Planmeca Romexis can be used to capture intraoral images with Planmeca

ProSensor, Planmeca ProScanner and intraoral cameras. Intraoral images
can be captured either as a study into a template or as single images.
4.1 Capturing images with Planmeca ProSensor
4.1.1 Capturing images into a study
1. Click this icon.
2. Select the desired study template from the list.
At the beginning of the list there are empty templates and at the bottom of the
list there are previous studies arranged by date.
While capturing images into a study Planmeca Romexis browses through the
template in a predefined order, denoting the current image to be captured by a
blue border around the slot.

3. Follow the tooth numbering and sensor orientation as shown on the top, also
predefined in the template.
To cancel the exposure click Cancel. The captured images are saved and the
incomplete study is preserved for later use.
4. When all images have been captured click Done.

4.1.2 Capturing single ProSensor images
1. Click this icon.
The Intraoral Exposure Window appears. When the X-ray unit is in ready state
the message Waiting for exposure appears on top of the window.
NOTE For more information see Planmeca Intra X-ray unit’s user’s manual.
3. Take an exposure as usual.
4. Define the tooth numbers and sensor orientation and take the next exposure.
module.

CAPTURING INTRAORAL IMAGES WITH PLANMECA PROSCANNER
5 CAPTURING INTRAORAL IMAGES WITH

PLANMECA PROSCANNER
5.1 Standalone Planmeca ProScanner
5.1.1 Capturing images
1. Click ProScanner Capture button.
NOTE If the ProScanner capture is not enabled tick the ProScanner Capture
Enabled check box in the Admin module’s Local settings tab.
The image capturing dialogue with the message Waiting for a Scanner will
open.

The following texts at the top of the window are shown (from left to right):
1) Scanner status
2) Connection type
3) Resolution
4) Imaging plate size
5) RFID status
6) SN with number
1. 2. 3. 4. 5. 6.
When scanner is connected and ready the status will change to Ready for
Scanning.
2. Take exposures as instructed in Planmeca ProScanner user’s manual and

your intraoral X-ray unit’s user’s manual.
3. Scan the image as instructed in Planmeca ProScanner user’s manual.

The image is first transferred from scanner to Planmeca Romexis.
Once the transfer is complete a preview image will appear on the image
capturing window.
When the status on the top bar changes to Ready for scanning, next image
can be scanned.

4. To scan several images, keep the image capturing dialogue window open and
scan the images one by one. For each image, a preview will appear on the
screen.
5. When all images have been scanned, click Done.
6. In the opening window, give the orientation and the type of the image.
The opening dialogue window will be shown for each image.
7. Click OK.
The images will open in the 2D Imaging Module.

1. Click New Study.
2. Select the study from the list and click OK.
The selected study will open.
3. Click ProScanner Capture. The image capturing window will open.
4. Continue as described in section 5.1 “Standalone Planmeca ProScanner” on

page C-15.
5.2 Planmeca ProScanner with Planmeca ProID reader
5.2.1 Capturing images
1. Click ProScanner Capture.
NOTE If the ProScanner capture is not enabled tick the ProScanner Capture
Enabled check box in the Admin module’s Local settings tab.

The image capturing dialogue will open.
2. Show the image plate to the reader as instructed in Planmeca ProScanner

user’s manual.
When the image plate is successfully read by Planmeca ProID an imaging

plate template will appear on the screen.
The text RFID read and the serial number of the plate will be shown on the
plate template.
To scan multiple images in the same image capturing session repeat Step 2
to all plates.

For each scanned plate a new template will appear on the screen.
Maximum of 6 templates can be displayed on the screen at the same time. If

more RFID’s are read with ProID, the templates will be divided to several
pages. To move between pages, use the buttons in the middle of the screen.
An imaging plate can be scanned only once during one imaging session. If a
plate is read again with ProID, the template in question will blink in yellow.

NOTE Image capturing window must remain open on the same workstation
where the imaging plates are read with Planmeca ProID until all images
have been scanned. Never close the image capturing window before all
images appear on the screen.
3. Take the exposure as instructed in the Planmeca ProScanner User’s manual

and your intraoral X-ray unit’s User’s manual.
4. Scan the image as instructed in Planmeca ProScanner User’s manual.
As images are scanned, a preview of the image will appear on the template.
5. When all the images have been scanned and appear on the screen, click
Done.
6. In the opening window, select orientation and image type.

7. Click Done.
The dialogue window will be shown to all scanned images one by one.
The images will appear in the Planmeca Romexis 2D Imaging Module.
1. Click New Study.
2. Select the study from the list and click OK.
The selected study will open.
3. Click ProScanner Capture.
The image capturing dialogue will open.
4. Continue as described in section 5.1 “Standalone Planmeca ProScanner” on

page C-15.

CAPTURING INTRAORAL CAMERA IMAGES
5.3 ProScanner image recovery
5.3.1 Recovering images automatically
See section 8.3 “TWAIN auto recovery” on page C-29 for more information.
5.3.2 Recovering images manually
The Planmeca ProScanner automatically saves the latest scanned image to

its internal memory card. If due to a technical or user error the image does not
appear in Romexis, the image may be retrieved manually in the image
capturing window.
To retrieve the latest image, press the Latest Image button. Fetch the latest
image button in image capturing window.
6 CAPTURING INTRAORAL CAMERA IMAGES
Start the intraoral camera by clicking this icon.
On how to install and use the intraoral camera see the Panasonic intraoral
camera User’s manual (publication number 10032056).

SEARCHING IMAGES IN CASE SERVER CONNECTION IS LOST
7 SEARCHING IMAGES IN CASE SERVER

CONNECTION IS LOST
In case the connection to the server during image acquisition is lost the
message Connection to the server lost appears.
In such case you may either:
• Try to re-establish the connection by clicking the Try to Reconnect button.
OR
• Shut down and exit Romexis
Although the connection to the server was lost radiation continues to be

emitted and the exposure is been taken normally. The images can be
searched as follows:
7.1 2D images
The 2D images are saved to the %temp% folder.

To access the folder:
1. Click the Windows key + R on your key board.

SEARCHING IMAGES IN CASE SERVER CONNECTION IS LOST
2. In the opening window type %temp% and click OK.
7.2 3D images
1. To search for 3D images open the patient whose images you want to search
in Planmeca Romexis.
2. Go to 3D module
3. From the File menu select Capture > Redo 3D Reconstruction.
4. Select the correct imaging sequence from the list (based on the time of
exposure for example.)

TWAIN SETUP
8 TWAIN SETUP
TWAIN is a cross-platform interface for acquiring images captured by

scanners, digital cameras or frame grabbers. The manufacturer of the TWAIN
device must provide a Source Manager and TWAIN Data source for your
device to work with Planmeca Romexis.
Planmeca Romexis supports the current TWAIN_32 standard. Refer to your

device manufacturer’s documentation for information on the availability of
TWAIN_32 source interfaces.
8.1 TWAIN settings
The settings for the used TWAIN sources must be defined in TWAIN Setup. If
several TWAIN sources are used, the TWAIN Setup must be performed once
for each source.
1. Click the Select TWAIN Source button.
2. Select the correct device from the drop-down menu.

TWAIN SETUP
8.1.1 Quick launch settings
A separate button can be assigned to the TWAIN source by selecting Show

quick launch button in toolbar.
If the check box is not selected, the TWAIN source will use the TWAIN
Capture icon.
Enter the name and tooltip text of the button in the Text and Tooltip fields
respectively.
8.1.2 TWAIN source settings
Wait for TWAIN driver Close
Specifies whether a Close command is expected from the TWAIN driver to

signal the end of scanning session. If disabled, only single scan is expected to
be received. When enabled, multiple scans can be made in one session
which are all returned in one batch when the scanning dialogue is closed. If
the scanner software is capable of scanning multiple images in one session
this setting should be enabled.
Prefer Memory Transfer
Enables Memory Transfer instead of Native Transfer mode. Refer to your

scanner documentation for more information on supported and/or preferred
mode. For scanning colour images this option should be enabled.
Show TWAIN Launch dialogue
If enabled, a dialogue is shown when the scanner software has been

launched via TWAIN. On some lower end systems showing the dialogue can
take some time during which it may be useful to notify the user of the process.
Some virus scanning software is also known to slow down the TWAIN launch.
Show Import dialogue
Specify whether the Planmeca Romexis image import dialogue should be

shown for each imported image. The image import dialogue allows to choose
image modality, specify tooth numbers, and crop or reorient the image. If
disabled each scan is imported with default settings and modality is defined
by the Default Image Type setting below.
Default image type
Specifies the default modality for scanned images.

TWAIN SETUP
Default orientation
Specifies the default orientation for scanned images.
8.1.3 TWAIN auto import settings
In some cases you need to configure TWAIN Auto Import Settings to enable
automatic import of images as part of the TWAIN capture. Generally this is not
required and you can safely ignore these settings.
8.2 TWAIN image preprocessing
TWAIN scans can be preprocessed using respective auto enhancement

settings in Planmeca Romexis configuration application see section 3.1.4
“Auto Enhancements” on page I-11.
8.3 TWAIN auto recovery
If the scanned images cannot be correctly imported to Planmeca Romexis

due to technical or user error during the process, Planmeca Romexis will try to
recover the images in the beginning of the next scanning session. If scanned
images are available in the temporary folder (usually %temp% on Windows
computers) Planmeca Romexis will match the images with the patient for
which they were originally scanned to and ask the user how to proceed:
• If the patient currently open is the same as the patient to whom the images
were acquired the following prompt will be shown and Planmeca Romexis will
proceed with importing the images to the patient.

TWAIN CAPTURE
• If a different patient is open Planmeca Romexis informs the user of unpro-

cessed TWAIN scans and indicates to which patient ID the scans belong to.
You can continue working normally with the current patient. Once the correct
patient has been opened after and all images have been successfully
imported to the patient the prompt will stop appearing.
8.3.1 Removing TWAIN source configuration
1. Click this icon.
2. Select the source from the drop-down menu (see the image in section 8.1
“TWAIN settings” on page C-27).
3. Click the Remove settings button to erase the settings for the selected
TWAIN source.
NOTE If a separate button has been assigned to the source, Romexis Client
must be restarted for the change to take effect.
9 TWAIN CAPTURE
To acquire an image from the TWAIN device click the Acquire image using
TWAIN button to start the TWAIN interface. Refer to the user’s manual of your
scanner/camera for more information on how to proceed with the device you
are using.

IMPORTING IMAGES
10 IMPORTING IMAGES
1. Click this icon.
2. Browse to the image folder and select the images you want to import.
To select several images press and hold down the Shift or Ctrl key while
selecting files.
The window for setting image parameters appears.
3. Select the image type, and, for intraoral images, define the tooth numbers.

DICOM IMPORT
If you are importing multiple images you are prompted separately for each
image:
• If you click Cancel to skip a single image when importing multiple images,
Planmeca Romexis will ask: “Continue importing images?”.
• If you want to continue importing the rest of the images select Yes.
To crop the image when importing:
1. Click the Crop button.
2. Click and drag the mouse on top of the image to specify the area of interest
for cropping.
A green rectangle marks the area currently selected. When the area has been
selected the rectangle turns red.
11 DICOM IMPORT
DICOM 3.0 format images can be imported using the DICOM Import function
similar to other images. For more information on the import process see
section 8.3 “TWAIN auto recovery” on page C-29.
11.1 DICOM import with patient data
To import a DICOM image and to create a new patient from the information
included in the DICOM file, use the DICOM with Patient option available in the
File menu.

DICOMDIR IMPORT
12 DICOMDIR IMPORT
DICOMDIR Import allows you to import a set of multiple patients with their
patient information and images from DICOMDIR into Romexis.
NOTE Before you start using DICOMDIR import or make sure that the user has
appropriate import and export images permissions granted in the Admin
module (For more information on permissions see section 1.1 “Groups
tab” on page G-1.
1. Click this icon.
or
Select DICOMDIR with patients from the File menu.

DICOMDIR IMPORT
2. Click the Browse button to select the DICOMDIR file you want to import.
A tree list with images and thumbnails appears. It shows each patient in the
DICOMDIR file and the images it contains in a hierarchical list. The DICOM
tags of the selected image are displayed at the bottom of the window and its
thumbnail is highlighted on the right.
3. Select all images you want to import and deselect any unwanted patients and
images.
4. Click Import.
If necessary new patient entries are created and the selected images are
imported to them.
If a patient with the same name is already found in the database, you will be
asked whether to import the images to the existing patient or create a new
one. Verify that you have the correct patient in question before continuing.
All images in the database that have an image UID (Unique Identifier) will be
rejected unless Allow duplicate UIDs option at the bottom of the dialogue
has been enabled.
To import SmartPan images as stacks instead of separate images check the

option Stack single frame CT images.

NEW STUDY
13 NEW STUDY
1. To create a new study click this icon.
2. Select the suitable template.
3. Click OK.
To add images to an empty study see section 14.2.5 “Adding an image to a

study” on page C-48.
To capture images directly into a template see section 3.1 “Capturing intraoral
images into a study” on page C-9.

IMAGE BROWSER
14 IMAGE BROWSER
The Image browser is intended for browsing 2D images.
The browser shows all images of the patient grouped according to the image
type (panoramic, CBVT, cephalometric, and intraoral, images and photos).
When the Imaging module is opened the Image browser opens by default at
the bottom of the screen.
To open and close the image browser click the Image Browser icon on the
main toolbar.
14.1 Browser tab
14.1.1 Image types
The images are grouped as follows:
• Panoramic: Panoramic and SmartPan exposures and scans.
• CBVT: 2D snapshots generated in the 3D module.
• Cephalometric: Cephalometric exposures and scans, including images gen-

erated using the Virtual Cephalometric tool in the 3D module, see section 9.12
“Creating virtual cephalometric images” on page D-103.
• Photo: Intraoral video camera images, scans and imported photos from hand-
held cameras.
• Intraoral: Bite-wing and periapical exposures and scans with specified tooth
sites.
Intraoral images with no specified tooth sites are placed into the Other subcat-
egory.
Intraoral images can be further divided into three sub-categories:
• Periapical
• Bitewing
and
• Other based on selected tooth sites.

IMAGE BROWSER
14.1.2 Browsing images in different browsing modes
The following browsing modes are available:
All categories (image types) browsing mode
Displays all image types grouped in thumbnails. The image type, range of
exposure dates and number of images are shown under the thumbnail.
To view a preview of all images in the image type category move the mouse
over the image thumbnail from left to right.
To open the image currently shown in the thumbnail double-click the

thumbnail.
To open all images in an image type category click the currently shown
thumbnail.
The images will open in Grid view mode.
To select the suitable viewing options right-click on the thumbnail and select
the desired options, for detailed information see section 14.1.3 “Image
browser settings” on page C-41.

IMAGE BROWSER
Image list
Displays a list of all patient images.
To select multiple images click and drag the images, or use Shift or Ctrl keys
on your keyboard.
To export selected the images right-click on one of them and select Export
selected images.
To export all images right-click on the list and click Export all images.
The default folder where the images are exported on the disk can be set in
Admin module under Local Settings in section 5 “LOCAL SETTINGS” on page
G-24.
If the default folder has been set in Admin module, the folder will be
automatically suggested in the opening Export all images dialogue window.
To move images for another patient, right click on the image and select Move
to other patient.
To delete images right-click on the image and select Inactivate.

IMAGE BROWSER
All Images
Shows an overview of all patient images:
Image type, exposure dates and number of images are shown in each image
type category.
To collapse/expand a category click on the smaller thumbnail next to the

category title.
To moves to the next row of images in the same category or to the next
category title scroll the mouse wheel.
Click on the
smaller
thumbnail
to expand/
collapse
the image
type category
Grid
Shows images of the selected image type in grid format. In the grid browsing
mode the maximum number of images are shown simultaneously.
If the Image Browser is set to hide automatically when an image is opened in

the Image Viewer, the browser will automatically reappear when all images
have been closed in the Image Viewer.
To reopen the image browser click this icon on the main toolbar.
The image type (e.g. CBVT), exposure dates range and the number of images
are displayed in the image browser title bar.
To view a more detailed description of image properties right-click the

thumbnail and select Show Properties.

IMAGE BROWSER
To hide properties right-click the thumbnail and select Hide Properties.
Film-strip
Images are displayed from left to right in film-strip format.
To browse images one-by-one use the mouse wheel.
To view the full range of images use the scroll bar at the bottom of the screen.
Scroll bar
Carousel
Images are displayed from left to right in a 3D carousel.
To scroll images one-by-one use the mouse wheel or the scroll bar at the
bottom to view the full range of images.
In the carousel mode only the middle image (largest image in front and centre)
can be selected, highlighted or opened.

IMAGE BROWSER
14.1.3 Image browser settings
The settings are user specific and the latest settings of each user will be
recorded.
To access the Settings menu click this icon.
The image browser settings can be used to define:
• Default view: The view mode in which the browser opens when opening a
patient file
• Options shown on the screen with image thumbnail
• Sort order
and to

IMAGE BROWSER
• Reset browser to defaults.
14.1.4 Using image thumbnails

The border of the currentl
The border of the selected Image Specified highlighted image shows
image shows in light blue evaluation tooth sites in light grey
Exposure date Image comment Last updated
If both exposure date and update date do not fit into the thumbnail although
both are configured to be shown only exposure date will be shown.
To open an image double-click the thumbnail.
To open multiple images in the Image Viewer use the View Selected button.
To open images directly into the Image Viewer double-click on the thumbnails.
Adding and editing image comment
1. Click on the image comment field.
2. Type the text in the comment field.

IMAGE BROWSER
Symbols on top of thumbnails
The following symbols may appear on top of the image thumbnails:
SmartPan stack image with multiple layers.
Image stored into Long Time Archive. Full size image becomes available for
viewing when restored from Long Time Archive.
Image belonging to a study.
Image contains an attached diagnosis that can be viewed in the image

properties dialogue.
Adjusting thumbnail size
To change the size of the image thumbnail use this slider. The size setting is
remembered separately for each view mode. The approximate viewing
position inside a category is preserved when changing thumbnail sizes.
Adjusting image browser window size
To expand / collapse the image browser window click the arrow to view the
browser in full screen or in default height.
To freely resize the browser window drag the top edge of the Image Browser
with your mouse.
Re-clicking this arrow will revert the browser to its default height.
Selecting/deselecting images
To view/open selected images in full size click the View Selected button.

IMAGE BROWSER
To clear the currently selected image(s) click the Clear selection button.
The number of currently selected images is shown in the Selected field.
When the option Close browser on double-click is selected and you want to
open multiple images, first select the images and then click on the View
Selected button.
Refreshing the image browser
When new exposures of the same patient have been taken at another
workstation and the images do not yet show on the current workstation they
can be reloaded and updated from the server by clicking the Refresh button.
Filtering and selecting images by date
• The dates of all images are shown in the Dates field.
• To filter images by exposure date check the dates of the images you want to
view.
• To filter images by year check the dates of the images you want to view on the
screen.
• To reset the filter to show all images first deselect All Dates option and then
reselect it.

IMAGE BROWSER
14.2 Study tab
A study is a collection of related images of one patient. A study is always

based on a study template where tooth numbers and exposure order can be
predefined.
For creating image templates see section 4.1 “Templates” on page G-12.
For capturing images into a study see section 3.1 “Capturing intraoral images
into a study” on page C-9.
14.2.1 Opening a study
The studies can be viewed in the Study tab. The existing studies are listed,
and by clicking the name of a study a preview is shown.
To open an image from a study (for adjustment etc.) select the desired image
in the preview and click the View Selected button.
To view all images in a study click the View Study button. For more
information on how to work with studies see section 32.1 “Show properties” on
page C-94.

IMAGE BROWSER
14.2.2 Opening images in the study
Double-click the image in the image browser you want to open
or
Select the image in the image browser and click the View Selected button.
To close images click this icon on the top right corner of the image you
want to close.
14.2.3 Arranging images in a study
1. Click the Study tab.
2. Select the study you want to rearrange and click the View Study button.
3. Drag and drop images from one slot to another.
• If you’re dragging an image to an empty slot select Yes in the opening dia-
logue.

IMAGE BROWSER
• If there is already an image in the target slot the system will ask whether you
want to move the image on top of the old image or whether you want to swap
the images.
• In case there is more than one image in a study slot use the scroll bar to navi-
gate between images.
14.2.4 Deleting images from study
1. Drag the image outside the study window.
NOTE The image will still remain in Planmeca Romexis as a single image.
2. To delete the image from the study select Yes in the opening dialogue.

IMAGE BROWSER
14.2.5 Adding an image to a study
1. Open the study.
2. Select the image you want to add to the study.
3. Add it to the first empty slot by double-clicking the image.
To hide the study list and reveal the images underneath the image browser
click the Overview button.
In case you want to add a new image to a slot that already contains an image,
detach the old image first. In case you want to move an image to another slot
just drag it with the mouse to a new location.
14.3 Findings tab
In the Findings tab you can create interpretations of dental findings in

radiographs. The findings tool replaces paper check lists. Both 2D and 3D
images can be interpreted.
An odontogram is used to indicate location of findings and the findings list can
be used for entering findings into a radiological report. Also free text can be
added.

IMAGE BROWSER
The Findings tab consist of three sections:
1. Radiological Findings
2. Odontogram
3. Findings list
Radiological findings Odontogram Findings list
14.3.1 Using the radiological findings field
To select images in which you want to mark findings use the Image Browser
or click the image links in the Radiological Findings field.
To view the list of all images of the current patient click Show all images.
NOTE If Show all images is not pressed, only the findings of the currently open
image will be listed. SmartPan stack is shown as a single image.
When a tooth is selected, the tooth number will be shown in the note.
To expand / collapse the list of findings for the selected image, click the arrow
on the right edge of each image row.
To open the image in the main window click on the image link.

IMAGE BROWSER
To display all information of the selected finding place your mouse over the
finding in question.
1. 5.
2. & 3.
4.
1. Image link 2. Tooth number

3. Finding info 4. Tool-tip
5. Expand /collapse finding
To create a free text note for a selected image click the Add free text button.
The following window opens. Enter the appropriate text in the field. When
finished click OK.
Freely added text will be indicated with Note marking in the findings row.
To delete a finding or to edit a tooth selection right-click the finding you want
to modify.
From the opening pop-up window select Delete or Edit Tooth Selection. The
modifications will be automatically updated in the odontogram.

IMAGE BROWSER
14.3.2 Using the odontogram
The odontogram is used to select the tooth to be interpreted or to mark a

missing tooth.
To select a tooth click the tooth in the Odontogram. The edges of the selected
tooth or tooth parts are marked in bold.
Tooth number and selected tooth surfaces are shown in the text box with
letters (MODBLMDL).
14.3.3 Adding a finding to an image using the findings list
1. Open the image in which you want to add a finding.
NOTE If no image has been selected the screen with message Select single
image from list will appear. To use the findings list first select image.
The findings list shows all the possible findings grouped under different fields
of dentistry.

IMAGE BROWSER
2. Add a finding in the image by selecting the appropriate finding from the list
and clicking it with the left mouse button.
NOTE If you are trying to select a finding from the list that is not applicable to
the current selection in the odontogram, a tool tip appears. Selection of
tooth or part of a tooth might be required.
Tool tip explaining why the finding cannot be selected
The finding will now appear in the radiological findings field under the image in
which the finding was recorded.
All findings are image specific which means that an interpretation can relate to
one image only. A study or SmartPan stack is considered as a single image.

IMAGE BROWSER
14.3.4 Exporting radiological interpretations
1. Click this icon on the main toolbar.
The following window opens.
2. Check the box Create patient and image information file.
3. Click OK.
Findings and other parameters are added to a .txt file.
14.3.5 Creating and printing radiological interpretations
To add findings of a selected image to a printable layout select Add Text Box
> Add radiological findings to layout.
To insert the odontogram into a layout click the Odontogram button.

IMAGE BROWSER
If the Findings tab is selected in the Imaging module when print editor is
opened, the findings and the odontogram will be automatically added to
layout.
14.4 Attachments
Using the image browser’s Attachment tab you can add, export, launch or
delete document attachments such as PDF and MS Word files etc.
The reports saved in the Planmeca Romexis Cephalometric Analysis module

will be automatically saved to Attachments.
1. To add an attachment go to the Attachments tab.
2. Click the Add button.
3. Browse to the folder where the attachment is stored by clicking the square
next to the Select File to Attach field.

IMAGE BROWSER
4. Select the file you would like to attach and click Open or double-click the file.
A comment can be added if desired.
5. When finished click OK.
The attachment will now show on the Attachments tab.

IMAGE BROWSER
14.4.1 Viewing attachments
1. Select the attachment and click View.
2. The attachment will open in the program defined as the default program for
handling the file type in question in the settings of your operating system.
14.4.2 Export attachment to disk
1. Select the attachment from the list and click Save.
2. In the opening Save window select the location on the disk where you want to
export the attachment.
14.4.3 Inactivate attachments
1. Select the attachment from the list and click Inactivate.
2. In the following window select Yes.
When the attachment is inactivated it disappears from Planmeca Romexis,

but will remain in the image folder on the hard drive.
To permanently delete attachments see section 4.2.1 “Reactivate and empty

trash” on page I-29.

SETTING THE LAYOUT
15 SETTING THE LAYOUT
The opened and captured images automatically appear in the screen in their
maximum size.
To arrange images opened in the Viewer into a temporary layout click this
icon.
The layout settings can be used to position multiple images for print layout.
If you’re using the same layout frequently, it is recommended to define and

use a study template instead. For using studies see the previous sections and
on how to define templates see section 4.1 “Templates” on page G-12.
16 CLOSING ALL OPEN IMAGES
All open images can be closed by clicking this icon.
17 DICOMDIR MEDIA STORAGE
The DICOMDIR file format specifies a standard way to organize storage and
retrieval of DICOM format file sets to and from offline storage such as a CD. A
compatible DICOMDIR CD, for example, contains description and access
information for all the studies on that CD. Planmeca Romexis supports both
DICOMDIR import and export functions.

EXPORTING IMAGES
18 EXPORTING IMAGES
1. Open the image(s) or study that you want to export.
2. Click this icon.
3. In the opening window select from the following options:
• Processed images
Export image(s) in 8 bit with all enhancements applied.
• Original images
Export original image(s) (8 or 16 bits, depending on the original capturing

mode).
• All images in one file
Export multiple open images or a study as a single file.
When exporting as multiple files (option not selected) a sequence number and
file extension will be automatically added to the file name.
NOTE By default the Filename field is empty. To change the default setting to
patient name see section 2.1.2 “Person” on page I-4.

EXPORTING IMAGES
NOTE To export all images select the view All images in table in the Image
Browser, see section 14 “IMAGE BROWSER” on page C-36 or use
DICOMDIR Export, see section 20 “DICOMDIR EXPORT” on page C-61.
• Do not create patient and image information file.
No image related text file will be created.
• “Burn” patient information to the export file.
Attach the image information directly on the exported image.
• Export image to
• Folder: Data is exported to a folder
• Disc image (.ISO): Data is exported to a CD/DVD disc image that can be
written to a media using 3rd party CD/DVD writer software.
• CD or DVD: Data is written directly to a CD/DVD if a CD/DVD writer is
installed.
• Viewer options
• Include Viewer: Select to includes the Planmeca Romexis Viewer software

in the export.
• Skip Viewer launcher: When exporting single image select this option for
the Planmeca Romexis Viewer to open without displaying the patient selec-
tion dialog in the launcher.
• Viewer language: Set the default language for the exported Planmeca
Romexis Viewer software.
4. To start the export click OK.

EXPORTING IMAGES USING DICOM EXPORT
19 EXPORTING IMAGES USING DICOM EXPORT
1. Open the images or study that needs to be exported.
2. Click this icon.
The following window opens:
3. Select suitable export options. For detailed descriptions of the export options
see section 18 “EXPORTING IMAGES” on page C-58.
4. Click OK to start the export.

DICOMDIR EXPORT
20 DICOMDIR EXPORT
DICOMDIR Export can be used to export a set of multiple patient files with
patient data and images into a DICOMDIR file structure. A DICOMDIR
Directory information file is saved as specified in the Export To dialogue and
all exported DICOM image files are stored into its adjacent sub-folder titled
\images.
NOTE Before starting to use DICOMDIR export, make sure that you have the
appropriate import and export permissions, see section 1.1 “Groups
tab” on page G-1.
1. Click this icon.
If no patient is selected, select Export > DICOMDIR from the File menu

DICOMDIR EXPORT
2. Click the Export To button to select the DICOMDIR file.
3. Browse to the correct folder and enter a file name for the new DICOMDIR file.
4. Add patients to the list by clicking the Add Patient button.
5. In the dialogue that opens you can search and select a patient to be added
into the DICOMDIR file.
6. To add a patient click on it in the list and click OK.
All the patients added into the DICOMDIR file will show in the list with all their
studies and images in a hierarchical list.
You can browse the item DICOM tags and thumbnails by highlighting an item
and referring to the bottom and right edges of the dialogue.

DICOMDIR EXPORT
To include or exclude options from the final DICOMDIR file check/uncheck the
box next to each item.
Save processed image
Images are exported with all processing merged into the image.
Save Annotations
Images are exported with all annotations added in Planmeca Romexis.
Additional options
Regenerate 2D DICOM Headers
Enables DICOM headers rewriting using the newest information in database.
Anonymize File(s)
All patient information is removed from the exported DICOM image(s).
Export with Romexis Viewer
A copy of Planmeca Romexis Viewer is exported into the same folder with the
DICOMDIR file-set. The contents of the export folder can then be written on a
CD using any 3rd party tools and passed on to a customer or referrer.

DICOMDIR EXPORT
NOTE DICOMDIR file-sets can be opened in Planmeca Romexis Viewer version

2.0 and later.
When forwarding the DICOMDIR file-set, make sure to include the

DICOMDIR Directory information file specified in the Export To dialogue and
the adjacent \images sub-folder.
Export DICOMDIR and Romexis Viewer as ISO image
A CD ISO image file that can be written to a CD using any 3rd party CD writer
utility is created. Normally double clicking on the exported ISO image file will
start the 3rd party CD writing utility if correctly installed. In case Burn image(s)
and Planmeca Romexis Viewer to CD does not work on your computer use
this option.
Burn DICOMDIR and Romexis Viewer to CD
Allows writing the DICOMDIR file and a copy of the Planmeca Romexis
Viewer directly onto a CD. Make sure you have an empty writeable media in
the drive before using this option.

PRINTING IMAGES / PRINT EDITOR
21 PRINTING IMAGES / PRINT EDITOR
Planmeca Romexis Print Editor is a comprehensive tool for printing 2D

exposures, 3D exposures, photos and DICOM images.
Using the Print Editor you can add multiple images of different type on a
single print layout. The images can be scaled in size and cropped. Also image
properties labels can be added to the layout.

21.1 Creating print pages
1. Click this icon.
The Select Print View window opens.
• To create a print page where images are positioned as in the current screen
select Create Snapshots as shown on screen
• To specify how to divide the images on the page select the option Specify
panel division and enter appropriate values for layout.
To adjust the layout drag and drop the images in the layout as desired.
To browse the print pages move the slider on the right or click on the page
browser thumbnails.

21.2 Print editor tool bar
The toolbar on top consists of tools for printing and viewing of print layouts.
Page setup
In the Page Setup window, the header and footer settings can be set visible
and editable, the page margins can be set and page size and orientation can
be defined, see section “Editing header and footer” on page C-74 for more
information.
Print page
After defining print settings in Page Setup click this icon to start the printing.
Save Print
Saves current print pages as non-editable snapshots into Imaging module

under photo category. Prints can be recreated by adding snapshots to a new
print page in 100% scale.

Export Images
The print editor layout can be exported as a regular image to the hard disk.
1. Click this icon.
2. In the opening dialogue select export resolution, image format and export
folder and enter file name.
3. Click OK.
Browse Images
To add more images into the layout click this icon.
To add images of the current patient to the print layout double-click the
desired image(s). The image will be inserted into an image template slot for
the respective image type if existing in the layout.
Add New Page
Adds new page to print layout with two options:
• Empty page: A new, empty page is added with no specified image slots
• Copy of current page: A copy of the currently shown page and its predefined
image slots. This option is useful for creating multiples pages with same lay-
out.
Previous and Next Page
Moves to previous or to the next page in a multi-page layout.

Page Thumbnails
Shows/hides the page browser on the screen on the left.
Adjust Print Crop
To adjust the area of each image that will be included in the prints, select the
desired image and use the Adjust Print Crop tool. Draw the crop region with
mouse and apply crop from the right-click menu. The crop can also be
cancelled from the right-click menu by choosing Reset crop Region.
Show / Hide Annotations
Image annotations can be shown or left out of the print by clicking this icon.
Save layout
The layouts can be saved for future use as Named or Default template.
The default layout will open every time the Print Editor is opened whereas the
named layout can be restored from the layout list. The image will be inserted
into an image template slot for the respective image type if existing in the
layout.
Select layout
A saved template can be opened by clicking this icon and selecting the
template from the template list. To add images into template double-click the
images from image browser.
Delete layout
To delete a saved print template click this icon and choosing the template to
be deleted from the template list.
Zoom print layout
The print layout can be zoomed in and out by using the Zoom In and Zoom
Out icons.
To fit the image to the view to view use this icon.

Adjusting images / Right-click menu
The image can be dragged around the screen. To resize the image drag it
from its corners.
To open a shortcut list for layout adjustments right-click on top of an image.
21.3 Vertical toolbar
The vertical toolbar can be used to adjust the size, position and labels of the
images. As the adjustments in the vertical tool bar are image specific it only
shows when an image is selected.
Scale
To scale the image select the appropriate scale value from the drop-down
menu.
Position and Size
To change the position of an image on the layout drag the image to a suitable
position. Alternatively you may enter / browse the desired location (X, Y) from
the Position and Size menus.
Image border
Borders can be added to each image in the print layout.
To change the borders’ size type or select the desired border width (W) and
height (H).

To change the border fill colour click BG field and choose the desired colour.
To change the border edge colour click the FG field.
The borders can be rounded by typing / browsing the desired radius (R) from
the Image Border controls.
Moving images in the layout
By selecting the options Snap To Area Edges and Snap To Object Edges, the
image is attached to its nearest edges on the print area.
By selecting the Scale Image With Slot option the new image will be
automatically scaled with the slot.
Labels
The labels can be hidden by unchecking the Show Labels checkbox.
Image labels can be added, edited and deleted from the Contents table.
To add a button to a new label row click the Add button.
Select the label type from the drop-down menu.
The text field includes text that is added to the layout after the image property
data of the selected label. I.e the text field of the label Img Exp mA adds the
string “mA” after the image exposure mA, e.g. “10 mA”.

To add a line brake after the label row click the LB field of the label row. The
line brakes can be useful if many labels are added to the same area of the
layout.
To delete a row select it and click Del.
To moved a row in the table up and down select the row you want to move
and click the Up and Down buttons.
When the image label is selected from the Contents table, its opacity,
background (BG) and foreground colour (FG) (text colour), text font as well as
relative position in the layout can be defined.
To select the relative position in the layout click on the grey fields of the layout
preview.

The changes in the labels show on the print editor layout.
Editing font
To change the font click the square button next to the Font field.
Select the suitable font, font style and size. Click OK.

Editing header and footer
1. Click this icon.
2. From the following window check the Editable checkboxes in the Header and
Footer fields.
3. The header or footer in the Contents table can now be edited.

DICOM PRINT (OPTIONAL)
22 DICOM PRINT (OPTIONAL)
With DICOM Print license images can be printed with DICOM compatible
printers. DICOM Print needs to be configured in the Admin module before the
DICOM printer can be used, see section 4.2.2 “DICOM Printer Setup” on page
G-20.

DICOM STORAGE & STORAGE COMMITMENT (OPTIONAL)
23 DICOM STORAGE & STORAGE COMMITMENT

(OPTIONAL)
With DICOM Full license images can be sent to a remote DICOM application,
i.e. DICOM image archive PACS. DICOM Storage needs to be configured in
the Admin module before the DICOM storage can be used, see section 4.2.1
“DICOM Storage Setup ” on page G-18.
1. Open the image you want to store.
2. Click this icon.
3. Click OK in the opening dialogue.
To check the status of storage transaction, use the Image Properties

dialogue.
DICOM Storage Commitment is also shown in the Image Properties dialogue

next to the storage status. When DICOM Storage is enabled, storage of a
single image can be cancelled in the Image Properties dialogue.
NOTE Images can also be automatically stored after capturing, see section 4.2
“DICOM Configuration” on page G-16 and section 6.3 “External
communication” on page I-39.
24 LAUNCH EXTERNAL APPLICATIONS
See section 9.17 “Launch external applications” on page D-110.

CLOUD EXPORT
25 CLOUD EXPORT
Planmeca Romexis Cloud is a subscription based service that is integrated

into Planmeca Romexis and can be used to transfer images and documents
between Planmeca Romexis users. All transfers are encrypted and are
always appointed from user to user (both using Planmeca Online account),
eg. users cannot see each other’s cases.
To use the cloud export you need a cloud user account. On how to setup an
account see section 1.2.2 “Cloud (User account setup)” on page G-7.
On how to configure the Planmeca Romexis Cloud application see section 3.9
“Cloud” on page I-25.
For more information on the service, creating an account and subscribing to

the service please visit: http://online.planmeca.com.
NOTE Planmeca Romexis Cloud is not an image storage or archival service.
With Cloud Export image(s) and documents can be sent to a recipient who
may or may not have Planmeca Romexis installed. It is designed to replace
insecure e-mail and DVDs as an image transfer process.
NOTE Sending cases requires an active Planmeca Romexis Cloud

subscription.

CLOUD EXPORT
25.1 Sending cases using the Planmeca Romexis Cloud service
1. Open the image to be sent in 2D or 3D module.
2. Click this icon.
If you want to send a document only click on the icon while no images are
open.
3. Enter recipient’s e-mail address in the Send to field or click the Recent button
to select from past recipients.
4. To add any attachments click the Add button in the Attachments field.
Add the attachments first to the 2D Module’s Attachments tab see section
14.4 “Attachments” on page C-54 for more information.
5. In the Case Description field enter the information that the recipient can see
before downloading the case.
The case description can be used as a short referral message or to indicate

urgency.
The Package size estimate field shows the amount of data that will be sent
and counted towards your monthly subscription quota.

CLOUD EXPORT
6. When finished click the Send button.
The case will be transferred to the cloud for the recipient to download it. An e-
mail will be automatically generated and sent to the recipient notifying that
there is a new case available for download. If the recipient is using Planmeca
Romexis, the new cases will automatically appear in the Cloud Management
tab under the Patient module.
The case is sent in the background so you can continue working in Romexis
and check the status of the transfer in the Cloud Management tab under the
Patient module.
25.1.1 Additional settings and information
Send to recipient as E-mail download link
Enable this option if the recipient does not have Planmeca Romexis installed
but wishes to view the case in Planmeca Romexis Viewer installed on
computer.
Include Romexis Viewer
This option selected the recipient does not need any version of Planmeca
Romexis or Viewer in order to view the case. This option is closest to creating
and sending a Planmeca Romexis Viewer DVD.
Case History
Shows a list of cases that have been sent by the currently logged in Romexis
user. Information shown includes
Patient Name
Status
The current status of the case whether being uploaded, waiting for download
or downloaded by the recipient.
Receiver
Who was the case referred to.
Notes
The Case Description that you entered for the case when sending it.

PLANMECA ROMEXIS CEPHALOMETRIC ANALYSIS (CEPH) MODULE
User Account
The Planmeca Online account attached to the Romexis user currently logged
into Romexis. Also shows the available quota and how much quota the user
has used up.
Log List
Shows messages about recent communication between Planmeca Romexis

and the cloud server.
26 PLANMECA ROMEXIS CEPHALOMETRIC

ANALYSIS (CEPH) MODULE
NOTE The Planmeca Romexis Cephalometric analysis module has a separate

manual (10031278).
In the Planmeca Romexis® Cephalometric Analysis module, cephalometric

analyses and superimpositions can be composed of 2D cephalometric
images, facial photos and views of the dental arch. The analyses are used
e.g. in orthodontic growth analysis, diagnosis, treatment planning and
monitoring as well as in treatment outcome evaluation.
If you have the Ceph module licence the icon shows on the top tool bar in the
Imaging module.
Patient information (date of birth, gender) is passed to Ceph module from

Planmeca Romexis and the patient files are automatically saved into
Planmeca Romexis database when closing the Ceph module.

VIEW ADJUSTMENT TOOLS
27 VIEW ADJUSTMENT TOOLS
Zooms in the image
Zooms out the image
Fits images to viewing window
Show images in their actual size.
Scale all images in same size
Magnifies the image twice its size (2X).
Shows an overview of an image when the image is zoomed in.
Enables a movable square Flashlight overlay that allows regional filter for
Gamma, Contrast & Brightness, Invert, Equalize, Sharpen, and Emboss. Use
the mouse wheel to adjust the size of the filter area and right-click to switch
between different filters.
Similar to Flashlight function above but allows setting of Gamma, Contrast &
Brightness values. The settings are image specific. Use the mouse scroll
wheel to adjust the size of the filter area, and the radio buttons or the right
click to switch between different filters.
Moves image on the screen

VIEW ADJUSTMENT TOOLS
Adjust brightness and contrast by dragging the slider or by moving the mouse
on the image while pressing the left mouse button. Horizontal movement
changes the brightness and vertical movement the contrast.
Defines the affective area for image processing tools and certain
measurements. To view grey scale values of a region use this tool together
with for example Histogram.
You can specify multiple regions and to switch between them. The active
region is denoted in green and the inactive regions in blue.
To delete the selected region use Delete Measurements icon or press the
Delete key.

MEASURING IMAGES
28 MEASURING IMAGES
Calibrate for measurement
1. Click this icon.
2. Draw the calibration line by holding down the left mouse button, end the line
with a right-click and the calibration window appears.
3. Enter the length and click OK.
NOTE You should not use the calibration tool on CBVT snapshots as they are
automatically calibrated.
Measure angle
Click this icon. Draw the angle by pressing the left mouse button.
Measure length
To select between single measurement and polyline measurement down the

left mouse button.
Single measurement – use to measure length between 2 points (default).

Hold down the left mouse button to define measurement, release mouse
button to finish.
Polyline measurement – use to measure length over multiple points. Draw

the line by pressing the left mouse button down. Release mouse button to
finish.

MEASURING IMAGES
Line profile
By clicking the Line Profile icon and drawing a line to the 2D image, the user
can view the gray scale profile of the respective line. Min, Max, Average and
Standard Deviation of the line profile are also available. If the line profile gray
scale values are very near to each other, by ticking the Relative values
checkbox the variations between these values are emphasized.
Show histogram
By clicking this icon the histogram of the open image/selected region of

interest is shown. A histogram is a graphical representation of the gray scale
distribution in the image/area. By default the histogram is drawn in square root
scale. Linear scale can be enabled by ticking the Linear scale checkbox. Max,
Average and Standard Deviation of the histogram data is also available.
Show measurements, Show/hide values

DRAWING TOOLS
29 DRAWING TOOLS
Draw Line
Draw line over single or multiple points. Draw Line is a dual mode button, hold
down mouse button to call up mode selection between single line and polyline
drawing.
Draw single line - use to draw line between 2 points (default). Hold down left
mouse button to define line, release the button to finish.
Draw polyline - use to draw line over multiple points. Draw the line by
pressing the left mouse button down and release the button to finish.
Draw horizontal line
Draw vertical line
Add arrow
Draw curve
Measure rectangle
Measure ellipse
Add text
Click this icon and point with the mouse where you want to add the text. Type
the text to the opening window and click OK.
To edit the text later select the text with the Select annotations button (see
below) and then double-click the text. Edit the text and click OK.
Add Text Box button allows adding different free or itemized text lists into
printouts. The following options are available:
• Add Free Text Box to Layout – Add freely editable text box.
• Add Image Implant List to Layout – Add an itemized list of implants (only for
3D print).
• Add Image Diagnosis to Layout – Add a copy of the image diagnosis if

entered in the Image Properties (only for 2D images or snapshots).

DRAWING TOOLS
Select annotations
When an annotation (line, arrow, circle, rectangle, curve) is selected, its

colour and line width can be adjusted. Select the annotation to edit the Color
and Width settings shown in the Image Toolbar.
Delete selected annotations or measurements
Select the annotation/measurement you want to delete and click this icon.
Show annotations
Shows and hides annotations. Even if the annotations are hidden they are still
stored with the image.
Sketch a free line
Sketch a free line for demonstration purposes.
NOTE Sketch lines are not saved or stored and are lost when image is closed.

2D IMPLANT LIBRARY (OPTIONAL)
30 2D IMPLANT LIBRARY (OPTIONAL)
The 2D Implant Library can be used to visualize realistic implant models on

2D images. The 2D Implant Library is optional and is available on licence.
NOTE When using panoramic imaging mode, magnification of object may

appear uneven depending on its position and angle in relation to the
focal plane. Use panoramic or other 2D images for treatment planning
prudently.
Implant library
tools

30.1 Adding and managing implants in the plan
1. Add an implant into the plan by clicking this button.
2. Select the appropriate implant and properties from the library and click Add to
Plan.
Square box corresponding to implant insertion depth appears next to cursor.
3. Add an implant to the image by placing the box in the implant site and clicking
the left mouse button.
To rotate or move an implant activate it by clicking it with the left mouse

button.
To rotate an implant drag the implant from its control points.
To move an implant drag the implant with the mouse. When the implant library
is open and the implant is activated the corresponding implant type is
displayed in the library.
To replace an implant, select another implant from the library and click
Replace.
To delete an implant select the implant and click Delete Annotation or Delete
key on your keyboard.
NOTE Modifications performed in the 2D Implant Library, such as adding or

deleting implants will also affect the 3D Implant Library.

To edit the name and colour of the selected implant click this tool.
To save your settings when finished click OK.

IMAGE SPECIFIC TOOLS
31 IMAGE SPECIFIC TOOLS
These tools affect the selected image only.
Scale the image 1:1.
Zoom in
Zoom out
Show image properties
Opens the General tab under Image properties window where tooth numbers
(for intraoral images) can be defined, the image can be rotated/flipped and the
image file info and exposure parameters can be viewed.
Show image diagnosis
Opens the image Diagnosis tab under Image Properties. Shows and allows
editing image diagnosis. The maximum number of characters is 5000.
Open image processing toolbar
For more information on image processing tools see section 31.1 “Image
processing tools” on page C-91.
Maximize the image
When an image is maximized use Next and Previous buttons to browse other
open images in the layout or study.
Close the image

31.1 Image processing tools
Adjust levels
The gamma curve can be adjusted by moving the green line in the histogram.
The histogram can be cut from the ends by moving the red lines.
The levels can also be adjusted by moving the mouse vertically and
horizontally on the image.
To show the advanced options use the small double arrow in the bottom left
corner.
To scale the histogram to bring out details. Use the up/down arrows and the
1:1 button
To highlight the resulting histogram select the option Overlay result histogram
To draw the histogram in linear scale instead of the default logarithmic scale
select the option Linear scale.
The Min, Max, Avg (Average), and StdDev (standard deviation) values show
the corresponding grayscale values in the image or in the Region of Interest
when one is active.
When pseudo-colours are enabled, this dialogue can be used to select

colours and to alter their balance.
To adjust the colour balance double-click on a handle to change the colour for
its range.
To apply preset colours click the small arrow pointing downwards.

C/B (contrast brightness)
Adjust sharpness of the image
Adjusting can be done by using the sliders or by moving the mouse on top of
the image.
Sharpen the image
Sharpens the image according to the settings in the tool above.
Soften the image
Noise removal
Invert the image
Apply Ceph filter
Use this tool to show more facial soft tissue.

To specify the area of effect adjust the vertical green lines.
To adjust the strength of the filter Use the Gain slider: higher values will show
more tissue. To apply filter on the left edge of the image enable the Left
option.
Apply pseudo colours
Use the Adjust levels dialogue to modify the colours.
Optimize for diagnosis
This tool is to be used for optimizing a selected region of interest in a

radiograph for diagnostic tasks.
The optimize contrast function uses three algorithms to recalculate the image
data. The gamma correction algorithm gives the result where equal steps in
object thickness will be displayed on the computer monitor as equal steps in
brightness. Since the human eye response to the light intensities is non-linear,
the second algorithm takes this response into account. Therefore the final
result is that equal steps in object thickness will be perceived as equal steps
in brightness. However this applies fully only to a homogeneous object. In
case of a true object with different tissues having a different attenuation of X-
rays, the result will be of weighted averaging.

Thus, the real result is that equal steps in object thickness will be perceived as
approximately equal steps in brightness. The third algorithm shifts the
average brightness in a region of interest to the mean of the brightness range
of the computer monitor. This is performed because the perception is
optimum in the middle of the brightness range. When this function is used a
selected region of interest will be optimized for diagnostic tasks.
Application
Select the reference point within the brightest area of a radiograph but NOT in
a filling. The ideal reference point should be selected in the sound enamel of
the brightest tooth. If there is another area in the a radiograph that is brighter
than the enamel, e.g. the compact bone the reference point should be
selected in that area.
NOTE It is important to know that other areas than the region of interest may
be destroyed with respect to the diagnostic image quality as no
radiograph can be optimized simultaneously in all regions and over all
brightnesses. For multiple diagnostic tasks, recalculate the radiograph
with respect to the different regions of interest.
Show image processing
Shows history of image processing. Click on an operation in the history to

revert image to that state.
To apply the enhancement shown in the list to all new exposures of the same
type from the File menu select Capture > Save image enhancements as
default enhancements option. For more information on how to review and
adjust default enhancements for new exposures, see section 3 “IMAGING” on
page I-10.
Revert to original
Removes filters and grayscale adjustment from the image and shows it
without preprocessing as it was when received from the X-Ray unit.
Undo
Redo

IMAGE PROPERTIES
32 IMAGE PROPERTIES
32.1 Show properties
1. To access the properties of a single image right-click on the image.
2. From the appearing menu select Show properties.

IMAGE PROPERTIES
32.1.1 General tab
Shows general properties for selected image including exposure information.

In image properties you can define image type, sensor orientation, exposure
date, tooth numbers, and image comments.
If an image has been mirrored or flipped horizontally there is a small dual in

the image status bar.
If added comments are shown in the image title bar you can search images by
comments in the Find by Image tab, see section 4 “FIND BY IMAGE” on page
B-8.

IMAGE PROPERTIES
X-ray quality value
The quality value is to follow up possible changes of the exposure level over
time. The value indicates changes after system start-up and approval when a
reference value may be recorded. The quality value is not an absolute
measure of dose and should only be used per system. The value also
depends on many image processing settings as well as on user. Therefore no
exact recommendations are given.
The value mathematically measures the logarithmic average of signal

intensity behind the bone tissue using image histogram.
32.1.2 Diagnosis tab
Diagnosis of up to 2500 characters can be entered. When finished click OK.

IMAGE PROPERTIES
32.1.3 All Parameters tab
Displays image parameters in detail.
32.2 Alignments
1. To access the Alignments dialogue right-click on top of an image..
2. From the appearing menu select Alignments.

IMAGE PROPERTIES
3. Define the alignment of the image inside the layout slot. These settings affect
image placement on screen and when selecting the option Export / All images
in one file.
32.3 Copy to clipboard
The image can be copied to the Windows clipboard by right-clicking the image
and selecting Copy to clipboard from the pop-up menu.
32.4 Moving to other patient
To move an image to another patient right-click it and select Move to other

patient from the pop-up menu. Define the patient to receive the image using
the Search dialogue.

IMAGE PROPERTIES
32.5 Assign as face photo
Assigns the selected photo as patient’s face photo. This feature only works for
photographs.
The photo will now show in General tab screen under Files module.
32.6 Inactivate
An image can be inactivated by right-clicking the image and selecting

Inactivate from the pop-up menu.
When the image is inactivated it will disappear from Romexis, but will remain
in the image folder on the hard drive.
To permanently delete images see section 4.2.1 “Reactivate and empty trash”
on page I-29.

IMAGE PROPERTIES

Chapter
D 3D IMAGING MODULE
1 INTRODUCTION
The Planmeca Romexis 3D Imaging module is designed for capturing,

processing and storing images acquired with Planmeca ProMax 3D model X-
ray units.
The three-dimensional data of the maxillofacial region is called an X-ray

volume. The dimensions of the 3D volume varies depending on the source.
NOTE A patient needs to be selected before the 3D module can be accessed.

For more information see chapter B “PATIENTS & FILES MODULES”.
The 3D module consists of the following elements (see the image on the
following page):
1. Tabs
• Volumes tab
• Explorer tab
• Panoramic tab (optional)
• Cross sections tab (optional) or Implant tab (optional) in case implant license
is installed
• TMJ tab (optional)
• ProFace tab (optional)
2. Views (coronal, sagittal, axial and rendering) and slice specific tools
NOTE A volume must be opened from the Volumes tab before it can be viewed
in the Explorer, Panoramic, Cross sections, TMJ or ProFace tab.
3. Volume adjustment tools
4. 3D main toolbar (contains tools common to all tabs in the 3D module)
User’s Manual Planmeca Romexis D-1

INTRODUCTION
4.
2.
1.
3.
2.-7.
D-2 Planmeca Romexis User’s Manual

VOLUMES TAB
2 VOLUMES TAB
2.1 Opening and viewing 3D volumes
In the Volumes tab the patient’s 3D volumes are listed and axial-view
thumbnail is displayed.
Thumbnail’s axial slices can be scrolled with arrow or mouse wheel.
To open a 3D volume double-click the volume line or select the volume and
click the View button.
To show volume properties right-click on the volume and select Show

Properties.
To inactivate volume right-click on it and select Inactivate.
2.2 Show properties
Right-click on a volume in the Volumes tab and select Show properties.

VOLUMES TAB
In the following window you can view image file information, x-ray parameters
and added comments.
2.3 Moving volume to other patient
1. Right-click on a volume in the Volumes tab and select Move to other patient
(see the image above).
2. Select and enter the search criteria. Select the patient and click OK

VOLUMES TAB
2.4 Inactivate
Right-click on a volume in the Volumes tab and select Inactivate (see the
image above). The volume will be removed from the list.
The volume is moved to Trash folder from where it can be deleted

permanently or returned to its original location, see section 4.2.1 “Reactivate
and empty trash” on page I-29 for more information.

EXPLORER TAB
3 EXPLORER TAB
3.1 Short description of the 3D module main toolbar
The 3D main toolbar contains tools common to all tabs of the 3D module. In
the following their functions are explained in brief and references to sections
providing more information are listed.
NOTE To activate all tools in the toolbar a volume needs to be opened from the
Volumes tab.
3D Capture
Starts 3D exposure. Only available in the Volumes and Explorer tab. See
section 3.2 “3D capture” on page D-10.
Model Capture
Optional, requires 3D Implant Planning license: Starts model capture. See

section 3.3 “3D model capture” on page D-12.
3D Import
Imports DICOM Multi Frame, DICOM Single Frame, ProFace 3D photo, STL
surface model, Planmeca Romexis native REC files. See section 3.6
“Importing 3D Images” on page D-20.
Artefact Removal
Opens the Artefact Removal dialogue for the currently open volume. Only
available in the Explorer tab. See section 3.4 “Artefact removal” on page D-
14.
Volume Stitching
Opens the dialogue for stitching together multiple adjacent 3D volumes. Only
available in the Explorer tab, see section 3.5 “Stitch volumes” on page D-16.
Export
Opens the Export dialogue that allows selecting the export format and other
options before exporting. See section 3.9 “Exporting 3D Images” on page D-
25.
DICOM Print

EXPLORER TAB
Opens the Print Editor dialogue where you can select views to be printed and
other print options. See section 3.15 “DICOM Print” on page D-45.
Print Editor
Opens the dialogue that allows the selection of views to be printed and other
print options. See section 3.14 “Print editor” on page D-40.
DICOM Storage
Send open volume to DICOM storage (requires full DICOM license). See
section 3.16 “DICOM Storage” on page D-46.
Launch external application
Executes a user-definable third party software with the currently open 3D

volume. See section 3.18 “Launch external applications” on page D-47.
ProModel Order
Opens the integrated order form for Planmeca ProModel. See section
APPENDIX A: “ORDER SERVICES” on page A-1.
Save 2D View
Save a copy of the selected view into the Imaging module. See section 3.12
“Save 2D view” on page D-33.
Virtual Ceph
Opens a dialogue where virtual 2D cephalometric image can be generated

from 3D volume data. See section 3.13 “Creating virtual cephalometric
images” on page D-38.
Cloud Export
Cloud export can be used to export images via Romexis Cloud service. See
section 25 “CLOUD EXPORT” on page C-75 for more information.
Send to iPhone

EXPLORER TAB
Sends images currently open to specified iPhone. Enter the IP address of the
Planmeca iRomexis device where you want to send the image to.
Order guide (Materialise Dental Surgiguide®)
Opens an ordering form which can be used for placing an order for
SurgiGuide® of an implant plan.
See section APPENDIX A: “ORDER SERVICES” on page APPENDIX A-1 for

ordering Materialise Dental SurgiGuide® with Planmeca Romexis.
3D Diagnostix order services
3D Diagnostix order services can be used for ordering Radiology reports of

CBVT images and surgical guides based on a 3D implant plan made in
Planmeca Romexis. For more information see section 3 “3D DIAGNOSTIX
ORDER SERVICES” on page APPENDIX A-8
Adjust Levels
Opens the histogram for adjusting the view. See section “Adjusting contrast,
brightness and sharpness” on page D-56.
Measure length
See section 3.21 “Measure length” on page D-49.
Measure angle
See section 3.20 “Measure angle” on page D-49.
Save View
Click this icon to save view. See section 3.22 “Save view” on page D-49.

EXPLORER TAB
Select view
Click this icon to select a view. See section 3.23 “Select view” on page D-49.
Delete view
Click this icon to delete view. See section 3.24 “Delete view” on page D-50.
Reset view
Click this icon reset view. See section 3.25 “Reset view” on page D-50.
Toggle overlay
Toggles the visibility of orientation lines in the view.
Toggle zoom
Toggles zoom operation of the mouse wheel on/off. See section 3.26 “Toggle
zoom” on page D-50.
Findings
See section 3.27.1 “Using the radiological findings tool” on page D-51.
Image Properties
View and edit image properties. See section 3.28 “Image properties” on page
D-52.
Inactivate
Inactivates the currently open 3D volume. See section 3.29 “Inactivate image”
on page D-52.

EXPLORER TAB
3.2 3D capture
NOTE See also Planmeca ProMax 3D/Dimax3 user’s manual.
NOTE Do not use the software for other tasks during exposure.
1. To start exposure click this icon.
The image acquisition window appears.
Optionally you can take 2 scout images or 2D Views before the actual 3D
volume exposure. These options can be selected on Planmeca ProMax 3D
GUI.
(On how to activate/deactivate the scout / 2D View exposure, see Planmeca

ProMax 3D user’s manual).
With this function two images, one coronal and one sagittal image, in an angle
of 90° to each other will be captured. This means that patient positioning can
be verified before the final exposure, and additional radiation caused by a
possible retake can be avoided.
2. Select the appropriate level of artefact removal (None / Low / Med / High) that
is applied to the image.
Use the higher settings with patients who have more high density materials in
the exposed area such as amalgam fillings.

EXPLORER TAB
If the result is not satisfactory the artefact removal can be re-applied with
different settings as explained in section 3.4 “Artefact removal” on page D-14.
When all exposures have been taken and the reconstruction calculation is
completed, the 3D study is automatically saved into the database under the
patient file and displayed on the screen.
If ProMax 3D stitching mode is used, the stitching window is automatically

presented in Planmeca Romexis. For more information see section 3.5 “Stitch
volumes” on page D-16.
HU correction enabled
When enabled provides more uniform HU-values on the edges of the volume.
AINO Filter
AINO (Adaptive Intelligent Noise Optimiser) is a 3D noise filter that reduces

noise in CBCT images with minimal loss of detail. The filter analyses
exposure data during reconstruction and adaptively differentiates noise and
fine details. It is most useful with images that have very small voxel size or
very low radiation dose. The AINO Filter is available only on supported
hardware combinations. For more information on availability contact your local
sales representative.
The original image is stored in the reconstruction PC (100 exposure buffer)

and can be recalled using Redo 3D Reconstruction from the File > Capture
menu.

EXPLORER TAB
3.3 3D model capture
The 3D Model Capture is intended to be used with Planmeca ProMax 3D

unit’s model scan program. The program automatically generates 3D surface
dental models. The models show in the Volumes tab once the exposure is
completed.
NOTE Only the surface model is stored into Planmeca Romexis image archive,
the CBVT volume is discarded.
The surface models can be viewed and processed in the ProFace tab and
exported to other software using the Export Volume tool, for more information
see section 3.10 “Exporting surface models in ProFace tab” on page D-29
For step-by-step instructions on how to take exposures on dental models, see

your Planmeca X-ray unit user’s manual.
The digital casts can be used for electronic archiving of the impressions or
they can be turned into STL surface models for further use in Planmeca
Romexis or other treatment planning software. See also section 3.7
“Importing Intra oral scans” on page D-21 and section “Converting dental
impressions into actual dentures (Digital cast conversion tool)” on page D-60.
3.3.1 Adding, selecting and removing material
Select Material
Use this drop-down menu to select calibrated material that was used to
produce the dental impression to be scanned.
NOTE Each material needs to be calibrated before accurate model scans can
be produced.

EXPLORER TAB
Add Material
After crafting a calibration target for Planmeca ProMax, use this button to start
a calibration scan and to name the calibrated material for later use.
Calibration exposure values are automatically predefined to the material
name. The Model Capture should always be done using exposure values
identical to those of the calibration scan.
Remove Material
Click this button to remove material from the calibrated materials list.
Artefact removal
Select the level of artefact removal applied to the scan.
CAUTION The 3D model capture can only be used to scan dental models or plaster
casts. It must never be used to scan patients.
Automatic artefact removal can be applied to all new exposures. This

eliminates the need to remove artefacts separately from each volume. The
following preset artefact removal options are available:
• None – no artefact removal is applied
• Low – low threshold level to reduce some artifacts with minimum effect on
anatomic information.
• Mid – medium threshold level to compromise between artifact reduction and

effect on anatomic information.
• High – high threshold level to maximize artifact reduction but with the risk of
hard tissue anatomic information of being affected.
The default level for automatic artefact removal can be configured in

Planmeca Romexis Configuration application. The default level setting can be
overridden per exposure using the buttons as described above.

EXPLORER TAB
3.4 Artefact removal
Objects of high density, such as amalgam or other metallic bodies, can cause
artefacts on X-ray images because the radiation cannot penetrate them.
Artefact removal is not automatically applied when the volume is
reconstructed, but if disturbing artefacts are present after a successful capture
recalculate the volume using the Artefact Removal.
1. Use the sagittal (or coronal) view to align the axial view so that the whole teeth
arch can be seen and the amount of amalgam visible is maximized in the axial
view.
2. Click the Artefact Removeval icon.
3. In the opening window set the Artefact threshold by moving the slider.
The threshold can be set between 0 for pure black and 4096 for pure white
(amalgam, for example, ranges near 4000). By decreasing the threshold more
potential artefacts (darker shades of grey) whereas by increasing less will be
removed. This means that a decrease in threshold value makes suspect
areas more likely to be considered for removal. Therefore, a decrease in
value may also increase the processing time as more areas will need to be
processed.

EXPLORER TAB
4. When adjusting the slider from right to left, pay attention to the axial view
aligned in step 1.
The areas of amalgam, which are normally bright white, turn red.
NOTE Only adjust the threshold until the amalgam or other metallic bodies
appear red, not further. Too aggressive settings may affect dentin.
5. Keep moving the slider to the left until all presumed areas of amalgam have
barely turned red and the dentin remains white or light grey.
NOTE Too many red areas can escalate the recalculation time and produce
unwanted results. Adjust threshold individually for each volume.
6. To start the artefact removal click.
The reconstruction PC will start a recalculation of the 3D volume, ignoring all

areas (voxels) above a certain grey level, which have been flagged as
undesired in step 3 by colouring them red. Leaving the problematic areas out
of the calculation will remove artefacts caused by amalgam or other metallic
bodies from the recalculated volume. The bodies that caused artefacts will,
however, still be visible. To finish the removal, click Done.
NOTE If the volume was taken with a Planmeca Romexis version older than 1.4
you need to manually select the right frameset ID from the dialogue.
Planmeca Romexis asks the originally captured frame sets from the
reconstruction PC. If the correct frameset is not on the reconstruction
PC anymore, it is not possible to proceed with the Artefact Removal.

EXPLORER TAB
3.5 Stitch volumes
By joining together 2 or more volumes captured from neighbouring anatomy

you can produce larger volumes in Planmeca Romexis than the native
maximum of 8 x 8 cm allowed by ProMax 3D.
When positioning the patient for stitched imaging it is important to consider

the barrel-like shape of the volume and to allow adequate overlap between
each volume. See also the latest Planmeca ProMax manuals for more
information on automatic stitching modes.
If stitching exposure mode is selected from the X-ray unit the Stitching
dialogue is automatically presented at exposure. The volumes are
automatically aligned so that the user only needs to check the correct
alignment and click Stitch to finish.
NOTE For vertical stitching the volumes must be manually pre-aligned in

Planmeca Romexis using the stitching mode Auto with Tilt.
Volumes can also be re-stitched and volumes captured n some other program
than stitching mode can be stitched manually.
NOTE All volumes are converted into 300 µm voxel size for stitching. This
resolution corresponds to the resolution normally achieved using
ProMax 3D Low Dose exposure mode.
NOTE Before starting to stitch volumes make sure that the patient has at least
two volumes suitable for stitching.
1. Click this icon.
2. From the drop-down menu on the top select the volume you would like to use
for stitching.
The drop-down menu lists all volumes of the current patient available for
stitching.
3. Click Add.

EXPLORER TAB
The volume opens in the window.
One volume
added
4. Add the rest of the volumes for stitching.
Three volumes
added,
correctly
aligned

EXPLORER TAB
Three volumes
added, incorrect
alignment
The Planmeca Romexis automatically aligns the volumes according to

exposure geometry information from Planmeca ProMax 3D, but you may
occasionally need to adjust the alignment for better results.
5. Adjust the volumes so that they are aligned as accurately as possible.
6. Select Horizontal or Vertical mode depending on whether the volumes are to

be stitched horizontally side by side, or vertically on top of one another.
7. Select Black or White background colour.
In some cases it is easier to work against a white background, but this option
is for user convenience only and will not affect the stitching result.

EXPLORER TAB
8. Select stitching mode.
• Auto – In the Auto mode Planmeca Romexis will search for the best horizontal
alignment for stitching after the user has provided a rough alignment in the
work area. This mode is most suitable for horizontal stitching and it is the
default setting for horizontal mode in Planmeca ProMax 3D model X-ray units.
• Auto with Tilt – In addition to the Auto mode Planmeca Romexis will also con-
sider different rotations for the volumes in case the patient has tilted their
head between the exposures. This mode is most suitable for vertical stitching
and used as default when vertical stitching mode is used in Planmeca ProMax
3D model X-ray units.
• Manual – The manual mode can be used in case the two automatic modes
explained above do not produce expected results.
NOTE Both auto modes provide a snap-to feature that recognizes matching
anatomy and pulls the volumes into the correct position during the
alignment.
9. Adjust slices if necessary
If the volumes do not share anatomy in the same slice, the sliders can be
used to adjust the slices so that a common anatomy can be seen in all
volumes. This is necessary in vertical stitching, as the anatomy shown by the
default centre slice (125) of the top and bottom volume will be 2-4 cm apart.
Check/uncheck the box on the left of each slider to toggle the visibility of each
volume.
10.Click Stitch.
Planmeca Romexis will automatically execute fine-tuning and stitching of the

volumes. Planmeca Romexis to iterate for the best alignment and save the
stitched image into the database.

EXPLORER TAB
3.6 Importing 3D Images
The 3D Import can be used to import DICOM MF, DICOM SF and ProFace
files.
Select the appropriate file type in the Open window.
Select a single DICOM file to import single DICOM MultiFrame image.
Select multiple DICOM files to import them as single DICOM SingleFrame

image.
Select single PRO file to import it as Planmeca ProFace 3D photo.
Select single STL file to import it as surface model.
Multiple file selection is only accepted for DICOM SF images, otherwise

multiple selection is ignored.

EXPLORER TAB
3.7 Importing Intra oral scans
NOTE Surface model import requires the optional Planmeca Romexis 3D

Implant Planning License. The surface models can be separately
processed in the ProFace tab.
3D surface models can be acquired and added to the Volumes list by using
the 3D Model Capture (see section 3.3 “3D model capture” on page D-12) or
by using the 3D Import (see section 3.6 “Importing 3D Images” on page D-20).
When the models have been added to the Volumes list, they can be matched
with CBVT volumes using the IOS Import tool.
Once matched to a CBVT volume the properties of the matched surface

model can be adjusted (delete, change colour) in the 3D module’s Implant tab
using the Implant List dialogue.
3.7.1 Matching STL surface models to CBVT data
To import intraoral scan as a surface model:
1. Open the 3D volume you want to match with the surface model.
2. Start matching by clicking the IO-Scan Import icon
• To match a new surface file select Browse
• To match an existing surface model from the patient’s Volumes list use
Select.
3. Orient CBVT volume and surface model to comparable positions:

EXPLORER TAB
• To rotate the image, press and hold down the left mouse button while drag-
ging the image
• To pan/move surface model and crop CBVT, press and hold down the right
mouse button, while dragging the image.
• To pan/move CBVT volume press and hold down the middle mouse button
while dragging the image.
• To zoom in/out the image use the mouse wheel.
4. Right-click on 3 common landmark points in the surface model and CBVT

rendering.
5. Start by selecting a landmark in the surface model and then in the CBVT and
so forth.
Note that by rotating the models you can select landmarks on any side of the
anatomy.
To undo and repeat the previous step click the Back / Repeat button.
Ideally the landmarks should be placed on corners of occlusal and buccal or

distal and mesial or distal surfaces. Landmarks are indicated as follows:
• 1st landmark: sphere

EXPLORER TAB
• 2nd landmark: cylinder
• 3rd landmark: cube
6. To finish positioning click Done.
Planmeca Romexis will automatically match the surface model to the CBVT
volume.

EXPLORER TAB
7. The following options are available
• Direction icons to orient the CBVT rendering to default positions
• Set Crop to limit the anatomy that is used for matching the surface model to
the CBVT
• Threshold to adjust the CBVT rendering bone surface
The imported surface models can be found in the Implant list where there
colour can be modified, (see section “List of added implants” on page D-92).
Additionally the following options can be selected:
• Allow Scaling
When enabled, Planmeca Romexis will stretch the surface model to achieve
better fit with the CBVT volume. Note that this may alter proportions of the
surface model.
• Fine Tune Match
When enabled, Planmeca Romexis will analyze the anatomy around each
control point and uses the actual anatomy for best possible fit.
When disabled, Planmeca Romexis will minimise the deviation between the
three control points in each data to get the closest fit with no additional analy-
sis.
8. To import crown(s) repeat the above process starting from Step 2 on page 21.
9. To use the same match for crown placement as for the surface click Use
Existing Match button.
The crown will be automatically placed into the exact same area where it was
placed in the crown planning software.

EXPLORER TAB
3.8 Scanning with PlanScan scanner
The Planmeca PlanScan is an optical impression system for CAD/CAM of

dental restorations. For detailed description on how to use the scanner see
Planmeca PlanScan User’s manual (publication number 10033946).
3.9 Exporting 3D Images
1. To export volumes click this icon.
2. In the following window select the appropriate export options.
For detailed descriptions of the export options see the following sections.
3.9.1 File & format options
Planmeca Romexis can export 3D volumes in different formats:
Single Multi Frame DICOM File
A single DICOM standard file that contains the 3D image data in a set of
frames.

EXPLORER TAB
Set of Single Frame DICOM Files
A set of multiple DICOM standard files each of which contains a single Frame
of the 3D Image data.
If images are to be exported as they were originally captured, tick the Export
Original (not rotated) selection. All rotations and translations done to the
image afterwards will not be exported with this function.
After inserting a blank writeable CD click OK to start the CD creation and

writing process.
Resolution
Select the desired resolution for exporting DICOM files from the Resolution
drop-down menu.
Bit depth
Select the volume bit depth, 12 or 15 bits
Original orientation
Check this option to export images as shown right after exposure
Export cropped
Check this option to export cropped volume when cropping has been applied.
Anonymize
Remove personal identification information from the export DICOM file.

EXPLORER TAB
3.9.2 Overlay options
Burn Nerves and Implants
Export voxel representation of nerves and implants (as cylinders) present in

the study. Nerves and implants cannot be edited after export. Implants are
exported as realistic models if a suitable model is available in the Implant
library. In case no corresponding model is available the implants will be
exported as 3D cylinders.
Include Nerves and Implants
Export nerves and implants as Planmeca Romexis objects attached to the

image. When imported into another Planmeca Romexis, nerves will appear as
editable objects and implants as actual implant models if present in the locally
installed implant library. When used with Planmeca Romexis Viewer, the
implants will appear as cylinders and the nerves as non-editable objects.
Include annotations
Includes annotations (such as measurements, labels and arrows) as editable

Planmeca Romexis objects.
Include ProFace (.PRO)
Includes Planmeca ProFace images in the export.
Include ProFace (.OBJ)
Includes Planmeca ProFace images in the export.
Include IO-Scan
Includes intraoral scan in the export.
NOTE All surface models (ProFace & STL) currently visible in the 3D module
will be included in the export. To add or remove surface models from the
export use the 3D Overlays menu. This allows exporting, for example, a
full combination of CBVT, ProFace and intraoral scans in correct
coordinates. The images can then be imported into another Planmeca
Romexis or viewed in Planmeca Romexis Viewer.

EXPLORER TAB
3.9.3 Export 3D volume to
Folder
Data is exported to a folder
Disc image (.ISO)
Data is exported to a CD/DVD disc image that can be written to a media using
3rd party CD/DVD writer software.
CD or DVD
Data is written directly to a CD/DVD if a CD/DVD writer is installed.
3.9.4 Viewer options
Include Viewer
Select to includes the Planmeca Romexis Viewer software in the export.
Skip Viewer launcher
When exporting single image select this option for the Planmeca Romexis
Viewer to open without displaying the patient selection dialog in the launcher.
Viewer language
Set the default language for the exported Planmeca Romexis Viewer
software.

EXPLORER TAB
3.10 Exporting surface models in ProFace tab
When ProFace tab is active you can export currently open surface model as
follows:
Planmeca ProFace image with .PRO extension
• Export with overlay offset (optional): apply overlay offset so that the ProFace
surface can later be positioned in relation to the patient’s CBVT volume. It is
possible to export 3D CBVT with ProFace image attached to the volume.
• Export Romexis Viewer (optional): can be used to view ProFace image.
Wavefront Object format
Not supported
STL File format
Only surface shape is included (skin texture is discarded).

EXPLORER TAB
3.11 Exporting CBVT volumes in STL (surface model) format
The CBVT volumes created of dental impressions can be converted to STL

surface model format (.STL) and exported to desired location.
The STL surface models can then be re-used in any 3rd party software
supporting the STL standard format.
For more information on dental impressions and digital cast conversion see
section “Converting dental impressions into actual dentures (Digital cast
conversion tool)” on page D-60.)
To export volume in STL format:
1. Open the CBVT volume that you want to export.
2. Adjust the 3D Rendering threshold value so that the surface that you want to
export shows cleanly.
3D Rendering view to be exported as STL
3. From the File menu select Export > Export Volume as STL

EXPLORER TAB
4. In the opening window the following settings can be adjusted:
Normal or low resolution
The selected resolution affects the amount of detail in the exported STL file.
Using Normal resolution also results in a larger file size
Apply smoothing
The exported STL is smoothed but with possible loss of detail.
Export cropped
Select this option to export the STL of the selected crop region only. You can
adjust the crop region by drawing a box around the area that you want to
export.

EXPLORER TAB
TIP! You can preview the crop result in real-time in the 3D Rendering view
where it can also be rotated while the STL Export dialogue is open.
Crop result preview in 3D rendering
Folder
Select the folder where to export.
File name
Name the file to be exported
5. When finished with adjusting click OK.
Planmeca Romexis will now export the STL file.
The STL file can now be used in 3rd party software for further processing or
imported back to Planmeca Romexis using the STL Import, see section 3.7
“Importing Intra oral scans” on page D-21 for more information.
Sample view of post-processing the STL model in

3rd party software.

EXPLORER TAB
3.12 Save 2D view
This tool can be used to generate 2D snapshots of 3D volumes.
The snapshots will appear in the 2D imaging module under the CBVT
category where they can be measured and processed using the tools
described in the (see chapter C “2D IMAGING MODULE”).
By default the snapshots are generated as they appear on the screen but the
appearance and number of snapshots can be adjusted in the Save 2D View
window.
1. Click the Save 2D View.

EXPLORER TAB
2. In the appearing dialogue specify the image(s) or ranges of images to be

included in the snapshots.
To exclude a view:
Click on it in the preview image
or
After having enabled the Specify panel division option deselect it in the
Panel list.
TIP! To include only one image in the snapshot, eg. Cross Sections,
maximize the image in Planmeca Romexis before opening the 2D
Snapshot dialogue. You may also use the snapshot button next to each
3D view.
NOTE The 2D Snapshot dialogue is a shared feature with 3D Printing and the
following applies to defining views for printing as well.

EXPLORER TAB
3.12.1 MultiPanel division
In the MultiPanel division field you can define the exact layout for generated
2D snapshots.
It is particularly useful when a large number of slices (usually over 30) is

processed and the slices would not fit in one reasonably sized image. For
example for multi-page printouts a large number of slices is needed. For
better visualization and navigation of large number of cross sectional slices
see section 5.2 “Full arc mode” on page D-86.
Create snapshots as shown on the screen
When this option is enabled, the snapshots are created as they appear in the
preview. The snapshot options can be used to further adjust the appearance
of the generated images.
This option is used by default.
Specify panel division
This option can be used to create slice snapshots in freely configurable

numbers and layouts from all available projections in the underlying 3D
module. It can for example be used to generate multiple images that include
cross-sectional slices from the full dental arch at 1mm spacing. The slice
settings such as distance, thickness and width should first be defined in the
underlying 3D module.
To create slice snapshots:
1. Select the Specify panel division option.
2. Select the panels that you want to configure by ticking the check box next to
its label.
If you do not select a panel the default snapshot as shown in the preview will
still be generated unless you also deselect that by clicking on the preview.
3. Specify the range of slices that you want to generate for each selected panel.
The range maximum depends on the slice settings in the underlying module
For example:
• Axial and Panoramic: The size of the volume divided by the distance between
slices. For example for 80 mm high volume with 1mm axial slice distance a
maximum of 80 axial slices can be generated.

EXPLORER TAB
• Cross Sectional: The length of the panoramic curve divided by the distance
between cross sectional slices. For a full jaw panoramic curve totalling 180
mm in length and with 1 mm cross section distance a maximum of 180 cross
sectional slices can be generated.
4. To create a desired number of images of each panel use the Divide Into drop-
down menu.
5. To set the distribution of slices on the final image(s) use the fields under Cols
and Rows.
The Image Size shows an estimate snapshot dimensions and fit on portrait or
landscape setup.
6. Click OK to generate snapshots as specified.
3.12.2 Snapshot options
There are 6 options for generating 2D snapshots:
• Color image
If this option is checked an 8 bit color image will be created. If the option is
unchecked a 12 bit gray scale image is created.
NOTE If you intend to further process the images in the 2D imaging module
(brightness, contrast, gamma) it is preferable to select 12 bit grayscale
images)
• Create single image
If this option is checked one single image is created. If this option is not
checked single images from different views will be created.
• High resolution
Doubles the resolution of the image. This option is useful for low resolution
images on which the labels may appear grainy.
• Large fonts
Larger label font improves readability.
• Generate images as shown
When enabled will generate the snapshot with the same zoom level that is
applied in the underlying module.

EXPLORER TAB
• Set As Default Preset
Sets the current values as defaults for the 2D Snapshot dialogue.
The view is saved as 2D image and opened in the 2D Imaging module.

EXPLORER TAB
3.13 Creating virtual cephalometric images
Virtual Cephalometric can be used to generate 2D cephalometric images from

3D volume data and save them to patient’s 2D images. Different projections
and composition algorithms can be used and the volume orientation can be
freely adjusted.
• To rotate and align the volume use left mouse button. Note that the projec-
tion is perspective free so the close and far anatomy can be aligned perfectly.
• To rotate the volume sagittally (nodding) use the Ctrl + right mouse button.
• To adjust contrast and brightness Ctrl + left mouse button.
Use the direction icons at the right side of the image to choose from which
direction the cephalometric image should be generated. These can be used
together with crop options so that the far side of anatomy is removed from the
cephalometric image creating an image where duplicate anatomy does not
need to be considered.
To use different algorithms for the calculation of the cephalometric image use
the Calculation Method drop down:

EXPLORER TAB
• Default: Produces the most film like quality in the image.
• Flat: Flattens the image by reducing contrast differences between areas in the
image.
• Log: Uses logarithmic mapping to add contrast in the image.
Rulers
To have a ruler shown/hidden on the image check/uncheck the Rulers box.
ProFace Profile
To turn on/off the ProFace profile overlay check/uncheck the ProFace profile
check box.
Use the slider on the right edge of the image to adjust the left/right positioning
of the ProFace profile line.

EXPLORER TAB
3.14 Print editor
To print images to a Windows printer:
1. Click this icon.
2. Select images to be printed from the views (Axial, Panoramic, Sectional) and
how to divide them in Print editor.
On how to use the multipanel division please see section 3.12.1 “MultiPanel
division” on page D-35.
3. To open images in Print Editor click OK.

EXPLORER TAB
4. The images will open in Print editor.
3.14.1 Example case for creating a multi-page printout.
Original data: Planmeca ProMax 3D volume with general anatomy.
End result:
• 6 page printout
• 2 panoramic images on one page
• 4 axial slices on one page
• 120 cross sections at 1mm distance between slices, spanning 5 pages. This
example assumes that the panoramic curve is exactly 120 mm long but any
length can be used although division may need to be adjusted. Slice distance
is set to 1 mm, slice thickness to 1mm and slice width to 25mm.
• 6 page print template that will allow easy generation of similar prints easily.

EXPLORER TAB
Steps:
1. Using Cross Sections or Implant tab turn on full arch mode, see section 5.2
“Full arc mode” on page D-86 for typical work-flow suggested.
2. Set Axial view to show 4 slices using the view settings. Set desired slice
distance, thickness and position for good coverage.
3. Set Panoramic view to show 2 panoramic images with desired distance and
layer thickness.
For better clarity you can select the option Show every fifth section and
deselect the option Panorama referenced in Show/Hide Settings dialogue.
4. Start Print Editor.
5. Check the option Specify panel division
• Deselect the Axial check box. Axials will be generated as shown in the pre-
view.
• Deselect the Panoramic check box. Panoramic images will be generated as

shown in the preview.
• Leave Sectional division enabled and:
• Leave full range specified (1-120 in this example)
• Set Divide Into 5
• Set Cols to 6 and Rows to 4. These settings will produce cross sectional
images that are 149 x 220 mm in dimensions and will fit on A4 paper.

EXPLORER TAB
6. Set appropriate snapshot options.
7. Click OK to create print images.
8. In Print Editor window click the Page Setup icon.
9. Select Portrait for orientation.

EXPLORER TAB
10.When adding new pages to the layout you can:
• Add 5 new empty pages by selecting Add New Empty Page to Layout.
or
• Copy the image slots and their settings by selecting Add Copy of Current
Page To Layout.
11.Select the cross-sectional image.
12.Right-click on the selected image and select Move to Page > 2.
You may need to adjust the image scale to make it fit to the page.
13.Repeat for each cross section slice image and move them to pages from 2
through 6.
14.Align each image to its page.
• To add slice thickness, distance and other information use Labels.

• To add 2D exposures or 2D snapshots into the printout go to the Image
Browser.
• To add page numbers and other information use Labels.
• The finished page layout is shown below.
15.To save the layout to print templates click the Save Layout button.

EXPLORER TAB
To create similar layout in the future you can create the corresponding images
and select the saved template from the Select Layout menu.
The images will be automatically placed into correct pages and slots.
3.15 DICOM Print
To print with DICOM compatible printers click this icon.
For more information see section 3.14 “Print editor” on page D-40.
NOTE On how configure DICOM printer see section 4.2 “DICOM Configuration”
on page G-16 in chapter G “ADMIN MODULE”.

EXPLORER TAB
3.16 DICOM Storage
In case a full DICOM license is purchased, images can be sent to a remote

DICOM application, i.e. DICOM image archive (PACS).
NOTE DICOM Storage needs to be configured in the Admin module before the
DICOM Storage service can be used, see chapter G “ADMIN MODULE”.
1. Open the image you want to store.
2. Click this icon.
NOTE Images can also be automatically stored to the DICOM archive after
capturing, see section 4.2 “DICOM Configuration” on page G-16 in
chapter G “ADMIN MODULE”.

EXPLORER TAB
3.16.1 Settings
AE Title
Specifies the AE Title of the PACS server where the image is to be stored.
Calling AE Title
Shows the AE Title of the current Planmeca Romexis workstation.
Crop Empty Space from Volume
Empty space from around the volume (from the top, bottom, left, right, anterior
or posterior) is removed before sending. a volume smaller in size is sent
compared to original volume.
Advanced Options
• Send Axial, Coronal, Sagittal slices
By default only axial slices are sent. Additionally or instead coronal or sagittal
slices can be sent.
• Send Full Resolution / Specify Range
By default full range of thinnest possible slices (smaller range if Crop Empty
Space is selected) are sent. The range can be specified with the starting and
end points, distance between slices and slice thickness all in millimetres. If
start and end points are outside of the volume after applying Crop Empty
Space settings they are adjusted to new volume limits.
3.17 Cloud export
See section 25 “CLOUD EXPORT” on page C-75.
3.18 Launch external applications
A 3D image with patient information can be automatically transferred to a 3rd

party application. The application path is defined in chapter G “ADMIN
MODULE”, see section 5 “LOCAL SETTINGS” on page G-24.
Open the 3D image that you want to transfer and click the Launch Ext. App.
icon.
3D volume brightness/contrast and settings, thickness and the position of the

volume are automatically saved when the image is closed. In addition the 3D
Views tools can be applied to save the currently displayed views.

EXPLORER TAB
3.19 Adjust levels (contrast & brightness)
If the adjustment of the 3D volume rendering is not satisfactory, the

adjustments can be done manually as follows:
1. Click this icon.
2. The Input Values window opens and show a histogram, a graphic

representation of the intensity distribution in the volume.
To adjust the gamma curve move the green line in the histogram. The value
is displayed under the histogram in the middle field.
To adjust contrast and brightness the histogram can be cut from both ends by
moving the red lines.
Scale histogram
By pressing the arrows in the middle, the histogram can be scaled up or

down. Click this button to restore the original scale of the histogram.
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. Pressing the button alters and allocates the colour
selection for different tissues automatically, based on the curve of the
histogram. To modify the Pseudo Colours manually, drag the rectangles
above the histogram left or right.

EXPLORER TAB
With this, the position and range of the specific colour can be altered. By
double clicking the rectangle, the colours can be changed for an individual
selection.
The button resets the settings of the Pseudo Colours. From the arrow
button ready made colour maps can be selected.
3.20 Measure angle
Click this icon to draw an angle into a slice view by pressing the left mouse
button down. Drag to draw the first line and then click and drag to draw the
second line.
3.21 Measure length
Using the measurement tool you can measure length between two or multiple
points.
To select between single measurement and polyline measurement hold down

the left mouse button.
Single measurement – Hold down the left mouse button to define

measurement, release mouse button to finish.
Polyline measurement – Draw the line by pressing and holding down the left
mouse button, release mouse button to finish.
NOTE All measurements are automatically stored as saved views, use the
Open Saved View button to open the saved views.
3.21.1 Choosing measurement colour
See section 3.33.1 “Setting the colour for annotations and measurements” on
page D-64.
3.22 Save view
Saves the current displayed view. Enter a name to the opening dialogue.
3.23 Select view
Opens a previously saved view.

EXPLORER TAB
3.24 Delete view
Delete one of the saved views from a list.
3.25 Reset view
Restores the original orientation and settings of the views.
3.26 Toggle zoom
When the Toggle Zoom icon 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 the Zoom Mode icon is deactivated, turning the mouse wheel over
a view will scroll through the image layers as the Layer Slide Bars do
(see section “Layer slide bar and maximize” on page D-54).
NOTE The rendered volume can be zoomed with and without the Zoom Mode
icon activated.

EXPLORER TAB
3.27 Findings
3.27.1 Using the radiological findings tool
Click the Findings icon on the top toolbar.
In the 3D module the orientation of the volume (axial, sagittal; cross-sectional)

can be modified at any time without closing the dialogue.
Orientation
links
When a finding is added in 3D module the orientation is saved with the

finding.
To return to the orientation in which the finding was registered click the link on
the finding as illustrated above.
NOTE For detailed information on how to use the 3D Radiological findings

application, see section 14.3 “Findings tab” on page C-45.

EXPLORER TAB
3.28 Image properties
1. Click the Image Properties icon to view Image properties or add an image
comment.
3.29 Inactivate image
To inactivate an image click the Inactivate Image icon.
The image is moved to Trash folder from where it can be deleted permanently
or returned to its original location, see section 4.2.1 “Reactivate and empty
trash” on page I-29 for more information.
NOTE Inactivating can be restricted with user rights, see section 1.1 “Groups
tab” on page G-1 in chapter G “ADMIN MODULE” for more information.
3.30 Views
The 3D volume is displayed simultaneously in four different views:
• Sagittal (red),
• Coronal (green),

EXPLORER TAB
• Axial (blue) and
• 3D rendered view.
The red, blue and green lines across the views indicate the slicing planes in
the views.
NOTE It is recommended that the 3D rendered view is disabled in image

capturing workstations (see section 5 “LOCAL SETTINGS” on page G-
24).
The position of the volume can be freely adjusted by holding down the left
mouse button while moving the volume. Moving a volume in one view will
affect the other views as well, except for the rendered volume. While moving
the mouse in one view, the two other views automatically move to the
corresponding position.
The viewing angle can be rotated freely by holding down the right mouse
button while moving the mouse.
When orienting the image, you can recognize anterior, posterior, left, and right
anatomies by the A/P/L/R letters respectively on the edges of the views.
These will automatically update to denote the nearest anatomy to the edge.
When moving the mouse cursor on top of the image, a Hounsfield Unit (HU)
value will be shown at the bottom right of the current view. The value shown is
an average value of 3 x 3 pixel area under the mouse cursor.
The orientation lines in each view visualize the relations between views. This
means that the view of the coronal plane, e.g., is indicated with a green line in
the sagittal plane, axial plane and with a green auxiliary plane in the

EXPLORER TAB
perspective view. Likewise the sagittal and axial planes are indicated. With
the buttons of the Rendered Volume Auxiliaries it is possible to switch the
auxiliary lines in the rendered volume on or off.
3.31 Slice specific tools
The slice specific tools are located vertically next to each slice view (axial,
sagittal, coronal).
Layer slide bar and maximize
Clicking the Maximize icon at the top right corner of a view opens the
corresponding view in full size window.
NOTE It is also possible to scroll through the image layers using the mouse
wheel, when the Zoom Mode is deactivated, see section 3.26 “Toggle
zoom” on page D-50.
Layer and curve slide bar
A slide bar is located at the right border of each view, sagittal, axial and
panoramic. In the sagittal and axial view the slide bar can be moved to scroll
through the image layers. This means that scrolling the slide bar of the axial
view up and down moves the view inside the layers forward or backwards.
The corresponding orientation lines in the sagittal and panoramic view
automatically move to reflect the changes.
Moving the slide bar of the panoramic view modifies the radius of the
panoramic curve and the change is immediately reflected in the axial view by
the panoramic curve moving in or out in relation to the patient’s anatomy.
When the slider is released, the panoramic view is automatically updated with
the new curve.
A Layer Slide Bar is located at the right border of the coronal, sagittal and
axial view.
In each case the slide bar can be moved to scroll through the image layers of
the corresponding view. For example, scrolling the slide bar of the coronal
view up and down moves the view inside the layers forward and backwards.
The corresponding orientation lines in the two other views as well as the
auxiliary plane in the 3D rendered view automatically move to the appropriate
position, to reflect the change.
Snap shot

EXPLORER TAB
With snap shot tool a 2D snapshot can be quickly created out of a 2D image
for single view.
Snap shot - Saves a 2D CBVT snapshot of the viewport with default settings.
For more information see section 3.12 “Save 2D view” on page D-33.
Volume mirroring
Reorients volume in the view as follows:
Coronal: Anterior vs Posterior
Sagittal: Lateral vs Contralateral
Axial Upper vs Exterior
• Axial view: From above / below

• Coronal view: From front / back
• Sagittal view: From left / right
Mirror - Reverses data viewing direction as follows
Show vieport settings - Define number of slices, slice distance and thickness.
Adjusting Explorer Layer Settings
Explorer layer settings dialogue can be opened by clicking on the icon in the
top right corner of each 2D view. The number of images, layer thickness and
distance between layers can be set individually for each view (coronal,
sagittal, axial).

EXPLORER TAB
3.32 Volume adjustment tools
The Adjust tools can be used in the coronal, sagittal and axial views for
enhancement, examination and measurements.
Adjusting thickness
Defines the displayed slice thickness of the slice views.
The re-sampling/thickness can be adjusted from the drop-down menu. The

option Bilinear applies a bilinear interpolation filter on the thinnest slice data,
resulting in a smoother but less detailed image.
NOTE This setting will override view specific layer thickness settings.
Adjusting contrast, brightness and sharpness
To adjust contrast, brightness and sharpness of the coronal, sagittal and axial
view drag these sliders. The best results for contrast are achieved using
thicker layer settings (2-5 mm).
The settings are automatically saved when the image is closed.
Exporting views to other tabs
Use this tool to export the currently displayed slices to the Panoramic and
Cross Sections tabs. The processed slices are shown in the other tabs like in
the Explorer.
Show / hide settings
To select the elements shown/hidden in the display click the Show / Hide
Settings icon.

EXPLORER TAB
In the opening window select the overlays to be shown.
NOTE Cross sectional slice numbering can be changed between ordinal and
panorama referenced. Panorama references will label the slices by their
distance in millimeters from the beginning of the panoramic curve and
starting at zero.

EXPLORER TAB
Volume re-slicer tool
Using the volume reslicer you can create a new set of projections and send
them to DICOM storage as a 3D volume stack. This way the volumes can be
more conveniently viewed in some 3rd party DICOM viewers that do not allow
free reorientation of the data in axial, sagittal and coronal views.
The reslicer allows a stack of slices perpendicular to the mandible to be stored

into PACS instead of a stack of axial slices for example.
Alternatively you can save the stack created with reslicer tool to Imaging
module where the images will be visible as 2D stacks, similar to SmartPan
images.
Using the volume reslicer tool
1. Open the 3D volume that you want to re-slice.
2. Click on the Volume Reslicer icon.
3. Select the projection to use as a basis for the new stack from the Source drop-
down menu.
The new stack slices will be perpendicular to the source projection so that the
Axial source allows generation of coronal and sagittal like slices.
To define a line or arc that is used as the direction of the re-sliced stack use
the Draw Arc and Edit Arc tools.
The new slices will be perpendicular to this line and the source projection. The
new stack of slices is generated immediately after the arc has been drawn
and a preview is available on the right.

EXPLORER TAB
The preview allows adjusting the stack slice settings of distance, width and
thickness, as well as mirroring of the slices.
To include the source view in final stack select the option Include Source
view in stack.
To send the result to DICOM Storage queue click the Send to Storage
button.
To save the stack to 2D imaging module click the Save stack as 2D

snapshots button.
Cropping volumes for 3D rendering
Crop Volume for 3D Rendering crops the rendered volume. It is applied over
the sliced views but affects only the 3D rendered volume view.
After pressing the Crop icon, move the mouse pointer over one sliced view.
Press the left mouse button and a white framed rectangle appears. By
dragging the mouse on the view the cropped area can be defined. The
rectangle also appears in the two other sliced views, as reference to define an
exact area for the cropping. In case volume has not been rotated a preview of
the cropped volume is shown instantly. The cropping operation is finalised
with mouse right-click. The cropped rendering is automatically centred when
right mouse button is clicked. The cropping can be adjusted by turning on the
cropping feature and moving the crop box or adjusting the cropping boundary
by dragging its corner points.
Moving and rotating volumes
Toggles editing mode to move/rotate volume and annotation and

measurement editing. Use the left mouse button to move and right button to
rotate the volume. Select an annotation or measurement to activate handles
for editing the control points.
To change the position of the slice views (axial, coronal and sagittal) disable
the tool to drag the slice rulers around.

EXPLORER TAB
Converting dental impressions into actual dentures

(Digital cast conversion tool)
NOTE For automatic capture and conversion of dental impressions and plaster
casts see section 3.3 “3D model capture” on page D-12.
With Digital Cast conversion tool the dental impressions (negative) generated
in Planmeca ProMax 3D Impression Mode can be converted into digital
models representing an actual denture (positive). The tool can be used to
replace plaster casts (in certain cases).
For more information on how to work with surface models see section 3.11
“Exporting CBVT volumes in STL (surface model) format” on page D-30 and
section 3.7 “Importing Intra oral scans” on page D-21.
Producing digital casts
1. Acquire a CBVT scan of dental impression using Planmeca ProMax 3D Model

Scan mode.
2. Make sure that the scan is approximately centred in Planmeca Romexis as

indicated in the digital cast dialogue.
3. Open the digital cast dialogue by clicking this icon.
The positioning of the volume can be adjusted while the dialogue is open.

EXPLORER TAB
Planmeca Romexis now produces a Digital Cast CBVT model. Please wait
while the data is being processed. This may take a few minutes.
5. The Digital Cast (positive) model opens in the 3D Explorer.
If the model doesn’t show correctly in the rendered view, adjust the threshold
setting slider under 3D Rendering Adjustments until the surface is shown
cleanly.
NOTE Due to large file size digital casts are not automatically saved. To store
the Digital Cast model for later use, export the model into a small STL
surface model. For more information see section 3.11 “Exporting CBVT
volumes in STL (surface model) format” on page D-30.
NOTE The Digital Cast operation requires a lot of memory. If you receive a low
memory warning during Digital Cast operation increase your Planmeca
Romexis memory reservation. For more information see section 5.1.2
“Java VM Parameters” on page I-32.

EXPLORER TAB
3D noise filter
The 3D noise filter applies noise removal and sharpening filter on the 3D
volume.
To set the strength of the noise filter and to enable an additional sharpening
filter:
1. Click the 3D noise filter icon.
2. In the opening preview window set the strength of filtering by moving the
Strength slider select the appropriate settings.
3. Apply sharpening filter by checking the Sharpen check box.
You can either filter the current volume without storing the results to the
database or create a new filtered volume by checking the appropriate check
box.
NOTE Applying noise filtering and sharpening on an image may alter its
diagnostic quality.
To remove the filtering close and reopen the volume in the Explorer tab.

EXPLORER TAB
Lock IO scan
To prevent the intraoral scans and other surface models superimposed on the
CBCT image from moving select this tool.
For moving intraoral the scans from their control points disable this feature.
3.33 Annotations
The 3D annotation tools can be used to add text annotations and

measurements on 3D slices. The location of text and point of interest can be
moved after placement. All 3D annotations including region growing results
are stored as saved views.
Add text
1. Click the icon and point with the mouse where you want to add the text.
2. Type the text to the opening window and click OK.
To edit the text later select the text with the Select annotations button and
double-click the text. Edit the text and click OK.
Add arrow
1. Select Add arrow tool.
2. Click on a location to indicate point of interest,
3. Enter text and adjust the location of text label if necessary.

EXPLORER TAB
Measure rectangle
Use this tool to draw a rectangle
Draw an ellipse
Use this tool to draw an ellipse.
Measure cube
Use this tool to measure a cubic area in the image.
Measure ellipsoid
Use this tool to draw and measure an elliptic area in the image.
3.33.1 Setting the colour for annotations and measurements
You can set a color for measurements and 3D annotations based on their
orientation or type, for example the same colour for all ellipsoid shapes or
angle measurements. With length measurements it is also possible to set
colour separately for vertical and horizontal measurements.
1. Double-click the measurement or annotation.

EXPLORER TAB
2. In the following window click on the colour you would like to use for the
measurement or annotation.
By checking the box Apply to all new shapes of the selected type the selected
colour will be used for all the shapes of the same type.
With length measurements it is possible to set a colour for vertical and

horizontal measurements separately by selecting Apply to all new vertical
length shapes or Apply to all new horizontal length shapes respectively.
3. To choose a different colour click on the Other button.
You can select the colour in three different ways as follows:
• From the swatches by clicking on the desired colour.

The used colors are memorized and saved to the Recent chart.

EXPLORER TAB
• Entering values for hue (H), saturation (S) and brightness (B). The proportions
of red (R), green (G) and blue (B) are shown below.
• Adjusting the proportions of red, green and blue using the sliders and drop-
down menus.

EXPLORER TAB
3.33.2 Using the region growing tool
The region growing tool can be used to approximate the area and volume of
non-uniform anatomical regions. It works best in areas where there is a
distinct fall-off in density, e.g. air and soft tissue or soft tissue and bone. It can
be used e.g. to estimate volumes of sinus lifts or evaluate shape and volume
of airways. The software calculates the volume based on the gray scale
values in the image using the threshold value and the seed point specified by
the user. The calculated volume square centimetres in the ROI info boxes
among other statistics.
To toggle between minimised/maximized state of the ROI info box double-

click on it.
NOTE Due to the technology used in CBVT imaging the calculated HU-values
are approximates and may vary between patients depending on
individual anatomy, volume size and other factors. Therefore the
calculated HU-values should be considered as relative reference values
only and they must not be depended on as absolute values.
Presets
There are four presets for the region growing tool:

EXPLORER TAB
Bone for determining the amount of bone in the area in question
Soft Tissue for measuring the amount of soft tissue
Air cavity for measuring the dimensions in the air cavity
Root cavity for measuring the dimensions in the root cavity
Threshold
Voxels with values differing (either higher or lower) from the seed point less
than the Threshold setting are included in the region.
Solid Color
Choose the solid color that should be used to highlight the shape of the 3D
region.
Colored by area
Choose and adjust the colour range that should be used to highlight axial
areas in the 3D region. This option can be used to colour an airway so that
narrowest passages with smallest area will be highlighted in red for example.
After the region grow has been executed the exact slice specific area
measurement (in square mm) will be shown in each axial, sagittal and coronal
slice respectively.
Additionally minimum and maximum axial areas will be shown above the color
bar in the Region Grow dialogue.
Advanced options
Pre-Smooth Data
Use this option to filter voxel data before region growing for less noisy result.
NOTE This setting may cause very small features to be lost.
Always include lower
Include voxels with values lower than the seed value in the region regardless
of the threshold setting. Use this setting for segmenting air cavities.

EXPLORER TAB
Always include higher
Include voxels with values higher than the seed value in the region regardless
of the threshold setting. Use this setting for segmenting bone.
Post-Smooth Region Grow Result
Use this tool to remove noisy voxels from the region grow result. This setting
may cause very small features to be lost.
NOTE The settings Always include lower / higher should not be used together
since this selection would always include whole volume in the result.
Use Local Threshold / Local Threshold slide bar
This setting is useful for segmenting areas with slow gradients, if the current
voxel value is outside of the Threshold range but very similar to the previous
neighbouring voxel included in the region (difference is less than the Local
Threshold setting).
This setting prevents false contours in the segmentation result caused by slow
gradients.

EXPLORER TAB
3.34 3D 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.
3.34.1 Setting 3D rendering options
To set rendering options click this icon.
The following options are available.
Table 3: 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

EXPLORER TAB
To set current rendering setting as the custom preset click the Add button.
The currently selected option will be shown in the thumbnail circled with white
line.
To delete the current custom preset click the Del button.
NOTE 3D rendered view quality can be changed in the Admin module, see
section “3D Rendering Texture Quality” on page G-25 for more
information.
3.34.2 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 Cut-off threshold

Brightness
Transparency
Adjust levels
See section “Adjusting contrast, brightness and sharpness” on page D-56.
Rotate Light Direction
Available only in Surface Style rendering.
3.34.3 Rendering orientation tools
The rendered volume view has three coloured planes indicating the coronal,
sagittal, and axial planes. These planes help you in orienting the three slice
views in relation to the 3D rendering and actual anatomy. The planes can be
shown/hidden by pressing the corresponding icons at the right side of the
rendered volume views as follows:
Show/Hide Orientation Lines:
Shows/hides orientation lines and measurements in rendered view only.
Show sagittal plane (red)

EXPLORER TAB
Show coronal plane (green)
Show axial plane (blue)
Show/Hide all planes
Show/Hide Volume Boundaries:
3D volumes are by default surrounded by a volume boundary box that may in

some cases help in orientating the 3D volume.
Show/Hide Perspective in 3D Rendering:
To turn on linear perspective that provides a more natural view of the anatomy
click this icon. By default the rendering is shown in an isometric style that has
no perspective effect.
When in the default non perspective mode, hold down the right mouse button
and move the mouse up and down to produce a slicing effect in which the
anatomy is sliced out as you move the mouse up. This effect can be used to
slice of thin layer of the anatomy or to clear obstructing anatomy from the view
for example.
Smoothing
Applies a smoothing filter on the 3D rendering.

EXPLORER TAB
3.35 3D overlays
The 3D overlays menu can be used for adjusting the settings of objects
superimposed to the CBVT 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 you have several images open you can scroll the list of overlays up and
down to view all the overlays using the mouse wheel.
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.

EXPLORER TAB
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 - Toggle the visibility of ProFace profile lines in 2D Slice views
3 -Toggle the visibility of ProFace images in 3D rendered view
Color – Select colour for ProFace profile line in 2D Slice views
3.36 Soft tissue overlay
3D rendering overlay can be used e.g. for colouring of soft tissue and airways
to enhance the informative value of the 3D rendering.
To turn the overlay on/off use the Show Overlay check box and the Overlay
Properties to specify the qualities of the overlay present in the image.
• Color – Select colour for gray levels.
• Transparency – Specify the level of transparency of the overlay against the

rendering.
0% is for fully opaque and 100% for fully transparent.
• Threshold – Specify the gray-scale value to be colorized (between 0 - 4095).

Show Show Select
overlay outline colour
Transparency
Threshold

EXPLORER TAB
In the following image the bones and soft tissues are shown simultaneously.
By selecting the outline mode (O) it is easier to view the outline of the soft-
tissue and how the soft tissue is positioned in relation to bone.
In this image only the soft tissues are shown. The volume has been cut in
order to show the intra-cranial air cavities

EXPLORER TAB
3.36.1 Choosing overlay colour
1. Check the box C in the 3D overlays menu.
2. In the following window click on the colour you would like to use for the
overlay.
To choose a different colour for the overlay click on the Other button.
3. You can select the colour in three different ways as follows:
• From the swatches by clicking on the desired colour.

The used colors are memorized and saved to the Recent chart.

EXPLORER TAB
• Entering values for hue (H), saturation (S) and brightness (B). The proportions
of red (R), green (G) and blue (B) are shown below.
• Adjusting the proportions of red, green and blue using the sliders and drop-
down menus.
4. Click OK when finished.

PANORAMIC (PAN) TAB
4 PANORAMIC (PAN) TAB
In the 3D Panoramic tab panoramic views can be generated from the 3D data.
The 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 3.12 “Save 2D view” on page D-33.
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 the generated panoramic image is shown.
• 3D Rendered view
By scrolling the mouse wheel on top of the sagittal or axial view, the view can
be zoomed in or out.
To move the 3D volume hold down the left mouse button while dragging the
Axial or Sagittal view.
To rotate the volume hold down the right mouse button. Refreshing the views
may take a moment.

PANORAMIC (PAN) TAB
4.1 Adjusting panoramic layer settings
NOTE This option applies to panoramic layers only and overrides any other
contrast and sharpness settings.
To open the Panoramic layer settings dialogue click this icon on the top right
corner of the panoramic image window.
In the opening window the number of panoramic images, layer thickness and
the distance between the layers can be adjusted.
The Panoramic autofocus tool automatically identifies anatomy in a CBCT

image and shapes the panoramic layer so that it follows anatomy in all three
dimensions. This results in a great overview of the whole denture. When used
in combination with the Panoramic autofit tool, detailed panoramic view can
be very easily generated.
By selecting the Auto Adjust tool the contrast and sharpness of the generated
panoramic layers are automatically enhanced resulting in an image with more
resemblance to a standard panoramic exposure.

PANORAMIC (PAN) TAB
4.2 Using panoramic tools
With the Panoramic tools, the panoramic view can be defined and adjusted by
drawing a curve to the axial view and choosing a range to be displayed.
4.2.1 Defining panoramic curve
The panoramic curve (focal layer) can be defined in two different ways: by
using the Draw Panoramic Curve tool or Panoramic autofit or autofocus
tools. These two methods are described in detail in the following.
Drawing panoramic curve manually
1. Click this icon.
The panoramic curve appears on top of the image.
2. Place the points for the curve on the axial view by using the left mouse button.
• To add a new control point between two existing points, click anywhere
between them where you want to add a new point.
• To remove an existing control point, press and hold down the Ctrl and click on
any existing control point. The cursor will turn into a pen with a minus sign to
indicate removal.
• To move an existing control point, press and hold down the Shift key.
3. To finish click the right mouse button.
NOTE All created panoramic curves will be saved and listed in the Select
Panoramic Curve option.

PANORAMIC (PAN) TAB
Using the Panoramic autofit tool
1. 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 4.2.7 “Defining data range”
on page D-83).
4.2.2 Using the Panoramic autofocus tool
The Panororamic autofocus tool automatically identifies anatomy in a CBCT

image and shapes the panoramic layer so that it follows anatomy in all three
dimensions. This results in a great overview of the whole denture. When used
in combination with the Panoramic autofit tool, detailed panoramic view can
be easily generated.
Without autofocus With autofocus
4.2.3 Editing panoramic curve
1. Click the Edit curve icon.
• To move single points in the curve drag the points as desired using the left
mouse button.
• To move the whole curve drag the curve from the green curve line using the
left mouse button.

PANORAMIC (PAN) TAB
• To add a new control point, hold down the Ctrl key while clicking between any
existing control points or beyond the ends of the curve.
• To remove a control point, hold down the Ctrl and click on any existing control
point.
The cursor turns into a pen with a minus sign to indicate removal.
2. When finished with editing click the Edit curve icon again.
4.2.4 Selecting panoramic curve from the saved curves list
1. To show a list of all saved panoramic curves click the Select panoramic
curve icon.
All curves are saved and named with the date and time they were created.
2. Select curve from the list.
3. To show the curve on image click the Edit curve icon.

PANORAMIC (PAN) TAB
4.2.5 Deleting current panoramic curve
Clicking the Delete Current Panoramic Curve icon deletes the panoramic
curve currently displayed. The standard curves are not deleted.
4.2.6 Adjusting 3D rendered view
See section 3.34 “3D rendering” on page D-70.
4.2.7 Defining data range
By clicking the Define Data Range icon the area of interest for the panoramic
image can be defined. You can select from which part, lower or upper jaw, the
panoramic image is created. In the appearing window move the sliders up or
down. The left slider restricts the upper jaw and the right slider the lower jaw.
4.2.8 Moving and rotating volumes
Toggles editing mode to move/rotate volume and annotation and

measurement editing. Use the left mouse button to move and right button to
rotate the volume. Select an annotation or measurement to activate handles
for editing the control points.
4.2.9 Show/hide renderer
Allows showing and hiding of the 3D rendered view.

3D CROSS SECTIONS TAB
5 3D CROSS SECTIONS TAB
NOTE In case you have purchased Planmeca Romexis Implant license the
Cross Sections tab will be replaced with Implant tab. All features
described below for Cross Sections will also be available in the Implant
tab, see section 6 “IMPLANT TAB” on page D-91.
In the 3D Cross Sections tab cross sectional slices, axial slices and
panoramic images can be created from 3D data.
The Cross Sections tab contains four views:
• Axial view
• 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 end of the
view dividers or maximized by clicking the Maximize icon.

5.1 Adjusting slices in cross sections views
Click this icon in the upper right corner to mirror the cross sections.
Click this icon to automatically mirror the cross-sections at the apex of the
panoramic curve.
Click this icon in the upper right corner of the cross sections view to open a
dialogue where the number of cross sectional slices, the distance between
them, and the width and the thickness of the slices can be defined.
NOTE The Panoramic and Cross Section tabs in the 3D module share the same
panoramic curve and data range definition. Therefore when one is
modified in either of the tabs, the changes will be reflected in the other
tab as well. Sagittal or axial rotation of the 3D volume is defined in the
Panoramic tab and also shows in the Cross Section tab.
5.1.1 Edit cross sectional slice interval
To edit the cross sectional slice interval, move the slider up or down. If the
section lines are activated (see section “Show / hide settings” on page D-56)
the adjustment is visible in the axial view, indicated by the yellow lines. After
moving the slider the cross sectional view will be updated accordingly.

5.1.2 Edit cross sectional slice width
To edit the cross sectional slice width, move the slider up or down. If the
section lines are activated (see section “Show / hide settings” on page D-56)
the adjustment is visible in the axial view, indicated by the yellow lines. After
moving the slider the cross sectional view will e updated accordingly.
5.2 Full arc mode
Full Arc Mode allows the whole arc specified by the panoramic curve to be
processed as individual cross sections. This mode is most useful when the
user wants to produce a print out of cross sections covering the whole jaw
anatomy. Differences between the normal editing and Full Arc Mode are listed
in the following table.
Table 4: Normal mode and Full Arc mode comparison table
Normal Mode Full Arc Mode

Moving Cross Limited to intra slice
Free
Sections increments
Maximum number of cross All cross sections
section reference lines reference lines can be
Printing and 2D shown in Axial and shown. Maximum number
Snapshots Panoramic view is what is is defined by length of
currently shown in the panoramic curve and
Cross Section browser. distance between slices.
Cross Section Previous setting is Ordinal numbering is used
numbering remembered by default
Complex printouts where
3D image diagnostics
Typical use measurements must be
done in Planmeca
case available on all or most
Romexis only
cross sections.

Table 4: Normal mode and Full Arc mode comparison table
Normal Mode Full Arc Mode

1. Align volume optimally
for best compromise
between Panoramic
coverage and Cross
Sectional alignment. No
volume re-alignment
should be done after this
point to prevent existing
measurements from not
being shown on Cross
Sections.
1. Browse and rotate 2. Turn on Full Arc Mode

volume freely to make to limit movement of Cross
findings Sections. This ensures
that measurements made
2. Use views and on Cross Section always
Typical measurements to indicate remain visible in them.
workflow findings.
3. Save View is used so
3. Use saved views to that the selected volume
return to findings and alignment can be restored
measurements when if volume needs to be re-
necessary aligned between
measurements.
4. All Cross Sections are

processed and
measurements made on
them where required.
5. When all Cross

Sections have been
processed they are all
printed out in a multi-page
printout.

5.3 Adjusting axial slices
Clicking this icon in the upper right corner of the axial view opens a dialogue
where the number of axial slices, the distance between them and the
thickness of the slices can be defined.
5.4 Adjusting panoramic slices
Clicking this icon in the upper right corner of the panoramic view opens a
dialogue where the number of panoramic slices, the distance between them
and the thickness of the slices can be defined.
5.5 Cross sectional scroll bar
At the top of the Cross Sectional View is a scroll bar for moving cross
sections. Moving the scroll bar right or left shifts the visible slices to the
corresponding direction along the panoramic curve. If the Cross section lines
option is activated (see section “Show / hide settings” on page D-56) they will
also be shown in the axial and panoramic view. The middle section is
indicated by a bright red line and by a bright red ruler in the cross sections
view.
Using the Cross sectional scroll bar
1. Click on the end arrows to move cross sections voxel by voxel.
2. Drag the scroll box to freely move cross sections around.
3. Click between the scroll box and end arrows to move cross sections in
increments of the distance between the slices.
NOTE Full Arc mode will modify the behaviour of the cross sectional scroll bar.

5.6 Nerve tools
The Nerve tools at the bottom right enable to add and modify nerve channels
to the views.
Draw nerve
To draw a new nerve channel click the Draw Nerve icon. Use the left mouse
button to place points either on the panoramic or on the cross sectional view
for a curve depicting the nerve channel of the patient. When you are done,
click the right mouse button and the nerve channel will be displayed as a
coloured line in the panoramic view and as dots of the same colour in the
cross sectional views.
Delete nerve
This option deletes the currently selected nerve channel. To select an existing
nerve channel, point the mouse on it and press the left mouse button or open
the List of Nerves. If no nerve channel is selected, the action has no effect.
Properties
By clicking this icon the properties of a nerve channel can be adjusted. A

window opens where you can name the nerve and modify the colour and
diameter. To change its properties a nerve needs to be selected. To select an
existing nerve channel, point the mouse on it and press the left mouse button
or open the List of Nerves and select the nerve from the list.

Nerve list
To open a list of all nerves visible in the Cross Section / Implant tab click this
icon.
To delete a nerve select a nerve and click the Delete button. (The nerve is
deleted from both the list and the Cross Section tab),
To change the properties of a nerve, select the nerve and click the Properties
button. The Nerve Properties window opens, see section “Properties” on
page D-89.

IMPLANT TAB
6 IMPLANT TAB
Planmeca Romexis Implant tab provides tools for planning and placing an
implant into a 3D volume. The Implant tab extends the Cross Sections tab and
shares all its features. For more information on the tools in the Cross Sections
tab (such as cross section, panoramic, and nerve adjustments), see section 5
“3D CROSS SECTIONS TAB” on page D-84.
Selected implants are available in accurate silhouettes in 2D slices allowing

more accurate planning of implant sites.
6.1 Implant tools
Add implant
Use Add default implant tool to place a pre-selected default implant into the
plan. The default implant can be defined in the Implant library.
Delete implant
Select the implant you want to delete from the plan and click this icon.
Draw implant

IMPLANT TAB
Use this tool to draw an approximation of the implant’s width and height, using
the patient’s anatomy as a reference for sizing. Then use Implant Library to
search and select the nearest matching real implants from your library. With
this method you will get the correct length and diameter without first having to
guess which size would provide the best fit.
List of added implants
The Implant list dialogue shows all implants that are present in the current
plan. Use it to change the name, colour, length, and diameter of the listed
implants. The dialogue allows setting the length and diameter of the implant
accurately in tenths of a millimeter by using a keyboard entry.
Properties
To open the Properties dialogue click this icon or double-click on any implant.

IMPLANT TAB
The name, colour, length, and diameter of the selected implant is showa. The
dialogue allows setting the length and diameter of the implant accurately in
tenths of a millimetre. Use the Library button to move to the Implant Library.
NOTE If the implant has been added or replaced from the Library, the length
and diameter cannot be changed as they are fixed to the values that
were set in the library. To change the measurement of such an implant,
use the Replace feature in the Library.
Implant library
Use this tool to place implants to the plan directly from the Implant Library.
This allows you to first browse your selection of available implants and decide
on the type before placing an implant into the plan. After selecting the implant
type, press the Add button to add the selected implant into the plan. You can
then align the implant to match the patient’s anatomy. You can also use the
Implant Library to add new implants into the library and modify existing
designs. See below for more information on the Implant Library.
Implant verification
Opens implant verification tool. On how to use implant verification tool, see
section 6.5 “3D implant verification tool” on page D-99
Crown library
Opens the crown library where you can select and edit crowns for specific
implant, see section 6.4 “Using crown library” on page D-98
6.2 Placing implants
1. Add implant to the plan by using a default choice, drawing to size, or a specific
model from library.
2. Place the implant to the correct location and use control handles to orient it to
match the patient’s anatomy. You can use all available views (panoramic,
axial, cross-sections and rendering) for placement and orienting.
To reorient the implant in the rendered view hold down the Ctrl+Shift or
Alt+Shift keys while dragging the implant from its control points.
You can change the size of the implant model from the Properties window, or
in the Implant Library.
3. Verify margins and orientation by using the Impant Verification tool and place
next implant. For more information on how to use the tool, see section 6.5 “3D
implant verification tool” on page D-99.

IMPLANT TAB
6.3 Managing implants using the implant library
Implant library can be used to create new implants, modify, add and replace
implants in the plan, and search for implants. Implants that are commonly
used can be freely added and will be automatically grouped by manufacturer
and product lines. If available a realistic preview of the currently selected
implant model will be shown on the screen.
The implants that have been placed into the plan are not affected by any
changes made in the library. To modify implants that are already placed,
modify the properties of an individual implant with the Properties icon, use
the Replace function, or the implant list.
6.3.1 Implant library tab
New
Create a new implant in the Implant Library by specifying the required

information. Use the drop-down menus to select existing manufacturers or
product lines.
To modify the colour of an implant click the colour chart in the right hand side
of the Color field.
Use the length and diameter field to enter new measurement for the implant.

IMPLANT TAB
When entering numerous implant models, the Copy function explained below
may be more suitable.
Copy
Copy the selected implant to a new one and change one or more properties.
This option is useful when creating groups of implants that share some
properties.
Properties
Modify the properties of the selected implant.
NOTE Changing the properties in the library does not affect implants that have
already been placed into the plan.
Delete
Deletes the selected model from the library.
NOTE Deleting an implant from the library does not affect implants that have
already been placed into the plan.

IMPLANT TAB
Set default
Set the selected model as the default implant. This default selection is used
by the Add default implant feature.
Add to plan
Use Add to Plan to add the selected implant into the current plan and
automatically close the Implant Library dialogue. When you add implants from
the library, you cannot adjust their size with the Properties dialogue. To
change the size, use the Implant Library and the Replace selected button.
Replace selected
Use Replace selected to replace the selected implant with implant an implant
selected from the Implant Library. The dialogue will automatically close. When
you replace an implant with another from the library, the dimensions of the
placed implant can no longer be adjusted with the Properties dialogue. To
change the size, use the Implant Library and the Replace selected button
again.
6.3.2 Abutment library tab
When you have added the implant(s) in the plan select the corresponding
abutment and attach it to the selected implant:
1. Select the implant in the plan.
2. Select the abutment from the library.
3. Click Attach.
The implant and the abutment can now be moved simultaneously as a single
object.
To replace an abutment in the plan:
1. Select the abutment in the plan.

IMPLANT TAB
2. Select the appropriate abutment in the library.
3. Click Replace.
The abutments now shows in the image.
To change the properties of the implant and abutment double click the object.
The properties of the implant and the abutment can be seen and adjusted on
separate tabs in the opening Properties dialogue window.
6.3.3 Crown library tab
See section 6.4 “Using crown library” on page D-98.
6.3.4 Library search tab
To search implants by manufacturer or product line select the search criteria

from the corresponding drop-down menu.
To search implants with specific measurements enter the length and

diameter.
Start the search by clicking the Search button. To clear the results click Clear.

IMPLANT TAB
6.4 Using crown library
To open the crown library click this icon.
On the right select the tooth numbering system you would like to use:
• FDI (World dental federation)
• ADA (American Dental Association)
To add a crown to the plan click the suitable crown in the chart and select
Add to plan.
To replace an existing crown first select the crown in the plan, select suitable
crown in the chart and click Replace.
To rotate the crown in the plan, hold down the right-mouse button on top of
the crown and drag the mouse until the crown is in the desired orientation.
To adjust the width and height of the crown press and hold down the Shift +
Ctrl or Alt + Shift keys while dragging the crown with the mouse.
The precise angle can be adjusted in the Implant properties dialogue.
To exit the Crown library click Close.

IMPLANT TAB
6.4.1 Importing crowns to the plan
To import a specific crown see section 3.7 “Importing Intra oral scans” on
page D-21.
6.5 3D implant verification tool
The 3D Implant Verification tool can be used to evaluate the placement of

implants. To estimate the fit between implant and anatomy at the site the slice
views and average HU-values in the proximity of an implant can be used.
Contrary to other Planmeca Romexis 3D views the Implant Verification views

are always centred on the current implant whereas the 3D volume revolves
around the vertical axis of the implant. This makes it easy to focus on the
implant and it’s relation to the surrounding anatomy.
When the 3D Implant Verification dialogue is accessed the currently selected

implant is automatically shown. The implant can be selected and reoriented in
Planmeca Romexis Implant tab while the 3D Implant Verification dialogue is
being shown. The slice orientations and measurement margins can be easily
adjusted as described in the following illustration.

IMPLANT TAB
1. Around implant slice 2. Green cross section

3. Red cross section 4. HU mean values around and
inside the implant
5. Axial slice 6. HU mean values around implant
7. Choose previous or next implant 8. Total mean value and standard
deviation around and inside the
implant
9. Adjust thickness of measured 10. Colours corresponding to HU
layer both inside and outside the values and adjustment dialogue
implant
11. Adjust implant color or HU
measurement layers
Visual implant site evaluation
Axial, Cross Section and Envelope slice views
Use the axial slice to rotate the cross section views around the implant’s
vertical axis by clicking and dragging with mouse. This allows you to inspect
the anatomy by viewing the green and red cross sections (lines 1 and 2
respectively on the axial view) and compare them with the overview on the
implant Envelope view.
Also shown on the Axial slice are the implant envelope ring and anatomical
orientation of the data (Anterior, Posterior, Left, Right)
Use mouse wheel to move the axial slice plane (blue line) up and down on the
vertical axis. of the implant. This allows you to view the axial slice at any level
on the implant’s height.
Cross Section Views
The green and red cross sections (number 1. and 2. on the axial slice) are
slices perpendicular to each other and parallel to the axis of the implant. They
allow the inspection of the anatomy around the implant when rotated using the
axial view. They also show the silhouette of the implant, axial slice position
and orientation (A,P,L,R).
Use mouse wheel on the cross section and envelope slice views to zoom in
and out.

IMPLANT TAB
Implant Envelope View
The Implant Envelope view is a flattened cylinder view of anatomy on the

implant’s outer perimeter. It allows you to see if any of the implant’s outer wall
would fall on a weaker bone for example instead of having to do 360 degree
rotation of the cross section views. Shown on the Implant Envelope are the
implant apex and insertion depths (cyan lines) and intersections with the
green and red cross section slices.
Density colors
Use this option to enable pseudo-colouring of the data to enhance

differentiation between different anatomy densities. Using pseudo-colours
each gray scale value will be mapped to different colour so that the fine
differences between different values are easier to perceive. The used colors
and their distribution over the gray scale histogram can be adjusted in the
histogram dialogue.
Statistical implant site evaluation
The HU mean values component displays the mean value of voxels inside or
outside of the implant in the margin specified using the Options - Measure
range outside / inside sliders. The values are shown in a line graph
progressing from top of the implant towards the apex with implant silhouette
and margin thickness references on the right and HU value scale reference at
the bottom.
The mean value totals are shown with vertical lines that correspond to the
values under the Measurements value box. The Measurements box also
displays the corresponding standard deviation values. By default the outside
values are violet and the inside values orange in colour but the colors can be
adjusted using the radio and palette buttons at the bottom of the Options box.
The bulls-eye chart at the bottom right indicates the distribution of mean HU
values in the outside margin around the implant in the posterior/anterior, left/
right directions.

TMJ TAB
7 TMJ TAB
The TMJ tab is intended for viewing and diagnosis of the temporomandibular
joint regions.
7.1 TMJ Tools
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
Enable / Disable synchronisation of left PA line with right PA line. When

enabled the drawing of PA line length will automatically constrained to match
the length of existing lines. The length can still be adjusted using the view
settings dialogue which will then affect both PA lines simultaneously. When
disabled each PA line can be individually defined.

TMJ TAB
7.1.1 Using the TMJ tools
After drawing posterior anterior line (PA line) for each side of the anatomy,
multiple dedicated lateral slices and PA slices are provided. These views
correspond to a double lateral-PA exposure but can be easily aligned, rotated
and adjusted to give a better understanding of the anatomy in the region.
Multiple studies with single exposure can be generated.
1. Open the volume to be studied in Planmeca Romexis Explorer tab.
The volume can be a full head exposure, a single TMJ or both TMJs stitched
together with Planmeca Romexis stitching feature. The only requirement is
that the TMJ region must be visible in the volume that is used.
2. Orient the volume in anterior-posterior line so that the mandible is aligned

correctly (TMJ slices are perpendicular to the axial plane).
3. Orient the left-right line so that both condyles (if visible) are on the same axial
plane.
4. Click the Export View to Other Tabs icon to apply the new orientation in
other views.
5. Go to TMJ tab.
6. Verify alignment of the volume using the Axial view. Use the slider on its right
edge to bring condyles into view.
7. Draw right posterior anterior (PA) line using this tool.
8. Start drawing by clicking on the middle of the condyle and holding down the
left mouse button while dragging to define the length and direction of the PA
line.
9. Planmeca Romexis will automatically introduce the opposite half of the line
and round its total length to nearest millimetre.

TMJ TAB
To finish the line, release the left mouse button and Planmeca Romexis will
automatically populate the slice views.
10.Draw left PA line using this tool. Repeat the process described in step 5.
By default the Synchronise Sides tool is enabled so that the left PA line length
is constrained to match that of the right PA line. In this case only the direction
of the left PA line needs to be defined. To specify a left PA line of different
length, disable the Synchronise Sides tool.
11.Use the view settings dialogues to adjust the number, width and spacing of
the PA and lateral slices similar to other 3D modules.
12.To adjust the position of the PA lines verify that the Move/ rotate volume tool
is disabled and then use left mouse button to move a PA line or right mouse
button to rotate.
13.To adjust the width of the slices (length of the PA line) either use the slice
specific settings menu or redraw the line.

PROFACE TAB
8 PROFACE TAB
NOTE For more information on Planmeca ProFace image acquisition and

processing see your Planmeca ProMax X-ray unit User’s manual.
The ProFace tab is divided in four sections according to their functions:
• Rendering view
• Object browser
• CBVT rendering view
• Planmeca ProFace image adjustment tools
Rendering
view Tools
CBVT
rendering
Object view
browser
8.1 Planmeca ProFace rendering view
The Planmeca ProFace rendering view displays texturized range images

captured by Planmeca ProFace sensor.
To rotate an image click and drag it with the left mouse button.
To pan an image (move image on the screen) click and drag the image while
holding down both mouse buttons.
To zoom in/out in the image click the image you want to zoom and scroll the
mouse wheel.
To set COI (center of interest around which the virtual camera rotates) right-
click in a desired point on an image.

PROFACE TAB
8.2 3D overlays
See section 3.35 “3D overlays” on page D-73 for detailed description on how
to use 3D overlays.
8.3 CBVT rendering view
The CBVT rendering view is identical with the 3D module’s Explorer tab.
In case Planmeca ProFace image was captured simultaneously with CBVT

image the CBVT data will be displayed in this the CBVT rendering view.
An image in the Planmeca ProFace rendering view can be set as an overlay

for the CBVT data.
8.4 Planmeca ProFace image adjustment tools
This tool bar contains the main tools for adjusting and measuring Planmeca
ProFace images.
Based on their functions, the tools are divided in the following groups:
• General
• Adjust
• Rend mode
• ROI
• Trim
• Measurements
• Fitting
• CBVT rendering

PROFACE TAB
General
Set move mode
By clicking this icon the image can be moved, rotated and zoomed in and out.
To drag the image on the screen to the left or right, click the blue arrow with
the left mouse button and hold it down while dragging the image to the desired
direction.
To drag the image on the screen up or down, click the red arrow with the left
mouse button and hold it down while dragging the image to the desired
direction.
To rotate the image horizontally (around its Y-axis) click the green arc using
the left mouse button and hold it down while rotating the image to the desired
direction.
When the move mode is switched on, the other modes are switched off. For
example, if the Measurement Mode was active before switching on the move
mode the measurements are no longer displayed once the move mode is
activated.
To rotate and pan the rendered view press and hold down the Alt key on your
keyboard while moving the image.
Reset offset
To reset any rotations or translations applied to an image click this icon. The
Reset offset tool can be used to detect variations in patient positioning.
Add Planmeca ProFace image
To select and open another image from the same patient click this icon.
The added image will be saved and opened the next time the original image is
opened from the Volumes tab. The position and orientation of added images
will also be saved.
The added images can be used for measurements and image comparisons.

PROFACE TAB
Remove Planmeca ProFace image
To remove an image select the image you want to remove and click this icon.
NOTE The main image cannot be removed.
Adjust
Adjusts contrast, brightness and softness of the Planmeca ProFace images
(before, after, CBVT rendering view). By dragging the sliders up and down the
brightness, contrast and softness can be adjusted. The settings are saved
automatically when the image is closed.
NOTE These adjustment affect only the original Planmeca ProFace image.
Rendering modes
Wireframe
Wireframe rendering can be used to analyse the triangulation in scanned

images. To set rendering style as wireframe for all images click this icon.
Surface rendering can be used to analyse the topography of a measured

surface. To set surface (i.e. no texture) rendering style for all images click this
icon.
ROI tools
Draw ROI
Use this tool to draw a new ROI (Region of Interest) in the image. The ROI
can also be used for trimming parts of scans and marking regions.
The ROI is essentially a closed polyline shape.
To add vertex points to a ROI using the left mouse button, click the Draw ROI
icon.

PROFACE TAB
To finish and close a polyline double-click in the area in the image where you
want to end the polyline. Alternatively you may single-click the right mouse
button.
NOTE The rendering view can be rotated and panned by holding down ALT-key
while drawing the ROI.
Clear ROI
To clear any existing ROI object click this icon.
To clear the previous ROI before drawing a new one click the “Clear ROI”
icon.
Trim tools
Paint ROI to trim
To remove any unwanted areas from the selected surface paint the areas
using this tool. The painted area(s) will be automatically removed.
To increase/decrease the size of the paint tool press and hold down the Alt
key while scrolling the mouse wheel.
To rotate the image while the tool is selected press and hold down the Alt key
while pressing the left mouse button.
NOTE Select Wireframe rendering mode when using Paint ROI to trim.
Trim
This tool can be used to remove areas from a surface given that a region is
selected using the ROI tool. Information about trimmed regions is stored with
image data. If images are added to a session the trimming to added images
will not be stored.
The trim tools can also be used with STL files.
NOTE Trim the main image before any processing or measuring.

PROFACE TAB
Reset trim
This tool restores all trimmed areas of the original surface. The effect of reset
will be stored within image data if the selected image is the original image.
Measurements
Show/hide measurements
Use this tool to show and add new measurements.
Polyline measurement
The measurements are poly lines that display the distance of every line
segment and the overall length of the measurement.
To make a new measurement select the this tool.
Using the left mouse button click on the image where you want to start the
measurement. Next click a point on the image where you want the measured
to finish.
To save the measurement double click in the area where you want to end the
measurement with left mouse button or single click with right mouse button.
Measurements can be added to surfaces other than those of the main image.
However, all measurements belong to the main image. Therefore
measurements only follow the movement of the main image.
NOTE The rendering view can be rotated and panned by holding down ALT-key
while adding measurements.

PROFACE TAB
Two-surface measurement mode
When the two-surface measurement mode is activated new measurements

can be added to measure distances between two surfaces. These
measurements contain only two points, both on separate surfaces.
By left-clicking the first measurement point on a surface, the image containing

this point is toggled invisible until the second measurement point is left-clicked
on another surface.
After the second measurement point is added, the first surface is toggled
visible once the measurement is finished. New measurements can now be
added in similar fashion as long as the Two-surface Measurement Mode
icon is toggled. If this mode is deselected while measurement is still
unfinished, the unfinished measurement is deleted.
Select measurement
Use this tool to select individual measurements. To select a measurement

click it with the left mouse button. The selected measurement is indicated by a
blue polyline.
The selection can be made easier by panning and rotating the rendering view
to find a suitable orientation.
NOTE Only one measurement can be selected at a time.
Show grid
To show a symmetric grid on top of ProFace image click this icon. By

selecting parallel projection also measurement values are shown in the grid.
Delete measurement
Deletes the selected measurement.
Clear all measurements
Removes all measurements in the main image’s session. The user is always
asked for confirmation before measurements are deleted.

PROFACE TAB
Fitting
The Fitting tools can be used to analyse differences between scanned

surfaces.
The BEFORE group marks the scan taken earlier of the two scans and
AFTER group the latest scan image.
NOTE For the matching process to work the registered images need to have
common surface (anatomy).
Add to BEFORE group
Click this icon to add the selected image to the Before group. All previous
assignments to that group will be reset. The selected image shows in blue.
Add to AFTER group
Click this icon to add the selected image to the After group. All previous
assignments to the After group will be reset. The selected image shows in
green.
Add ROI to BEFORE group
Click this icon to add the ROI area of selected image to the Before group. All
previous assignments to the Before group will be reset. The selected area
shows in blue.
Add ROI to AFTER group
Click this icon to add the ROI area of selected image to the After group. All
previous assignments to the After group will be reset. The selected area
shows in green.
Paint before group ROI
Click this icon to paint the areas to be added into the before group.

PROFACE TAB
Paint after group ROI
Click this icon to paint the areas to be added into the after group.
Paint ROI to remove from before/after group
Click this icon to paint the areas to be removed from the assigned before or
after group.
Remove grouping
Click this icon to remove the Before or After grouping from the selected
image.
Remove all groupings
Click this icon to remove the Before or After group from all images in the
active session.
Fit after to before
Using the Fit After To Before tool the anatomical regions can be matched
together using the Before and After groups.
Fitting is successful when the fit result is 1 or less. If the fit result is not
acceptable try to readjust the point sets or to re-align the images.
In the fitting the latest scan (After or green group) will be fitted to the blue
Before group.
In order for the fitting to be successful there needs to be more fitting points in
the Before than in the After group. If this is not the case the user will be
prompted with an error message.
To select appropriate amount of fitting points either:
• select fewer points from the After group by using ROI
or
• switch the groups.
NOTE Switching the groups flips the chronological order of the scans.

PROFACE TAB
Fitting settings - Dialogue
Use the overlap parameter to improve point selection and noise in

measurements. Ideally the point sets fully overlap and contain very little noise.
Show deviation
Given that Before and After groups have been properly defined the Show
deviation function will calculate the distance between After and Before
surfaces.
Warm colours indicate that the After group surface is over the Before surface
and similarly cold colours indicate the After group surface is below Before
surface.
The default deviation range is from – 5 mm to + 5 mm. The range can be

redefined in the Deviation Map Settings dialogue.
Deviation map settings
The Deviation Map Settings - dialogue allows the user to set the scale for the
deviation map. The value is given in millimetres and it indicates the scale's
maximum in positive values' limit.
Rendering snapshot
To create a snapshot position the CBVT rendering object so that the features
of interest are visible in the image. Features that are not visible in the CBVT
rendering will not be available in the snapshot surface.
If CBVT image is not open during the session no snapshot can be created and
an error message will appear.
When a Planmeca ProFace image is set as an overlay for CBVT data, all
rendering snapshots created from the CBVT data inherit the (inverse) offset
from the overlay. This means that when Planmeca ProFace images are
captured together with CBVT data, the user can create rendering snapshots
from CBVT data and start doing measurements immediately between soft-
tissue and bone surfaces.
Save overlay offset
The tool can be used to save the fitted position between the CBVT image and
Planmeca ProFace image in the rendering in case Planmeca ProFace and
CBVT image have been taken in different occasions and therefore not
automatically fitted. The Planmeca ProFace image will be fitted correctly in
the rendering in relation to the CBVT image.

PROFACE TAB
To use this tool the images need to be designated to Before and After groups.
To save the definition click the Save overlay offset tool. The face image will be
shown in the saved position in the Rendering view with CBVT volume data.
Launch fitting wizard
The fitting wizard allows easy fitting of 3D models that have common
anatomy. It can mainly be used to
• Fit together ProFace 3D photos of before and after treatment
• Fit ProFace 3D after treatment photos to CBCT data using an earlier ProFace
3D photo, which is already correctly positioned (offset) over CBCT data.
• Fit dental models to correct bite using a bite piece model.
See the following sections for detailed information on different fitting methods.
8.5 Comparing ProFace images before and after treatment
Planmeca ProFace can be used for comparing the anatomy of the patient
before and after treatment. Planmeca Romexis software automatically
superimposes the images and shows the anatomical differences between the
images acquired before and after treatment.
1. Click this icon to launch the Fitting wizard.
2. Open the before and after ProFace images using the Select Before and
Select After buttons.
NOTE The images must show in the Volumes tab in order to be used in the
wizard.

PROFACE TAB
3. Turn the models so that you can select common anatomy in them.
• To turn the model hold down left mouse button.
• To move the model around hold down both mouse buttons.
• To adjust zoom use mouse wheel.
4. To select common anatomy on both models click this icon.
NOTE For maximum accuracy of the fitting process select anatomy that has
not been affected by treatment.
• To adjust the tool size press and hold down the Alt key while scrolling the
mouse wheel.
• To turn the models while the paint tools are active press and hold down the
Alt key.
• To move the model press and hold down the Alt key and both mouse buttons.
NOTE If the before status is already mapped to a CBVT image and you want to
use the same offset mapping for the after exposure enable the Save
Overlay Offset option. This will make the after status ProFace image
appear in the correct position over the CBVT image.

PROFACE TAB
If necessary you can use the ROI removal tool to remove unnecessary areas
from the selection.
5. When finished click the Fit button.
The images are automatically fitted together and appear in correct position.
6. To study the differences in coloured topology based on the amount of change

in anatomy click the Deviation Map icon.
Blue indicates retraction of anatomy and red indicated protrusion.

PROFACE TAB
8.5.1 Automatic fitting using a previous ProFace image
If the patient has an earlier ProFace image mapped to a CBVT image, its
offset can be used to map new ProFace images to the same CBVT as follows.
1. Open the CBVT image to which the earlier ProFace exposure is mapped to.
2. Go to ProFace tab.
3. Launch the Fitting Wizard
4. Open the before (already mapped to CBVT) and after ProFace images using
the Select Before and Select After buttons.
The images must be present in the Volumes tab to be used in the wizard.
5. Turn the models so that you can select common anatomy in them.
• To turn the model press and hold down the left mouse button.
• To move the model around hold down both mouse buttons.

PROFACE TAB
• To zoom in/out use the mouse wheel.
6. Paint common anatomy on both models by using the ROI paint tools.
NOTE For maximum accuracy of the fitting process select anatomy that has
not been affected by treatment.
• To adjust the tool size use Alt + mouse wheel.
• To turn the models while the paint tools are active press and hold down the
Alt key.
• To move the model press and hold down the Alt key and both mouse buttons.
7. Enable the Save Overlay Offset option. This will make the After ProFace
image appear in the correct position over the CBVT exposure.
8. If necessary remove areas from the selection by using the ROI removal tool.
9. Click the Fit button.
10.Planmeca Romexis fits the images together and they appear in correct
position over the CBVT image.

PROFACE TAB
8.6 Alternative method for comparing images before and after

treatment
This section describes an alternative method for comparing ProFace or other

surface models as described in section section 8.5 “Comparing ProFace
images before and after treatment” on page D-115
1. Open the CBVT volume (or earlier Planmeca ProFace image if no CBVT is
available) by double-clicking it from the Volumes tab.
2. The image will open in the ProFace tab.
3. To add both Planmeca ProFace images to the study click the Add ProFace
Image icon.
4. Select the image acquired before treatment and click the Add to Before icon.
The image is added to the Before group and shows in blue.
5. Select the image acquired after treatment.

PROFACE TAB
6. Use the Draw ROI icon to mark an area that is identical in both images (not
affected by the treatment).
7. Click the Add ROI to After Group icon. The marked area turns green.
8. Drag one image on top of another so that their anatomy roughly matches.
9. Click the Fit After to Before icon. Planmeca Romexis now fits the surfaces
precisely.
10.To evaluate the changes in anatomy click the Show Deviation Map icon and
uncheck the before ProFace image from the IMAGES list.
Blue colour indicates receded anatomy, green colour shows unchanged areas
and red areas indicate the areas that have protruded after treatment.

PROFACE TAB
8.7 Fitting Planmeca ProFace image to CBVT volume
Planmeca ProFace image is normally automatically fitted to the CBVT data

during the exposure. However, manual fitting is necessary for example in
case the images were acquired at different times.
Manual fitting is easiest on 3D volumes that include skin surface as the

surface can be used as a fitting reference.
On how to fit a new ProFace image to a CBVT volume using an earlier

ProFace image see section section 8.5.1 “Automatic fitting using a previous
ProFace image” on page D-118.
1. Check that the CBVT volume and its related Planmeca ProFace image are
listed in the Volumes tab.
2. Open the CBVT volume and click the ProFace tab.
3. Click the Add ProFace Image icon to add the Planmeca ProFace image to
the study.
4. To adjust 3D rendering so that skin surface is visible use Soft Tissue 3D

rendering preset.
5. Click Create Rendering Snapshot icon to make a surface model of the 3D

rendering.

PROFACE TAB
The snapshot is added to the IMAGES list. There should now be two items in
the IMAGES list that can be activated and modified.
6. Select the 3D rendering snapshot and click the Draw ROI icon to mark an
area that is unmodified in both images.
TIP! The cheeks and forehead are suitable for selecting common anatomy.
The chin can be used if chin support was not used in the exposure and
nose when included in the volume.
7. Click the Add to Before Group icon. The selected area turns blue.
8. Select the Planmeca ProFace image and click the Draw ROI icon to define a
common area with the 3D rendering snapshot.
9. Click the Add ROI to After Group icon. The marked ROI turns green.
10.Move the surfaces on top of each other so that the anatomy roughly matches.

PROFACE TAB
11.Click the Fit After to Before icon to have Planmeca Romexis fit the surfaces
precisely.
NOTE If the following warning appears when using the Fit After to Before tool,
you need to change the groupings so that the blue (before) group is
larger than the green (after) group. To evaluate the size of the trimmed
area in each group by turning on the Wireframe mode. Generally the
trimmed areas in the 3D rendering snapshots are much larger than in the
Planmeca ProFace scans.
12.To evaluate the fitting result click the Show Deviation Map icon and
deactivate the 3D rendering snapshot from the IMAGES list.
The fitting is successful when most of the face shows in bright green, see
Step 8 on page 121.
13.To save the Planmeca ProFace offset select the Planmeca ProFace image
and click on the Save Overlay Offset icon.
The Save overlay offset tool ensures that the Planmeca ProFace surface is
correctly positioned in relation to the CBVT volume when shown in the 3D
rendering as an overlay
14.In case the following error about missing rendering overlay appears, click the
3D overlay menu to attach the Planmeca ProFace image to the CBVT
volume.
NOTE In case there is no soft tissue surface suitable for fitting in the CBVT
volume, accurate overlay fitting cannot be done. For manual overlay
calibration, the rendering snapshot should be taken using bone surface
in the rendering.

PROFACE TAB
8.8 Fitting surface models
8.8.1 Fitting two 3D models using bite piece
The Fitting Wizard can be used to fit two dental models into correct bite using
a bite piece model. In order to fit STL models they need to be listed in the
Volumes tab. To fit the models into correct bite follow these steps.
The general work-flow is always as follows:
• Run the fitting wizard and set the bite piece as the Before model and the
upper model as After model.
• Run the fitting wizard again and select the bite piece again as the Before
model and the lower model as the After model.
1. Launch the Fitting Wizard

PROFACE TAB
2. Turn the models so that occlusal surfaces are directed towards yourself.
• To turn the model press and hold down the left mouse button.
• To move the model around press and hold down both mouse buttons.
• To zoom in/out use the mouse wheel.
3. Paint occlusal surfaces on both models by using the ROI paint tools.
• To adjust the tool size use the Alt key and the mouse wheel. In general all the
occlusal surfaces can be painted with one stroke using a wide brush.
• To turn the models while the paint tools are active press and hold down the Alt
key.
• To move the model hold down the Alt key and both mouse buttons.
For improved fitting result use the ROI removal tool to in the After model
(lower / upper bite) to clean any extra selections from the non-occlusal
surfaces (MDBL).

PROFACE TAB
A few wide swipes across the sides of the dental arch is usually sufficient for
good results.
4. Check that:
• The anterior teeth are at the top, the molar teeth at the bottom

PROFACE TAB
• The occlusal surfaces of the bite being facing towards yourself
5. Click the Fit button.
6. The models are automatically fitted.
7. Repeat the steps from 1 to 4 for the remaining opposite bite.

PROFACE TAB
8.9 Adjusting ProPace rendering overlay offset manually
If it is not possible to use automatic fitting of the Planmeca ProFace image to

CBVT volume due to missing soft tissue surface or other issues, the images
can be manually positioned and attached.
1. Manually position the volumes as accurately as possible.
2. Select the rendering snapshot and click the Add to Before Group icon. The
snapshot turns blue.
3. Select the Planmeca ProFace image and click the Add to After Group icon.
The snapshot turns green.
4. Attach the Planmeca ProFace image to the CBVT volume using the Save
Overlay Offset icon.

PROFACE TAB
8.10 Creating a set of Planmeca ProFace 2D snaphots
1. Click the Save 2D view or Print Editor icon.
2. In the following window click on the images you would like to appear in the
snapshot set.
3. Select the suitable snapshot options. For detailed description of options see
section 3.12.2 “Snapshot options” on page D-36.
4. Click OK.
The set of Planmeca ProFace snapshots appears in Planmeca Romexis.

PROFACE TAB
8.11 Taking Planmeca ProFace quickshots
With the quick shot tool a 2D snapshot of CBVT volume with Planmeca
ProFace data (blue line) can be created out of a CBVT volume’s single view.
A quick shot can be created in every tab of the 3D module.
NOTE Face data is visible only when Toggle Overlay is enabled.
• Quick shot from combined 3D and face data can be created e.g. in the
Explorer tab.

PROFACE TAB
• Quick shot from face photo can be created only in ProFace tab.
Selected views are saved as 2D images into the 2D Imaging module.

PROFACE TAB
8.12 Importing Planmeca ProFace images
1. Go to the 3D module by clicking the 3D icon.
2. Click the ProFace and Surface tab.
3. Select Import image from 3D main tool bar.
4. In the opening window select the image to be imported.

PROFACE TAB
5. The imported Planmeca ProFace image is automatically opened in ProFace

tab.
8.13 Exporting Planmeca ProFace images
1. Go to 3D module by clicking the 3D icon.
2. Click the ProFace tab.
3. From the top tool bar click the Export volume icon.
Planmeca ProFace image can be exported with overlay offset and with
viewer.

PROFACE TAB
The extension of the exported Planmeca ProFace-image is *.PRO. However

when selecting Wavefront Object (.OBJ) the extension is .OBJ and .STL for
STL file.
8.13.1 Exporting CBVT volumes with Planmeca ProFace images
The combination of CBVT volume, ProFace image and STL file can be
exported with matching coordinates. This means that as the receiver opens
the exported images they will open as aligned by the sender. The files can
also be imported to 3rd party software.
For external software use the .OBJ format for ProFace images.
1. Open CBVT volume with Planmeca ProFace overlay and click the Explorer
tab.

PROFACE TAB
2. From the main tool bar select Export volume.
3. Select the option Include ProFace.
NOTE CBVT volume and Planmeca ProFace image are exported as separate
files. The extension for the exported Planmeca ProFace-image is *.pro
and *.dcm. for the CBVT volume.
NOTE If you select the option Include ProFace make sure that the setting in 3D
Rend / Overlay Properties / Type is set to 3D Photo.

FILE MENU
9 FILE MENU
9.1 About
From the About menu you can check license data, current software versions,
memory settings, currently logged in user and open patient, name of the
workstation and number of active images in the system.
To view all information scroll down the bar.
9.2 ROI reconstructions
When using Planmeca ProMax 3D units it is possible to generate higher

resolution partial reconstructions of original volumes using selected exposure
modes. The following exposure modes can be used to generate Partial
Reconstructions:
Planmeca ProMax 3D Max Full Skull 400µm (Normal)
The voxel size of the ROI reconstruction will be half of the original (double the
resolution) so that original volume of 400µm will produce a ROI reconstruction
of 200 µm with approximately half of the physical dimensions of the original.

FILE MENU
To generate ROI Reconstruction in Planmeca Romexis:
1. In 3D Explorer tab move the intersection of axial, sagittal and coronal slice
reference lines in the middle of the region of interest using your mouse. The
intersection of the reference lines will be the center of the new high-resolution
volume.
2. From the File menu select Capture > ROI Reconstruction.
The Reconstruction PC will indicate if it is possible to generate a ROI

reconstruction of the selected volume.
NOTE ROI reconstruction is possible only if the original raw data is available
on the reconstruction PC. Therefore ROI reconstructions should be
generated as soon as possible after the exposure is taken.
3. The ROI reconstruction will be generated and opened for viewing

automatically in Explorer tab.
NOTE When generating a new ROI reconstruction from stitched volumes only
the volume in which the ROI is closest to the center will be included in
the new volume.

FILE MENU
9.3 Recovering 3D volumes
In case the 3D volume is not correctly stored into Planmeca Romexis

database after exposure due to network disruption or other problems, in most
cases it is possible to download the original exposure from the ProMax 3D
system using the 3D recovery feature.
To recover a 3D volume:
1. Start Planmeca Romexis on the 3D exposure workstation. This feature

requires connection to the ProMax 3D system that is usually not available on
other workstations.
2. Make sure that the correct patient is open in Planmeca Romexis.
3. Go to 3D module’s Volumes tab.
4. From the File menu place your mouse over Capture and select Recover 3D
Volume from the list.
A list of recent exposures in the Promax 3D system will be shown.
5. Select whether to apply HU correction to the recovered 3D volume.
6. Choose the correct exposure and click OK. The 3D volume will be
automatically downloaded and added to the Volumes list.
NOTE If you accidentally downloaded the wrong volume you can inactivate it
and try again. In case the correct volume cannot be found please
contact your local Planmeca technician as the exposure may still be
recoverable by other means.

FILE MENU

Chapter
E CAD/CAM MODULE
1 INTRODUCTION
Planmeca Romexis CAD/CAM module offers an environment for working with

digital impressions and restorations. New digital impressions can be acquired
with Planmeca PlanScan scanner using a link to Planmeca PlanScan &
PlanCAD Easy scanning and restoration design software. The existing digital
impressions can also be used for designing restorations in the software.
Acquired digital impressions and designed restorations can then be paired
with CBCT volume in Planmeca Romexis 3D Implant Planning module to
support implant simulation.
All data are automatically stored into Planmeca Romexis database and
organized into cases which can be exported to another system or sent to a
certified laboratory for design and milling using Planmeca Romexis Cloud
service (see section 25 “CLOUD EXPORT” on page C-75).
User’s Manual Planmeca Romexis E-1

INTRODUCTION
1.1 Scan & design new restorations
New scan
To start a new scan click New Scan. For more information see the Planmeca
PlanScan & PlanCAD Easy User’s manual.
Settings
To adjust the CAD/CAM settings click Settings. The Settings window opens.
For more information see the Planmeca PlanScan & PlanCAD Easy User’s
manual.
1.2 Import 3D models
1.2.1 3D model import
Click 3D model import.
You may import models either from an external source (A) or from Planmeca
Romexis 3D module’s Volumes tab (B):
E-2 Planmeca Romexis User’s Manual

INTRODUCTION
• To import models from an external source (A):
1. Click Browse.
2. Go to the folder from where you want to import the models.
3. Select the files and click Open.
NOTE Both prep and opposing models must be imported.
4. When you have imported both models click Done.
The imported files will appear in the Setup tab of Planmeca PlanScan &
PlanCAD Easy.
• To import models from the Planmeca Romexis 3D module’s Volumes list (B):
1. Click Select.
2. In the following window select the file to import and click OK.
The imported files will open in the Setup tab of the Planmeca PlanScan &
PlanCAD Easy.

INTRODUCTION
1.3 Export 3D models
3D model export
To export scans and restorations select them from the list and click 3D model
export.
Cloud export
To export scans and restorations via Planmeca Romexis Cloud select them
from the list and click Cloud export. For more information on how to use the
Cloud service, see section 25 “CLOUD EXPORT” on page C-75.
Send to iRomexis
To send scans and restorations to iOS click Send to iRomexis. For more
information on how to use the Planmeca iRomexis see section APPENDIX C:
“PLANMECA iROMEXIS”.
1.4 Patient’s case files
To open an existing scan or restoration (crown, inlay, onlay etc.) double-click

on a case on the list or click the Open Restoration button
The case opens in the Setup tab of the Planmeca PlanScan & PlanCAD Easy.
To open a case in 3D module right-click on the case and select View STL in
3D Module.

INTRODUCTION
By clicking this icon on the top right corner of the Patient’s Case Files window
you can extend/reduce the window size.
1.4.1 Deleting files
To delete an image (stl file) from the patient’s case files right-click on the file
and select Inactivate STL.
To delete a case from the patient’s case files right-click on the case and select
Inactivate restoration.
To reactivate or permanently delete a case from the database see section


INTRODUCTION
1.5 Scans and restorations in 3D module
All scans and designed restorations will automatically appear in the in the 3D
module volumes list.
You can open a scan/restoration for viewing and further processing by

double-clicking on it.
To view the properties of a scan/restoration, see section 2.2 “Show

properties” on page D-3.
To move a scan/restoration to another patient, see section 2.3 “Moving

volume to other patient” on page D-4.
To inactivate a scan/restoration, see section 2.4 “Inactivate” on page D-4.

Chapter
F CLINIC MODULE
1 INTRODUCTION
Planmeca Romexis Clinic management module allows time stamped

recording and real-time monitoring and control of most activities performed
using in Planmeca Compact i, Planmeca Compact i Touch and Planmeca
Sovereign dental units. The features and the gathered data can be used for
remote assistance, service and maintenance support, as well as preventive
maintenance planning.
NOTE Depending on the dental unit configuration the views presented in this
manual may appear different from the views on your computer screen.
2 CLINIC MONITORING
Clinic monitoring view shows a graphical overview of all the devices in the
clinic connected to Planmeca Romexis. The user can monitor the dental unit
usage in each section of the clinic, and spot users requiring assistance.
The logged in users are marked with a square and the dental units with a
circle in the clinic layout.
The user-unit pairs are colour-coded based on their status. The tool tips show
more information on the status and the active provider. To locate providers,
units or users in the clinic click Search.
A right-click menu shows short-cuts to other views for the selected device.
User’s Manual Planmeca Romexis F-1

CLINIC MONITORING
The clinic layout can be configured for up to eight floors. The operatories can
be freely placed in the layout and the dental units can be upgraded remotely.
2.1 Operatories
The operatories represent rooms or work areas. An operatory consists of a

chairside PC and dental units. The operatories are colour coded according to
their current operational status and connectivity as follows:
Units connected (the number of units)
No connection to unit
Usage alert
Unit error
F-2 Planmeca Romexis User’s Manual

CLINIC MONITORING
Users logged in (the number of users)
Patients selected (the number of patients)
No connection to Planmeca Romexis
To enable registration and logging of the dental unit’s user activities it is

important to match each chairside PC with its respective dental unit in an
operatory.
By holding the mouse over an operatory the following information is shown:
• Name of the operatory
• Name of the dental unit and its current status
• Name of the current provider logged in on the chairside PC
• Alert or error message if present
Right-clicking on an operatory opens a quick access menu to other views:
2.2 Searching dental units, operatories and users
To search a specific dental unit, operatory or user at the clinic you can use the
Search feature
Start the search by clicking the Search button at the bottom of the Clinic view.

CLINIC MONITORING
In the opening window select the appropriate search criterion from the Search
by drop-down menu. You can search by user, patient, operatory or dental unit.
Click OK.
To search by name type the name in the Name field or select Provider
default from the drop-down menu.
Click OK.
2.3 Configuring clinic layout
NOTE To configure the clinic layout administer rights are required.
To configure the clinic layout click this button at the bottom of the screen. The
operatories are shown as black rectangles containing a PC and dental unit.
A list of operatories, chairside PCs and dental units are shown in the control
panel. A PC or a dental unit becomes available in the list once it has
connected to the server. If a PC or a dental unit is not on the list, verify that a
connection can be established and that the dental unit has been connected to
Planmeca Romexis Server.

CLINIC MONITORING
2.3.1 Creating new operatories
1. Select an operatory (you can choose between vertical or horizontal

operatories).
2. Drag and drop it into the layout.
The following window appears.
3. Enter the name of the operatory (the operatories can be named e.g. to match
the names of the actual operatories in the clinic) and click OK.
The operatory now appears in the layout.
To add a corresponding PC/dental unit pair into the layout by drag drop it to
the layout.
2.3.2 Creating multiple floor plans
For multi-floor, multi-clinic or other complex layouts you can create multiple
floorplans in PNG format on the server. For more information see the
Planmeca Romexis installation manual (publication number 10014600).

CLINIC MONITORING
2.4 Update firmware (centralized update of Planmeca dental unit

software)
NOTE To update firmware administer rights are required.
The Update Firmware can be used to check the current version of dental unit
software as well as to upload new firmware to selected units.
To show the update options click the Update Firmware button.
A list of all connected dental units and their software version is shown at the
bottom of the screen.
To select multiple units for update press and hold down Ctrl key while
selecting units.
To choose software for specific dental units click the Find Files.
Browse to the *.MOT file that contains the new software. To update the units
click on Update Selected Units.

UNIT MONITORING
3 UNIT MONITORING
In the Unit Monitoring view the usage of the selected dental unit can me
monitored in real time. Unit monitoring can also be used to review, store and
restore dental unit’s settings.
The dental unit service modes with full descriptions of each setting are
accessible for maintenance personnel.
Instrument Chair
console movements
User &
patient data
Dental unit
control panel
Short cuts
Error
messages
Overall usage
3.1 User and patient data
Status: the status of the unit currently in use
Operatory: the name of the operatory
User: Default provider
Patient: Name of the patient currently treated

UNIT MONITORING
3.2 Dental unit control panel
The dental unit control panel corresponds to the control panel of the unit that
is currently in use. See dental unit user’s manual for detailed description of the
control panel functions.
3.3 Storing and restoring dental unit settings
The dental unit settings can be adjusted according to user’s preferences. (On
how to adjust the instrument settings see your dental unit’s user’s manual.)
When satisfied with the settings you can record the settings on the unit.
Click Save Settings icon on the dental unit control panel.
To restore the previous settings click the Restore Settings button. To

overwrite the settings stored earlier in the database save the settings again.
Currently a single set of instrument settings per user can be stored.

UNIT MONITORING
3.4 Short cuts
The short cuts allow quick access to routine dental unit activities.
By placing the cursor on top of the icon you can see a tool tip explaining the
shortcut activity.
The following short cuts are available:
Save current dental unit settings to the current user profile in Planmeca
Romexis database. See also section 3.3 “Storing and restoring dental unit
settings” on page F-8.
Load settings from current user profile to dental unit
Delete saved settings
Service mode
NOTE Before entering the service mode on a unit remotely, make sure that the
unit is not currently in use.
BienAir micromotor reverse operation mode
BienAir micromotor torque operation mode
Start short instrument flushing
Start long instrument flushing
Start Waterline Cleaning System cycle
Start Suction Tube Cleaning System cycle

UNIT MONITORING
3.5 Error messages
This section displays eventual error messages.
3.6 Instrument console
The instrument that is currently in use is indicated by the arrow on the console
and it is coloured in blue in the panel.
The instrument speed/power is shown in percentage points or in rpm as

selected in dental unit settings. On how to adjust the settings see your dental
units User’s manual for more information.

UNIT MONITORING
3.7 Chair position
In this field you can monitor the backrest and legrest angle, seat height, as
well as headrest length, height, and angle.
3.8 Graphic display
The following unit activities can be monitored in the graphic display:
• Active instrument and power level

Different instruments are denoted with different colours as following:
• Water usage
• Air usage
• Seat height
• Backrest angle
• Operating light level
• Syringe on/off

UNIT MONITORING
• Suction on/off
The graphics are automatically displayed. To hide the graphics click this
button on the top right corner of the graphics window.

DIAGNOSTIC LOG
4 DIAGNOSTIC LOG
The Diagnostic Log records and displays the dental unit status and events
with detailed error and help descriptions and codes. The log can be used to
monitor and diagnose unit events. The event history can also be reviewed.
Monitoring can be done remotely off-site or on-site when applicable.

DIAGNOSTIC LOG
4.1 Reviewing dental unit events
The events can be viewed by dental unit, type of events, or according to a

certain time period.
Click on the appropriate drop-down menu and select the desired criterion.
By selecting <All> with current date, the log displays all dental unit events in
real time.
To forward an event log via e-mail see section 3.7.6 “E-mail Notification ” on
page I-23.
To copy and send a report forward click the Copy to Clipboard button. You
can now send the report by e-mail for example.
To see an error in its context of use, select an event and click the Show
Event in Graph button.
In front of the selected event a history graph of the unit is shown which can be
used for troubleshooting. The history graph shows the context of use at the
time the error occurred.

DEVICE SUMMARY
5 DEVICE SUMMARY
The Device summary provides information on the dental unit’s usage and
maintenance.
To view the summary select the unit for which you want to view the summary
for.

DEVICE SUMMARY
5.1 Unit
Total column
The Total column indicates the total usage time of the dental unit and
operating light.
Current column
The Current column indicates the number of usage hours after the last reset
(usually annual maintenance or lamp change). Usage time is shown for:
• Dental unit
• Operating light
• Suction
• Chair seat height
• Chair headrest
• Chair backrest
• Chair legrest
NOTE Total usage of a specific instrument or instrument type, cannot be

monitored.
Limit column
The Limit column shows the time until the preset alert limit.

DEVICE SUMMARY
5.2 Instruments
The instruments section shows the total usage hours for different dental unit
instruments.
5.3 Latest cleaning procedures
Based on real-time data collected on dental unit usage, a full history of the
unit’s cleaning procedures is recorded and can be reviewed. Entries of the
latest cleaning procedures are shown for:
• Planmeca Waterline Cleaning System full cycle (disinfection)
• Instrument flushing (water)
• Suction line cleaning
To display a full history of the cleaning procedures listed above in the

Diagnostic Log select View All.

DEVICE SUMMARY
5.4 Service history
The Service history shows a list of recent maintenance procedures and a form
for entering new maintenance records or for reviewing the previous records.
5.4.1 Service visit information
The following information is recorded from a service visit:
• Entry ID (for quick reference)
• Date
• Entry Reason (reason for visit)
• Service Visit:
A scheduled visit such as annual maintenance.
• Unscheduled Service Visit:
A non-scheduled visit that may have caused unscheduled downtime. Possibly caused by
an unexpected lamp failure or similar.

DEVICE SUMMARY
• User Guidance Visit:
A visit is required to instruct the user in proper use or maintenance of the dental unit.
• Remote Service:
Recorded when a technical problem can be solved without visiting the clinic, for example
by adjusting service modes remotely.
• Remote User Guidance:
Used for example when the user can be remotely instructed on the phone on the proper
use of the dental unit by referring to the recorded history information.
• User name
The name of the person who provided the service (automatically records the
currently logged in user)
• Comments
To provide more details and to assist in later maintenance visits.
To view the existing entries select them from the Service History list, which
automatically updates the recorded values onto the form.
To record a new entry, click on New Entry.
To edit an existing record, click the Edit button.
• Error codes
Error events that the service entry negates can be selected from the list of all
errors. Click the Add and Remove buttons to modify the list. Once negated
the errors no longer show in Diagnostic Log.
• Elapsed Time
For recording the time consumed on the service operation.

DEVICE SUMMARY
• Spare Parts
A list of components used. Part number, part name and quantity can be
recorded as listed in Planmeca’s spare part manuals, for example.
• Comments
A field for explaining, for example, the steps taken during the maintenance.
• Reset Values
Set a service point to reset the unit’s summary counter values. Use these
options after servicing a part or the dental unit. The options can be changed at
a later point in case an erroneous recording was made. These settings only
affect the display of summary values and they do not affect the data stored
into the database, which remains fully available for reporting.
• Dental Unit
Resets the dental unit counter when, for example, annual maintenance is
done.
• Operating light
Resets the operating light counter when the lamp is changed.
5.5 Viewing events in diagnostic log
To view the events in the diagnostic log click on the View in Diagnostic Log
button. The report opens in the Diagnostic Log tab. For more information see
section 4 “DIAGNOSTIC LOG” on page F-13.

INFO
6 INFO
The Info tab provides instructions for general dental unit use and maintenance
procedures.
The quick guides for use and maintenance are currently available for
Planmeca Compact i, Planmeca Compact i Touch and Planmeca Sovereign
dental units.
To display instructions on specific functions proceed as follows:
1. Select your dental unit from the drop-down menu.

INFO
2. From the list on the left select the instructions you want to view.
3. Scroll down the screen to read all of the instructions.

Chapter
G ADMIN MODULE
The Admin module is divided into the following tab sheets:
1. Resource
2. Device alerts
3. Dental record
4. Imaging
5. Local settings
1 RESOURCE
Under the Resource tab you can create user groups and define user names,
passwords and clinic names.
1.1 Groups tab
The existing groups are listed in the Groups tab.
User’s Manual Planmeca Romexis G-1

RESOURCE
1.1.1 Adding groups
Group
1. To add a new user group click the Add button at the bottom of the screen.
2. In the opening dialogue enter the name and description for the new group.
3. Define the permissions for the new group by selecting the permission(s) and
clicking the using the Add / Remove buttons.
4. Click OK.
Use the Update button to modify permissions of an existing group.
Use the Inactivate button to inactivate the user group.
Active Directory Map
Use ADM to map a Planmeca Romexis group to a an Active Directory user

group. Select group by clicking the Browse AD Groups button.
G-2 Planmeca Romexis User’s Manual

RESOURCE
1.1.2 Updating groups
In the Toolbars tab each user group can select the tools suited for its work on
any Planmeca Romexis workstation. By default all toolbar icons are visible.
To hide tools from the toolbar select the tool you want to hide and click the
Add button. The tools now show in the Hidden field.
The users belonging to a group that has the Edit Toolbars permission granted,
can freely modify the toolbar settings directly from the toolbar, see section
“Customize Toolbar below. The settings will be automatically saved and
applied to each user when they login to Planmeca Romexis.
Active Directory Map
See section “Active Directory Map” on page G-2

RESOURCE
Customize Toolbar
Allows showing and hiding buttons in each tool group. Click on the arrow on
the top right corner of the toolbar (if toolbar borders are enabled) or right-click
on any button in the toolbar.
Reset Toolbar to Defaults
Reset the currently selected toolbar to settings for the user’s group.
Show Text Labels
Show the function of each tool in a text label below the icon.
Text label
Show Toolbar Borders
Show a title bar and border for each tool group.

Title bar and
borders

RESOURCE
Show or hide all toolbars
Right-click between the toolbars or anywhere in an empty area next to the

toolbars. Select Show All / Hide All
1.2 Users
The existing users are shown in the list.

RESOURCE
1.2.1 User
1. Click the Add button at the bottom of the screen.
2. In the opening dialogue fill in or select the necessary information.
3. Fill in the information in the Personal, Contact, Photo and Cloud tabs.
The photo added in the Photo tab will be shown in the user interface where
remote user identification is relevant.

RESOURCE
1.2.2 Cloud (user account setup)
To start using the Planmeca Romexis Cloud service for sending and receiving
cases you will need a user account. The user account identifies each user
globally when sending and receiving cases. It is also used to establish a
secure private-public key encryption for all data transferred through Cloud. An
additional fee based service subscription may be required to use certain
features such as sending new cases.
1. To create an account click the Web link for Account Creation button.
2. Enter your account ID and password in the respective fields.
3. When successfully logged into the cloud for the first time, your private keys
will be created in the Planmeca Romexis database.
To access the cloud from another computer you need to move your private
key to that computer using the Export Keys and Import Keys buttons before
logging into the cloud.
If for some reason you have lost access to the private keys click the Generate
new Keys button. A new private key will be generated in the Planmeca
Romexis database.
NOTE Generating new keys will invalidate all previously received cases as the
private key information required to decrypt them no longer exists.
NOTE To prevent any unauthorized person from accessing your cases in the
cloud make sure to protect the private key after it has been exported.
Use the Update button to modify user information.
Use the Inactivate button to inactivate the user in Planmeca Romexis.
NOTE On how to configure the Planmeca Romexis Cloud application see

section 3.9 “Cloud” on page I-25.

DEVICE ALERTS
2 DEVICE ALERTS
2.1 Configure device alerts
The Device Alerts tab allows configuration of error forwarding to user e-mails
(Device Alerts) and clinic-specific alerts for dental unit use (Usage Data
Alerts). To enable the sending of e-mails the user must have Work E-mail
address entered and Listens to Device Alerts property enabled in user
settings.

DEVICE ALERTS
The Configure Device Alerts tab allows configuring of specific error and help
events to be forwarded to a selected user’s e-mail.

DEVICE ALERTS
2.1.1 Configuring usage data alerts
The Configure Usage Data Alerts tab is used to configure triggers that allow
custom events on:
• Unit component mileage limits (hours) for preventive maintenance.
• Unit instrument activation frequency to track inappropriate use.

DENTAL RECORD
3 DENTAL RECORD
3.1 Materials
In the Materials tab you can add, edit or delete materials in different material
groups.
3.1.1 Adding new material into a material group
1. Select the group to which you want to add a material by clicking it with the left
mouse button.
2. Click the New button.
3. Fill in the necessary information and click OK.

DENTAL RECORD
3.1.2 Editing material in a material group
1. Select the group which you want to edit by clicking it with the left mouse
button.
2. Click the Edit button.
3. Fill in the necessary information and click OK.
3.1.3 Deleting material from material group
1. Select the material to delete from a group by clicking it with the left mouse
button.
2. Click the Delete button.
3. In the following window select Yes.

IMAGING
4 IMAGING
4.1 Templates
Templates are used for capturing multiple images to a certain predefined

layout.
A template can contain intraoral, panoramic and cephalometric X-ray images

and photos. The print layout and the alignment for the images in it can also be
defined in the template.
The list of existing image templates is shown in the Templates tab.
To prevent using a certain template for new studies click Inactivate.
NOTE Inactivation does not affect the existing studies based on the template.
4.1.1 Creating a new template
1. To create a new template click New.
2. In the opening window enter a name for the new template and click OK.
3. Click the Layout button.

IMAGING
4. Define the layout for the template
5. In the following window double-click the image slot you want to modify.

IMAGING
6. Select the image type, sensor orientation, horizontal and vertical alignment of
the images in the study, exposure order, send order and tooth numbers.
NOTE The alignment X and Y are also used to position images into a print layout. Appropriate
alignment allows printing images in larger scale with less white space in between.
7. After you have defined all necessary information for all the slots click OK.
The template is saved into the database. It can now be used in Imaging
module and in radiology approval process in the Clinic module.
4.1.2 Editing an existing template
1. Select the template from the list and click Update.
2. To define a new layout or a template click this button.
3. Select predefined layouts or customize the number of images per row or per
column.
The last option allows you to create complex templates such as FMX 20.

IMAGING
4. In the following window double-click the image slot you want to modify.
5. Select the image type, sensor orientation, horizontal and vertical alignment of
the images in the study, exposure order, send order and tooth numbers.
NOTE The alignment X and Y are also used to position images into a print
layout. Appropriate alignment allows printing images in larger scale with
less white space in between.
6. After you have defined all necessary information for all the slots click OK.
The template is saved into the database. It can now be used in Imaging
module and in radiology approval process in the Clinic module.

IMAGING
4.2 DICOM Configuration
In order to configure DICOM destinations the following information is needed

from the local network administrator:
• Network configuration information for Planmeca Romexis workstation
• Port numbers for DICOM configurations
• IP addresses of DICOM services
• AE titles, Port numbers and IP addresses for the needed DICOM services
• Storage server
• Printer
• Worklist
• Modality Performed Procedure Step (MPPS)
• Query / Retrieve
• AE title for workstation (default AE_title is ROMEXIS_1) and Planmeca

Romexis server SCU and SCP are needed for some of the services.
NOTE If there are several Planmeca Romexis workstations in the network

configured under local settings the workstations should have unique AE
titles, for example ROMEXIS_2, ROMEXIS_3 etc, unless the
Communicate through server option is enabled. For more information
see section 4.2.1 “DICOM Storage Setup ” on page G-20

IMAGING
In the DICOM tab all the default destination applications are defined. By
clicking the Select button the Default AE window opens.
To add a new Application Entity (AE) click the Add button and define the AE
title, host name and port number in the opening window.

IMAGING
In addition to AE Title, Host Name and Port Number parameters, the Transfer
Syntax to be used can be set to No Restriction (automatically negotiated) or
limited to a certain Transfer Syntax for increased compatibility.

IMAGING
4.2.1 DICOM Storage Setup
In the opening Storage Setup window the DICOM Storage Settings can be
changed or checked.
Communicate through server
Route all DICOM communication from Planmeca Romexis clients to DICOM

services via Planmeca Romexis Server. The SCU AE Title will be used
instead of Client AE Title.
General
• Reuse association for Singleframe CT images:

Specifies whether a single storage association is reused for all frames in a
Singleframe CT images. If disabled a new association will be opened for each
frame.
• Supports Enhanced (Multiframe) CT images:

3D volumes will be sent to DICOM Storage in multiframe format. See your
DICOM Storage server documentation for more information.
• Send Images with processing applied:

All image enhancements made in Planmeca Romexis are merged into the
image sent to DICOM storage.
• Send Images with annotations applied:

Annotations added in Planmeca Romexis are merged into the images sent to
DICOM storage.

IMAGING
• Send grayscale images with LUT:

The Lookup Table (LUT) is included with images sent to DICOM Storage. In
Planmeca Romexis the following applies to LUT values:
• If a gamma correction value unequal to 1.00 is set in Planmeca Romexis

Configuration > Imaging > Panoramic > Auto-enhancements > Gamma,
only that value will be used as LUT. If the value equal to 1.00 is set in the
first Adjust Levels operation gamma and min/max values will be used as
LUT.
• In general only the first adjustment in the Adjust Levels will be used as LUT
whereas the next adjustments will be ignored.
SOP Class
The Force SOP Classes option allows forcing of a specific SOP Class to be
used for each image category in Planmeca Romexis. By default Planmeca
Romexis selects the correct SOP Class for each image. Forcing of SOP Class
is usually not required but may be useful in some cases to maximize
compatibility with different PACS systems. The first class item in each drop
down list is the default value.

IMAGING
Modality
The Force Modalities option allows forcing of specific modality to be used for
each image category. By default Planmeca Romexis selects the best suitable
modality for each image. Forcing of modality is usually not required but may
be useful e.g. to maximize compatibility with different PACS systems (for
example if the system doesn’t support PX dental modality).
Storage Commitment
• Storage Commitment Enabled:

Storage commitments will be shown in Image properties once received.
• Use separate commitment threads:

Threads Storage Commitment into maximum 10 parallel processes improving
Storage throughput in cases where PACS Storage Commitment processing
time is long.
• Two association mode for commitment:

When two association mode is enabled, a dedicated association socket will be
opened for establishing Storage Commitment. Otherwise the original Storage
association socket is reused to establish Storage Commitment.
NOTE Two association mode for commitment cannot be used with server autostorage.
• Listening port for commitment:

Specify port where Planmeca Romexis server listens to Storage Commit-
ments when Two Association mode is used
• Timeout for commitment(s):

Specify Planmeca Romexis Server timeout for receiving Storage Commit-
ment whenTwo Association mode is used

IMAGING
4.2.2 DICOM Printer Setup
The DICOM Printer settings can be checked and changed in the opening
DICOM Printer Setup window.
Under Film Box the following settings can be made:
• Orientation: Default / Portrait / Landscape

Default: The printer automatically select the page orientation while Portrait or
Landscape forces the selected orientation.
• Film Size: Several choices

This setting allows forcing the printer to use a certain film size.
• Magnification Type: Default, Replicate, Bilinear, Cubic, None

Default will use the default magnification type of the printer while the others
can be used to overrule.
• Smoothing Type: Please see your DICOM printer manual for more informa-
tion on this setting.
• Magnification Factor: The multiplier to magnify prints.

Set this to a value larger than 0 to scale images up or down. 0.5 will yield 50%
size, 1 yields 100% while 1.5 yields 150% scaling. Leave empty to let the
printer fit the image on the film.

IMAGING
• Header Text Height: Text height for text in header.

Values between 20-50 are usually good. Leaving this empty will cause no
header to be printed. Please note that if a magnification is applied in printing
the text sizes will also be scaled accordingly.
• Footer Text Height: Text height for text in footer.

footer to be printed.
• Annotation Text Height: Text height for annotation.

annotations to be printed.
4.2.3 DICOM worklist setup
• Communicate through server:

Enable this option to route all DICOM communication from Planmeca
Romexis clients to DICOM services via Planmeca Romexis Server. If enabled
Planmeca Romexis server SCU AE Title will be used instead of Planmeca
Romexis Client AE Title.
General
• Enable Select and update closes matching patient automatically to have Plan-
meca Romexis select and update closes matching patient automatically when
a patient is opened from DICOM Worklist and a patient with similar informa-
tion already exists in Planmeca Romexis database. Normally Planmeca
Romexis will ask the user to make a selection between updating or creating a
new patient.
• Default Modality – Specifies the default value for the modality in the DICOM
Worklist screen in the Patient module.

IMAGING
4.2.4 DICOM Modality performed procedure step (MPPS)
DICOM MPPS SCU service is used together with DICOM Modality Worklist
SCU service. If Planmeca Romexis MPPS service is configured, the ID, status
and dates of studies as well as patient name will be sent to PACS when
starting the exposure. Dates and compete list of images including X-ray
parameters will be sent to the HIS/RIS server after closing exposure task.
To connect to HIS/RIS MPPS the provider service Default MPPS AE should

be enabled.
For sending messages select Default MPPS AE and tick the box Allow
sending messages in Modality Performed Procedure field.

IMAGING
4.2.5 DICOM Query / Retrieve Setup
• Use Planmeca Romexis Serve AE title:

Use Planmeca Romexis Server SCU title in Query mode as calling AE title
instead of using Planmeca Romexis Client AE title.
• Allow only for current patient:

Limits DICOM Query Retrieve queries to the currently selected patient only.
• Automatic for PMBRIDGE patient:

Automatically execute Query / Retrieve for current patient when new patient is
selected using PMBRIDGE.
4.2.6 DICOM Storage Settings
The following options require that DICOM polling has been enabled in
Planmeca Romexis Configuration application. For more information see
section 6.3 “External communication” on page I-39.
• Store new Images automatically:

Specify whether newly captured images should be automatically processed
by the server side automatic DICOM Storage. Please note that if the server
side automatic DICOM Storage is disabled, this setting will have no effect.
Even if this setting is enabled, automatic storage can be canceled per image
in the image properties dialogue.
• Retry storage for failed commitment:

Enable this feature to retry Dicom Storage for image when its commitment
fails.
• Delete image with successful commitment after X number of days.

IMAGING
4.2.7 DICOM Query / Retrieve Settings
• Listening port: Port number where DICOM Query / Retrieve results should be
expected. Default is port 104.
4.2.8 DICOM default specific character set
To support patient names and information in different languages and

character sets, this setting allows a specific character set to be defined for
saving DICOM files. Set this option according to your local requirements to
allow any DICOM compatible application to correctly read and display patient
information as you have entered it.

LOCAL SETTINGS
5 LOCAL SETTINGS
5.1 Set as global defaults
To specify the settings made on the current workstation as global default

values on all new workstations that log in to the same Planmeca Romexis
server click the Set as Global Defaults button. The settings of those
workstations that have already logged into Planmeca Romexis server at some
point are not affected. Only the settings modified by the user are affected.
This feature is especially useful for settings such as 3D Module Enabled or
DIDAPI Enabled for example.

LOCAL SETTINGS
5.2 3D
3D Module Enabled on This Workstation
This setting enables the organization to allow/deny access to the 3D module

per workstation.
3D Rendering Enabled
Enabling this function generates 3D rendered view in 3D module but

consumes more memory. This function should be disabled in image capturing
workstations.
Surface Rendering
Enabling this feature uses an optimised proprietary ray tracing engine to

produce a real life solid object appearance to 3D volumes. The Surface
Rendering mode allows 6 different rendering styles that can be selected in the
volume Rendering Style menu.
When this feature is disabled, a more X-ray like rendering allowing see-
through anatomy is generated.
3D Rendering Texture Quality
The following settings affecting the quality of the 3D rendered view (but not 2D
slices) can be made:
• Low - Low quality resolution with the lowest demand on hardware and low
memory usage. This setting is equal to Planmeca Romexis 1.6 and previous
versions.
• Normal - Average resolution mode with modest memory requirements. Dedi-

cated graphics card recommended as graphic chips integrated on mother-
board may degrade performance.
• High - High resolution mode that demands a high-end graphics card with a
minimum of 256 memory on board.
Use Low Quality Preview
When enabled previews of 2D and 3D views are shown in low quality when
the views are manipulated.

LOCAL SETTINGS
5.3 Reconstruction Server
The 3D reconstruction PC’s Host Name and Port Number is defined here.
5.4 2D
Image Capture (DIDAPI) Enabled
This setting requires Planmeca DIDAPI to be installed.
Image Reprocessing Enabled
This setting enables Reprocessing of exposures in certain modalities.

Reprocessing allows easy exploration of different DIDAPI pre-processing
settings and is therefore well suited for identifying optimal settings during
initial configuration of a X-ray device. A single exposure can be processed
multiple times with different DIDAPI Configuration values applied and returned
to Planmeca Romexis each time as if it was a new exposure.
Starting from Planmeca Romexis 2.0.R only panoramic exposures (excluding

tomographies and sinus mode) can be reprocessed.
dimax3: pan, bw, sinus.
dimax4: all.
proceph (didapi 5.0.0).
NOTE Only TIFF images can be reprocessed. Please set Image Type to TIFF in Planmeca
Romexis Configuration application before using Image Reprocessing, see section 3
“IMAGING” on page I-10.
When Image Reprocessing is enabled and panoramic exposure is started, the

above dialogue is shown. The following choices are available:
• ReProcess Latest Image: Returns the most recent real exposure as a new
image with current DIDAPI configuration applied.
• Choose Image to ReProcess: Select an existing image in Planmeca Romexis

for Reprocessing, apply current DIDAPI configuration on it, and return the
result as a new image.

LOCAL SETTINGS
• Launch DIDAPI Config: Launches DIDAPI Configuration tool for changing

DIDAPI preprocessing settings.
• Turn ReProcessing OFF: Turns OFF the Image Reprocessing Enabled setting
in Admin / Local Settings.
Reprocessing is usually used as follows:
1. Check DIDAPI Configuration that preprocessing settings are enabled.
2. Expose an image of a patient or a test target.
3. Enable Image Reprocessing in Admin / Local Settings
4. Evaluate image and use DIDAPI Configuration to adjust preprocessing to

better match customer's preferences.
5. Start new exposure and choose Reprocess Latest Image. The original image
is returned with new preprocessing settings and verify image quality. Repeat
steps 4. and 5. until desired image quality is achieved.
6. Turn Reprocessing off.
Rejecting exposures is allowed.
Allows user to cancel exposure during exposure time.
Export all default folder
The default export folder is used when the option Export all is selected in the
image browser of the Imaging module.
Export all images option can be selected in the Image Browser when selecting
the Image list browsing mode.
For more information see section “Image list” on page C-35.

LOCAL SETTINGS
5.5 External applications
Some 3rd party applications can be launched directly from Imaging and 3D
modules with the Launch Ext. App. icon. Image and patient information is
transferred to this software simultaneously.
To define the path click the Select button.
Browse to the Simplant-exe file. Type the name of the Simplant and type -sf
”%0” in the Command Line field
NOTE The launch feature requires that the receiving software is capable of
receiving file and patient information via command line. Please see the
3rd party documentation for correct parameters.

LOCAL SETTINGS
5.5.1 Show 3D quick launch presets
The pre-defined 3D Quick Launch preset can be selected for the following
software:
The toolbar logo can be defined for each software and the launch command
can be customized when necessary using the 3D Imaging Application setting.
NOTE Only one software can be selected for Quick Launch at a time.
3D Binning
The 3D Binning option specifies pre-scaling performed on 3D images before

opened in the launched application. The operation is called binning and it
combines two or more adjacent voxels into one, reducing the resolution of the
resulting image. Binning does not affect the geometry or dimensions of the
image.
The valid settings are:
• Original resolution with no image processing. This is the default value if left
blank.
• Apply binning so that the volume shrinks to half of the original, so that for
example a 0.16mm resolution results in 0.32mm resolution.
• Apply binning so that the volume shrinks to one third of the original, so that
0.16mm resolution results in 0.48mm resolution.
A recommended output to use in 3rd party implant planning software is

0.32mm or 0.48mm voxel size. When exposing in High resolution or Standard
modes (0.16mm,) use binning value 1 or 2 (resulting in 0.32mm or 0.48mm),
and with the Low dose mode (0.32mm) use binning value 1 or blank (resulting
in 0.32mm).

LOCAL SETTINGS
5.6 Dental unit interface (PlanLink)
Use the PLANLINK Dental Unit interface to enable intraoral video camera
activation and foot pedal automation in Planmeca Romexis. This setting
should be used instead of intraoral video camera Serial Connection only in
case the PLANLINK service is in use. In most cases, however, this should be
disabled and the intraoral video camera Serial Connection explained below
should be used instead. Please note that the PLANLINK operation requires a
PLANLINK enabled Planmeca Compact i unit.
5.7 Intraoral video camera Serial Connection (CamComm)
Enable this setting to enable intraoral video camera activation and foot pedal
automation in Planmeca Romexis using standard Serial Connection. The
Comm port needs to be specified correctly and is in most cases COM1.
Please note that this requires the use of Planmeca Compact unit.
5.8 Practice management software interface (PMBRIDGE)
Enables Practice Management (PMBridge) interface.
5.9 CD recording device
Device Bus
Specify device bus where the CD recording device is located. Modify this
setting only if the AUTOMATIC setting doesn’t work.
Log CD-burn
Write a log of the CD-writing process for troubleshooting purposes.
5.10 DICOM
AE title for workstation and other workstation specific DICOM identifiers.

Chapter
H REPORT MODULE
The Report module enables to list several processes of Planmeca Romexis

as a report. These reports contain direct links to images and patients as well
as the possibility to print the report.
The Report module offers three kinds of reports:
1. Images by Date and Type
2. Images by Capturer
3. X-ray log book
User’s Manual Planmeca Romexis H-1

REPORT GENERATION
1 REPORT GENERATION
Select one report mode from the drop down menu and press the Generate
button.
Perform your selection and click OK. The selected report mode will be
displayed.
1.1 Image Link
To view one of the listed images, double-click on the blue image name in the
left column (Image Link) or select the image or several images by holding
down control, and press the Open Link(s) button. The Image View tab opens
and the selected image(s) is shown.
1.2 Patient link
By double-clicking on a red patient name, a patient file can be opened directly

for further processing.
1.3 Refresh
The Refresh button updates the current report on the screen.
1.4 Print
Reports can be printed with the button. Open the report you want to print and
click the Print button. The preview window appears and the report is printed
according to the layout on the screen.
H-2 Planmeca Romexis User’s Manual

IMAGE VIEW
2 IMAGE VIEW
The Image View tab displays images opened from the report in the Report
Generation tab. Each open image has its own horizontal toolbar above the
image. These viewing and processing tools affect only that respective image.
As images are viewed Read Only, no changes will be saved.
Prev Image
Opens the previous image in the report list.
Next Image
Opens the next image in the report list.
Open Copy
Opens an exact copy of the current image for further processing.
User’s Manual Planmeca Romexis H-3

IMAGE VIEW
Set Layout
Allows you to choose a new layout for currently open images.
H-4 Planmeca Romexis User’s Manual

Chapter
I PLANMECA ROMEXIS
CONFIGURATION APPLICATION
The Planmeca Romexis Configuration application is a password-protected
facility for adjusting various system-wide Planmeca Romexis settings.
The application is accessible only for users with administrator rights. The
access is defined by user group permissions.
To display an interactive help explaining the options in each window click this
button.
To restore the default settings click the Set to defaults button.
1 ENTERING THE APPLICATION
1. Browse to the folder C:/Program files/Planmeca/Romexis/admin
2. Double-click the RomexisConfig file.
3. Log in the Planmeca Romexis Configuration application by entering your user

name and password in the respective fields and click OK.
User’s Manual Planmeca Romexis I-1

ENTERING THE APPLICATION
1.1 Changing password
1. Click the Change password button.
2. In the following window enter the current password and the new password in
the corresponding fields.
3. Click OK.
I-2 Planmeca Romexis User’s Manual

GENERAL SETTINGS
2 GENERAL SETTINGS
2.1 Resources
2.1.1 General
Client instance
Images Decoded/Decompressed on Server
In Planmeca Romexis version 3.0.R and later this setting is off by default and
2D images are transferred in compressed format from server to client where
the image is decompressed before viewing.
Show Instance Name in Client’s title bar
By checking / unchecking this option you can define whether the instance
name that is defined in the Instance Name field (see below) is shown in the
Planmeca Romexis title bar.
Show Username Name in Client’s title bar
By checking / unchecking this option you can define whether the username
that is defined in the Instance Name field is shown in the Planmeca Romexis
title bar.
Allow more than one client instance on one workstation
With this options selected multiple Planmeca Romexis Clients can be started
on the same computer.

GENERAL SETTINGS
Instance Name
Enter the instance name (for example clinic name) into the Planmeca
Romexis title bar. All Planmeca Romexis Clients that are connected to the
same server have the same Instance name.
2.1.2 Person
Name Formatting
The Name Formatting selection affects the formatting of name display on the
screen.
Don’t Format
The names are displayed as they were entered into the database.
Capitalize First Letter
The first letter of each name is capitalized and the rest remain in lower case.

GENERAL SETTINGS
Capitalize ALL
Capitalizes all letters in a name.
Name Formatting affects the processing of searches for names so that when
Don't Format is used, searches are case sensitive, while Capitalize First
Letter / Capitalize ALL make searches case insensitive.
Name Display Order
In Name Display Order you can decide which name, family name or first
name, is displayed first in Planmeca Romexis
Patient identification
Patient Identification defines which Patient ID is used to refer to patients. The

same ID is also used in patient search. Planmeca Romexis can maintain three
different Patient IDs at a time.
Custom ID
Refers to an ID typed into Planmeca Romexis at patient creation, or an ID

generated by e.g. Axium.
Other ID
Refers to an ID imported from another software, where this usually

administrative ID has been assigned to patients manually (may e.g. refer to a
patient’s old paper file).
Autonumber
Instructs Planmeca Romexis to automatically assign a Patient ID to the

created patient and to use this unique identifier. This is viable only in cases
where Planmeca Romexis is used as the master patient management
software.
Patient ID Sorting
The following options are available when patient list is sorted by the Patient ID
column.
Insertion order
Sorting in the order the patients were entered into the database.

GENERAL SETTINGS
Alphabetical
Alphabetical sorting: 001, 1111, 22, aaa, aab, aba
Numerical
Numerical sorting ignoring leading zeros: 001, 22, 1111, aaa, aab
Prefix alphabetically
Sorting first by leading alphabets and then numerically: A22, A1111, B01
Patient
Give warning for Selecting all patients
Warns the user when all patients are searched at the same time from the
database in the Patient module.
Export files using patient name
Specifies the patient’s name to be used as the default filenmae for exports.
The suggested filename can still be changed. When disabled the filename
field shows empty by default.
2.1.3 Security

GENERAL SETTINGS
The Login and Approval settings affect the information requested from users
when logging into Planmeca Romexis or when granting approvals. This allows
for the facilities to adjust the security measures in Planmeca Romexis
according to their local policies.
Login user name and password
User Name and Password are required
When logging in to Planmeca Romexis both user name and password are
required.
User Name required, Password is optional
Only user name is required when logging in.
Login only with Swipe Card
When additionally selecting this option, the user can log in only with a swipe
card.
Approval User Name and Password
User Name and Password are required
When granting approvals e.g. for image acquisition requests, Planmeca

Romexis asks for both user name and password.
User Name required, Password is optional
Only user name is required.
Approval only with Swipe Card
When additionally selecting Approval only with Swipe Card the approval can
only be made with swipe card.
Password
Maximum password age in days
Set to 0 for password that never expires.

GENERAL SETTINGS
Minimum password length
Sets the required minimum length for the password.
Maximum number of wrong password
The number of wrong entries is set to 0 as default (wrong entries are not
calculated)
At least one digit required
At minimum one number is required in the password. This setting is disabled

as default
At least one special character required
At least one non-alphanumeric character (e.g. @,#,!,%,&,?) required in the

password. This setting is disabled as default.
Swipe Card User ID
When swiping the card, the card produces an output text string that contains
the user ID and password.
Track No (Number) in Swipe Card
Indicates the row in the text output from which the password string is read.
Assume e.g. the following typical Swipe Card output

: %testusera6yz8cat?
;0000948721?
;20060101=20070101?
The User ID test user is located on the first track (0), starting from the second
column (1) and ending in the eigth column (7).
Start Column in Swipe Card
Indicates the column in the text output where the password string starts.
End Column in Swipe Card
Indicates the column in the text output where the password string ends.

GENERAL SETTINGS
Swipe Card Password
See Swipe Card User ID above for more information.
Active Directory
Planmeca Romexis can be configured to use Active Directory for user

authentication and permission management. Each Planmeca Romexis user
group must be mapped to an Active Directory group in the Admin module.
Use AD Authentication
Authentication of Planmeca Romexis users against Active Directory.
Server address
Address of the Active Directory server.
DNS Domain
DNS Domain of the Active Directory server.
Test SSO Auth
Tests the configuration against the Active Directory server.
NOTE Additional configuration of the Windows client environments may be

required to enable Single Sign On authentication.

GENERAL SETTINGS
2.1.4 Regional
Tooth Identification System
FDI/ISO
This option refers to the two-digit FDI World Dental Notation.
ADA
Universal Numbering System adopted by the American Dental Association.
Regional Settings
These settings specify default values and available settings in the Patient
Demographics.
Country
Defines the default country for demographics.
Language
Defines the default language for demographics.
Show State & State Prompt
Enables showing an input field for patients home state or similar, and a freely
configurable prompt text.

GENERAL SETTINGS
Show PIN & Prompt
Enables showing an input field for patients personal identification number or

similar, and a freely configurable prompt text.
ProModel Price List
Specify the HTTP address location of the regional ProModel price list.

IMAGING
3 IMAGING
3.1 Panoramic
In the Panoramic tab you can make adjustments to the image quality settings
of panoramic images.
Resolution, Bits Per Pixel and Image Format define how the images are
stored in the database after the image has been taken.
Autoenhancements settings affect the display of new exposures in Planmeca

Romexis.

IMAGING
3.1.1 Resolution
See the pixel sizes for Normal, Enhanced and High resolution in your
Planmeca X-ray unit’s user’s manual.
NOTE The size of the image is much larger and the handling of the image
slower when the pixel size is smaller.
NOTE The resolution selected in the Planmeca Romexis Configuration

panoramic settings does not affect the image size (pixel size is always
127µm). Other Planmeca RomexisConfig settings (BitsPerPixel,
ImageFormat, Gamma, Sharpening, Median) are same as the settings for
other 2D images acquired with Dimax sensor.
3.1.2 Bits Per Pixel
This field defines whether the images are captured as 8 bit or 16 bit. The best
dynamic contrast range is reached by using 16 bit per pixel, but the images
will be twice the size of 8 bit images.
3.1.3 Image Format
The format in which the images are stored in the database. The options are
TIFF and JPEG.
JPEG Quality
The JPEG Quality can be set to Low, Medium, High or Maximum.

IMAGING
3.1.4 Auto Enhancements
The Auto Enhancements group includes settings that affect the visualization
of the images in Planmeca Romexis. They do not affect the original images in
the database.
Use normal preprocessing
Auto enhancement are automatically performed on all new images If the

automatic adjustments are not satisfactory, it can be undone by clicking the
Undo button in the Imaging module, and the adjustments can be done
manually using the Adjust Levels.
• Gamma Correction:
Adjusts the gamma curve of the image. By adjusting the gamma value, the
image can be made to look more like a conventional X-ray image.
• Sharpen:
The image can be sharpened with a specific filter and strength (Low, Medium
or High).
• Despecle:
A specific filter can be used to remove noise from the image by selecting
Despecle.
Use custom preprocessing
For more information see section 3.3.4 “Auto Enhancements” on page I-18.
3.1.5 Bitewing Auto Enhancements
The Bitewing Auto Enhancements group includes dedicated settings that

affect exposures taken with the bitewing programs available in selected
Planmeca X-ray units. They will not affect exposures taken with intraoral
sensors. The same values as for the Auto Enhancements for panoramic
images above apply.

IMAGING
3.1.6 Save Autofocus Images
Save Autofocus images as normal exposures among other X-ray images in

Planmeca Romexis.
Save auto Focus Images is available only with Dimax sensor, as Autofocus is
not available with SmartPan.
3.2 Cephalometric
In the Cephalometric tab you can adjust cephalometric image quality settings.
The Resolution and Image Format settings define how the images are stored
in the database.
Autoenhancements settings affect the visualization of the images in Planmeca

Romexis.
3.2.1 Resolution
See the pixel sizes for Normal, Enhanced and High resolution in your
Planmeca X-ray unit’s user’s manual.
NOTE The size of the image is much larger and the handling of the image is
slower when the resolution of the image is higher.

IMAGING
3.2.2 Image Format
TIFF and JPEG.
JPEG Quality: The JPEG Quality can be set to be Low, Medium, High or
Maximum.
3.2.3 Auto enhancements
the database.
When a new image is captured, the Adjust Levels operation is automatically

performed to the image with the Auto Enhancement group settings. If the
automatic adjustment is not satisfactory, it can be undone by clicking the
Undo button in the Imaging module, and the adjustments can be done
manually using Adjust Levels function.
Gamma Correction
image can be made to look more like a conventional x-ray image.
Sharpen
or High).
Despecle
Despecle.
For more information see section “Use custom preprocessing” on page I-18:

IMAGING
3.3 Intraoral
In the Intraoral tab you can make adjustments to the image quality settings for
the intraoral images.
The Resolution, Bits Per Pixel and Image Format settings define how the
images are stored in the database.
3.3.1 Resolution
See the pixel sizes for Normal, and High resolution in your Planmeca X-ray
unit’s user’s manual.
NOTE The size of the image is much larger and the handling of the image is
slower when the resolution is higher.
3.3.2 Bits Per Pixel
In the Bits Per Pixel group you can select whether the images are stored as 8
bit or 16 bit images. The best dynamic contrast range is reached by using 16
bit per pixel, but the images will be twice the size of 8 bit images.
3.3.3 Image Format
TIFF and JPEG.
JPEG Quality: The JPEG Quality can be set to be Low, Medium, High or
Maximum.

IMAGING
the database.
When a new image is captured, the Adjust Levels operation is automatically

performed to the image with the Auto Enhancement group settings. If the
automatic adjustment is not satisfactory, it can be undone by clicking the
Undo button in the Imaging module and the adjustments can be done
manually in Planmeca Romexis through the Adjust Levels function.
Gamma Correction
image can be made to look more like a conventional x-ray image.
Sharpen
or High).
Despecle
Despecle.
NOTE For more information on image processing and archiving see section
1.5 “Archiving” on page A-3 and section 1.6 “Processing and restoring
images” on page A-5 in chapter A “GENERAL”.
Custom Preprocessing in Planmeca Romexis allows defining default

preprocessing settings for all new exposures. The preprocessing settings to
be used are specified per image type in Imaging module.
NOTE All preprocessing adjustments are set and modified in Imaging module
whereas the current settings can be viewed in Configuration application.

IMAGING
To define custom preprocessing settings proceed as follows:
1. Take an exposure or open a 2D image in Planmeca Romexis.
2. Use the image specific toolbar to adjust levels or sharpen the image until
acceptable image quality is achieved.
3. Check that the correct enhancements are listed in the Image Operations field.
Note that applying the same enhancement several times on the image will
slow down opening of images. so it is better to try to minimize the number of
enhancements if possible.
4. From the File menu select Capture > Save Image Enhancements as Default
Enhancements to set the current settings in the Image Operations list as
default enhancements for the current image type.
5. Check the preprocessing list and enable option Use Custom Preprocessing in
Planmeca Romexis Configuration for the image type.
Table 5: Custom image preprosessing
Planmeca Romexis
Planmeca Romexis Imaging module
Configuration application

IMAGING
3.4 CBVT
In the CBVT tab you can make adjustments to the image quality settings for
the CBVT images.
Default Settings and Auto Enhancements affect the visualization of the CBVT
images when they are opened in Planmeca Romexis.
3.4.1 Default Settings
Default Artefact Removal
Sets the default Artefact removal level that is selected in the 3D Exposure
dialogue. The default setting can be overridden by the user per exposure.
Bit Depth
Specifies the bit depth at which 3D exposures are stored in Planmeca

Romexis image database. The default value is 12bit. When 15bit is used 3D
volumes can be exported optionally in 12 or 15 bit depth. 15bit setting should
be used only in cases where 15bit exports to other systems are a
requirement.
Window
Defines the amount of grey shades in the image. The window range is 0 -
4095 shades of gray and it is typically set to 2000.

IMAGING
Level
Defines the midpoint for the shades of gray (0 - 4095). If level is set to 2000
and window is 2000, the shades of gray that are in use include values from
1000 to 3000.
Gamma Correction
Defines the default gamma value for the Auto Enhancement.
Auto Levels Min Pct (%)
Defines the percentage of cumulative shades of gray that is left out of the
contrast range from the lower end of the contrast range.
Auto Levels Max Pct (%)
Defines the percentage of the cumulative shades of gray that is left out of the
contrast range from the upper end of the histogram.
3.5 Display

IMAGING
3.5.1 Background colors
Background for X-Rays
Defines the background colour for the taking of X-rays.
Background for Photos
Defines the background colour for the image explorer.
3.5.2 Fonts
Default GUI Font and Default GUI Font Size
Define the default font for the graphical user interface.
Image Annotation Font Size
Defines the font size for the image annotations.
Image Measurement Font Size
Defines the font size for the measurements made on the images.
3.5.3 General settings
Use system file dialogue.

IMAGING
3.6 Dental record
3.6.1 Image Acquisition Request
Approval Expiry / Days
Sets the image acquisition request approval expiration time in days (1 day =
24 hours).
Approval Expiry / Hours
Sets the same time in hours.
3.6.2 Clinical Menus
Show Menu Numbers
Shows Clinical Menu numbers.
Show Menu Guidance
Shows menu guidance.

IMAGING
Show Tooltips
Enables tool tips in the clinical menus.
3.6.3 Odontogram
Show Tooltips
Enables tool tips in the Odontogram.
Show Large Perio Boxes
Enables large perio boxes in the Odontogram.
3.6.4 Case History
Create CaseHX Note for Approvals
Creates a case history note of every approval.
Warn About Unapproved Notes
If Warn About Unapproved Notes is selected, Planmeca Romexis warns

about unapproved notes.
3.6.5 Student Evaluation
Show Student Grade Evaluation
Enables the Grade Evaluation when approving case notes.
Show Student Free Evaluation
The Free Evaluation field is presented.
Grade Scale
The Grade Scale can be selected manually, for example (A, B, C,...) or,
alternatively, (10, 9, 8,...) by setting the grade scale from the best to the worst.

IMAGING
3.7 PlanLink & Diagnostics
3.7.1 Clinic overview and log refresh rate
Sets the refresh rate for the clinic status overview and log screens. The high
refresh rate may be useful for troubleshooting.
3.7.2 PlanLink – Compact Unit Lock
Specifies whether the dental unit should be locked when PlanLink proxy
service is not available to collect diagnostic information. If locking is enabled,
the dental unit will be inoperable when the connected PC running PlanLink
proxy is shut down or otherwise connection cannot be established between
the PC and the dental unit. When connection is re-established the dental unit
will again become operable after a power cycle.
3.7.3 Save Diagnostic Events to Database
Specifies whether the diagnostic events and messages collected from the
dental unit should be save into the database. The default setting is
recommended.

IMAGING
3.7.4 Export Ergodata files
Export to Zip
Use this function to export all recorded diagnostic data (ergodata) from dental
units to a zip file for troubleshooting purposes.
3.7.5 Dental Unit User Settings
Send Service Modes
Enable this setting to include dental unit service mode settings when dental
unit settings are stored to database and restored back to dental units. In
normal operation this should be left disabled but can be useful at dental unit
installations if numerous new dental units must be configured identically.
3.7.6 E-mail Notification
Planmeca Romexis Server can be configured to send alert e-mails when

specific diagnostic events take place in dental units. Planmeca Romexis
sends the e-mails to the SMTP Server configured here. Device alerts can be
configured in the Admin module.
SMTP Server Host Name
Defines the SMTP Server host
SMTP Server Port
Defines the SMTP Server port.
Notification period (mins)
Defines the delay in minutes after which an error is considered to be important

enough to be reported in an e-mail. If an error is negated by itself or fixed by a
user within this time limit, then no error will be reported. The error will still be
shown in the dental unit event log.
Don't e-mail for same error in (mins)
Defines the time limit during which a persistent error will not be reported
again.

IMAGING
3.8 Print
3.8.1 Updating Print Logo Files
Client Logo
Shown in the top left corner of the printed paper.
Planmeca Romexis Logo
Shown in the top right corner of the printed paper. By default it is the
Planmeca Romexis logo.
Footer Logo
Shown in the bottom left corner of the printed paper. The image which will
replace a logo must be in Portable Network Graphics file format (.png). The
height of all logos is limited to 1.0 inches.
By clicking the Browse button the user can browse for desired image and by
clicking the Update button the image is updated to Planmeca Romexis
database.
3.8.2 Show Logos in Printouts
The logos showing in printouts can be selected here.

IMAGING
3.9 Cloud
Configure the Cloud server as follows:
Cloud Server Address: eu.online.planmeca.com
Port: 443
In cases where Planmeca Romexis Client workstation is behind a firewall that

blocks outgoing connections, a firewall proxy server IP and port should be
configured as follows:
Client Proxy Address: IP of the proxy server that proxies HTTPS

connections
Proxy Port: Port of the proxy server that proxies HTTPS connections

IMAGING
3.10 DDX dental
3.10.1 DDX Site
Server Address
The host address of DDX Dental cloud service provider. The default address
is www.ddxdental.com
Client Proxy Address
Internet proxy address used in the practice, if any.
Proxy Port
Port of the proxy address if proxy address is used.
3.10.2 Register Romexis Application
Client(s) using App Name
The application name the practice uses when communicating with DDX cloud
server. Security keys will be registered for the application using this name.

IMAGING
App Public Key
The security public key registered for App Name. The keys are created and
shown in the web browser when registering the application using the (Re-
)Register button. Both keys must be manually copy-pasted from the web
browser display.
App Private Key
Security private key.
3.10.3 Test of DDX Link
Test Get Practice Info button
If the practice is registered as a DDX client and the application is successfully

registered, the practice info is successfully found and shown. If the test is
passed, the registration and settings are correctly executed.
Test Get Accounts Info button
Gets and shows all labs registered for this practice.

IMAGE & DATA MANAGEMENT
4 IMAGE & DATA MANAGEMENT
4.1 Data folders
Romexis data folders
The Planmeca Romexis Data Folders settings sheet allows re-configuration of

the Planmeca Romexis image and ergodata (dental unit diagnostic data)
storage paths can be re-configured and all existing data can be relocated to a
new folder.
Set path
Use the Set Path button to specify a new root folder for Planmeca Romexis
Data folders. Eg. if the root folder is specified as R:\romexis_data\ then
Planmeca Romexis_images, romexis_cache and romexis_ergodata folders
will be automatically created under it. After the Planmeca Romexis Server
service is restarted all new images will be stored to the new location.
Move data
To move all existing data files to a new location and update all database
references to point to the moved files click the Move Data button
It is possible to change the path to point to a new location and have new files
stored there while keeping existing files in the old location.

NOTE Planmeca Romexis Server service must be restarted after changing the
root path or moving images for the changes to activate the
modifications.
4.2 Trash
4.2.1 Reactivate and empty trash
To search for inactivated patients, images and devices select the suitable
alternative from the drop-down menu.
To reactivate patients, images or devices select the appropriate alternative

from the list and click the Reactivate button. The selected items are restored
to Planmeca Romexis.
To permanently delete patients, images, attachments or devices from the

Planmeca Romexis database click the Empty Trash button.

4.3 Long Term Archive
Long Term Archive (LTA) allows old images to be moved to a more

permanent storage based on their age. Long Term Archive is not a backup
system but appropriate backups should be maintained in addition to LTA
media.
4.3.1 Create Long Term Archive
These settings specify which images are to be placed in the Long Term
Archive (LTA), where the archived files should be placed and whether a
maximum size for a single archive should be enforced eg. 650 MB for CD.
Archives will be created as subfolders named “ARCHIVE_1”, “ARCHIVE_2”

etc. under the Archive path. If archive size exceeds the set maximum limit,
then any remaining images will be spanned into the next archive. Every
archived image is accompanied by an image information text file that will allow
manually linking the images back to correct patients in a disaster scenario, or
to manually locate single images inside the archive.
Archived images will have an archive thumbnail shown in Planmeca Romexis

client in place of the actual image thumbnail. When the thumbnail is double
clicked the user is presented with an option to browse to the correct archive
with the Archive path provided as default.
Archive Images button will start the process of moving images from
Planmeca Romexis images folder to the Archive path. Summary and progress
information for the process is shown in the area below.

START-UP
5 START-UP
5.1 Client parameters
NOTE This tab can be used to configure only the Client that is installed on this
current workstation.
5.1.1 Connection to Planmeca Romexis Server
Server Address and Server Port
Define the Planmeca Romexis Server address into which Planmeca Romexis
Client connects to. Host address can be either IP or DNS name.
User ID and Password
Optional login information for the Client.

START-UP
5.1.2 Java VM Parameters
JVM Path
Set the Java Virtual Machine to be used by Planmeca Romexis client.
Stack Size
Defines the amount of stack memory in use. This parameter is optional, and
needs to be configured only if certain TWAIN devices are used.
Max Heap Size
Defines the maximum amount of memory which Planmeca Romexis Client

has in use.
3D Rendering
Defines the rendering method for 3D images.
5.1.3 User Interface
Language
Defines the language file used with Planmeca Romexis Client.
Main Window Size X and Main Window Size Y
These parameters can be used to force the Client's main window to a certain
size.
Default monitor
5.1.4 Set Defaults
To restore the default settings click this button.

START-UP
5.2 Romexis Service
Planmeca Romexis Service is a Windows program that starts Planmeca

Romexis Server every time Windows is started. In this tab all settings for the
Planmeca Romexis Service can be configured.
NOTE Changes to these parameters take effect after you restart Planmeca
Romexis Service.
5.2.1 Romexis Service
Windows Service Name
Defines the name of the Planmeca Romexis Service in the Windows Services
list.
Executable Name
Name of the wrapper executable to be used as Planmeca Romexis Service.
Startup Delay (min)
Defines the Planmeca Romexis Service Startup Delay in minutes.

START-UP
5.2.2 Java VM Parameters
These parameters affect the way Planmeca Romexis Server is launched.
JVM Path
Defines the path to the Java Virtual Machine in use.
Classpath
Defines the files that the Virtual Machine uses.
Main Class
Defines the Main Class inside the Planmeca RomexisServer.jar.
Optional App Args
Allows passing optional configuration parameters to Planmeca Romexis

Server, normally specified in romexis_server.properties.
Optional JVM Args
Allows passing optional configuration parameters to Planmeca Romexis

Server’s Java Virtual Machine. Normally specified in RomexisService.ini.
Max Heap Size
Defines the maximum amount of memory which Planmeca Romexis Server

has in use.
Aggressive/Multi-core Garbage Collection
By selecting Aggressive/Multi-core Garbage Collection, the garbage collection

can be enhanced.
5.2.3 Planmeca Romexis Service Control
Start Service
Starts the Planmeca Romexis Service.

START-UP
Stop Service
Stops the service.
Remove Service
Stops the Service and removes it from the Windows Services list.
Show Log
Opens the Planmeca Romexis Service Log.
5.2.4 Set Defaults
To restore default settings click this button.

SERVER PARAMETERS
6 SERVER PARAMETERS
6.1 Server
6.1.1 RMI - Server/Client Communication
RMI Server Host
Planmeca Romexis Server IP or DNS name is configured here.
RMI Server Port
Defines the port for Planmeca Romexis Server-Client-communication.

SERVER PARAMETERS
6.1.2 Class Server
Class Server Enabled
If this option is selected, Planmeca Romexis Server provides the latest

PMUAPI classes to PMUAPI proxies which communicate with the dental
units.
6.1.3 Class Server Port
This is the port the Server listens to.
Mobile server
Enable communication with Planmeca iRomexis clients and allows

configuration of the port where incoming Planmeca iRomexis client
communications are listened to (default=8083). Mobile Server is by default
ON in new installations.
6.1.4 Unit Communication (PlanLink)
Diagnostics Enabled:
Enables the communication between Planmeca dental units and Planmeca

Romexis.
Diagnostics Log Enabled:
Starts the logging of the diagnostic communication.
Save diagnostic data only when patient is selected
Diagnostic Port
Defines the Planmeca Romexis Server port for diagnostic communication.
6.1.5 Server Log
To open the Planmeca Romexis Server Log click the Show Log button.

SERVER PARAMETERS
6.1.6 Set Defaults
6.2 Database
6.2.1 Database connection
The database that is used with Planmeca Romexis can be selected among
the four alternatives shown in this field.
• Solid
• Oracle
• SQL server
• Firebird 2

SERVER PARAMETERS
JDBC Connect URL
Planmeca Romexis uses JDBC driver to connect to the database. If you use a
different database than the one provided in the Planmeca Romexis
installation, you must acquire JDBC driver for the alternative database.
JDBC Connect URL is the connection string which JDBC driver uses to locate
the data source. An example URL can be seen beside the database names,
but because it is defined by the provider of the driver, it can differ from the
example URL. In such case contact the provider of the JDBC driver.
User ID and Password
The login information to enter the Planmeca Romexis Database.
Test connection
The database connection can be tested by clicking the Test Connection

button.
Set Defaults

SERVER PARAMETERS
6.3 External communication
6.3.1 Data gate - external patient management system
Planmeca Romexis can connect to an external patient management system

through data gate. Data gate is a connection to the database from which
Planmeca Romexis polls for new external information.
Active from
Defines the starting hour of the day for the automatic data gate polling.
Active to
Defines the last hour of the day until which the data gate polling is on.
Poll Interval (min)
Defines the time interval between consecutive queries into the database.

SERVER PARAMETERS
6.3.2 DICOM
Planmeca Romexis can be configured to use auto storage to automatically

send DICOM images to external PACS image database after acquisition.
Planmeca Romexis polls for new DICOM images according to the Poll Interval
from the Planmeca Romexis database.
DICOM Polling Enabled
Defines whether polling and automatic storage are performed.
Active from
Defines the starting hour of the day for automatic DICOM polling.
Active to
Defines the last hour of the day until when the DICOM polling is on.
Poll Interval
Defines the time interval between consecutive queries into image database.
6.3.3 Set Defaults

APPENDIX A: ORDER SERVICES
1 PLANMECA PROMODEL
Planmeca ProModel is a patient specific physical model designed for dental
professionals to use as an assisting tool for preoperative planning of
challenging dental and maxillo-facial procedures. The ProModel is designed
to be used with the original ProMax 3D imaged volume. The model should not
be used as only tool for planning procedures. In no circumstances ProModel
can be used in vivo.
Planmeca ProModel order icon is enabled by default.
To remove the order icon from the main toolbar:
NOTE User must have administrator rights in Planmeca Romexis to disable (or
enable) Planmeca ProModel ordering.
1. Select Admin from the toolbar.
2. Click the Local Settings tab.
3. Click the Show ProModel Order icon.
4. Click Save.
5. Restart your Planmeca Romexis software. The order icon no longer appears
on the top toolbar.
1.1 Placing an order
NOTE In case of artifacts caused by high-density objects, such as amalgam or

other metallic bodies use the artifact removal tool before placing
Planmeca ProModel order.
NOTE Planmeca ProModel is not autoclavable and it is not recommended to

use liquid disinfectants.
NOTE In case you need separate models for mandible and maxilla take 3D
exposure with a mouthpiece on.
1. Open the volume of which you would like to create the model from the
Explorer tab.
2. Click the ProModel icon.
User’s Manual Planmeca Romexis Appendix A-1

The Planmeca ProModel order form opens.
3. Enter the necessary information.
The required fields (in bold) are:
• First and last name
• Company
• Address
• Postal code
• City
• Country
• E-mail
The order confirmation will be to the user by e-mail, please give a valid email
address.
Appendix A-2 Planmeca Romexis User’s Manual

• ProModel ID
The ID will be printed on the ProModel. The software automatically value is

the person id of the volume under examination. The default value is given by
Planmeca Romexis software. This value can be changed, as user likes. It can
be in text, numbers or special characters format.
• Reference
Used for order processing.
The optional fields and buttons include:
• Comments
You can use the Comments field is for special requests, e.g. if you would like
to order the model in other than the default (white) colour. If you would like to
have the ROI marked in the model or give a notice to Planmeca concerning
the volume you can write it down in the comments.
• Reference
Used for order processing.
• Price List button
By clicking this button a ProModel price list opens in your default web
browser. If your computer is not online clicking the button gives the URL of the
price list in your default web browser. The prices in the list are recommended
prices. For further information contact your local Planmeca dealer.
• Include nerves and Implants check box.
Select this option if you have drawn mandibular nerve or placed implants in
the patient’s data in Romexis. The colored nerve can be printed on the
ProModel and the implants will be included as cylinder representations.
NOTE For the nerves to show in the ordered ProModel, the order must be
placed from the 3D module's Cross Section/Implant tab

• Add Billing Address button
If you have selected the option Different Address for Delivery instead of Same
address for Delivery and Billing this button will be enabled.
To enter a different address for billing click the Add Billing Address button.
• Add Dealer Information button
Enter the local Planmeca dealer information. The information is required for
billing purposes. This information is filled by your local Planmeca dealer and it
needs to be given once.
• By selecting this box, I agree to these Terms and Conditions check box
To read the terms and conditions click the respective hyper link. This box
must be checked before placing the order.
• Save this order form as a template button.

By selecting this option saving you do not need to refill all the required fields
every time when placing an order.
4. After you have entered all necessary information click the Continue button.
5. Select the appropriate ordering option.
NOTE In all ordering options all personal information of the patient is removed
from the 3D volume.
The options include:
• Send online
The image and order form are sent to Planmeca’s FTP server. The computer
needs to be online and possible firewall needs to be set to allow outgoing
FTP-connections. Order confirmation and courier package tracking number
will be sent to customer’s email account
• Burn to CD/DVD
The image and order are burned to CD or DVD which can be sent by mail to
Planmeca.
• Export to My Documents
A zip-folder including the image and order form to user’s My Documents folder
(OS WinXP).
6. Click Accept.

2 ORDERING SURGIGUIDE® DRILL GUIDES WITH
PLANMECA ROMEXIS
After having finished the implant plan in Planmeca Romexis you can order a
Surgiguide with
Planmeca Romexis ordering wizard.
1. To launch the order wizard click the Order Guide icon.
2. The following window opens

3. Fill in the order form.
If necessary you can send plaster model with the order by selecting the
correct ordering option.
4. When the order is completed click Place Order button.
5. You will soon receive an automatic confirmation e-mail.
6. To complete the order send the e-mail to Materialise Dental Support Service.
NOTE If a suitable internet connection is not available, the order can be saved
to file and sent to Materialise Dental manually. In this case no automatic
e-mail will be sent
Materialise Dental SurgiGuide® specialist will contact the customer to

implement the guide design and discuss it with the customer.
After production the customer receives the SurgiGuide® ready for use in
surgery via their Materialise Dental distributor.

3 3D DIAGNOSTIX ORDER SERVICES
Planmeca Romexis users can send their CBVT data, implant planning and
Planmeca ProMax 3D scanned impression in STL format to 3D Diagnostix for
ordering surgical guides. In addition CBVT volumes can be sent for
radiological interpretation. The volumes are read by 3D Diagnostix’s board
certified radiologists for a variety of diagnostic objectives such as pathology
findings, implant planning, existing implant evaluation, sinus evaluation and
TMJ analysis.
The 3D Diagnostix order Services button can be enabled in Admin module.
3.1 Radiology report order
1. Open the CBVT volume to which you want to order the radiology report..
2. Start the 3D DX Order Services by clicking this icon.
To view examples of ordering processes click these buttons.
3. Enter your contact information and select the necessary options from the list
of order options:
• Rule out pathology
• Implant planned
• Evaluate existing implant
• Sinus evaluation
• TMJ evaluation
If necessary you can enter comments or additional information.

4. When you have entered all the necessary information click the Place order
button.
The Send Order Options Window opens.
5. When ordering TMJ evaluation make sure that you include both open and
closed TMJ images in the order. Add second volume to the order by using the
Add Additional Datasets to Order button.
In the same window you can select whether to send your order online or save
the order in a file.

6. When finished place the order by clicking Accept.
The order will now be sent to 3D Diagnostix FTP site.
NOTE Do not close Romexis until the upload has completed.
NOTE If internet connection is not available, the order can be saved to file and
sent to 3D Diagnostix manually.
7. Once the order is ready 3D Diagnostix will send you an email with directions
on how to download the ready report in PDF.
8. To download the report, log on to 3D Diagnostix’s online management system

and update your billing information.

3.2 Treatment plan and guide order
1. When required, create scan denture, bite registration etc. For more
information on the required actions, Guided surgery overview and Service
description can be found in Romexis.
2. Scan with Planmeca ProMax 3D unit, dual or single scan.
3. When required, send traditional plaster cast to 3D Diagnostix. Alternatively

you can scan the impression impression with Planmeca ProMax 3D Model
Scan program and add it to the order in Step 9 on page 11.
4. Create implant plan
5. Start the 3D Diagnostix Order Services by clicking this icon.
6. Fill in the order form.
7. Select the arch(es) of interest from the respective drop-down menu.
8. Press Place Order button.
9. When required, attach the scanned denture or the Planmeca ProMax 3D

scanned impression to the order by using the wizard’s Order Send Options
step.

10.Place the order by clicking Accept.
The order will now be sent to 3D Diagnostix FTP site.
NOTE Do not close Romexis until the upload has completed.
NOTE If internet connection is not available, the order can be saved to file and
sent to 3D Diagnostix manually.
11.The specialist from 3D Diagnostix will contact you for an online case review to
fine-tune and approve the optimized plan.
12.Once you have accepted it you will receive the guide ready for surgery.

APPENDIX B:PLANMECA ROMEXIS VIEWER
The Planmeca Romexis Viewer can be distributed freely with images taken
using Planmeca equipment. Planmeca Romexis Viewer can by used for
sending images for referral in case the user does not have the full Planmeca
Romexis license.
The Viewer can be used to measure images while making new exposures,
however saving changes or measurements is not possible. Also printing is
more basic compared to the full version of Romexis software. The 2D files in
DICOM format, 3D files in DICOM MultiFrame and DICOMDir filesets. can be
opened in Planmeca Romexis Viewer.
The features available in Planmeca Romexis Viewer are the same as with the
Planmeca Romexis but with some limitations. For example if the Planmeca
Romexis has been used to export the viewer with Implant tab enabled, the
Implant tab will also be available in the viewer except for saving.
1 OPENING IMAGES
Planmeca Romexis Viewer is most commonly exported from Planmeca
Romexis accompanied with a DICOMDir fileset of a patient's images. In these
cases the DICOMDir will reside in the same folder with Planmeca Romexis
Viewer and will be automatically presented to the user when Planmeca
Romexis viewer is started. The user can then select a subset of images from
the DICOMDir or open all available images for viewing. Please note that no
preview is available for 3D images. After selecting images and clicking Import
the images will be opened in the image browser. To view 3D images move to
the 3D module. For more information on how to view and enhance 2D images
please see Planmeca Romexis manual chapter C “2D IMAGING MODULE”.

Please note that some features such as exposure, export, and DICOM are not
available in Planmeca Romexis Viewer.
Planmeca Romexis Viewer can also be used to open single DICOM images or
to open DICOMDir filesets outside the default Viewer folder.
To open a single DICOM image click the Open DICOM File icon on the
toolbar.
Alternatively you can use the File menu option Open DICOM File. Next
browse to the DICOM file you wish to open in Romexis. RomexisViewer will
present you with a list of images found in the folder and require you to choose
which image to open.
Please note that when a single DICOM image is opened any previously
opened images will be closed.

To open a DICOMDir file use click this icon on the toolbar.
Alternatively you can select Open DICOMDir from the File menu. Next browse
to the DICOMDir you wish to open and proceed with opening the DICOMDir
as when starting the Planmeca Romexis Viewer.
2 VIEWING 3D IMAGES
1. Click 3D module icon.
2. Click the Volumes tab.
3. Select the image you want to view.
4. Double-click the image or click View
You can switch between Explorer, Panoramic and Cross Section / Implant
tabs (when available).
For more information on how to view and enhance 3D images please see
chapter D “3D IMAGING MODULE”.
NOTE Some features such as exposure, export, and DICOM are not available in
Planmeca Romexis Viewer.

APPENDIX C:PLANMECA iROMEXIS
1 INTRODUCTION
Planmeca iRomexis application is designed for viewing of 2D and 3D images
with Apple iPhone and iPad devices. All image types acquired with Planmeca
X-ray units, including Planmeca ProMax 3D volumes and ProFace 3D photos,
can be viewed, enhanced, and studied in the application.
Planmeca iRomexis is designed to work with Planmeca Romexis desktop

software and it has integrated 2D and 3D image viewer with 3D surface
rendering. Images acquired using Planmeca Romexis desktop software can
be accessed on the local network.
Planmeca iRomexis is compatible with Planmeca Romexis version 2.6.R or

later. Planmeca iRomexis is available as a free download at Apple iTunes App
Store.
Planmeca Romexis is now compatible with iOS5 and iOS6 on iPad.
NOTE Please note that as a generic viewing application Planmeca iRomexis

mobile application is not suited for diagnostic purposes. It is, however,
an excellent tool for communicating a diagnosis made at Planmeca
Romexis desktop workstation.

2 CONNECTING PLANMECA IROMEXIS TO SERVER
To search patients and view images on the local Planmeca Romexis server, a
wifi connection to the server must be established. To establish a connection
proceed as follows:
To access the Server configuration touch the Arrow icon in the Planmeca
iRomexis main menu.
Adding a new server connection
1. Click on the Add New Server field.
2. In the Add New Server dialogue enter the following information:

Server Name for Planmeca Romexis server
connection
Planmeca Romexis Server IP Address
Login Name
Login Password
Set as default
If you have multiple servers configured,

you can set the respective Planmeca Romexis
server as default.
It is possible to add multiple Planmeca Romexis server

connections to the server list.
3. To test the server connection click on the Test Server Connection button*.

NOTE Make sure Fire wall does not block the connection to the port 8083
which is used for the communication to Planmeca Romexis server.
NOTE Make sure class server is enabled in the Planmeca Romexis Server. On
how to enable the class server see section 6.1.2 “Class Server” on page
I-37.

3 ADJUSTING USER INTERFACE AND DATABASE
SETTINGS
1. Click on the Settings icon in the Planmeca iRomexis main window.
The following settings can be configured:
Show / Hide Image Dates
Show / Hide image comments in the image list.
Store patients locally in the iRomexis.
Store images locally in the iRomexis.
Use black image background instead of grey one.
Delete all local patient and image information in the

iRomexis.

4 VIEWING AND BROWSING IMAGES
To view patients and images click on the Patients field in the Planmeca
iRomexis main window.
Viewing Images stored in the iRomexis
In the Patients view, click on the Local tab to see the patients stored in
Planmeca iRomexis database.
Viewing Images Stored in the Local Planmeca Romexis Server
Click on the Server tab to see all patients on the connected Planmeca
Romexis server.
In order to view patient’s images, select a patient by clicking on the patient list
=> Patient data is transferred to iRomexis.
Browsing images
After selecting a patient browse the image list by sliding the screen up and
down with your finger.
Opening images
To open an image click on the image thumbnail.
Viewing images
Rotate the image by moving two fingers on a circular orbit on the screen.

Zoom in / out by moving two fingers towards / away from each other on the
screen.
Browse through a 3D image stack by using the slider on the right side of the
screen.

Change the rendering type for face images between Flat, Shaded and
Surface at the bottom of the screen.
Image processing tools
To store a snapshot of the current image to the Camera Roll [of the iPhone/
iPad] click on the camera icon.
To reset the image to its original state click on the Reset View icon.
To make distance measurement on the image click on the Measure icon.

Touch the screen with two fingers at the same time and drag them to the end
points of the desired measurement.
Click on the Brightness and Contrast icon and move your finger up and down
on the screen to adjust brightness and left and right to adjust contrast.

Planmeca Oy | Asentajankatu 6 | 00880 Helsinki | Finland
tel. +358 20 7795 500 | fax +358 20 7795 555 | sales@planmeca.com | www.planmeca.com

Romexis en

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Romexis en

Uploaded by

Copyright:

Available Formats

Planmeca Romexis ®

1 INTRODUCTION TO PLANMECA ROMEXIS IMAGING SOFTWARE A-1

2 STARTING PLANMECA ROMEXIS ..................................................... A-9

Chapter B PATIENTS & FILES MODULES

1 ALL PATIENTS .................................................................................... B-1

2 DICOM WORKLIST SEARCH .............................................................. B-8

User’s Manual Planmeca Romexis 1

6 DEMOGRAPHICS .............................................................................. B-14

Chapter C 2D IMAGING MODULE

1 PANORAMIC IMAGES ......................................................................... C-2

2 CAPTURING CEPHALOMETRIC IMAGES ......................................... C-7

4 CAPTURING INTRAORAL IMAGES ................................................. C-12

5 CAPTURING INTRAORAL IMAGES WITH PLANMECA

6 CAPTURING INTRAORAL CAMERA IMAGES ................................ C-24

8 TWAIN SETUP ................................................................................... C-27

9 TWAIN CAPTURE .............................................................................. C-30

2 Planmeca Romexis User’s Manual

11 DICOM IMPORT ................................................................................. C-32

12 DICOMDIR IMPORT ........................................................................... C-33

15 SETTING THE LAYOUT .................................................................... C-57

22 DICOM PRINT (OPTIONAL) .............................................................. C-75

26 PLANMECA ROMEXIS CEPHALOMETRIC ANALYSIS

User’s Manual Planmeca Romexis 3

31 IMAGE SPECIFIC TOOLS ................................................................. C-90

32 IMAGE PROPERTIES ........................................................................ C-94

Chapter D 3D IMAGING MODULE

1 INTRODUCTION .................................................................................. D-1

3 EXPLORER TAB .................................................................................. D-6

4 Planmeca Romexis User’s Manual

3.19 Adjust levels (contrast & brightness) .............................................................. D-48

4 PANORAMIC (PAN) TAB .................................................................. D-78

5 3D CROSS SECTIONS TAB .............................................................. D-84

6 IMPLANT TAB .................................................................................... D-91

7 TMJ TAB .......................................................................................... D-102

User’s Manual Planmeca Romexis 5

8 PROFACE TAB ................................................................................ D-105

9 FILE MENU ....................................................................................... D-137

Chapter E CAD/CAM MODULE

1 INTRODUCTION .................................................................................. E-1

Chapter F CLINIC MODULE

1 INTRODUCTION .................................................................................. F-1

6 Planmeca Romexis User’s Manual

3 UNIT MONITORING ............................................................................. F-7

4 DIAGNOSTIC LOG ............................................................................. F-13

5 DEVICE SUMMARY ........................................................................... F-15

6 INFO ................................................................................................... F-21

Chapter G ADMIN MODULE

2 DEVICE ALERTS .................................................................................G-8

3 DENTAL RECORD .............................................................................G-11

5 LOCAL SETTINGS .............................................................................G-28

User’s Manual Planmeca Romexis 7

5.5 External applications ....................................................................................... G-32

Chapter H REPORT MODULE

1 REPORT GENERATION ...................................................................... H-2

2 IMAGE VIEW ........................................................................................ H-3

Chapter I PLANMECA ROMEXIS CONFIGURATION APPLICATION

1 ENTERING THE APPLICATION ............................................................I-1

2 GENERAL SETTINGS ...........................................................................I-3

4 IMAGE & DATA MANAGEMENT ........................................................I-31

8 Planmeca Romexis User’s Manual

6 SERVER PARAMETERS .....................................................................I-39

APPENDIX A: ORDER SERVICES .........................................APPENDIX A-1

2 ORDERING SURGIGUIDE® DRILL GUIDES WITH