OnyxCeph3™ Software Manual · 2D and 3D image records in dental institutions – in particular...

Copyrights Image Instruments

Software Manual Version 3.1

Visual Diagnostics | treatment Planning | Patient Educationfor General Dentists, Orthodontists and Oral-Maxilofacial Surgeons

WindowsXP | WindowsVista | Windows7 | Windows8

instruments

Intended Purpose

OnyxCeph³™ is a powerful Client-/Server WindowsApplication with a SQL-type Database to work with 2D and3D image records. OnyxCeph³™ was primarily developed as an imagemanagement and image analysis software for dental units tosupport the work flow in image-based diagnostics, treatmentplanning and patient education in general dentistry,orthodontics, prothetics, implantology, and oral-maxillofacialsurgery as well.

Stand alone software OnyxCeph³™, developed, placed onthe marked and put into service by Image Instruments isintended to be used for the medical purpose of managingand diagnostically evaluating two-dimensional andthree-dimensional images in the framework of dentalapplications by qualified staff only.Diagnostic and therapeutic decisions cannot be motivatedexclusively or even mainly on evaluation results provided bythe software.

The intended medical purpose requires a correct registrationand activation of the software by the user.Unauthorized trial versions can only be used to becomefamiliar with the application acc. to its user interface andfunctionality but do not represent a medical product so far.

All rights reserved. No parts of this work may be reproduced in any form or by any means - graphic,electronic, or mechanical, including photocopying, recording, taping, or information storage and retrievalsystems - without the written permission of the publisher.

Products that are referred to in this document may be either trademarks and/or registered trademarks of therespective owners. The publisher and the author make no claim to these trademarks.

While every precaution has been taken in the preparation of this document, the publisher and the authorassume no responsibility for errors or omissions, or for damages resulting from the use of informationcontained in this document or from the use of programs and source code that may accompany it. In no eventshall the publisher and the author be liable for any loss of profit or any other commercial damage caused oralleged to have been caused directly or indirectly by this document.

Chemnitz, Juni 2015

OnyxCeph³™ - Digital Cephalometric Imaging Software

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OnyxCeph³™

Functionality and layout of the software Onyx Ceph³™ is aligned tothe work flow in orthodontic diagnostic imaging and treatmentplanning. Most of the implemented features can be customized.

The variety of diagnostic and treatment concepts in orthodontics andoral-maxillofacial surgery may require additional features.

Image Instruments is grateful for each such hint and will implementeach new feature that may improve the usability of the software.

Image Instruments GmbHOlbernhauer Str. 5D 09125 ChemnitzGermanyPhone +49 371 9093 140Fax +49 371 9093 149

Support

www.onyx-ceph.deinfo@onyx-ceph.de

Print date: 30.06.2015

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IContent

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Content1

I Welcome at OnyxCeph™ 2

II Standards and Definitions 4

................................................................................................................................... 51 Release Notes

................................................................................................................................... 62 EC Certificate of Conformity

................................................................................................................................... 73 Definitions

III Specifics 10

................................................................................................................................... 111 Prerequisites

................................................................................................................................... 122 Technical Limits of Applicability

IV Characteristics 15

................................................................................................................................... 161 New in Version 3

................................................................................................................................... 172 Functional Overview

................................................................................................................................... 193 Data Organization

................................................................................................................................... 214 Concept

................................................................................................................................... 225 Contractual Information

V System Requirements 25

................................................................................................................................... 261 Network Server

................................................................................................................................... 272 Network Clients

VI Installation Instruction 29

................................................................................................................................... 301 Client-/Server-Network

................................................................................................................................... 322 Stand-Alone Workstation

................................................................................................................................... 333 Interfaces

VII Registration Process 35

................................................................................................................................... 371 Step 1: Register as User

................................................................................................................................... 382 Step 2: Request Authorization

................................................................................................................................... 403 Step 3: Unlock Application

VIII Program Group Onyx3 Server 43

................................................................................................................................... 441 Onyx3Config

................................................................................................................................... 462 OnyxDBServer

................................................................................................................................... 493 Other Links

IX Program Group OnyxCeph 3 51

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................................................................................................................................... 521 OnyxAdmin

................................................................................................................................... 542 OnyxCeph

.......................................................................................................................................................... 55User Interface ......................................................................................................................................................... 56Main Menu

......................................................................................................................................... 56Menu Patient

......................................................................................................................................... 58Menu Edit

......................................................................................................................................... 58Menu View

......................................................................................................................................... 58Menu Communication

......................................................................................................................................... 60Menu Go To

......................................................................................................................................... 60Menu Options

......................................................................................................................................... 61Menu Help

......................................................................................................................................... 62Menu Exit......................................................................................................................................................... 63Select Lists

......................................................................................................................................... 63Practice List

......................................................................................................................................... 64Patient List......................................................................................................................................................... 66Tabs

......................................................................................................................................... 67Tab Patient

......................................................................................................................................... 69Tab Images

................................................................................................................................... 702D Data

................................................................................................................................... 73Add Image

................................................................................................................................... 73Capture Image

................................................................................................................................... 79Adjust Image

................................................................................................................................... 82Adjust

................................................................................................................................... 84Clone

................................................................................................................................... 85Edit

................................................................................................................................... 88Digitize

................................................................................................................................... 89Digitize Screen

................................................................................................................................... 98Perform Analysis

................................................................................................................................... 102Combine

................................................................................................................................... 106Mirror

................................................................................................................................... 108CO-CR Correction

................................................................................................................................... 110Treatment Simulation

................................................................................................................................... 111Simulation Screen

................................................................................................................................... 116Perform Simulation

................................................................................................................................... 124Ricketts VTO

................................................................................................................................... 126VTO Screen

................................................................................................................................... 135Perform VTO

................................................................................................................................... 136Superimposition

................................................................................................................................... 139Exchange Container

................................................................................................................................... 140Case Report

................................................................................................................................... 141Save

................................................................................................................................... 142Save As...

................................................................................................................................... 143Copy

................................................................................................................................... 144Delete

................................................................................................................................... 145Print

................................................................................................................................... 149Presentation

................................................................................................................................... 150Send To

................................................................................................................................... 151Mouse Mode

................................................................................................................................... 152Full-Screen

................................................................................................................................... 154Image Attributes

................................................................................................................................... 156Properties

................................................................................................................................... 1573D Data

................................................................................................................................... 160Add Image

................................................................................................................................... 161Clone

................................................................................................................................... 162Digitize

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................................................................................................................................... 163Combine

................................................................................................................................... 164Mirror

................................................................................................................................... 165Waefer Creation

................................................................................................................................... 166Model Base

................................................................................................................................... 167Segmentation

................................................................................................................................... 168FA_Bonding

................................................................................................................................... 169V.T.O.3D

................................................................................................................................... 170Wire_Bonding

................................................................................................................................... 171Custom Lab Modules

................................................................................................................................... 172Exchange Container

................................................................................................................................... 173Case Report

................................................................................................................................... 174Save

................................................................................................................................... 175Save As ...

................................................................................................................................... 176Copy

................................................................................................................................... 177Delete

................................................................................................................................... 178Print

................................................................................................................................... 181Presentation

................................................................................................................................... 182Sent To

................................................................................................................................... 183Mouse Mode

................................................................................................................................... 184Full-Screen

................................................................................................................................... 187Image Attributes

................................................................................................................................... 189Properties

......................................................................................................................................... 190Tab Presentation

................................................................................................................................... 191Slides

................................................................................................................................... 194Media

......................................................................................................................................... 195Tab Letters

......................................................................................................................................... 196Tab Forms

......................................................................................................................................... 198Tab Online

......................................................................................................................................... 199Tab Recycle

.......................................................................................................................................................... 200Settings ......................................................................................................................................................... 201Patient Data Tab......................................................................................................................................................... 203Sessions Tab......................................................................................................................................................... 204Image Types Tab......................................................................................................................................................... 208Galleries Tab......................................................................................................................................................... 210Presentation Tab......................................................................................................................................................... 212Printouts Tab......................................................................................................................................................... 214Forms Tab......................................................................................................................................................... 216Digitize Tab......................................................................................................................................................... 218Interfaces Tab......................................................................................................................................................... 220Third Party Tools Tab

.......................................................................................................................................................... 223Editors ......................................................................................................................................................... 224Use......................................................................................................................................................... 227Gallery Editor......................................................................................................................................................... 229Presentation Editor......................................................................................................................................................... 231Print Editor......................................................................................................................................................... 234Media Editor

................................................................................................................................... 2353 OnyxRegister

................................................................................................................................... 2364 OnyxUninstall

................................................................................................................................... 2375 Further Links

X Support 239

IVContent

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1Current Version

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Current VersionThis manual refers to software version:

3.1.138 (362)

Welcome at OnyxCeph™

Welcome at OnyxCeph™ 2

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1 Welcome at OnyxCeph™

OnyxCeph³™ is a powerful client/server Windows application with SQL database for processing of2D and 3D image records in dental institutions – in particular for image-based diagnostics, treatmentplanning and patient education in general dentistry, orthodontics, prosthodontics, implantology andmaxillo-facial surgery. Moreover, OnyxCeph³™ supports effective exchange of diagnostic andtherapeutic information between referring and treating doctors, between doctors and laboratories aswell as between doctor and patient. The optionally available statistics module allows statisticalanalyses as per selectable criteria spanning several practices.

OnyxCeph³™ can import, store, manage and evaluate treatment-relevant 2D and 3D image records. For this a consistent evaluation concept is applied that treats the information gathered by differentmethods as individual reproduction of the issue to be analyzed. This allows the parallel andconsistent use of traditionally established methods and new technologies within one and the samesystem.

OnyxCeph³™ manages all data practice - and patient related in an efficient SQL database. Theprogram can be used on stand-alone computers (e.g. on a notebooks or on a desktop PC at home)or in networks with central database on a server or with a computer serving as database server. Provided that the database server is unequivocally addressed and data transfer is adequately fastusing the program via internet is also possible.

This manual includes general, technical, and application information for the OnyxCeph³™ softwarepackage independent . A functional description of single parts and modules of the main applicationOnyxCeph³™ can be found in section User Interface .

Intended Medical Purpose:

Stand alone software OnyxCeph³™, developed, placed on the marked and put into service by ImageInstruments is intended to be used for the medical purpose of managing and diagnostically evaluatingtwo-dimensional and three-dimensional images in the framework of dental applications by qualifiedstaff only.Diagnostic and therapeutic decisions can not be motivated exclusively or even mainly on evaluationresults provided by the software.

The intended medical purpose requires a correct registration and activation of the software by theuser.Unauthorized trial versions can only be used to become familiar with the application acc. to its userinterface and functionality but do not represent a medical product so far.

Standards and Definitions

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2 Standards and Definitions

OnyxCeph³™ is classified as a Class 1 medical product. As per European Medical Device Directive(MDD), in a Conformity assessment procedure it was attested that a quality assurance system isapplied for final inspection.

Content of the Chapter

Release NotesCE-Declaration of Conformity Definitions

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2.1 Release Notes

This manual refers to release version 3.1.138 (362). If the version you currently use is other than thisversion, certain irregularities can come up between the descriptions given in the manual and thesoftware's actual functioning. The current release version of your software is stated within the infowindow of menu item Help|About...

In order to ensure operability and proper functioning of the software the user has to keep the versionup to date and, if necessary, update it. Information on the current release is available on the productwebsite www.onyxceph.de. Updating is done by means of the CD-ROM sent to registered users orvia online update.

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2.2 EC Certificate of Conformity

Konformitätserklärung | Declaration of Conformity

Wir | We:

Image Instruments GmbHOlbernhauer Strasse 5D 09125 ChemnitzGermany

erklären in alleiniger Verantwortung, dass das Medizinproduktdeclare on our own responsibility that the medical device

OnyxCeph™ Version 3

als Medizinprodukt der Klasse I mit Messfunktion allen zutreffenden Anforderungen der Richtlinie93/42/EWG (MDD), Anhang IX (Regel 12) entspricht.is a medical software class 1 with measuring function and meets all relevant provisions of theDirective 93/42/EEC (MDD), Annex IX (rule 12) which apply to him.

Angewandte Normen:Applied standards:

EN 62304Medizingeräte-Software - Software-Lebenszyklus-ProzesseEingestuft in Risikoklasse (Sicherheitsklasse) AMedical device software - Software life-cycle processesClassifies as Risk Class (Safety Class) A

Benannte Stelle | Notified body:

SLG Prüf- und Zertifizierungs GmbH (CE-Prüfstelle 0494) - Burgstädter Straße 20, D - 09232HartmannsdorfSLG Prüf- und Zertifizierungs GmbH (CE-Authority 0494) - Burgstädter Straße 20, D - 09232Hartmannsdorf

KonformitätsbewertungsverfahrenConformity assessment procedure

EG-Konformitätsbewertungsverfahren nach Medizinprodukterichtlinie (MDD) Anhang VI inZusammenhang mit Anhang VII, 5. EC Conformity assessment procedure according to Medical Devices Directive (MDD) Annex VItogether with Annex VII, section 5.

Datum | Date: 30.06.2015 Unterschrift | Signature:

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2.3 Definitions

Find here the definition for some of the terms and syntax elements often used in this manual.

Term Definition

Release Version Program Version, z.B. 3.1.R (B) | R = Release Number and B = BuildNumber

License Type OSL | RL+ | PPL

Installation Type Client-/Server | Stand Alone

Server Server-PC (Database)

Client Client-PC (Application)

SQL-Database Server SQL-Software for Database Control (SQL = Structured Query Language)

Client files Database Directory, Manages Current Client Files

Registration Application for Commercial Use

Authorization Unlocking

Re-Indexing Update of Links to Image Records in the Image Database Table

Standard Terms Terms Generated During Setup as per Language Settings

"AutoStart" Syntax for Texts and Comments

GUI Graphic User Interface

Home Client Standard Practice

Gallery Image Record Template (Multiple Images)

Presentation Presentation Template

Thumbnail Preview Images on |Images| tab

Slide Preview Presentations on |Presentation| Tab

Guidelines Reference Lines for Finding Up Landmarks (e.g. Tangent)

Image Types Image Classification as per Object (e.g. Photo Lateral Right, Ceph Left,FaceScan)

Image Classes Image Classification as per Status (Primary Image, Secondary Image,Modified Image)

Primary Image Primary Image of Several Images of the Same Image Type in One and theSame Session

Multiple Images Additionally Recorded Images of the Same Image Type in One and theSame Session (Secondary Images)

Treated Images Images Saved as Copy of Modified Images

Attributes Characteristics to be Assigned to Patient -, Session - or Image Data

Syntax Used for ...

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|Tab| Index Cards (GUI)

[Button] [Icon-Button] Buttons (GUI)

Update Images Menu Item

Link Cross reference within the Manual

Specifics

Specifics 10

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3 Specifics

The appropriate use of the software OnyxCeph³™ is bound to certain professional and technicalprerequisites that are described below. Extend and duration of the use of the software or of separatesoftware options as well as other legal licensing subjects are regulated by the license agreementthat has to be die accepted prior to installation. prerequisites

Prerequisites Technical Limits of Applicability

Specifics 11

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3.1 Prerequisites

Disclaimer of Warranty

All measurement -, simulation - and image processing tools available in OnyxCeph³™ merely serveto assist you in finding a diagnosis. All diagnosis and possible treatments must be based on clinicalknowledge and experience. OnyxCeph³™ does not lay claim to replace the diagnosis of thephysician.

Furthermore, we would like to point out that the results obtained by the measuring functions of OnyxCeph³™ can only be correctly calculated on condition of the object to be evaluated beingdigitally imaged in the focal plane without distortion. This has to be secured by means of appropriatecalibration of the image acquisition process or suitable correction of the digitally recorded images.

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3.2 Technical Limits of Applicability

Operating Systems

OnyxCeph³™ can be applied on computers with Windows™XP, Windows™Vista and Windows™7operating systems. Windows™2003 or Windows™2005 can be used as server operating system. Ifrequired, please contact the support for information on the conditions for using OnyxCeph³™ togetherwith other operating systems.

Installation

For installation of OnyxCeph³™ server and workstation the demands described under SystemRequirements have to be considered. The setup program for the installation is delivered on CD-ROM or provided as download. Installation can also be executed from other data mediums if thesetup was downloaded or saved there. In any case the program OnyxCDMenu in the main path ofthe installation folder, that allows calling the respective functions, can be executed.

Installing the software is effected in two separate steps: (i) installation of system environment anddatabase on the computer to be used as server and (ii) setup of the workstations on the same orfurther computers in the network.

The server installation requires administrator privileges. Setting up of local or network clients calls fora completed server installation and the start of the SQL database server OnyxDBServer.exe at theserver PC as service (recommended) or as program. For effecting the client installation the programOnyxClientSetup.exe has to be executed at the client PC. It can be started from the install CD orout of the database server's "Install" path on the server PC. If OnyxCeph³™ is to be used at severalworkstations in the network, the client installation has to be separately executed for each of them. Detailed installation instruction is available in the Installation chapter.

Network and Access Rights

The local application can be connected to the locale or distant database in different ways. Werecommend the use of the pre-set connection via internet protocol (TCP/IP). Separate sharing ofdirectories is not necessary.

Data transport between application and database is effected via port address 16300 (Standard). Thisport address must not be blocked by local security settings. It may be changed the programenvironment requires that. In case of questions, please, contact the support.

Data Formats

OnyxCeph³™ can read and process image records of different file types and file contents (see table). If required, the list of accepted formats is upgraded. All imported records are stored in theOnyxCeph³™ image database in JPG (2D) or II3 (3D) format. As per the HIPPA specifications andindependently of image type-specific settings concerning size and orientation the conformity of theoriginal image data changed.

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Record Type Record Format

2D External JPG; CMP; JPEG; JIF; CAL; PNG; GIF; BMP; TIF; TIFF; EMF; WMF;ICO; IMG; PIC; PICT; PCX; JBG; PSD; AVI;PANO; CEPH; RVG; SC; DC; STV; DIC; DCM

Internal JPG

3D External II3; III; 3DS; DXF; OBJ; PLY; O3M; PMH; BRE; BCD; STL; SOP; OFF;ZPR; [DICOM]

Internal II3

Volume data being transformed into surface data during import represents a specific characteristic. The rendering processes used reproduce the dimensional model as polygonal surface model that canbe used for measuring purposes so that quick and meaningful presentation as well as effectivestorage of the records becomes possible. Any model can be repeatedly rendered in order to detectdifferent material junctions.

Owing to the fact that depending on the type and functioning of the image source the signal intensity(gray scale value) reproduced in the volumetric element (Voxel) cannot unambiguously attributed tothe X-radiation's attenuation coefficient and the radiographed tissue the morphological informationenclosed in the gray scale distribution may provide additional hints for evaluation (e.g. cephalometry)and further processing (e.g. implant planning). For this reason a volumetric model is stored as acomponent of the II3 record when the volumetric record is rendered. The spacial resolution can bespecified depending on the respective record's specific. X-radiation's

Data Volume and Transfer Rates

Depending on the average size of the image data stored at the server, an adequate data transfer rateto the client is a basic requirement for satisfying work with OnyxCeph³™. In case of regular use ofvery large data volumes (e.g. records with several surfaces rendered from large CBCT volumes) thesetup of a separate Onyx server or a stand-alone workstation may be advisable.

Interfaces

OnyxCeph³™ supports several interfaces for direct data exchange with third party tools. Theseinterfaces allow interactive exchange of patient data or images or both. Full particulars on these topicare in the Configure Interfaces chapter or in the separate technical documentation.33

Characteristics

Characteristics 15

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4 Characteristics

OnyxCeph³™ represents a software for management and evaluation of image data within the scopeof visual diagnostics, treatment planning and patient education in dental and oral and maxillofacialsurgical applications. The system can be used locally or in networks and is executable onWindows™XP, Windows™Vista and Windows™7 operating systems as well as on Windows Serveroperating system. It is characterized by integration of an efficient SQl database, multilingualism andprogram maintenance regulated by the Medical Device Directives.

OnyxCeph³™ is a consistent refinement of the previous program version 2.X, whose functionality hasbeen complemented and improved and adapted to the current device-related realities. In addition,new diagnostic options as well as new systematic and specialist developments were included.

OnyxCeph³™ represents an independent part within the modular structured Dental Software Concept(DSC).

New in Version 3.X Functional OverviewData Organization Concept Contractual Information

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4.1 New in Version 3

In the middle nineties, initiated by potential users, we started development of OnyxCeph™ in closecollaboration of medical scientists and developers experienced in different fields of digital imageprocessing. Since that time the software has continuously been upgraded and adapted to thecurrent state of the technology while since an early state of the development we've beenconcentrated on a flexible client/server multiuser application with an efficient SQL database.In the course of the preceding proliferation of practicable imaging techniques for 3D diagnostics andconsiderable improvement in the field of graphics processors in customary PC systems thequalitative demands on concept, functionality and features of dental imaging software increased. Inaddition the changed organizational conditions in dental institutions had do be considered. We metthis situation by the development of the main version 3 of OnyxCeph™ .

Within the scope of the present product concept's enhancement we pursue a modular softwaredevelopment strategy with OnyxCeph³™. That means that basic functionality is developed andprovided as module without direct database connection and may be unlocked and used within aconfigurable host application. Owing to the fact that modules for patient management, healthinsurance billing and other purposes are to be provided on the same basis the resulting consistentprogram system should allow better adapting of dental practices' software environment to theirconcrete demand

As regards content, beside revision and upgrading of the established 2D functionality, OnyxCeph³™allows cephalometric diagnostics and visual planning by means of 3-dimensional records, such asCT scans, face scans and virtual dental casts for the first time. Furthermore, the user interface wascompletely reworked in close collaboration with long-time users as to ergonomic aspects and interms of standardized work routines, so that the use of the diverse program options got more lucidand easier.

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4.2 Functional Overview

The following table provides a survey of the OnyxCeph³™ 3.1 versions' functionality. The functionshighlighted in red are optional components that are offered for an extra charge.

License Version 2D Basic 3D Basic 2D Pro 3D Pro

SQL Database

Stand-Alone License

Network License 5/1 ( X/1 onRequest )

Patient Index

Imaging Module 2D

Image Archive 2D

Import (incl. External Sources,Digital XRay, etc.)

Adjust (Classify, Crop)

Digitize (Cephalometry 2D)

Combine

Mapping

Symmetry

Ricketts V.T.O.

Simulation/Morphing

Superimposition (incl. Björk, Bolton)

Imaging Module 3D

Image Archive 3D

Import (incl. Basic DICOMRendering)

Adjust (Classify, Crop)

Digitize (Cephalometry 2D|3D)

Presentation

Slide Show

Case Studies (Media Library)

Letters

Form Viewer (DHTML)

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Internal Browser

Recycle Bin

Container Exchange

PMS Interface

Image/Result Import/Export

Findings Lexicon

Database Backup

User Administration

Basic Support

Advanced Support

The Basic license versions are suited in particular for management, visualization and archiving of 2Dor 3d records, while the Pro versions, beyond that, provide comprehensive evaluation and planningfunctions.

Characteristics 19

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4.3 Data Organization

All data managed by OnyxCeph³™ is situated on the computer on which database and theassociated directories are installed (server). Whenever the application OnyxCeph³™ is started at theworkstation the locally required components are synchronized with the version protocol available atthe server and, if necessary, updated. So central synchronization of all clients in the network as wellas high efficiency of the locally executed application is ensured. Data transport between server and client is carried out via internet protocol so that local sharing ofdirectories with specific rights for the users is not necessary. Merely the availability of the portaddress (Standard: 16300) used for transport has to be ensured. The OnyxCeph³™ server directorycontains the directory structure described below.

Caution

Any manual changes to the directory structure may limit the software's functional capability and|or performance and result in irreversible data loss.

The System Directory ClientFiles

All programs, libraries, images and other files required for executing of the local application at theworkstation are stored in the ClientFiles directory. On server re-start the server program comparesthese files to the copy in the database and, if necessary, updates them. The database copy, in turn,is used for synchronizing the client files that is effected during any program re-start. Any update imports updated components into the ClientFiles server directory. In order to avoid re-starting the database server OnyxDBServer the required update of the server database can beenforced by deleting of the "!! DeleteToUpdate !!" item. The item is re-generated after updating.

The System Directory Install

The installation directory Install contains the client setup program OnyxClientSetup.exe, that has tobe executed once at any client to be established for setting up of the local working environment. Theclient setup program connects to the appropriate database server, generates the local workingdirectory Onyx3Client and optional link on the desktop and as program group. OnyxClientSetup.exe can be executed locally or via network. For proper functioning in the differentlanguages supported by the program the current dictionary OnyxDict.iid is required to be stored inthe same directory.

The Backup Directory Backup

The automatic or manual backup files configurable via user interface of the program OnyxDBServercan be stored in selectable directories. If data saving is additionally effected by an external backupprogram we recommend configuring the internal backup so that the database directory OnyxDB issaved in the Backup directory. This enables the external backup program to copy the Backup andPictures directories without problems due to the running SQL server accessing the OnyxDBdirectory.

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The Database Directory OnyxDB

Beside several system tables, the database directory OnyxDB contains identically structuredsubordinate directories for any independent client. These are the user himself (subordinate directoryClient_Home) and all other registered users of the software (subordinate directory ClientXY) whosedata was imported via Exchange function. Patient-related data is separately managed for each client.

The Image Directory Pictures

Analogous to OnyxDB the image data directory Pictures manages all image records (2D|3D) inpatient- and practice-specific subordinate folders. The name of the patient-specific foldercorresponds to the patient ID on the file card on the |Patient| tab. For any image stored in the folderthere is an image record in the table structure of OnyxDB with all information on the record.

Beside the subordinate directories described above the database server program OnyxDBServer aswell as several configuration and protocol files are in the server directory.

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4.4 Concept

Any OnyxCeph³™ license allows authorization of a network server with up to five simultaneouslyusable workstations (more than five on request) and an additional stand-alone workstation (e.g. homecomputer or notebook). This, however, requires that an identical practice name is used forregistration of both installations.

In dental institutions the software is normally used as client-/server-network application within thescope of a locally connected establishment. For this, OnyxCeph³™ is installed at the practiceserver by means of the server installation. At the workstations of the server's local network merelythe client installation is effected. data transfer between client and database server happens viaInternet Protocol in the local network (Wired-LAN or WLAN). The computers used for server andclient installations as well as the network connection between server and client should comply withthe requirements described under Prerequisites.

The additional stand-alone installation included in the license comprises server and client installationon a stand-alone computer. This enables working independent of the practice network. Transfer ofrecords between the practice's database and the local one can be effected by means of theexchange functionality. Complete synchronizations of two databases are not supported.

If certain technical prerequisites are fulfilled, (high data transfer rate for up- and downloads, static IPaddress at the practice server) the database server can be connected to the workstation PC viainternet.

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4.5 Contractual Information

End User License Agreement

FOR CONCLUSION OF AN END USER LICENSE AGREEMENT WITH IMAGE INSTRUMENTSGMBH ("IMAGE INSTRUMENTS") CLICKING THE BUTTON "I AGREE" AT THE END OF THEFOLLOWING TEXT INDICATING THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO THECONDITIONS OF THIS AGREEMENT IS REQUIRED.

1. Termination.

Either party may terminate this End User License Agreement ("Agreement") at any time withoutgiving reasons and report effective upon notice. On termination of that agreement the user has toimmediately remove the software and all information provided by IMAGE INSTRUMENTS from all hisequipment.

2. License.

A. IMAGE INSTRUMENTS hereby grants the user a nonexclusive, limited license to use thesoftware according to the terms and conditions of this agreement. B. The software may only be used by the user's employees, students or partners and/orphysicians who have privileges at the user's facility, who are trained or training in the fields thesoftware is used for ("Authorized Personnel"). However, the software may used for medicaldiagnoses and treatment planning only by competent healthcare or dental care professionals whorely on their clinical discretion and judgement in diagnosis and treatment. The user declares his soleresponsibility for ensuring the responsible and appropriate use of the software in view of all attendantcircumstances, indications and contraindications.C. The software is licensed for the internal use at the user's facilities only. That means the usermay not (i) copy, download, upload or in any other way duplicate except for (a) one (1) copy of thesoftware on the hard drive of the authorized hardware and/or one (1) copy of the software for backuppurposes only, (b) the copy and/or (c) the printout of a limited extend of the information provided bythe software for internal use only; (ii) sell, distribute, sublicense or provide access to a third party; (iii)compile or develop further; (iv) use or let use the software for the benefit of third parties includingholdings and subsidiaries without the express written consent of IMAGE INSTRUMENTS; (v) de-compile or disassemble any part of the software or (vi) modify remove any proprietary markings orrestrictive legends placed on it.

3. Property Rights/Confidentiality.

A. The user regards the software as a whole and any parts of it as confidential information("Confidential Information"). The user may not, nor permit others to, provide, disclose or otherwisemake such Confidential Information available to, or accessible by, any person other than AuthorizedPersonnel.B The user shall take appropriate security precautions to effect his obligations acc. to section3(A). The software, the copyrights thereupon and the trademarks utilized in connection therewith areand shall remain the sole property of IMAGE INSTRUMENTS.

4. Warranties/Disclaimer.

A. IMAGE INSTRUMENTS warrants that the information contained in the software has beenobtained from what it believes are reliable sources. However, except as stated above in thisagreement the software is provided "AS IT IS" and NO ASSURANCE OR WARRANTY; EXPRESS

Characteristics 23

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OR IMPLIED; IS MADE REGARDING THE SOFTWARE, INCLUDING, WITHOUT LIMITATION; ANYWARRANTIES FOR APPLICABILITY OR FITNESS FOR A PARTICULAR PURPOSE. NOWARRANTY IS MADE THAT THE SOFTWARE WILL PERFORM WITHOUT INTERRUPTION ORFREE FROM ERRORS.B. In no event IMAGE INSTRUMENTS or any distributor of IMAGE INSTRUMENTS is liable forany direct, indirect, incidental, special or consequential damages arising from or caused by the useof, reliance on or inability to access and use any information contained in the software, even if theuser has been previously advised of the possibility of such damages or losses.

5. Survivability.

Not withstanding the expiration or termination of this Agreement for any reason whatsoever, theprovisions of sections 3 and 4 shall survive and bind the parties indefinitely.

System Requirements

System Requirements 25

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5 System Requirements

Depending on license version and type of installation, to use OnyxCeph³™ with full functionality,certain system requirements have to be fulfilled. These requirements are listed and described below.

Network Server Network Client

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5.1 Network Server

Subsequent parameters describe minimal hardware and software requirements for the proper use ofthe OnyxCeph³™ network server in a Client/Server environment.

License Version 2D Basic | 2D Pro 3D Basic | 3D Pro

CPU Intel® 1.5 GHz (or equivalent) Intel® 1.5 GHz (or equivalent)

Memory (RAM) 512 MByte 1024 MByte

Available space onHD ¹

60 GByte 120 GByte

RAID recommended

Drives CD-ROM drive for installation (recommended)REV tape for external data backup (recommended)

Network 100 Mbps Ethernet 1000 Mbps Ethernet

OS ² Windows™XP, Windows™Vista, Windows™7, Windows™Server 2KX

Network Protocol TCP/IP must be installed

SQL ServerEnvironment

provided by the application

Port Sharing 16300 [changeable]

¹ The required HD space depends on number and size of managed image data records. An usefulassessment can only be made if these values are known. For conventional 2D photos and Xrays,about 1GByte for each 2000 photos can more or less be taken as a benchmark.

² The use of a Server-OS is not mandatory.

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5.2 Network Clients

Subsequent parameters describe minimal hardware and software requirements for the proper use of aOnyxCeph³™ network client in a Client/Server environment.

License Version 2D Basic | 2D Pro 3D Basic | 3D Pro

CPU Intel® 1.5 GHz (or equivalent) Intel®Core™2 DUO 2.4 GHz (orequivalent)

Memory (RAM) 512 MByte 4 GByte

System 32 Bit | 64 Bit 32 Bit | 64 Bit

Available space oHD

2 GByte 5 GByte

Graphic board standard Nvidia GeForce 8800 GTX (orequivalent)

NetworkHardware

100 Mbps Ethernet 1000 Mbps Ethernet

OS Windows™XP, Windows™Vista, Windows™7, Windows™Server 2KX

Network Protocol TCP/IP must be installed

SQL ServerEnvironment

provided by the application

Port Sharing 16300 [changeable]

Installation Instruction

Installation Instruction 29

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6 Installation Instruction

Installation of the software OnyxCeph³™ is equal for both installation types and effected in two steps:(1) Server Installation of Database and System Directories and (2) Setup of Client Workstations.

For integration of the hard- and software environment available at the user's practice the respectiveinterfaces have to be configured at the workstation.

Client-/Server-Network Stand-Alone Workstation Interfaces

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6.1 Client-/Server-Network

Server-Installation (Configure System and Database)

The first step of the installation is setting up of the required working environment as to program anddata structure on a computer that is permanently available at runtime of the application. This so-called server installation is carried out from CD-ROM within the scope of the current programversion's setup. Installation is also possible by means of an 1:1 copy of the CD's contents onanother data medium, e.g. after download of the install files as ZIP.

Insert the installation CD at the PC to be used as database server for the practice. Correctfunctioning of the software does not require server operating system at tis computer. If your diskdrive supports the AutoRun function the install menu pops up after a few seconds. Otherwise,please manually start the OnyxCDMenu file in the main path of the setup directory. Select the menu item Install Server. Carefully read the License Agreement and continue bymeans of the respective button. Do not proceed without having read the license agreementcompletely and having agreed. Abort the installation process in case you haven't understoodsingle points of the agreement or you cannot agree to them. Select the installation's target position in the next window. You may accept the proposed path(recommended) or specify another position. The SQL database server OnyxDBServer is installed and started as service as soon as the serverinstallation is finished. Later, you may selectively execute it as service or program.

Starting the database server finishes the server installation process. According to the optionsselected in the install dialog the setup generates a program linkage via desktop icon and a quick-start linkage in the Windows task bar in addition to the program group Onyx3Server in theWindows start menu.

Client-Installation (Setup Client Workstations)

Setting up an Onyx workstation can be done at any PC that is connected to the server PC and canaccess the database by TCP/IP connection via port 16300. For installation merely the programOnyxClientSetup.exe and the Onyx dictionary OnyxDict.iid for proper language assignment have tobe available in one and the same path. The server installation stores both files in the databasedirectory's subordinate Install directory on the server PC. Alternatively, calling the OnyxClientSetupprogram is possible out of the Install Splash of the setup CD or from any data medium the OnyxClientSetup had been copied to.

Start OnyxClientSetup out of the respective directory and click the [Install] button. Then thenetwork is searched for running OnyxCeph³™- database servers via port 16300. Depending on thenetwork's complexity this may last some seconds or minutes.

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All server connections found for the protocols TCP/IP and Named Pipes are listed in a dialog. There, the database server to be used has to be selected via the name of the respective server inthe TCP/IP column and assigned by the [Connect] button. The use of Named Pipes is onlyrecommended in exceptional cases if TCP/IP is not available. After that the directory of the client installation can be adopted or changed. We recommend theuse of the proposed install directory. Subsequently the setup of the workstation is effected. After successful installation the start of theprogram at the workstation is offered in a separate dialog.

The client installation generates the OnyxCeph3 program group in the Windows Start menu and ashortcut via desktop icon.

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6.2 Stand-Alone Workstation

Setting up of a stand-alone workstation comprises the server and client installation as per theprocedure described in topic Client-/Server-Network on a stand-alone computer, e.g. for using ofOnyxCeph³™ on a home PC or notebook that is not connected to the practice's network and has noaccess to the network server.

If a computer with OnyxCeph³™ stand-alone installation is in the practice network it can selectivelylinked to the local database or to the practice database accessible via network without repeatedclient installation. In order to open the database selection dialog the STRG key has to be held whenthe program OnyxCeph³™ is started. For elimination of version conflicts the local workstation issynchronized with the database server's current program version.

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6.3 Interfaces

The configuration of internal interfaces to practice management systems, imaging systems andimage databases as well as connection of external programs is described in the technical manual,which is available as a separate component of the help documentation. Information on interfaces isalso available in topic Settings under program description ONYXCEPH%>.200

Registration Process

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7 Registration Process

For testing the suitability of the software OnyxCeph³™ it can be installed and used as trial version ona limited scale. Working with this trial version is limited to loading and evaluation of a total ofmaximum 100 image records for max. 10 patients. Pre-installed patient and image records areincluded in this limit. Several functions, such as data exchange and printing, are inactive in trialmode. A message window announcing the expiration of the trial period appears in regular intervals. This message window also appears before expiration of a temporary license. The software's certification as a medical product is not valid for the unregistered trial version. For thisreason, commercial use of results achieved by the unregistered trial version is not allowed.

The commercial use of OnyxCeph³™ with full functionality of the license version chosen requires thefollowing two steps:

(1) Registration of the Software by the User(2) Authorization by the Manufacturer.

Prior to registration the server installation has to be effected. Authorization of the registrationrequires the purchase of one of the license versions available.

User registration and authorization is effected by means of the program OnyxRegister which canbe called from the wokstation's OnyxCeph™ 3 program group or via menu item options directly fromthe application OnyxCeph³™. This program is also used for extending an authorized installation orfor renewing the registration after expiration, e.g. for OSL license type.

License Type Description

OSL Open Subscription License - Temporary Subscription (Standard: 12Months)

PPL Partial Payment License - Unlimited Installment License ¹

RL+ Perpetual License - Unlimited License

¹ Only Available for Specific Countries.

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Content of the ChapterStep 1: Register as User Step 2: Request Authorization Step 3: Unlock Application

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7.1 Step 1: Register as User

In Step 1 of the OnyxRegister program, please, complete all fields of the registration form. Pleasenote that the practice name is cAsE-SeNsItIvE and must consist of 10 to 80 characters. Aftercompleting all input fields go to Step 2.

Form Field Description

Pratice Name ¹ name of the institution - min. 10 | max. 80 characters.

Name ¹ last name of the licensee

First Name first name of the licensee

Title title of the licensee

Post Code ¹ zip code of the institution

Address ¹ street of the institution

Country ¹ country (not federal state)

Town ¹ town of the institution

Phone 1 ¹ preferential phone number of the institution including country and area code

Phone 2 alternative phone number of the institution including country and area code

Fax fax number of the institution including country and area code

Email email address of the institution

Internet homepage of the institution, if available

VAT-ID VAT-ID of the institution, if available

Lizense (selectlist) ¹

desired license type [OSL (subscription) | RL+ (purchase)]

Version (selectlist) ¹

desired license version [2D Basic | 2D Pro | 3D Basic | 3D Pro]

Payment (selectlist) ¹

desired payment method [bank transfer | credit card | check]

¹ mandatory fields

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7.2 Step 2: Request Authorization

In Step 2 of the OnyxRegister program all data entered in Step 1 as well as installation details aredisplayed. Please check the particulars entered (in particular the practice name) once again andadjust them, if necessary, by returning to Step 1. In Step 2 adjustment is not possible.

If all entries are correct, select a method for data transfer to the software producer by the [File],[Clipboard] or [Email] buttons. Prior to the first registration you have to select the type¹ of yourinstallation to be registered (network/practice server or stand-alone workstation/notebook). Data transfer can, of course, also be effected by phone or fax.

¹ Each license (OSL, RL+) comprises authorization of one network server with up to 5simultaneously usable workstations and one additional stand-alone workstation. This, however,requires an identical practice name for registration of both installations.

Particulars Description

Practice Name ² the practice name entered in Step 1

Install Code the install code automatically generated during server installation

Key Version the key version automatically generated during server installation

Check Sum check sum of the practice name, eliminates typing errors in case of datatransfer by telephone

Server Name the computer name of the server

License Version ² the license version designated in Step 1 [2D Basic | 2D Pro | 3D Basic | 3DPro]

² These particulars can be edited in Step 1

Transfer Description

File(recommended)

save the registration data as file, that is attached to an email and sent to register@onyx-ceph.de

Clipboard copy the registration data to the Windows-Clipboard, paste it into an emailand send to register@onyx-ceph.de

Email direct dispatch of an email containing the registration data to register@onyx-ceph.de. This method only works with an Outlook-Express email client on the relevantcomputer.

According to this registration request you receive a license key by email. Type or copy it into Step 3to effect the authorization. The responding email is not automatically generated. That means that,depending on time zone and weekday, up to 48 hours may elapse between sending the request andreceiving the reply. You can close the registration dialog after sending the request and open it againafter receiving the key.

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7.3 Step 3: Unlock Application

After receiving the license key, it can be typed, copied or loaded from file in Step 3. After enteringthe license key carefully read the license agreement and continue by pressing the [ I Agree ] button. Do not continue the authorization before having read and agreed the license agreement completely. Abort the authorization if you do not understand or agree every item of the agreement.

Now, click the [Registration] button. Initially the SQL workspace is created. After that you get amessage that the authorization was successfully completed and that you may display the licensestate again.

In case of errors occurring during the authorization, please, contact the technical support.

Each field has to be filled with exactly 5 characters. If you made a mistake when typing the key,mark the wrong character or the entire field and delete the marked content by the DEL-key on yourkeyboard or the Delete item of the context menu over the relevant input field.

In case of the message "Error in Key or Practice Name" after pressing the "Registration" key,please, check that the key is correctly typed and that the entries in the green fields of Step 2agree with the particulars in the authorization form.

After receiving the license key, it can be typed, copied or loaded from file in Step 3.

After entering the license key carefully read the license agreement and continue by pressing the [ IAgree ] button. Do not continue the authorization before having read and agreed the licenseagreement completely. Abort the authorization if you do not understand or agree every item of theagreement. By button [Save License Agreement] you can save the agreement text on file.

Now, click the [Registration] button. Initially the SQL workspace is created. After that you get amessage that the authorization was successfully completed and that you may display the licensestate again.

In case of errors occurring during the authorization, please, contact the technical support.

Each field has to be filled with exactly 5 characters. If you made a mistake when typing the key,mark the wrong character or the entire field and delete the marked content by the DEL-key on your

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keyboard or the Delete item of the context menu over the relevant input field.

In case of the message "Error in Key or Practice Name" after pressing the "Registration" key,please, check that the key is correctly typed and that the entries in the green fields of Step 2agree with the particulars in the authorization form.

The same authorization sequence will work only once - thus, there is no need to keep the key forlater use.

Authorization can be performed on any OnyxCeph³™ client but will work for all clients within thenetwork of the same database server thereafter.

Program Group Onyx3 Server

Program Group Onyx3 Server 43

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8 Program Group Onyx3 Server

The program group OnyxCeph™3 created by the server installation contains the links to thedatabase server program OnyxDBServer.exe as well as different functions required at the server.

OnyxConfigOnyxDBServer Other Links

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8.1 Onyx3Config

The utility program Onyx3Config offers a quick overview of authorization, the database's status andthe SQL database server's operation mode. The program is started out of the Onyx3 Server program group of the server computer's Windowsstart menu.

For a quick survey of the status of the SQL database server OnyxDBServer.exe and adjustment ofthe appropriate settings the program Onyx3Config can be started at the server. The program windowshows by means of color and text information

Type and Validity of the LicenseStatus of the Database (Active | Inactive)Operating Mode of the Database Server (Service | Program)Status of the Service (if Installed)Availability of Updates

Via the buttons of the Server Control panel it allows changing the operating mode as well asinstalling and uninstalling the Windows service. Additionally, available updates can be searched andinstalled via online download.

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Do not start, stop or close the service OnyxDBServer via service dialog. Use program Onyx3Configfor such purpose instead which can be launched from a desktop link or from program group Onyx3Server. This way, all server controls can be configured easily.

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8.2 OnyxDBServer

The utility program OnyxDBServer is used for settings concerning database access, databaseadministration and data storage. The program is started out of the Onyx3 Server program group of the server computer's Windowsstart menu.

Basic requirement for using OnyxCeph³™ is the SQL database server OnyxDBServer.exe beingactive as process on the server. OnyxDBServer runs as Windows service in standard operation butcan be started as program, too. Starting it as program is necessary for display of the SQL server'ssettings dialog and adjusting its configuration or backup settings. For normal operation activating theOnyxDBServer as service is recommended so that the programs can be used at the workstations inthe network without active login at the server. If you launch OnyxDBServer.exe directly, you can select by buttons if the database server should runas a program or as a service. However, it is strongly recommended to use program Onyx3Config onlyto control the execution type of the database server application.

Caution

Do not close the process OnyxDBServer.exe in the Windows Task Manager as this may lead todata loss or damage of database items. It is also not necessary to use the Windows ServiceAdministration. In order to close the service, use program Onyx3Config which you can find inprogram group Onyx3Server.

Settings

For changing the settings of database server or backup program OnyxDBServer.exe has to bestarted as program. For this, please, use the following approach:

Current Start Type Procedure for Start as Program

OnyxDBServer runs asservice

call OnyxDBServer from the Onyx3Server program group at the serverPCclick [Close Service and Start as Program] buttonmaximize server dialog by clicking the server icon in the task bar'ssystem tray

OnyxDBServer runs asprogram

maximize server dialog by clicking the server icon in the task bar'ssystem tray

OnyxDBServer isinactive

call OnyxDBServer from the Onyx3Server program group at the serverPC

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click [Start as Program] buttonmaximize server dialog by clicking the server icon in the task bar'ssystem tray

The OnyxCeph³™ database server comprises 7 tabs with different status information on programand database. Settings are only possible on the |Settings| and |Backup| tabs.

Subordinate Tab on |Settings

Description

|Options| Language selection for the server program. By the settings button¹translation of standard texts (e.g. image type names) into the languageselected can be compelled.

|Start Options| The database server is displayed under the name of the server computerin the network. It can be individualized by means of annexes in order toavoid mix-ups in networks with multiple databases. In addition, different options for the program start can be defined here. The option "Automatically Start Server Program when the Computer isBooted Up" must not be selected if the database server is installed asservice.

|Directories| Setting of the directories for database and image folders². Changing thedatabase directory is only possible if the SQL server is stopped ([StopServer] button).

The settings button¹ calls re-indexing of the database in case of loss ordamage to the relevant directories.

By the [Update Installation Files] button an update of the client installationfiles can be compelled. Then, the database entry used for version

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adjustment during program start at the workstation is updated by meansof the contents of the ClientFiles system directory.

|Connection| Setting of the port address used for IP communication with clientapplications or the server. The port address can only be changed if theSQL server is stopped ([Stop Server] button).

Subordinate Tab on |Backup|

Description

|Manual| Settings for manual data backup. The button [Start Backup Now]activates the backup. The [Recover Data] allows importing of backupfiles.

|Mo| ... |Su| Settings for automatic data backup. These settings can be madeindividual for any day of the week. In addition, the redundancy of dailydata backup can be specified.

Caution

During data recovery by import of a manually or automatically generated backup file the currentdatabase is overwritten. Prior to importing a backup file, if possible, please, execute a completemanual backup of your data in order to be able to restore the current state if indicated.

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8.3 Other Links

OnyxCeph³™ on the Internet

The OnyxCeph³™ shortcut on the internet opens the OnyxCeph™ homepage in the standardbrowser installed. Please, use this link for information on the latest software developments and thecurrent program version.

Service Dialog

The service dialog enables quick access to the Windows services list. Settings concerning theservice associated with the OnyxCeph³™ Database Server item can be checked and, if necessary,adjusted there.

Program Group OnyxCeph 3

Program Group OnyxCeph 3 51

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9 Program Group OnyxCeph 3

The program group Onyx3 generated by the client installation contains links to programs of the Onyxprogram group and further valuable links.

The OnyxCeph™3 program group generated during client installation comprises the links to thedatabase server program %ONYX%>DBServer.exe that are subsequently described as well asseveral functions required at the server.

OnyxAdmin OnyxCeph OnyxRegister OnyxUninstall Other Links

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9.1 OnyxAdmin

The utility program OnyxAdmin can be used for administration of the access to internal data andsettings during work with OnyxCeph™ by means of login-dependent assignment of privileges.Starting the program is done out of the OnyxCeph³™ program group of the Windows start menu.

The program OnyxAdmin enables a user logged-in as Onyx administrator to generate user accountsfor the work with OnyxCeph³™ and assign certain privileges. If the administrator activates the useradministration, using specific programs and functions requires signing on with user name andoptional password and is limited to the privileges defined for the used login. The user administration was developed for larger institutions in order to meet their privacy protectionrequirements and to limit maloperation and misuse opportunities. The holder of the respectivelicense decides on the need and the extend of regimentation by the program OnyxAdmin.

Administrator Panel

Via [Change Administrator´s Password] button of the administrator panel an Onyxadministratorpassword can be generated and edited. The [User Management Active] check box allows activatingand deactivating of the user administration by the administrator.

User Panel

The following privileges for imaging applications can be assigned or rejected in the user panel:

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0. Edit Patient Data1. Edit Treating Doctors List2. Delete Patient Records3. Generate New Findings4. Edit Findings5. Delete Findings6. Copy Findings7. Print8. Export Records9. Generate ReportsA. Effect RegistrationB. Edit PasswordsC. Define AnalysesD. Generate StatisticsE. Configure SystemF. Review All Treating Doctor's Images

Alternative to privilege F., in column [Treating Doctor] single doctors from the list can be specifiedwhose images can be reviewed by the respective user. The [Password] column shows a key symbolif the user generated an individual password for login. This password can be reset in the useradministration by the administrator but it cannot be reviewed.

User List

The buttons [Add User], [Copy User], [Delete User] as well as [ ] and [ ] allow editing of useraccounts with individual settings concerning login, description and privileges.

In case of activated user administration the user has to login with user name and password when theprogram is started.

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9.2 OnyxCeph

The main program OnyxCeph™ provides all functions for patient-related image acquisition, imageadministration, evaluation, planning, communication and patient education. Starting the program is done via linked icons on the desktop or in the Windows task bar or out ofthe OnyxCeph³™ program group of the Windows start menu. OnyxCeph™ can also be calledfrom the practice management software.

The descriptions of the program's functionality are arranged in the main chapters User Interface ,Settings and Editors . The user interface chapter offers information on calling and use of theseperate functions, whereas the settings chapter explains how the application can be adjusted to theworkflow and the hard- and software environment of the practice.

User InterfaceSettingsEditors

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9.2.1 User Interface

The graphic user interface (GUI) of the main program OnyxCeph™ consists of the operating controlsStart button (opens Main Menu) , Select Lists and Tabs . According to that selection theworkspace below shows the patient list or the content of the respective tab together with theappropriate icon bar.

In the status bar at the bottom of the work area details concerning the patient record selected aredisplayed. At the right the used database server is stated.

Structure

Main MenuSelect ListsTabs

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9.2.1.1 Main Menu

The OnyxCeph™ main menu is accessible by a left mouse click on the Onyx start button. It comprises the items

PatientEditViewCommunicationGo ToOptionsHelpExit

with the related submenus. As is the rule in modern Windows applications access to the functionsof the program menu is also provided by graphic operating controls or by context menu items andfunctional modules within the tabs. The menu item Options for changing and adjusting basicsettings of the system is an intentional exception. All menu items and submenus can be accessedby mouse and/or keyboard (arrow keys, shortcuts).

Menu item Options|System Options which may be frequently needed for configuration purposes canbe additionally opened by a right mouse click on the Onyx start button.

9.2.1.1.1 Menu Patient

New Patient (Ctrl+N)

The item New Patient opens an empty file card in the Patient tab. The particulars in the specifiedfields can be manually filled in or adopted from exteral programs (e.g. from patient managementsystems or databases of image management systems) via preconfigured interfaces. For creating anew patient record completing at least the master data fields

Patient's IDLast NameFirst NameGenderDate of Birth

highlighted in yellow and confirming the entries by the Save Data button is required.

see also: Full Screen .

Image Attributes Opens the Image Attributes dialog.

Properties Displays the image record properties in the Properties dialog .

The subordinate menu of the [Settings] button or the context menu above the album's backgroundallow selection and configuration of three available album views. The selection of album backgroundcolor and thumbnail size (fix or smooth) can be performed using the controls on the right end of thestatus bar.

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Other settings (image specifics and types, tracing options) are configured on tab |Session| in systemoptions.

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Add Image 2D Module

Purpose Dialog for Acquiring and Adjusting of Patient-Related Images

Image Types All

Call Icon Button | Context Menu Above Thumbnail |Main Menu |CTRL+2

For adding new images to the %ONYXCEPH3%> image database or adjusting available images theimage capture dialog has to be opened via [Add Image] icon button. There, the subordinate tabs |Capture Image | and |Adjust Image | are available. In addition, the image capture dialog allowscreating, managing and deleting of sessions.

Capture Image Tab

Selecting the source of the images to be captured, allocating the images to the appropriate sessionand assigning them the correct image type represents the first sub-step of acquiring new images forthe current patient. Image attributes and comments can be optionally assigned.If the image source contains images of more than one patient (e.g. all patient images of one day on acamera's memory card), switching to another patient can also be effected within the image capturedialog.

At its right and left side the icon bar at the upper margin of the window contains partly grouped iconbuttons.

Icon Buttons

Leave image capture.

Create new session.

Edit record series|session.

Delete record series|session.

Save current state.

Switch to another patient within the image capture dialog.

Adopt image/images from directory.

Adopt image/images from clipboard.

Get image/images from scanner|Twain source.

Get image/images from digital X-Ray source.

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Get image/images from VDDS partner.

Capture image/images by video camera.

Get image/images from external source.

Show/hide image types panel.

Show/hide serial import panel.

Show/hide image source panel.

Open help for |Capture Image| tab.

The current patient's master data is displayed in the status bar at the lower margin of the window.

Image Properties Panel

The image properties panel allows assigning of

Date of Acquisition Image AttributesNotes

to the images marked in the album panel. These properties can be reviewed above the context menuof the respective thumbnail in the album of the |2D|Images| tab. Image attributes can be used asfilter criterion in the statistics module.

The date of acquisition is adopted from the image source. Altering the date of acquisition mayresult in miscalculation of the patient's age, which can affect single evaluation - or planning stepsagain. The date of acquisition does not influence the allocation to a record series/session. Eachsession has an individual date. The date of acquisition should only be changed if the image source assigns a wrong date.

Image Types Panel

The image types panel shows all image types activated in the |Image Types| tab of theOptions|System Options dialog in the categories

ImageX-Ray

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IntraoralModel.

The icons allow assigning of the appropriate image type to the thumbnail in the album panel. Allocation is effected by Drag&Drop of pre-selected thumbnails to an image type icon or of an imagetype icon to an arbitrary thumbnail. Size and arrangement of the thumbnails can be set via context menu. The panel width can beadjusted to the desktop size by means of the vertical splitter. The double-arrows right of the relevantcategory name as well as the panel context menu allow expanding or collapsing the image typecategory view.

For checking the correct assignment of image types all thumbnails of the respective image type arehighlighted in the album panel as soon as an image type icon is selected.

Album Panel

In the album panel all the patient's 2D image record are displayed as thumbnails grouped accordingto record series (sessions). Sessions can be managed by means of the icon buttons [NewSession], [Edit Session] and [Delete Session]. The current session is highlighted by means of abackground color.

Any session can be assigned a type, date, attributes, title and a free text comment. The followingsession types can be selected

InitialObservationProgressFinalPost Treatment

Designation and sequence of the sessions can be adjusted in the |Sessions| tab of the Options|System Options dialog. Each session type can be used as often as required as long as thesession date differs. Session attributes, titles and notes represent optional additional information.

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Prior to assigning images to a session the session must be created unless the image acquisition iseffected in so-called Auto-Series-Mode (selectable via context menu of the image source panel),which automatically creates the sessions on the basis of the image records' dates.

The sessions panel shows newly acquired unclassified , newly acquired classified and alreadysaved in the database images. By assigning an image type an unclassified image gets classified;by saving a classified image is adopted to the database. The image type "Without Type" can beoptionally assigned if there are unclassified images in the image capture dialog when saving.

The thumbnails can be rearranged within the album panel by Drag&Drop. The thumbnail size can beadjusted to the desktop size by means of the respective slide control.

Context Menu Album Panel

New Record Series[CTRL+N]

Create new session.

Edit Record Series[CTRL+E]

Edit record series|session.

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Delete Record series[CTRL+Del]

Delete record series|session.

Adjust Image Go to subordinate |Adjust Image| tab.

Primary Define the image as primary image of several images of the same typewithin one and the same session.

Delete [Del] Delete the image from the album. ¹

Thumbnail Size Set fix thumbnail size: 48x48 | 64x64 | 80x80 | 96x96.

Change Record Series Assign image to another record series (analogous to rearrangement viaDrag&Drop).

Sort By Sort criterion for sequence within one record series: Type | Date | No Sort.

Sort Direction Sort direction acc. to sort criterion: Ascending | Descending.

Select All [Ctrl+A] Mark all thumbnails of the album selected.

Select None Mark no thumbnail selected.

¹ newly acquired images are faded out; saved images are dragged to the Onyx recycle bin.

Source Panel

The source panel shows the currently selected image source directory. In case of the database of athird party tool being selected as image source the panel stays empty. The |Restore Last Directory|button opens the most recently used directory and shows its content within the source panel.

Serial Import Panel

Via context menu and Drag&Drop of image type icons the serial import panel allows defining ofseries of images for importing an appropriate number of images from the source preview panel by the[Start Batch: "Name"] button, which supersedes manual assignment of image types. There is nolimit to the number of series. They are activated by means of the arrow buttons [Previous Set:"Name"], [Next Set: "Name"].

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Context Menu Serial Import Panel

Add Batch Define new image type sequence.

Rename Batch Rename image type sequence.

Clear Batch Delete the content of the batch - keep name.

Delete Batch Delete entire image type series.

Source Preview Panel

Assigning of new images from the source panel is effected via Drag&Drop of one, sveral or all previewimages or via double-click on one of the preview images. According to the import options set viacontext menu of the source panel the images are dragged from the source panel to the appropriatesession within the album panel. In case of the context menu option Auto-Series Mode beingselected Drag&Drop can be effected at any position of the album.

Context Menu Image Source Panel

Show Full Screen Shows the focussed preview image in full screen mode.

View Style Report | List | Array.

Sort by Sort criterion for display within the record series: Name | Date | Width |Height

Sort Direction Sort direction acc. to sort criterion: Ascending | Descending.

Select All [Ctrl+A] Mark all preview images selected.

Clear Selection Mark no preview image selected.

Delete Focussed Image[Del]

Delete the image selected from the source.

Options ... Auto-Series Mode | Hide Marked Images | Delete Marked Images

The changes applied within the |Capture Image| tab can be saved by the |Save Image Data| button.

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The |Exit| button closes the image capture function.

Adjust Image Tab

The second (optional) sub-step of acquiring of new images is adjusting the classified images in termsof size, orientation and quality separately as well as interdependently. Going to the subordinate |Adjust Image| tab can be effected by clicking the tab or via context menu of the album panel. According to the number of thumbnails selected the single image view or the most recently usedmultiple image (gallery) view appears within the |Adjust Image| tab. The single image view can alsobe opened via double-click on a single thumbnail.

At its right and left side the icon bar at the upper margin of the window contains partly grouped iconbuttons.

Icon Buttons

Adjust/Align set of images | gallery templates selectablefrom pull-down.

Adjust/Align single image | templates selectable from pull-down.

Activates mouse-adjust-mode Brightness | Contrast | Hue | Saturation.

Transfers an image's hue to another one by Drag&Drop (Hue Match).

Opens a dialog for manual correction of red eyes.

Activates horizontal|vertical reference lines (image type-specific and/or free).

Rotates the image 90° to the left.

Rotates the image 90° to the right.

Rotates the image 180°.

Mirrors the image vertically.

Mirrors the image horizontally.

Inverts the image.

Resets Zoom | Offset | Rotation | Color Correction | All

Opens help for |Adjust Image| tab.

The current patient's master data is displayed in the status bar at the lower margin of the window.

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Adjust / Align Single Image

For the display of a single image the width-to-height-ratio (Aspect Ratio - AR) defined in theappropriate image type properties is applied. For adjust-/alignment the horizontal and verticalstandard reference lines (Default Lines) that are also defined in the image type properties or freereference lines can be activated and used. The free reference lines stay active for the respectiveimage type until their position is changed. The active image can be displaced, rotated and zoomed. The respective functions are available viamouse-down over specific image areas and are indicated by different cursor icons. In addition, theicon buttons at the upper right margin of the window allow adjusting of alignment, brightness|contrastand hue|saturation as well as correction of red eyes. All changes to the image are saved asparameters of the image record in the database and are applied anytime the image is opened againwhile the original image remains unchanged. The context menu over the image panel allows resetting of single or all changes.

Move image (within incircle)

Rotate image (out of incircle)

Zoom image (slider left|right) - alternative: scroll wheel

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Adjust / Align Set of Images

Parallel adjust-/alignment of several single images has the advantage that the view of appurtenantimage types can be mutually adjusted and corrected. The user-defined layout templates (gallerytemplates) can be selected from the pull-down. Any single image in the gallery can be modified asdescribed above. Free reference lines stay available for the respective template until their position ischanged.In addition, the [Adapt Image Histogram] icon button allows transferring the standardized dyedistribution from one image to another. The context menu over the relevant image allows resetting ofsingle or all changes.

If there are several images of the adjusted image type in the current session they can beinterchanged via context menu. The current state can be saved or discarded when switchingbetween single and multiple image adjust-/alignment and between images of the same type.

Leaving the |Adjust Image| tab is done by going back to the |Capture Image| tab.

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Adjust Image 2D Module

Purpose Dialog for Adjusting of Single Images

Image Types All

Call Icon Buttons | Context Menu Above Thumbnail

The function Adjust Image allows fast and easy correction of image type, image properties andimage settings without calling the function Add Image again. Correcting the image type is done by clicking on the appropriate image type icon in the list. Itslayout can be adjusted via context menu. Image properties (date, attributes, notes) can be made upor adjusted within the according panel. For adjusting of image settings (size, position, rotation,orientation, brightness, contrast, hue, saturation, red-eye correction, inversion) icon buttons andmouse functions are available. .

The changes applied are adopted to the database by the icon button [Save Changes] or when thewindow is closed.

Icon Buttons

Save Changes Saves the changes applied

Adjust ImageColors

Activates the Brightness | Contrast | Hue | Saturation adjustment mode

Red-EyeReduction

Opens a dialog for manual correction of red eyes

Show LinesActivates horizontal|vertical reference lines (image type-specific and/orfree)

Rotate ImageLeft 90°

Rotates the image 90° to the left

Rotate ImageRight 90°

Rotates the image 90° to the right

Rotate Image180°

Rotates the image 180°

Flip Image Mirrors the image vertically

Mirror Image Mirrors the image horizontally

Invert Image Inverts the image

Reset All Resets Zoom | Offset | Rotation | Color Correction | All

Help Opens help for the Adjust function

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Image Field - Context Menu

Reset Resets Zoom | Offset | Rotation | Color Correction | All

Rotate Rotates the image 90° left | 180° | 90° right

Flip Mirrors the image vertically

Mirror Mirrors the image horizontally

Invert Inverts the image

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Clone Image 2D Module

Purpose Duplicate Image Record

Image Types All

Call Icon Button | Context Menu Above Thumbnail

The function Clone Image creates a copy of the image record selected in the album inclusive oftracing, evaluations, image attributes, comments. In addition, the cloned images is marked with thedefault attributes "Treated" for derived image and "Clone" for duplicated image.

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Edit Image 2D Moduled

Purpose Window for Image Processing

Image Types All

Call Icon Button | Thumbnail Context Menu

The image processing (Edit) function allows manipulating copies of the original images for increasingthe image quality or for simulating of prosthetic treatment goals. The icon buttons of the symbol bar provide several image processing and image enhancementfunctions to be applied to the entire image or to selectable regions. For some of the functions asettings dialog can be called via right mouse click on the icon button. These dialogs allow setting offilter parameters.

Image Processing / Enhancement Functions (Filters)

Brightness|Contrast

With activated mouse controller brightness and contrast of the currentdisplay can be changed by moving the mouse across the image field.Brightness is changed by moving the mouse with pressed left button invertical direction. Minimum brightness appears with the mouse pointer atthe upper margin of the image field. It increases by moving the mousepointer to the lower margin. Moving in horizontal direction results inchanging the contrast. Thereby contrast increases with moving from theright to the left margin.

HistogramEqualization

This function can be used to bring out the details in dark areas of animage.

CorrectBrightness

This filter increases the brightness of an image without changing thebrighter or darker areas significantly.

InvertBy this function the colors of the image are inverted to the complementarycolors, making it like a photographic negative.

Gray ScaleThis filter creates black-and-white images out of color images byconverting all color values into gray scale values.

Smooth ImageThis filter changes the color of each pixel in the image to the average colorof the pixels in its neighborhood. This results in a blur effect

Sharpen

The effect Sharpen increases or decreases the sharpness of the image.The margins of the bitmap are accentuated or blurred. For this purposethe margins are localized and then the contrast between the adjacentpixels is increased or reduced.

AccentuateStructures

This filter effects adaptive contrast spreading. Thereby the visibility ofdetails can be improved. For that purpose the difference of brightness ateach pixel is compared to the average brightness of its vicinity and spreadwithin the available dissolution.

ReliefThis function applies a three-dimensional emboss effect to the image.Depth and direction of the effect can be defined.

In addition to these image filters, or combined with them, different edit modes can be used formanipulations of the entire image or of the active region. Icon buttons allow switching between thethese modes. Any edit mode offers a parameter panel for the appurtenant settings.

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Edit Modes

Define Region Drawing of one ore several regions.

Adjust Region Selection and manipulation of pre-defined regions.

Insert Text Adding of text to the image.

Pencil Manual drawing within the image.

Reduce ColorTransitions

Smoothing of the color gradient within the mouse track

Bleach Bleaching of the color gradient within the mouse track

Clone Adopt color gradient from parallel area (ALT + mouse click)

Fill Area Fills the active region with fore- | background color (left | right click)

In addition, the functions Cut, Copy, Paste and Delete can be used for working with the active region:

The History buttons allow reconstruction of all changes applied in both directions.

Define / Select Region Panel

Defining of regions can be done by means of the Freehand | Polygon | Rectangle | RoundedRectangle | Ellipse forms.

For that purpose the icon button of the appropriate basic form is selected and the region is drawnwithin the image. Beside creating of new regions (Option New) available regions can be extended(Option Add) or reduced (Option Subtract).

Saved Regions Panel

The so-called regions library allows categorized saving and reloading of regions. There are buttonsfor pasting of regions from the library to the image | adopting of active regions to the library | sortingof list entries | deleting of list entries.

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Adjust Regions Panel

There are several operations to be applied to the active region: Rotate | Tilt | Mirror and there aresome functions concerning the region's sequence: To the Foreground | To the Background | Embed. In addition, the transparency of the region can be set.

Colors Panel

The color panel allows setting of fore- and background color. A left mouse click in the image allowsadopting the color at the cursor position for the active color area (fore- | background). A right mouseclick on the color area itself opens the color selection dialog.

Pen - / Line - / Spot Size Panel

The Pen - / Line - / Spot Size panel allows setting the spot sizes used for the different edit modes.

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Digitize 2D Module

Purpose Cephalometric Evaluation of 2D Images

Image Types All

The Digitize 2D function allows cephalometric evaluation of arbitrary 2D images. Depending on theimage type and the tracing type assigned to the image type in Options|System Options differentevaluation methods analyses can be selected. Any analysis consists of a set of diagnosticallysignificant variables that are calculated from the position of specific landmarks and. if necessary,from additional information. The basic function of the module comprises digitizing the requiredlandmarks in the image and the automatic calculation of the results as well as their graphicillustration by means of a tracing. In addition, pre-defined and -selected templates can be generatedand manually adjusted. The automatically calculated results can be displayed and furtherprocessed.

User InterfacePerform Analysis

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Digitize Screen

The graphic user interface of the evaluation dialog comprises the icon button bar at the top, thestatus bar with patient information at the bottom, the image field for finding and marking thelandmarks and for graphic result illustration at the left as well as the landmark and image navigator,image type sketch and analysis panel at the right side.

Icon Button Bar

The icon button bar provides functions for image enhancement , zoom setting , templateadjustment , printing , output functions , display options , calibration and view options

Image Enhancement Functions

The symbol group at the left above the image field contains a number of image manipulations thatimprove the recognizability of image details which eases finding the landmarks and evaluation. Calling these functions is effected by a left mouse click on the icon buttons. For most of thefunctions parameters can be set after a right mouse click on the button.

Icon Buttons Image Enhancement

90 91 91 91 92

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Change Brightness|Contrast by Mouse Movement Within the Image Field

Contrast Spreading in a Window of Adjustable Size Around Mouse Position.

Histogram Equalization

Brightness Correction

Invert Image

Display Color Image as Gray Scale Image

Sharpness

Contour Filter

Relief

Reset Image Manipulations

Zoom Control

For exact landmark positioning enlarging or reducing the image by means of the zoom dialog's arrowbuttons or slide control is often useful. Enlarging (zooming in) can be also effected by the imagenavigator. Reducing the image (zooming out) is especially useful if landmark positioning or templateadjustment outside of the image is necessary. The [Fit to Frame] button left of the slide control fitsthe entire image into the image field.

Template Adjustment

The templates activated for tracing are automatically generated on the basis of digitized landmarksthat are often necessary for calculating the analysis' results anyway. The curve progression betweentwo landmarks is adjusted by means of the Bolton-Standards. This adjustment often reflects thepatient's individual bony structures and soft tissues very well. In case of unacceptable deviationsclicking the icon button [Adjust Templates] displays the template to be corrected as Bezier curvewith control points and allows adjusting the template to the real progression of the structure.

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Adjusting of automatically generated templates by Bezier method only affects the display but notthe result calculation for the analyses selected. Even on the mathematical results of followingfunctions, such as VTO or treatment simulation, there is no influence. Owing to this fact you are recommended to preferentially adjust soft tissue outlines, as thesestructures may change during treatment. Adjustments of bony or dental structures should beomitted in order to avoid differences between different treatment states caused by the templateadjustment that could be misinterpreted as treatment-caused changes.

Printing the digitized image together with tracing and analysis results can be effected via the items

Print Standard/Form Print 100%

of the [Print] icon button ( see also: Print and Print Editor ). After adequate calibration of theprinter used the item Print 100% provides a metrically correct printout of image and tracing.

Output Functions

The items of the Export button allow copying and saving the image, the landmarks' coordinates andthe current analysis' results, so that they are available for use in other applications.

Display Options

The display of single graphic elements within the image field can be activated and deactivated by thebuttons of the Display Options icon bar.

Icon Buttons Display Options

Image Visible|Invisible

Tracing Visible|Invisible

Templates Visible|Invisible

Points Visible|Invisible

Show Point Name at Mouse Position

Show Point Name: No | Important | All

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For doing metric analyses the picture scale of the image must be known. Usually, for this reason ascale of known length positioned in the relevant plane(e.g. sagittal plane for lateral cephalograms) isfaded in when the picture is recorded. This scale can be used for calibration of the individual imageor, in case of identical image acquisition and digitize conditions (e.g. scan dissolution), for globalcalibration of all (prospective) images of one and the same image type.

Onyx Ceph™ uses the distance of the reference points Cal1 and Cal2 as reference length. Mark theposition of these landmarks, that usually appear at the top of the landmark list at the initial - andendpoint of your faded in scale.

Open the scale dialog by a mouse click on the [Show / Edit Scale] button and insert the actualmetric distance between the marked landmarks Cal1 and Cal2 in mm into the Calibration Lengthfield. If the metric differs between evaluation level and used scale, this can be corrected by an entry in theMagnification Factor field. If, as an alternative to the calibration length, a fix pixel size is to be used for calibration, it can beinserted in the Pixel Size field. By the help of the calculator button the pixel size for an specificcalibration length can be calculated as ratio of calibration length and number of pixels between Cal1and Cal2 (e.g. for calibration measurement). In case of the pixel size being used for calibration instead of the calibration length the calibrationpoints Cal1 and Cal2 will not appear in the landmark list any longer.

The button [Adopt as Standard Setting] allows using the settings selected for all oncoming images ofthe respective image type, so that no changes are required as long as the images come from thesame source. The settings may, however, be changed or adjusted for any single image at any time

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later.

The [Fade in Scale] check box activates the display of a ruler in the color selected at the upper andleft image margins.

View Options

The dialog of the [View Options] button allows different settings concerning the user interface and thedisplay of landmarks and results:

|Input Window| tab: font, size and colors of superimposed text and lines|Variables| and |Points| tab: line weights and colors for illustration of the landmarks' and points'calculation |Auxiliary Window| tab: number, size and colors of the landmarks' markers within the sketch|Templates| tab: type of the templates to be displayed. Activating of specific templates results inthe number of landmarks required for effecting a specific analysis is extended by the landmarksrequired for constructing the template(s). Activating|Deactivating the display of the templates inmenu point View|Templates has no impact on this extension. |Surface| tab: colors of different screen areas, form of the mouse pointer, calculation of deviationfrom clinical norm |3D| tab: background color, colors and sizes of landmark markers and lines, display of 3D datawithin the image field

Via [Help] button information about the cephalometry module is available.

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In the image field at the left of the window the image to be evaluated is displayed according to the setzoom -, display - and view options.

Landmark Navigator Panel

The landmark navigator is used for browsing the landmark list. The inner arrow buttons allow going tothe previous|next landmark, whereas the outer arrow buttons permit jumping to the next|previousunevaluated landmark. The loudspeaker symbol activates|deactivates the announcement of thelandmarks' names when they are selected within the list (provided that the user saved a WAV file forthe respective landmark). Optionally, the coordinates of the landmark selected can be displayed below the navigator buttons inpixels (px) and mm.

Panel Image Type Sketch

Within the sketch the relative position of the landmark selected in the landmark list is illustrated. Inaddition landmark selection can be effected by a left mouse click on its position within the sketch. Aright mouse click on a point's position shows its definition. Colors and sizes of measured, not yetmeasured and active landmarks can be set in the view options dialog.

Panel Image Navigator

The image navigator allows fast and easy zooming and moving of image areas as well as going backto the entire image view. The detail to be displayed enlarged within the image field is defined byDrag&Drop and marked by a red frame. This frame can be moved within the navigator with pressedleft mouse button. At the same time the content of the image field changes. By clicking outside of

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the red frame the image can be displayed completely within the image field again. Analogous tomoving the marked area within the image navigator the detail can be moved with pressed left mousebutton within the image field.

The navigator's advantage for evaluation is the possibility for quick display of a landmark'ssurrounding in suitable resolution and therefore faster and easier finding and exact digitizing oflandmarks.

Panel Analysis

Selection of the analyses regularly used in the practice is effected by the [Activate|DeactivateAnalysis] button right of the drop-down list of the Analysis field. This selection determines thecontent of the drop-down list as well the number of landmarks in the landmark list. In that list alllandmarks required for calculating the results of all activated analyses appear. Checking thecheckboxes

SimulationSegmented SuperimpositionVTO

ensures that also the landmarks necessary for performing of treatment simulations, growthpredictions and segmented superimpositions are displayed in the landmark list. In order to limit thenumber of landmarks to be measured, only the analyses that are frequently used in your practiceshould be activated.

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The analysis selected in the drop-down list determines the content of the result list as well as thetracing within the image field.

Panel Landmark List

This list contains all landmarks required for calculating the active analyses' results and, as far asactivated, for performing of simulations, VTOs and segmented superimpositions. Via context menuadditional information on the landmarks is available. The focussed landmark is showed in thelandmark navigator and can be digitized by a right mouse click on its position within the image field.

Panel Result List

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The result list shows all results of the analysis selected in the drop-down list together with theappropriate clinical norm and the value measured in the current finding. Via context menu additionalinformation on the result is available. Focussing a result (column Value) results in all landmarks required for calculation being highlightedin the landmark list.

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Perform Analysis

Select Landmark

Usually the landmark sequence given in the landmark list should be kept for evaluation. Manuallandmark selection is not necessary in this case. At the beginning the focus is on the first landmarkin the list. As soon as this point's position is marked, the focus jumps to the next landmark to bemeasured.

You may, however, perform the analysis as per your own sequence (e.g. if only a few results arerelevant). For that purpose, select the landmark to be measured by a left mouse click on therespective item within the Landmark List or click on its position within the Sketch . Thereuponthe landmark is focussed in the list and highlighted in the sketch. In addition, the Landmark Navigator can be used for landmark selection. By means of the arrowbuttons jumping to the previous or next landmark or to he previous or next unmarked landmark ispossible.

The landmarks marked by a magic wand are calculated from the position of further landmarks andcannot be directly focussed therefore. A right mouse click on such an item of the landmark listprovides an explanation to the relevant point.

For a number of landmarks OnyxCeph³™ offers input wizards that are displayed as soon as therelevant landmarks are selected in the landmark list. The performance of these wizards depends onthe given landmark sequence as there calculation requires specific further landmarks. All pointsnecessary for displaying the wizard appear above the relevant landmark in the list.

Center Image

For exact evaluation of landmark position enlarging the image by means of the zoom dialog's slidecontrol or arrow buttons is often helpful.

Owing to this enlargement only a detail of the original image is visible within the image field. Thisdetail is marked as red rectangle within Image Navigator . If this area is moved within thenavigator with pressed left mouse button the content of the image field changes accordingly.

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Move the rectangle within the navigator until the structure to be measured appears within the imagefield. Moving the image within the image field may, however, also be effected by means of the arrowbuttons at the image field's lower and right margin.

Via right mouse click on an item of the landmark list a description of the relevant landmark can becalled. In addition the landmark's position is highlighted in this sketch.

Mark Position

Digitizing a landmark is effected by a right mouse click on its position within the image field. Forimproving the recognizability of the structures required for finding the landmark several ImageProcessing Functions are available.

Correct Position

There are two ways of correcting a landmark's position. The point can be moved to the correctposition or it can be deleted and measured again. Deleting is done via context menu after a rightmouse click on the relevant item of the landmark list. After that the landmarks position is marked atthe right position within the image field again. For dragging the point to its new position it is clickedwithin the image field and moved with pressed left mouse button. When the point is at its rightposition the left mouse button is released.

Please note that after leaving the landmark sequence the next landmark to be measured has to bemanually selected from the landmark list.

Read Results

As soon as the landmarks required for result calculation are measured, the selected analysis' resultscan be read from the Result List . If necessary, the column width can be adjusted by Drag&Drop.Via context menu the result list can be displayed in full screen mode.

Context Men u Result List

Help to [Variable] Opens the lexicon with information on the result selected.

Calculation of Graphically illustrates the calculation of the result selected.

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[Variable]

Facial Growth Pattern Opens the growth diagram (if available for active analysis).

Harmony Box Opens the harmony diagram (if available for active analysis).

Full Screen Opens the configurable full screen view of the result list.

If facial growth diagram and harmony box are available for the analysis selected, these diagrams canalso be called via context menu. Via right mouse click on an item of the list the respective result'sdescription is displayed within a separate window. In addition the result's calculation can begraphically illustrated.

Print Results

Printing the image together with tracing and results in pre-defined or individual forms is done viaStandard/Form item of the [Print] button.

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Combine 2D Module

Purpose Combining of 2D Images

Image Types All

Call Icon Button | Context Menu above Thumbnail

The Combine Images 2D function allows superimposition of two images by means of mutuallandmarks or freely definable points. Calling the function is effected by the icon button or the contextmenu above the thumbnail when one or two images are selected in the album. The image selectedfirst is defined as primary image displayed within the left image filed on the |Initial Findings| tab. Incase of only one image being selected, the second one can be selected from within the Combinewindow. In addition, changing the images is possible within the |Initial Findings| tab.

The image navigator allows, as in other modules, zooming and navigating by Drag&Drop of an imagedetail. In the Landmarks panel the landmarks to be used for superimposition can be selected from the pull-downs. Alternatively, the landmarks can be selected by a left mouse click on their position withinone of the two images. The corresponding landmark is then automatically marked in the secondimage. If there are no mutual landmarks, manual superimposition points can be marked by rightmouse click in both images. In such cases the entry "manual" appears in the pull-down instead ofthe landmark name. In case of the checkbox "True to Scale" being activated, the second image issuperimposed to the primary image at superimposition point 1 and aligned in direction of the secondmutual superimposition point. If the checkbox is not activated, the second image is stretched orcompressed so that also superimposition point 2 of the second image is exactly above point 2 of theprimary one.

If superimposition of both images is required in a specific area only, drawing the superimposition areain the left or right image is possible by means of the icon button [Create Region]. The region's formis defined within the Shape panel.

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In case of one of the images containing pre-defined regions, in addition, the Regions panel, isdisplayed. There, selection of the superimposition regions to be used is possible by checking theappropriate checkboxes.

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Icon Buttons

Open/Change Image

Invert Image

Adjust Image (100%)

Create Region for Superimposition

Delete Region

Divide Image Panel into Identic Parts

Open Program Help

Effecting the combination pre-defined within the |Initial Findings| tab is done by switching to the |Combine| tab. There, in the Options panel the transparency of the superimposition region as well astype and sort of tracing can be set. Fine tuning of the superimposition region concerning position,rotation and zoom is also possible.

The [Save Finding] button saves the result image as modified finding. By means of the [SaveProject] and [Load Project] buttons the entire combination project together with the currentparameters can be saved and restored later.

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For best possible alignment the superimposition points should be close to the superimpositionregion. In addition, landmarks that can be exactly and reproducibly located should be used. Forcombining lateral photo and cephalogram in the occlusal area e.g. Sn (Subnasale) and Sm(Supramentale) are well-suited.

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Mirror 2D Module

Image Types All

Call Icon Buttons | Context Menu above Thumbnails

The Mirror 2D function serves the illustration of right-left asymmetries. Calling the function is effectedout of the album by the icon button or the context menu above the thumbnail.

As in other modules, the image navigator can be used for zooming and navigation .

For generating of mirror images a symmetry axis is required. For defining this axis two landmarkscan be selected from the pull-downs of the Landmarks panel. Alternatively, the landmarks can beselected by a mouse click on their position in the image. If there are no cephalometric landmarks available in the image manual points can be defined by right mouse clicks in the image. Instead of alandmark name the item "Manual" appears in the pull-down then.

Thereupon, according to the selection in the Display panel photographic fittings of two right and twoleft image halves are juxtaposed in the |Mirror| tab.

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Icon Buttons

Equal Left|Right Side of Image Panel

Print Mirror Images

Open Program Help

The [Print] button at the upper margin of the window allows printing of the original image together withthe right/right and left/left fittings. The button [Save Finding] saves the result image as modifiedfinding as per the settings within the Selection panel. By means of the [Save Project] button theentire combination symmetry project together with the current parameters can be save.

Reasonable use and informative results of the mirror function on the basis of 2D images requireexact frontal and centric alignment of the patients during image acquisition as well as a suitableaxis of symmetry. The Mirror function should only be applied if these requirements are met.

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CO-CR Correction 2D Module

Purpose Simulate Correction of Condyle Position

Image Types All

The CO-CR Correction 2D function can be used for transferring the condyle's correction from CR-(Centric Relation) to CO- (Centric Occlusion) position to the lateral cephalogram and generating amodified lateral photo. This correction of the tracing regarding different jaw positions is considered tobe prerequisite for simultaneous use of articulator casts and cephalometric X-Ray evaluations forplanning of orthodontic or surgical treatment by several authors.

Calling the function is effected by the icon button or the context menu above the pre-selectedcephalogram's thumbnail (optionally, the appropriate lateral photo can be already selected there). Ifno lateral photo is handed over when opening the CO|CR Correction it can be loaded by means of the|Load Photo| button at the upper margin of the CO|CR dialog.

Icon Buttons

Load/Change Photo Finding

Fit to Frame (100%)

Show|Hide Image

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Show|Hide Tracing

Show|Hide Templates

Show|Hide Landmarks

Compare Before|After Photos

View Options Dialog |Input Window|, |Templates|

Open Program Help

The Analysis panel allows selecting one of the analyses pre-selected for the respective image typefrom the drop-down list. The appropriate tracing is activated/deactivated by the Tracing button.

The image navigator allows, as in other modules, zooming and navigating by Drag&Drop of an imagedetail.

For simulating the jaw repositioning the condyle displacement measured with a suitable device isentered separately for left and right side and for horizontal and vertical direction by means of the slidecontrols of the CO|CR Correction panel. The tracing automatically changes. Different values for rightand left side are averaged.

Provided that all landmarks required are digitized, within the Vertical Fixation panel it can be set ifand in which place the mandible's tracing is to be fixated during jaw repositioning. Without fixationthe mandible is moved parallel to the image's coordinate system according to the given values.

Changing to the |Lateral Photo| tab results in the facial photo's adjustment to the new soft tissueprofile line calculated from the mandible displacement by an implemented soft tissue model.

The button Save Finding saves the changed cephalogram as well as the modified lateral photo. Bothmodified images are designated by a CO|CR label at the upper margin.

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Treatment Simulation 2D Module

Purpose Simulation of Orthodontic|Surgical Treatment incl. of FacialProspects

Image Types Lateral Cephalogram; Lateral Photo

The Treatment Simulation 2D function allows simulating of orthodontic and/or surgical treatmentprocedures on the basis of an evaluated lateral cephalometric X-Ray. In addition, it is possible tomorph an appropriate lateral photo in order to visualize the prospective treatment outcome.

The overriding purpose of this function is the provision of an effective and easy to use tool for patientconsultation and education concerning planned treatment and prospective results as well as thepossibility for comparative assessment of different treatment alternatives (compromises) by means ofthe results calculated on the basis of model assumptions.

Simulation ScreenPerform Simulation

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Simulation Screen

Below the icon bar, the user interface of the simulation dialog comprises two image fields for displayof initial images and simulation results at the left side as well as a panel area with control displayand buttons at the right side. In both image fields the lateral cephalogram and, if available, theappropriate lateral photo are displayed within two separate tabs. The control panels are arranged on separate tabs for the functional areas |Regions|, |Soft Tissue|, |Points| and |Options|. Below, there is the image navigator panel.

Icon Buttons

Calculate Soft Tissue Line (FE)

Load|Substitute Lateral Photo

Manually Start Photo Update (Morphing)

Open save simulation Project

Save Current Simulation Project as ...

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Adjust Image Field Size

Fit Left|Right Image to Frame ( see also: Zoom Control )

Compare Before/After Tracing

Compare Analysis Results

Juxtapose Before/After Images (Cephalogram, Photo)

Animated Before/After Comparison (Lat. Photo)

Show|Hide Cephalogram

Scan Landmark Displacement

Show|Hide Tracing

Show|Hide Landmarks

Show|Hide Templates

Show|Hide Regions

View Options ( see also: View Options )

Reset Image Manipulations

The [Soft Tissue Line] button starts the calculation of the new soft tissue line. It is only active incase of the Finite Elements method being selected for calculation and automatic calculation beingdeactivated. The selection list of the [Load Photo] button allows loading of a lateral facial photo by means ofwhich the treatment's prospective result can be illustrated. If the treatment simulation was startedwith an lateral photo being selected or a lateral photo with superimposed cephalometric tracing isused, loading the photo is unnecessary. The [Calculate] button starts the calculation of the new image in case of the automatic calculation ofthe soft tissue line being deactivated. The [Load Simulation] button allows loading of a simulation that was saved by the [Save Simulation]button at a earlier date. Via [Print] button a comparison of the initial image with the simulation resultcan be printed.

Zoom Control

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For exact navigation enlarging or reducing the image by means of the zoom dialog's arrow buttons orslide control is often useful. Enlarging (zooming in) can be also effected by the image navigator. Reducing the image (zooming out) is especially useful if landmark positioning or template adjustmentoutside of the image is necessary. The [Fit to Frame] button left of the slide control fits the entireimage into the image field.

|Regions| Tab

All settings concerning the regions to be moved during growth or treatment simulation are madewithin the |Regions| tab at the right margin of the screen. They merely refer to the displacement ofbony structures.

The Regions field shows all regions defined inclusive of their subordinate regions. Selection iseffected via mouse click on the desired item. A second mouse click allows changes to the region'sdesignation. By a right mouse click further areas can be added to the region selected which resultsin all regions highlighted being displaced at the same time as a block.

The buttons of the Create Region field allow creating of new regions and drawing them within theinitial image. In addition, pre-defined regions can be selected. In order to keep the amount of workas low as possible the simulation can be effected by the help of the Osteotomy Wizards. Theyautomatically draw and displace the regions to a great extend. Individual adjustment, however, ispossible.

The Displace Region field comprises all functions for manual rotation and displacement of regions. Inaddition, the amount of displacement can be read there.

|Points| Tab

The |Points| tab allows monitoring the point's displacement. The Maxima field shows the landmarksthat were displaced the farthest. In the Evaluation field the displacement of specific points within theselected region or the change of lines and angles between points within and out of the region can beread. After activating the buttons 1...3 landmarks can be selected from the lists or arbitrary pointscan be marked by mouse click in the initial finding. A left mouse click captures the landmark that issituated closest to the cursor position whereas the point can be freely positioned by a right mouseclick. In the tab sheets below the displacement and rotation of each of the points are displayed andthe values of all angles and lines between them before and after treatment are calculated.

|Soft Tissue| Tab

The settings within the |Soft Tissue| tab refer to the simulation of soft tissue reactions. The options(i) No Simulation, (ii) Simulation by Means of an Regulation (Multiple Linear Regression) and (iii)Simulation by Means of the Finite Elements Method can be selected from the tabs. According tothis selection further options appear.

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In case of the option Regulation being activated the regulation selected for calculating the soft tissuereaction is displayed. The standard regulation comprises a number of definitions describing thedisplacement of the soft tissue landmarks depending on the shift of bony landmarks or other softtissue landmarks. This definition is effected component-by-component separately for both directionsof the coordinate system selected and may comprise several description for one and the samelandmark. So simulation of nonlinear soft tissue reaction is possible. The Edit button allowsmodifying the standard regulation and saving it as individual regulation.

In case of the Finite Elements option being active it has to be selected when calculation of the softtissue line is to be started. It may automatically started after each change. It is also possible tomanually start calculation or to decide after each change if calculation is necessary

Displacement of defined soft tissue landmarks also influences undefined points in their surrounding. These points are also displaced up to a certain degree. The value of the displacement is the smallerthe further the point is situated from the defined landmark. In the relevant fields it can be inserted upto which distance the undefined points should be displaced as far as the defined landmarks and atwhich distance they should not be influenced anymore.

In the Manual Correction field the calculated displacement of single landmarks can be manuallycorrected by dragging the landmark to the wanted position in the result finding. Correction ispossible in the cephalogram as well as in the photograph. The name of the displaced landmark andthe amount of displacement are displayed. The left button cancels the manual correction of lastdisplaced landmark whereas the right button sets all landmarks back to their originally calculatedposition.

The templates used for automatic creation of the tracing were elaborated on the basis of the Bolton-Standards. For adaptation the landmarks of the template are reproduced on the corresponding positionsof the identical landmarks of the current finding and if necessary the template is shifted, rotated and

compressed (extended). As a result of this method differences between the calculated template andthe actual outline of the structure can occur in the areas between defined landmarks (e. g. at thebridge of the nose). The button Adjust Profile permits, if required, an exact adjustment of thetemplate automatically drawn to the actual outline of the structures in the current finding ( see also: Adjust Profile ).

|Options| Tab

The |Options| tab allows a number of general setting, such as analysis to be displayed or color of theactive region.

In the field the coordinate system displayed within the initial finding is specified. If the ImageCoordinates checkbox is activated the axes of the coordinate system run parallel to the edges of theimage. In addition, it is possible to define one of the axes by two landmarks. Therefore the point oforigin and the point for determining the direction of the axis are selected from the pull-down lists afteractivating the relevant checkbox. Selection can also be done by a left mouse click on theapproximate position of the landmark in the initial finding while the button right beside the lists isactivated. By entering a value in the field Angle deviation the defined coordinate system can additionally rotatedaround its origin.

In the Steps field it is specified how far a region is to be displaced or rotated after a single click onthe [Displace Region] within the [Regions] tab.

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The View field allows setting concerning the display of the active region. If the checkbox is activatedthe current regions brightened within the XRay. In the color selection dialog the wanted filling colorfor the selected region can be selected, by which the region is accentuated when the image is fadedout.

Image Navigator Panel

The image navigator allows fast and easy zooming and moving of image areas as well as going backto the entire image view. The detail to be displayed enlarged within the image field is defined byDrag&Drop and marked by a red frame. This frame can be moved within the navigator with pressedleft mouse button. At the same time the content of the image field changes. By clicking outside ofthe red frame the image can be displayed completely within the image field again. Analogous tomoving the marked area within the image navigator the detail can be moved with pressed left mousebutton within the image field.

The navigator's advantage for evaluation is the possibility for quick display of a landmark'ssurrounding in suitable resolution and therefore faster and easier finding and exact digitizing oflandmarks.

The [As Finding] button allows saving of the active result image (modified cephalogram or photo) asmodified image. Lateral photos can be saved as Photo Lateral image type together with the phototracing or as Ceph Lateral image type together with the XRay tracing.

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Perform Analysis

Select the lateral cephalogram designated for the simulation and an appropriate lateral photo fromthe album view of the patient's images. It is also possible to select the cephalogram only and loadthe photo from within the simulation screen later. Simulation of different treatment procedures requires the specification of bony and/or dental regionswhose position changes during treatment. There are several ways for defining regions. You maymanually draw region or create them by means of pre-defined templates, that can be manuallyadjusted and cut. In addition wizards for creating the regions and performing the simulation areavailable.

Create Region from Templates

If treatment planning is effected by means of a lateral cephalogram the [Regions Wizard] buttonallows creating the regions out of pre-defined templates by the help of a wizard. This button is onlyavailable for defining regions in lateral cephalograms.

Create New Region

The [Create New Main Region] button allows manual drawing of regions. The item Region1 appearsin the Region field. By a mouse click on this item the region may be named as the desired.

With active [Freehand] button, draw the shape of the region by dragging the mouse within the initialimage with left mouse-down.

Alternatively to drawing the [Template] button allows selecting of pre-defined regions.

Correct/Supplement Region

If necessary, correct or supplement the region's form by means of the buttons [Add Region] or[Subtract Region].

Split Region

Any region can be split into two subordinate regions, which can be independently displaced androtated. Select the region to be split in the Region field. Thereupon it is highlighted in the initialimage. Activate the [Incision] button and mark the initial point of the cut by a mouse click on itsposition in the initial finding. Then drag the mouse with left mouse-down to the final point of the cut. After confirming the query the cut will be displayed in the initial finding. At the same time twosubordinate items will be displayed below the selected region in the Region field at the right marginof the form. By clicking on that items you can type the names of the segments. Correcting the cutcan be done by dragging the endpoints to the desired position.

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The subordinate regions resulting from splitting can be split again. Owing to that fact and to thepossibility to group partial regions even complex cuts can be simulated. By the [Delete Incision] button the subordinate parts of an superior region can be merged again. Atthis the focus has to be on the superior region in the tree structure.

Move Region

For simulating the several steps of the treatment the selected regions are displaced or rotated. Theresult of the simulation is visualized and can be controlled by means of graphic collision control andnumeric specification of displacement and rotation of each area.Select the region to be displaced in the field Region by a left mouse click. Click on the subordinateregion if only this segment is to be moved. Selecting a region is also possible by a mouse click inthe initial finding.

If you want to displace several regions as one piece, further regions can be added to the first region. For that purpose the additional regions are selected by a right mouse click. Thereupon all selectedregions are highlighted by a blue background and are also accentuated in the result field.Displace the region by the help of the arrow buttons in horizontal or vertical direction. Thedisplacement takes places with relation to the image coordinates. Displacing a region can also bedone directly in the result field by mouse drag-&-drop.

It is also possible to move a region along or perpendicular to a defined line; e.g. tooth along its axis. Selection of the initial point and the endpoint of this line is done by the help of the buttons[Direction]. A left mouse click in the initial finding while the button is activated captures thelandmark that is situated closest to the cursor position. By right mouse clicks the points can befreely positioned in the initial finding. Displacing the region along the line or perpendicular to it isdone by the help of the buttons [Move Region].

In addition the selected region can be rotated by the relevant [Rotate] buttons to the directionrequested. Thereby the center of rotation, which first of all is situated in the calculated center of theselected region, can be displaced by the help of the button [Center of Rotation] and a mouse click onthe relevant position in the field of the initial finding. The amount of displacement and rotation isdisplayed below the button bar.

Monitor Displacement

If there are defined landmarks within the selected region, the landmarks having been displaced to thegreatest amount in general, in horizontal and in vertical direction and the landmark having beenrotated to the greatest amount are displayed in the Maxima field of the Points tab. In the evaluation field the displacement of specific points within the selected region or the change oflines and angles between points within and out of the region can be read. After activating the 3[Landmarks] buttons landmarks can be selected from the lists or arbitrary points can be marked bymouse click in the initial finding. A left mouse click captures the landmark that is situated closest tothe cursor position whereas the point can be freely positioned by a right mouse click.In the table below the displacement and rotation of each of the points is displayed and the values of

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all angles and lines between them before and after treatment are calculated.

Calculate Soft Tissue Reaction

The soft tissue does not follow the bony displacement during orthodontic treatment or orthognathicsurgery to the same extend. For calculation of the prospective soft tissue profile the relationsbetween bony displacement and resulting soft tissue changes have to be considered.

The calculation of a new soft tissue line can be optionally deactivated. In this case no automaticprediction of the soft tissue profile is offered. The soft tissue line may, however, be modified bymoving the soft tissue landmarks to the desired position.

If the resulting soft tissue profile is to be automatically calculated, this can be done by means ofregulations that deterministically calculate the soft tissue reaction from the bony displacement byquasi-linear regression models. The standard regulation comprises a number of definitions thatcalculate the vectorial shift of single soft tissue landmarks based on the displacement of one oreseveral bony points. The standard regulation may be modified and saved as individual regulation.

Another possibility for soft tissue prognosis is the Finite Elements method that assumes linear-elastic behavior of the deformed soft tissue. This can be seen as an approximation of the actual softtissue behavior that depends on age, gender and further factors in reality. In the right result window the position of single landmarks can be manually corrected. For thispurpose, select the landmark to be corrected by a left mouse click on its marker within the resultimage and drag it to the new position with left mouse-down. The amount of displacement can beread from the Adjust Soft Tissue Line field of the Soft Tissue tab. The buttons [Reset Landmark orLandmarks] right of the display of the landmark displaced set the last landmark or all landmarks totheir originally calculated position.

For photo-realistic illustration of the prospective treatment results the initial photo can be morphed tothe new calculated profile by the button [Calculate]. This merely serves visualization purposes andaims at illustration of the tendency of treatment-caused changes of the dento-facial area.

If treatment to be simulated is mere surgical without movement of single teeth the OsteotomyWizards that are called via the respective buttons can be used. They automatically create theregions to be displaced and subsequently move them to the desired position. After that, however,individual adjustment is possible.

For the following standard operations wizards are available

Icon Buttons

Bilateral Sagittale Split Osteotomy

Le Fort I Osteotomy

Bimaxillary Osteotomy

Genioplasty

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Bilateral Sagittal Split Osteotomy:

The mandibular region including the first molar, the first premolar and the central incisor is markedand split into a proximal and a distal segment by a pre-defined cut.

automatically drawn and segmented mandibular region

After that the distal segment is put in correct relationship to the maxilla. That means that at first thelower central incisor is correctly placed against the upper central incisor according to the overbiteand overjet set in the preview dialog. Then the entire distal segment of the mandible is rotatedaround the fixed lower incisal edge until the lower molar touches the occlusal surface of the uppermolar.

automatically shifted and rotated distal segment

After finishing the planning of the bilateral sagittal split osteotomy it has to be decided if an additionalcorrection of the chin is necessary. The simulation of a genioplasty is also supported by a wizardthat can be started following any other osteotomy.

The wizard merely simulates the bony displacement during a bilateral sagittal split osteotomy. After

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that the simulation of soft tissue changes can be carried out.

Le Fort | Osteotomy:

The maxillary and mandibular regions including the first molars, the first premolars and the centralincisors are marked.

automatically drawn maxillary and mandibular regions

After that the maxilla is put in correct relationship to the mandible. That means that at first the uppercentral incisor is correctly placed against the upper central incisor according to the overbite andoverjet set in the preview dialog. Then the entire maxilla is rotated around the fixed upper incisal edgeuntil the upper molar touches the occlusal surface of the lower molar.

In this position maxilla and mandible are fixed together and rotated as complex until the upper incisorreaches the relation to the upper lip set in the preview dialog. The rotation point is in the center of thecondyle.

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automatically displaced and rotated maxillary and mandibular segments

After finishing the planning of the Le Fort I osteotomy it has to be decided if an additional correctionof the chin is necessary. The simulation of a genioplasty is also supported by a wizard that can bestarted following any other osteotomy.

The wizard merely simulates the bony displacement during a Le Fort I osteotomy. After that thesimulation of soft tissue changes can be carried out.

Bimaxillary Surgery:

The maxillary and mandibular regions including the first molars, the first premolars and the centralincisors are marked. In addition the mandible is split into a proximal and a distal segment by a pre-defined cut.

automatically drawn regions

First of all the maxilla is correctly placed with regard to the sagittal position, dental exposition andinclination of the occlusal plane set in the preview dialog.

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After that the distal segment is put in correct relationship to the maxilla. That means that at first thelower central incisor is correctly placed against the upper central incisor according to the overbiteand overjet set in the preview dialog. Then the entire distal segment of the mandible is rotated aroundthe fixed lower incisal edge until the lower molar touches the occlusal surface of the upper molar.

automatically displaced and rotated segments

After finishing the planning of the bimaxillary osteotomy it has to be decided if an additionalcorrection of the chin is necessary. The simulation of a genioplasty is also supported by a wizardthat can be started following any other osteotomy.

The wizard merely simulates the bony displacement during a bimaxillary osteotomy. After that thesimulation of soft tissue changes can be carried out.

Genioplasty:

The mandibular region including the first molar, the first premolar and the central incisor is markedand split into a proximal segment and the region of the chin by a pre-defined cut.

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automatically drawn and split mandibular region

In the wizard several methods can be selected that include different standards for the harmony of thechin. Owing to the fact that the soft tissue of the chin follows the displacement of the bony chin tothe same extend the chin is displaced to the amount of the difference between norm value andmeasured value of the deciding variable of the selected method. That means that the chin will becorrectly positioned after the soft tissue simulation.

By means of a subsequent change of the inclination of the cut and another start of the wizard a slightcorrection in the vertical plane is possible in addition to the shift in sagittal direction.

automatically displaced chin region

The simulation of a genioplasty can be carried out separately or following any other osteotomiessupported by wizards.

The wizard merely simulates the bony displacement during a genioplasty. After that the simulation ofsoft tissue changes can be carried out.

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Ricketts VTO 2D Module

Purpose Simulation of Growth and Treatment as per the Method descr.by Ricketts

Image Types Ceph Lateral

Call Icon Button | Context Menu above Thumbnails

Mit Hilfe der Funktion Ricketts V.T.O. (Visual Treatment Objective)¹ 2D können kieferorthopädischeBehandlungsmaßnahmen auf der Grundlage eines durchgezeichneten Fernröntgenseitenbildessimuliert werden. Optional kann für die Behandlungssimulation zusätzlich ein zum FRS zugehörigesProfilfoto benutzt werden, um ein Fotomorphing als Möglichkeit der Visualisierung des zuerwartenden ästhetischen Behandlungsresultates durchzuführen.

Vorrangiger Zweck der Funktion ist zum einen die Bereitstellung eines einfache und effektivenWerkzeuges zur Beratung und Aufklärung des Patienten über die vorgesehenenBehandlungsmaßnahmen und die voraussichtlichen Behandlungsergebnisse, zum anderen dieMöglichkeit der vergleichenden Bewertung und Abwägung unterschiedlicher Alternativen derBehandlung (Kompromisse) anhand der auf Basis von Modellannahmen berechneten Ergebnissesdurch den Arzt.

VTO ScreenPerform VTO

___¹ The treatment and growth prediction according to Ricketts is an important part of the orthodontictreatment planning process in the Bioprogressive Therapy. The "visual treatment objectives" wereintroduced to orthodontics as VTO. For the orthodontist the graphic visualization is an additionalinstrument for checking his treatment outcomes. It can not only be used for retracing the treatmentprocess but makes it also possible to correct the planned treatment procedure. In addition it alsohelps the patient to visualize the single steps of his treatment and the changes to his face andprofile.

The VTO button hands over the digitized image to the implemented VTO module, which permitsprediction of normal growth of the patient and the expected results of the treatment in the tracing ofthe X-ray based on the cephalometric analysis according to Ricketts and in addition allowssimulation of these changes in the appropriate photograph of the patient.

The prediction is automatically done to a great extend according to the methodology described byRicketts. The user merely has to do some settings concerning the period of prediction and thetreatment planned for the patient.The results of the selected analysis are transformed during VTO and can be saved as modifiedfinding of the patient, so that comparison and superimposition of findings, morphing and furtherstandard functions of Onyx Ceph® can be executed.

Before handing over the finding to the VTO module the cephalometric finding as well as the lateralphotograph of the patient should be completely evaluated. To ensure measurement of all landmarksthat are necessary for the prediction of the changes the checkbox VTO of the dialog for selection of

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the active analyses should be activated

___² Source:R.M. Ricketts, R.W. Bench, C.F. Gugino, J.J. Hilgers, R.J. Schulhof.Bioprogressive Therapie.Dr. Alfred Hüthig Verlag GmbH, Heidelberg, 1988.

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VTO Screen

Below the icon bar, the user interface of the V.T.O. dialog comprises an image field for display ofinitial image, growth prediction and V.T.O. The different views can be activated separately or incombination by means of the appropriate icon buttons. Alternative to the entire tracing as per pre-selected analysis and activated templates the segmented superimposition view can be used. If an appropriate profile photo was pre-selected or loaded from within the VTO screen photo-morphingbased on the growth prediction or the VTO result can be effected. The appropriate photo and thephoto-morphing result are displayed on two separate tabs. The control panel is subdivided into the functional areas |VTO| and |Options| that are displayed onseparate tabs. Below, there is the image navigator panel.

Icon Buttons

Load Photo

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Fit Image to Frame

Superimposition Option (Whole Tracing)

Segemented Superimposition Option

Show|Hide Initial Finding

Show|Hide Growth Prediction

Show|Hide V.T.O.

Show|Hide Vectors

Show|Hide Tracing

Show|Hide Landmarks

Show|Hide Templates

Juxtapose Results

Juxtapose Pre/Post Images (Photo)

Animated Pre/Post Comparison (Photo)

Copy View to Clipboard

Reset Manipulations

¹ In the view to be activated by the button [Superimposition] the tracings of initial image andprediction are superimposed as per the method described by Ricketts on the reference line N-Ba inlandmark CC.

In the view to be activated by the button [Segmented Superimposition] changes between initial imageand prediction are illustrated by superimposition of separate segments. Landmark displacement relative to pre-defined superimposition planes can be read.

|VTO| Tab

Growth

The settings in this field merely concern the patient's normal growth without treatment. They refer to

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the period of prediction and the opening of the facial axis to be expected owing to the patient'sgrowth pattern. Both parameters can be set by means of the appropriate slide controls. Beside the manual setting of opening or closing by means of the slide control the facial axis'expected rotation can also be automatically calculated and adopted by the [Acc. to Ricketts]button.

Opening acc. to Ricketts

According to Ricketts the rotation of the mandible is subject to the facial growth pattern. It isdistinguished between three basic facial types:

1. the mesiofacial type2. the brachyfacial type with horizontal growth pattern3. the dolichofacial type with vertical growth pattern.

For describing the face five angles of the Eleven-Factors-Analysis acc. to Ricketts are used:

1. the Facial Axis Angle2. the Facial Angle3. the Mandibular Plane Angle4. the Lower Facial Height5. the Mandibular Arc Angle

Facial Axis Angle

The Facial Axis Angle determines the direction of growing of the chin or mandible, respectively. formed by the reference lines N-Ba and Pt-G

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Clinical Norm:

90° +/- 3° acc. to Ricketts

An angle more obtuse than the norm represents horizontal (brachyfacial) growing type, whereas anangle more acute represents vertical (dolichofacial) growing type. A small value is indicative of arecessive chin or a vertically excessive face. A large value indicates a prominent chin or a verticallydeficient face.

Every deviation of the measured value from the norm is used as one, two ore more standarddeviations for the calculation of the facial growth pattern.

mesiofacial: X » 87°...93°dolichofacial: X » 85°...86° XX » < 84°brachyfacial: X » 94°...95° XX » > 96°

Facial Angle

Angle between Facial Plane and Frankfort Horizontal. Determines the horizontal relation of themandible to the cranium and if the skeletal Class II or Class III is due to the mandible.formed by the reference lines N-Pog and P-Or

Clinical Norm:

Small values indicate a recessive chin, and large values indicate a prominent chin

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Mandibular Plane Angle

Angle between the mandibular plane and the Frankfort Horizontal. Is used to differentiate skeletalopen bite or skeletal deep bite, respectively.formed by the reference lines Me-Go and P-Or

Clinical Norm:

A high angle implies that a skeletal open bite is due to the mandible. A low angle implies a skeletaldeep bite is due to the mandible

mesiofacial: X » 20°...32°dolichofacial: X » 33°...34° XX » > 35°brachyfacial: X » 19°...18° XX » < 17°

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Lower Facial Height

The Lower Facial Height is formed by the reference lines ANS-Xi and Xi-PM

Clinical Norm:

Enlargement of the angle indicates skeletal open bite whereas reduction of the angle indicatesskeletal deep bite

mesiofacial: X » 43°...51°dolichofacial: X » 52°...54° XX » > 55°brachyfacial: X » 42°...40° XX » < 39°

Mandibular Arc

Angle between corpus axis and condylar axis of the mandible. formed by the reference lines DC-Xi and Xi-PM

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Clinical Norm:

Enlargement of the angle indicates deep bite and facial prognathism, whereas reduction of the angleindicates open bite and facial retrognathism

The combination of these angles defines the facial type being mesio-, brachy- or dolichofacial. Thefacial axis opens 1° per standard deviation with dolichofacial types and closes 1° with brachyfacialtypes.

Treatment

In addition to the growth prediction settings concerning the changes to be expected owing to thetreatment can be made. These settings refer to

Inclination of the Facial AxisDisplacement of the A-PointRotation of the Occlusal PlaneDisplacement of the Lower IncisorDisplacement of the Lower MolarPosition of the Upper Molar

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Inclination of the Facial Axis

Here the rotation for the construction of the mandible to be expected as a result of the treatment canbe defined by the help of the slide control.

The mandible rotates as a result of the use of biomechanical aids and the growth pattern of thepatient. Owing to the fact that opening or closing caused by the facial type is already considered inthe 'Growth' field, only the changes caused by the planned treatment should be set here.

The average effect to the rotation of the mandible is the following:

a) The facial axis may open during treatmentb) The facial axis may close as a result of extractions or the use of the High-pull-Headgear

Thereby the following biomechanical effects can occur:- During reduction of the convexity the facial axis opens 1° per 5mm - During correction of the molars the facial axis opens 1° per 4mm - During correction of the vertical overbite the facial axis opens 1° per 4mm- During elimination of the cross bite the facial axis opens 1-1,5°. After adaptation it closes half theamount again.

Displacement of the A-Point

The position of the A point changes as a result of the biomechanical influences. Below themaximum changes during the use of different biomechanical aids are mentioned:

Headgear 8mmClass-II-Elastics -3mmActivator 2mmPalatinal root torque -1...-2mmClass-III-Elastics +2...+3mmFace mask +3...+4mm

The changes to the A point to be expected can be defined by the help of the slider. For eachmillimeter of dorsal movement the A point will move cranially half a millimeter.

Rotation of the Occlusal Plane

By the help of this button the changes to the inclination of the occlusal plane are defined. T hischange can amount up to 3° in the one or the other direction as a result of Class II or Class IIItreatment.

Displacement of the Lower Incisor

The program puts the lower molar in an ideal position in relation to the symphysis of the mandible, tothe occlusal plane and to the A-Pog plane. Its exact position is to be determined by the requiredarch length and by the realistic idea of the treatment results to be achieved.

In a position of 1mm in front of the A-Pog line and 1mm above the occlusal plane the angle should be22°. This angle is to be increased 2° as compromise for each millimeter the incisor is inclined to thefront in order to achieve the arch length required.

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By the help of the slider it is defined to what extend the incisor is to be moved forward or backward. The inclination then is automatically corrected.

Displacement of the Lower Molar

The displacement of the lower first molar depends on the arch length required. The program lets thetooth erupt vertically on the occlusal plane and automatically uprights it. If treatment is applied 1mmdistal molar displacement corresponds to an arch length of 2mm. The necessary anterior orposterior displacement that depends on the space requirements is defined by the help of the slider. The space gained or lost as a result of the molar movement is stated in the field Results.

Position of the Upper Molaren

Here it is defined if the upper molar is to be placed against the lower molar in a neutral or distalposition. The space gained or lost in the upper jaw is stated in the field Results.

Results

There, the gain or loss of space for upper and lower jaw caused by the settings made is displayed.

|Options| Tab

The settings of this dialog concern the graphic display of the tracings, the landmarks to be used forsuperimposition, the comparison of initial and result images and the soft tissue line to be used forcreation of a modified photo.

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Perform V.T.O.

Prior to calling the VTO function, activate a lateral ceph image and an appropriate lateral photo. It isalso possible to select the cephalogram only and load the photo from within the VTO screen later.

Growth Prediction

Set the period of prediction and the facial axis' expected opening by means of the relevant slidecontrols within the Growth field of the VTO tab.

Beside the manual setting of opening or closing by means of the slide control the facial axis'expected rotation can also be automatically calculated and adopted by the [Acc. to Ricketts]button. In this case, the opening or closing is determined on the basis of the patient's facial type.

As soon the aforementioned settings are made the growth prediction is effected as per the methoddescribed by Ricketts. The appropriate tracing is displayed if the Growth button of the view optionssymbol bar above the image is active.

If merely treatment is to be simulated you may now pass on to Photo Morphing .

Treatment Goal

Set your parameters concerning

Opening (Inclination of the Facial Axis)Displacement of the A-PointRotation of the Occlusal PlaneDisplacement of the Lower IncisorDisplacement of the Lower MolarenPosition of the Upper Molar

The tracing is directly affected by your settings if the VTO button of the view options symbol bar isactive.

Within the Results panel the gain or loss of space resulting from growth or simulated treatment isdisplayed.

Photo Morphing

If no appropriate profile photo was handed over on calling the VTO module you may load it now bythe Load Photo button below the finding graphic. The profile photo is subsequently displayed in theseparate Photo of ... tab.

In the Soft Tissue Line Photo panel of the Options tab, select which of the calculated soft tissuelines is to be faded into the image and to be used for calculating of the prediction.

Click on the Calculate button below the image. The prognosis calculated acc. to the specifications(Photo Morphing) is subsequently displayed on the separate Prediction: Growth (or Prediction: VTO)tab.

Now you may print and save the result or use the different functions for comparing it to the initialimage.

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Superimposition 2D Module

Purpose Juxtaposition of Analysis Results and Superimposition ofImages of Diff. Treatment Stages

Image Types All

Call Icon Button | Context Menu Above Thumbnails

The finding comparison function Superimposition 2D allows juxtaposition of analysis results of twoore more findings created during treatment as well as superimposition of the appropriate tracings. Thus, growth-related changes and treatment progress can be depicted.

The [Superimposition] icon button or the appropriate context menu item open the findingjuxtaposition. Prior to calling this function at least one of the images to be compared has to beactivated in the album. All further images can be added within the Superimposition screen. It is,however, also possible to multi-select all images to be compared in the album. The analysis resultsof any of the selected findings is displayed in a separate column of the table.

Tabular Comparison

Analysis Panel

The analysis for comparison is selected from the drop-down list at the upper right margin of thewindow that contains a list of the analyses pre-selected in the system options dialog.

Add Column Panel

By the buttons of the Add Column the selection of images to be compared can be adjusted.

Icon Buttons

Adds a Column to the Table; the Desired Item is Selected from the Drop-Down List

Creates a Table Containing the Results of All Images of the Image Type Selected

Creates a Table Containing the Results, Clinical Norms and Deviations of All Images of theImage Type Selected

Adds a Column with the Values of the Bolton-Standard Consisting with the First Image. ViaRight Mouse Click a Bolton-Standard of a Different Age May be Selected.

Deletes the Highlighted Column.

Selection of the images to be compared can also be effected by right mouse click on the columnheader. The item desired can be selected from the appearing drop-down list.

Image Instruments

Extras Panel

In the Extras panel the selected graphic superimposition type is called.

Icon Buttons

Graphic Superimposition of Tracings by Means of Landmarks or Structures

Graphic Superimposition of Tracing Segments (Segmented Superimposition, Bjoerk)

Graphic Superimposition of Harmony Boxes

Superimposition

By superimposition of the images to be compared on two mutual landmarks or on growth-stablestructures the growth- or treatment-caused changes can be visualized. The Superimposition buttonopens the respective dialog.

Marking the field Superimposition on Landmarks allows transparent superimposition of the evaluatedimages by alignment of two landmarks that are available in all images to be compared.

In the drop-down lists the mutual landmarks of the tracings to be superimposed can be selected. Only the landmarks available in all images are listed. If there are no mutual landmarks the drop-down lists stay empty. In this case the columns of the comparison form that refer to not or notcompletely evaluated images should be deleted (hidden) by the context menu (right mouse button) orthe Delete Column button.

For adaptation the selected landmarks of the image to be superimposed are reproduced on thecorresponding positions of the identical landmarks of the current image and, if necessary, the imageis shifted, rotated and compressed (extended). If adaptation should be true to scale, shift resultsfrom adjustment of the first landmark, rotation from the direction of the connecting line between bothlandmarks and compression (extension) from the ratio of both scales.

Marking the field Superimposition on Structures allows superimposition of the evaluated images ongrowth-stable structures as per the method described by Bjoerk.

For that purpose first the images to be superimposed have to be aligned by means of two landmarksavailable in all images. The first landmark should belong to the stable structure whereas the secondlandmark should maintain its position in relation to this structure during growth.

In addition, it is necessary to mark a stable structure in the reference finding. For that purposeseveral tools can be used. After that the program looks for the structure within the marked region inall images and superimposes them along this structure.

As far as all landmarks required are measured, the superimposition of separate segments of allimages selected can be displayed within one form. In order to secure that all landmarks necessaryfor the segmented superimposition are shown in the list of landmarks the appropriate checkboxshould be activated in the analysis selection dialog.

If a harmony box is defined for the selected analysis, it can be displayed or printed for the chosenfindings by the help of the respective button

Image Instruments

Column Colors Panel

In this field it can be selected if the column and tracing colors are to be assigned as per theirsequence within the table or as per their status. The assignment as per sequence can be modifiedby a mouse click on the respective color flag.

Image Instruments

Exchange Container Function

Purpose Creating and Saving or Sending via FTP Onyx Exchange Containers

Image Types All

Call Icon Button | Context Menu Above Thumbnail | Main Menu

Image Instruments

Case Reports

Purpose Creating and Saving or Sending via FTP Onyx Case Reports

Image Types All

Image Instruments

Purpose Saves single focused image (thumbnail) in a selected image format

Image Types All

Call Context Menu Above Thumbnails

Pre-selected single image can be saved as it is (cropped) in a selected image format.

Image Instruments

Save As ... 2D

Purpose Export of the Images selected in the Album to a Stated Directory

Image Types All

Arbitrary images pre-selected within the album may be exported to data medium by the contextmenu item Save As ... At the stated storage location (folder) a subordinate folder with patient ID andbelow further subordinate folders with type and date of the respective image series are created. Inthese folders the appropriate images are saved as per their image type. The initial image inclusive of all modifications in original resolution is used for export.

Image Instruments

Copy 2D

Purpose Export the Image Selected to the Clipboard

Image Types All

An image pre-selected within the album can be exported to the Windows clipboard by the contextmenu item Copy. From the clipboard it can be inserted into third party programs. The initial image inclusive of all modifications in original resolution is used for export.

Image Instruments

Delete 2D

PurposeDeletes the Images Selected from the Album View and Moves theThumbnails to the Recycle|2D Tab

Image Types All

The context menu item delete deletes the selected images from the album view and shifts thethumbnails to the Recycle|2D tab. The original image records in the Pictures system folder are keptthere.

Image Instruments

Print 2D

Purpose Prints Pre-Defined Layouts

Image Types All

Call Icon Buttons | Context Menu Above Thumbnails

The Print call of the |Images| tab allows printing of images in print forms with pre-defined standardlayout. The parameters for up to three printers can be pre-set and called.

Icon Description

Creation of a new print form. It can be saved under any name and then appears in the list ofthe available forms. see: Editors

Opens the form selected in the list for editing. Modified forms can be saved under newname for getting different versions of one and the same layout. see: Editors

Deletes no longer required form from the list. Letters that were created and saved on thebasis of the deleted form can be furthermore displayed and used.

Exports a print form as patch file (file extension *.O3P). So print form exchange betweendifferent OnyxCeph™ users becomes possible.

Opens program help for print function.

Opens input dialog for graphics settings. ¹

¹ Setting of printer-specific graphic options in the View: Input Window dialog.

Standard Print Layout

Image Instruments

If one image is selected when calling the print function the form selection dialog with pre-selectedstandard form that comprises patient data and full-page image is opened. In the finding selectionfield the item of the image selected appears. This pre-selection can be replaced by another image ofthe same type by means of the [Search] button right of the input field. By selecting Printer 1 ...Printer 3 the printer can be assigned pre-defined graphic options. The [Preview] button opens theprint preview.

If more than one image (max. 8) is selected when calling the print function the form selection dialogwith pre-selected standard form that comprises patient data and rows of fitted in images (max. 4 perpage) inclusive of record date and session specification. In the finding selection fields the items ofthe images selected appear. This pre-selection can be replaced by other images of the same typeby means of the [Search] buttons right of the input fields. By selecting Printer 1 ... Printer 3 theprinter can be assigned pre-defined graphic options. The [Preview] button opens the print preview.

Image Instruments

Individual Print Layout

In the Form drop-down field of the print menu window beside the standard layout any other layout canbe selected from the list ( see also: Print Tab ). All images embedded in the form are displayedas separate fields of the image selection panel and can be replaced by images of the same typeagain. Empty or deactivated items deactivate the respective print object.

Image Instruments

Presentation 2D

Purpose Present Images in Pre-Defined Layouts

Image Types All

In order to call a presentation out of a specific session, select one or more of the session's imagesand call the gallery or presentation layout desired by means of the context menu. The layout isopened in the adjust mode that allows image adjustment. By the context menu item Export Viewabove the full-screen view of the presentation it can be handed over to the patient's slide show on the|Presentation| tab.

Image Instruments

Send to 2D

Purpose Make Image Record Available for Functions Outside of the |Images| Tab

Image Types All

In order to make the images selected in the album of the |Images| tab available for further functionsthe options

E-Mail FolderReportContainerPresentationImage Viewer

can be used.

Send to E-Mail Folder:Transfer of the images selected or of all the patient's images to the E-Mail folder that can bespecified via Options|System Options on the Interfaces tab. The transferred images are stored in theE-Mail folder as ZIP file. The item Empty Folder resets the content of the E-Mail folder.

Send to Report:Transfer of the images selected or of all the patient's to the HTML report that can be edited and sentby the Communication menu. The item Empty Report resets the HTML report's content (notactivated in Version 3.1).

Send to Container:Transfer of the images selected or of all the patient's images to the export mailbox that can be editedand sent by the Communication menu. The item Empty Container resets the export mailbox'content.

Send to Presentation:Transfer of the images selected to the |Presentation| tab. Via Single Image or Multiple Images itemit can be specified if the images are to be arranged on a mutual slide or each image on a separateone.

Send to Image Viewer:Opens external Onyx Image Viewer with the selected findings.

Image Instruments

Mouse Mode 2D

Purpose Defines initial mouse mode for preview panel in main window

Image Types All

The initial mouse mode for the image preview panel can be switched between options

ZoomEdit Image

Zoom:Standard mouse cursor is initially displayed and zooming in by drag&drop is enabled. Once zoomedin, the mouse mode switches to the Edit Image mode allowing image displacement, rotation andzoom in/out. Return to Zoom mode by double click.

Edit Image:Edit mouse cursor is initially activated allowing image displacement, rotation and zoom in/outimmediately. No zoom in by drag&drop is available.

Image Instruments

Full-Screen 2D

Purpose Full-Screen Display of up to 4 Thumbnails Selected in the Album

Image Types All

Call Context Menu Above Thumbnails | Double-Click on Thumbnail | Double-Click on Preview Panel

The thumbnail selected within the album can be displayed in full-screen mode via double-click on thethumbnail or preview window or via context menu. The usual view options, such as zoom in/out andmove, are available. By mouse-click it jumping to the next full-screen image of the image sequenceis possible. The context menu above the full-screen image comprises further functions.

Context Menu Full-Screen (Single Image Selected)

[Record Series] Allows Selective Jumping to Another Image Record

Show Navigator Activates | Deactivates Image Navigator Panel ¹

Show Tracing Displays Tracing Above Full-Screen Image, if Available

Reset Resets a Zoomed In/Out View

Save As Allows Exporting the Current View as Image File

Print View Allows Printing the Current View

Exit Closes the Full-Screen View

¹ Navigator Panel

The buttons of the image navigator panel allow going to the previous or next image (single arrow) orto the previous or next image of the same image type (double arrow). Via [Home] button the first full-screen image of the series is opened, the [Close] button closes the full-screen mode.

If more than one thumbnail (max. 4) are pre-selected the context menu item Full-Scree is divided intothe subordinate items Parallel and Serial. The Serial option restricts the full-screen series to the pre-selected records. The Parallel option simultaneously shows all pre-selected images on the desktop. The layout can be specified and adjusted via context menu.

Context Menu Full-Screen (More than One Image Selected)

Layout Arrangement Options ¹

Exchange Image Allows Exchanging the Respective Image by Any Image of the Database ²

Save As... Allows Exporting the Current View as Image File

Image Instruments

¹ Displays Tracing Above Full-Screen Image, if Available)

² So, juxtaposition of case studies by means of treatment images of other patients are possible.

Image Instruments

Image Attributes 2D

Purpose Assignment and Display of Information on the Image Record Selected

Image Types All

By the help of the Image Attributes function the images can be assigned attributes (keywords) orcomments (free text) for classification and description purposes. The list of attributes can be createdand managed by the user himself. In addition, attributes for modified images are automaticallygenerated and can be adopted to the list. The attributes can be used as filter criterion within thescope of statistical evaluations.

Creation and management of the image attributes is effected in the Define Attribute: Image dialog,that is opened via search button [...] of the Comments and Attributes: Image dialog.

Assigning the items available in the list is done by means of the arrow button [ ] of the Select

Image Instruments

Attributes window. The sequence of the assigned attributes in the list can be adjusted.

Image Instruments

Properties 2D

Purpose Display of Information on the Image Record Selected

Image Types All

The context menu item Properties above a thumbnail opens a window containing information on theselected image record.

Image Properties

File Name Name of Original Image File in Image Database Directory Pictures seehere

Server Name Database Server (Server-Computer Name)

Path Subordinate Folder of Original Image File in Image Database DirectoryPictures

File Type Type of Original Image File in Image Database Directory Pictures (ii3) see here

Compression Data Compression Type

Bits per Pixel No Indication for ii3 Records

Format Bitmap Size Width x Height (Pixel)

File Size Size of Original Image File

Required RAM Required RAM for Opening Original Image Record

File of Date of Recording

Image Instruments

9.2.1.3.2.2 3D Data

In the subordinate tab |Images|3D| (Patient Album 3D) all the patient's three-dimensional imagerecords available in the database are arranged by sessions (record series) and displayed asthumbnails. In Options|System Options|Image Types the sequence of the image types withinone session can be defined and adjusted. Thumbnails can be moved from one session to another byDrag&Drop. The slide control right of the status bar allows adjusting their size.

The icon bar above the workspace provides all currently available image processing -, diagnostics -and planning functions.

Icon Buttons

Add Image Opens the Image Import window for importing and adjusting of 3D data.

Clone Duplicates a 3D finding record.

DigitizeOpens the Digitize module for cephalometric evaluation of the 3Dfinding selected.

Combine Opens the Combine module for superimposing of two 3D findings.

Mirror Opens the Mirror module to create mirrored and symmetric images.

Waefer Creation Opens the Waefer Creation module for creating of surgical splints.

Model BaseOpens the Model Base module for attaching base trays to 3D modelscans.

SegmentationOpens the Segmentation module to segment, separate, and completesingle tooth from virtual models.

FA_BondingOpens the FA_Bonding module for placing virtual brackets onto virtualmalocclusion models.

V.T.O.3DOpens the V.T.O.3D module for setting up virtual treatment goalsbasing on segmented malocclusion models.

Wire_BondingOpens the Wire_Bonding module for placing virtual brackets ontovirtual set-up models.

CreateContainer

Drop icon for creating and configuring Exchange Containers .

Create Report Drop icon for creating and configuring Onyx Case Reports .

Activate ImagePreview

Activates the full-screen preview panel for the image selected within theworkspace.

Edit SessionComments

Edit / display session comments.

Image Instruments

Send ClientMessage

Allows setting of different view options. see here

Toggle RecycleTab

Activates/deactivates display of the |Recycle| tab.

Help Opens Help for |Images| tab.

Via right mouse click on any thumbnail a context menu is available. In addition to the functionsaddressable by the icon buttons this context menu provides valuable functions for imageadministration. Depending on the pre-selection of one or more images and their image types theitems of the context menu are active or inactive.

Context Menu

Save Saves the single data set selected in the album in ii3 format.

Save As ...Exports the data sets selected in the album in ii3 format to a stateddirectory. see also: Save As ...

CopyCopies the image selected to the Windows clipboard. see also: Copy

DeleteDeletes the images selected from the album view and moves thethumbnails to the Recycle|3D Data tab. see also: Delete .

PresentationOpens selection dialog with available gallery and presentation layouts andcreates the presentation selected with images of the active record series. see also: Presentation .

Send ToSends the images selected in the album to Report|Container|E-Mail|Presentation. see also: Send to .

Mouse Mode Switches the Mouse Mode .

Full-ScreenOpens max. 4 of the images selected in the album in full screen parallelor full screen serial.

see also: Full Screen .

Image Attributes Opens the Image Attributes dialog.

Properties Displays the image record properties in the Properties Dialog .

The subordinate menu of the [Settings] button or the context menu above the album's backgroundallow selection and configuration of three available album views. The selection of album backgroundcolor and thumbnail size (fix or smooth) can be performed using the controls on the right end of thestatus bar.

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Image Instruments

Other settings (image specifics and types, tracing options) are configured on tab |Session| in systemoptions..

Image Instruments

Add Image 3D Module

Purpose Import and Adjustment of Patient-related 3D Data Sets

Image Types All

Call Icon Button | Context Menu Above Thumbnail | Main Menu | CTRL+3

Image Instruments

Clone 3D Module

Image Types All

The function Clone Image creates a copy of the image record selected in the album inclusive oftracing, evaluations, image attributes, comments. In addition, the cloned images is marked with thedefault attributes "Treated" for derived image and "Clone" for duplicated image.

Image Instruments

Digitize 3D Module

Purpose Cephalometric Evaluation of 3D Images

Image Types All

Modul Digitize 3D makes possible cephalometric measurements on all datasets hosted in thedatabase in ii3 file format. Acc. to their image type and to the tracing types assigned in SystemOptions all of the pre-installed analyses can be selected single or multiple and applied for evaluation.Each analysis comprises a fix set of diagnostically important variables which can be calculatedbasing on 3D landmark coordinates in connection with other additional finding information.Consequently, the main purpose of the module is to locate and to digitize all landmarks required forthe analysis result calculation and its graphical presentation as tracing consisting of characteristiclines and planes. Additional functions for further processing and export of results are also available inmodule Digitize 3D.

In OnyxCeph³™ an unitary cephalometric concept 2D|3D was realized. This concept assumes thateach 2D or 3D or dataset generated from the partial or complete object under diagnosis can beinterpreted as different representations of an more or less identical situation - influenced byspecifics of the image generation only. Consequently, physiologically identical landmarks arehandled identically independent of image type and dimension. Additionally, all pairs of landmarkswhich collapse in 2D diagnostics have to be handled as 2 separate points. This is required forexact result calculation and interpretation of differences and deviations from symmetry which areignored in 2D.

One consequence caused by such concept is that we need a unique list of landmarks inOnyxCeph³™ to ensure finding exchange. Therefore, only Image Instruments can add newlandmarks to the global landmark list. Such new landmarks are distributed automatically byupdates or findings exchange between users.

Another consequence of this concept is that landmarks which have been digitized in 3D an beinterpreted in different coordinate systems. Thus, results can be calculated in relation to pre-defined 2D planes such as frontal, sagittal, or transversal planes but also in 3D where each resultcan have its own definition. In fact this means that basing on 3D landmarks all 2D analyses can beapplied what might be interesting at least for methodological studies.

User InterfacePerform Analysis

Image Instruments

Combine 3D Module

Purpose Acquisition and Adjustment of Patient-Related Images

Image Types All

Image Instruments

Mirror 3D Module

Image Types All

Image Instruments

Waefer Creation Module [optional]

Image Types All

Image Instruments

Model Base Module

Image Types All

Image Instruments

Segmentation Module

Image Types All

Image Instruments

FA_Bonding Module

Image Types All

Image Instruments

V.T.O.3D Module [optional]

Image Types All

Image Instruments

Wire_Bonding Module

Image Types All

Image Instruments

Custom Lab Modules

Image Types All

Image Instruments

Exchange Container Function

Purpose Creating and Saving or Sending via FTP Onyx Exchange Containers

Image Types All

Image Instruments

Case Reports

Purpose Creating and Saving or Sending via FTP Onyx Case Reports

Image Types All

Image Instruments

Purpose Saves single focused image (thumbnail) in ii3 format

Image Types All

Pre-selected single image can be saved in ii3 file format.

Image Instruments

Save As ... 3D

Purpose Export of the Images selected in the Album to a Stated Directory

Image Types All

Arbitrary images pre-selected within the album may be exported to data medium by the contextmenu item Save As ... At the stated storage location (folder) a subordinate folder with patient ID andbelow further subordinate folders with type and date of the respective image series are created. Inthese folders the appropriate images are saved as per their image type. The initial image inclusive of all modifications in original resolution is used for export.

Image Instruments

Copy 3D

Purpose Export the Image Selected to the Clipboard

Image Types All

An image pre-selected within the album can be exported to the Windows clipboard by the contextmenu item Copy. From the clipboard it can be inserted into third party programs.

Image Instruments

Delete 3D

Purpose Deletes the Images Selected from the Album View and Moves theThumbnails to the Recycle|3D Tab

Image Types All

The context menu item delete deletes the selected images from the album view and shifts thethumbnails to the Recycle|3D tab. The original image records in the Pictures system folder are keptthere.

Image Instruments

Print 3D

Purpose Prints Pre-Defined Layouts

Image Types All

Call Icon Buttons | Context Menu Above Thumbnails

The Print call of the |Images| tab allows printing of images in print forms with pre-defined standardlayout. The parameters for up to three printers can be pre-set and called.

Icon Description

Creation of a new print form. It can be saved under any name and then appears in the list ofthe available forms. see: Editors .

Opens the form selected in the list for editing. Modified forms can be saved under newname for getting different versions of one and the same layout. see: Editors .

Deletes no longer required form from the list. Letters that were created and saved on thebasis of the deleted form can be furthermore displayed and used.

Exports a print form as patch file (file extension *.O3P). So print form exchange betweendifferent OnyxCeph™ users becomes possible.

Opens program help for the print function.

Opens input dialog for graphics settings. ¹

¹ Setting of printer-specific graphic options in the View: Input Window dialog.

Standard Print Layout

Image Instruments

If one image is selected when calling the print function the form selection dialog with pre-selectedstandard form that comprises patient data and full-page image is opened. In the finding selectionfield the item of the image selected appears. This pre-selection can be replaced by another image ofthe same type by means of the [Search] button right of the input field. By selecting Printer 1 ...Printer 3 the printer can be assigned pre-defined graphic options. The [Preview] button opens theprint preview.

If more than one image (max. 8) is selected when calling the print function the form selection dialogwith pre-selected standard form that comprises patient data and rows of fitted in images (max. 4 perpage) inclusive of record date and session specification. In the finding selection fields the items ofthe images selected appear. This pre-selection can be replaced by other images of the same typeby means of the [Search] buttons right of the input fields. By selecting Printer 1 ... Printer 3 theprinter can be assigned pre-defined graphic options. The [Preview] button opens the print preview.

Image Instruments

Individual Print Layout

In the Form drop-down field of the print menu window beside the standard layout any other layout canbe selected from the list ( see also: Print Tab ). All images embedded in the form are displayedas separate fields of the image selection panel and can be replaced by images of the same typeagain. Empty or deactivated items deactivate the respective print object.

Via Print button a form containing the patient's data and all 3D records selected is printed.

Image Instruments

Presentation 3D

Purpose Present Images in Pre-Defined Layouts

Image Types All

In order to call a presentation out of a specific session, select one or more of the session's imagesand call the gallery or presentation layout desired by means of the context menu. The layout isopened in the adjust mode that allows image adjustment. By the context menu item Export Viewabove the full-screen view of the presentation it can be handed over to the patient's slide show on the|Presentation| tab.

Image Instruments

Send to 3D

Purpose Make Image Record Available for Functions Outside of the |Images| Tab

Image Types All

In order to make the images selected in the album of the |Images| tab available for further functionsthe options

E-Mail FolderReportContainerPresentationImage Viewer

can be used.

Send to E-Mail Folder:Transfer of the images selected or of all the patient's images to the E-Mail folder that can bespecified via Options|System Options on the Interfaces tab. The transferred images are stored in theE-Mail folder as ZIP file. The item Empty Folder resets the content of the E-Mail folder.

Send to Report:Transfer of the images selected or of all the patient's to the HTML report that can be edited and sentby the Communication menu. The item Empty Report resets the HTML report's content (notactivated in Version 3.1).

Send to Container:Transfer of the images selected or of all the patient's images to the export mailbox that can be editedand sent by the Communication menu. The item Empty Container resets the export mailbox'content.

Send to Presentation:Transfer of the images selected to the |Presentation| tab. Via Single Image or Multiple Images itemit can be specified if the images are to be arranged on a mutual slide or each image on a separateone.

Send to Image Viewer:Opens external Onyx Image Viewer with the selected image files.

Image Instruments

Mouse Mode 3D

Purpose Defines initial mouse mode for preview panel in main window

Image Types All

The initial mouse mode for the image preview panel can be switched between options

ZoomEdit Image

Zoom:Standard mouse cursor is initially displayed and zooming in by drag&drop is enabled. Once zoomedin, the mouse mode switches to the Edit Image mode allowing image movement, displacement,rotation and zoom in/out. Return to Zoom mode by double click.

Edit Image:Edit mouse cursor is initially activated allowing image movement, displacement, rotation and zoomin/out immediately. No zoom in by drag&drop is available.

Image Instruments

Full Screen 3D

Purpose Full-Screen Display of up to 4 Thumbnails Selected in the Album

Image Types All

CallContext Menu Above Thumbnails | Double-Click on Thumbnail | Double-Click on Preview Panel

The thumbnail selected within the album can be displayed in full-screen mode via double-click on thethumbnail or preview window or via context menu. The usual view options, such as zoom in/out andmove, are available. By mouse-click it jumping to the next full-screen image of the image sequenceis possible. The context menu above the full-screen image comprises further functions.

Context Menu Full-Screen (Single Image Selected)

[Record Series] Allows Selective Jumping to Another Image Record

Show Navigator Activates | Deactivates Image Navigator Panel ¹

Next Jump to the Next Full-Screen View

3D Control 3D Control Panel ²

Reset Resets Zoomed-In/-Out View

¹ Navigator Panel | ² 3D Control Panel

Image Instruments

The buttons of the image navigator panel allow going to the previous or next image (single arrow) orto the previous or next image of the same image type (double arrow). Via [Home] button the first full-screen image of the series is opened, the [Close] button closes the full-screen mode.

If more than one thumbnail (max. 4) are pre-selected the context menu item Full-Scree is divided intothe subordinate items Parallel and Serial. The Serial option restricts the full-screen series to the pre-selected records. The Parallel option simultaneously shows all pre-selected images on the desktop. The layout can be specified and adjusted via context menu.

Context Menu Full-Screen (More than One Image Selected)

3D Control 3D Control Panel

Image Instruments

Layout Arrangement Options ¹

Exchange Image Allows Exchanging the Respective Image by Any Image of the Database ²

Print View Allows Printing of the Current View

¹ Displays Tracing Above Full-Screen Image, if Available

² So, juxtaposition of case studies by means of treatment images of other patients are possible.

Image Instruments

Image Attributes 3D

Purpose Assignment and Display of Information on the Image Record Selected

Image Types All

By the help of the Image Attributes function the image records can be assigned attributes (keywords)or comments (free text) for classification and description purposes. The list of attributes can becreated and managed by the user himself. In addition, attributes for modified images areautomatically generated and can be adopted to the list. The attributes can be used as filter criterionwithin the scope of statistical evaluations.

Creation and management of the image attributes is effected in the Define Attribute: Image dialog,that is opened via search button [...] of the Comments and Attributes: Image dialog.

Image Instruments

Assigning the items available in the list is done by means of the arrow button [ ] of the SelectAttributes window. The sequence of the assigned attributes in the list can be adjusted.

Image Instruments

Properties

Purpose Display of Information on the Image Record Selected

Image Types All

The context menu item Properties above a thumbnail opens a window containing information on theselected image record.

Image Properties

File Name Name of Original Image File in Image Database Directory Pictures seehere

Server Name Database Server (Server-Computer Name)

Path Subordinate Folder of Original Image File in Image Database DirectoryPictures

File Type Type of Original Image File in Image Database Directory Pictures (ii3) see here

Compression Data Compression Type

Bits per Pixel No Indication for ii3 Records

Format Bitmap Size Width x Height (Pixel)

File Size Size of Original Image File

Required RAM Required RAM for Opening Original Image Record

File of Date of Recording

Image Instruments

9.2.1.3.3 Tab Presentation

The |Presentation| tab serves patient consultation purposes by patient-related presentation ofnumeric, verbal and graphic treatment data as well as patient-independent case studies in thesubordinate tabs |Slides| and |Media|.

patient consultation purposes

Subordinate |Slides| TabSubordinate |Media| Tab

Image Instruments

9.2.1.3.3.1 Slides

The subordinate |Slides| tab allows generating of PowerPoint-like presentations (slide shows) andusing them for consultation and documentation purposes. The presentations can be generated indifferent ways:

Generate New Presentation Generate Presentation from Layout DraftGenerate Presentation SequenceGenerate Presentation from Single Image

The presentations generated are displayed as thumbnails of adjustable size in the work space afterall other thumbnails available. Via icon buttons and context menu the presentation can be managedand started. The drag&drop symbol at the bottom of the thumbnail allows drag&drop transfer of thepresentation to PowerPoint or other MS Office applications.

Generate New Presentation

The icon button [Generate Presentation|New] opens the Presentation Editor in a modal window. The presentations generated and saved there appear in the work space of the subordinate [Slides]tab as thumbnails and can be displayed in full screen mode there. Via context menu |Edit| above fullscreen or thumbnail view the editor can be called again for further modifications.

Generate Presentation from Layout Draft

If a presentation is to be generated on the basis of pre-defined gallery or presentation layout drafts,the record series to be used has to be specified via context menu prior to specifying the layout draftitself. In case of not all required images being available in the record series selected or beingcorrectly placed within the frames, the edit mode for corrections can be opened via context menuabove the full screen view.

Generate Presentation Sequence

The settings of the |Presentation| Tab allow combining of pre-defined gallery and presentationlayouts as series (sequences) and saving them under any name. These sequences can be activatedby the icon button or the context menu [Slide Sequence].

Generate Presentation from Single Image

Via [Generate Presentation from Single Image] button any of the patient's image can be placed on apresentation together with a text field.

Icon Button Explanation

Image Instruments

Generatepresentation

Generate Presentation: New | From Single Image | From Layout Draft |From Sequence

Start Slide Show Opens the Thumbnail Selected in Full Screen Mode

Settings Activates the Preview Panel for the Thumbnail selected

Toggle RecycleTab

Activates/Deactivates Display of the Recycle Tab

Help Opens Help for the Presentation Tab

Context MenuBackground

Explanation

New Generate Presentation: New

Presentation Generate Presentation: From Layout Draft

Slide Sequence Generate Presentation: As Sequence

Load Image Generate Presentation from Single Image

Start Presentation Opens Selected Thumbnail in Full Screen Mode

Context MenuThumbnail View

Explanation

Edit Opens Presentation Selected in Edit Mode

Start Presentation Opens Thumbnail Selected in Full Screen Mode

Deactivate Deactivates Full Screen Mode for Selected Presentation

Copy Copies Full Screen View of Selected Presentation as Bitmap in DesktopResolution to Clipboard

Delete Deletes Selected Presentation

Context Menu FullScreen View

Explanation

Next Goes to the Next Presentation Full Screen View within the Slide Show

Go To Goes to the Selected Presentation Full Screen View within the SlideShow

Edit Opens Selected Presentation in edit Mode

Adjust Opens Selected Presentation in Adjust Mode

Copy View Copies Full Screen View of Selected Presentation as Bitmap in DesktopResolution to Clipboard

Export View ... Exports Full Screen View as Bitmap in Desktop Resolution

Print ... Prints Full Screen View

Player ¹ Player Functionality for Animated Images

Close Closes Full Screen View

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¹ for AVI Objects only

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9.2.1.3.3.2 Media

On the subordinate |Media| tab a structured presentation tree with patient-independent images andanimations can be used for consulting purposes. A sample tree "OnyxCeph" with images fordifferent problems within the scope of orthodontic treatment comes with the program. This sampletree cannot be edited. By means of the [New Tree Structure] button, however, the user himself cangenerate an unlimited number of new trees can. The [Edit Tree] button allows adding of own imagesand animations. By the [Save Tree Structure] button the tree is saved in the database ( see also:Media Editor ).

The stored images and animations can be opened in the right preview panel by selection of the tree'srespective branch. Double-clicking on the preview or the [Full Screen] button below the tree structureopen the full screen view of the image or the animation.

Edit Tree Open the Tree Selected in the Edit Mode

Save TreeStructure

Save Edited Media Tree

New TreeStructure

Generate New Media Tree

Settings Allows Setting of Display Options: Background Color

Toggle RecycleTab

Activates/Deactivates the Recycle Tab

Help Opens the Help for the Presentation Tab

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9.2.1.3.4 Tab Letters

The |Letters| tab allows generating, patient-related saving or printing of individual pre-defined lettersfor patients or colleagues.

For generating and managing of letters, whose contents refer to diagnostic information or planningdetails of the database, pre-defined layout drafts can be selected from the [Forms] pull-down ( seealso: Settings|Letters Tab ) of the |Letters| tab. The linked images are displayed in the panel rightof the preview area. The items pre-selected can be replaced by alternative images of the sameimage type by means of the [Select Image] button. The [Preview] button below the image list opensthe letter with the image data selected in the preview panel at the left. If there are editable text fieldsin the layout, they can be completed or edited in the preview mode by the help of the text optionsabove the preview area.

The letters displayed in the preview window can be directly printed by the [Print] button or saved inthe database under the layout draft's and the current date by the [Save Data] button. Already saved(completed) letters can be displayed and edited by the icon button [Open]. In addition the savedletters appear in the document tree on the |Patient| tab and, similar to all other entries, can bedirectly called there.

Save Data Save Completed Form

Print Print the Current Content of the Preview Window

Open Open Saved (Completed) Letter

Close closes the Current Content of the Preview Window

Delete Removes the Opened Letter from the Database

Toggle RecycleTab

Activates/Deactivates Display of the Recycle Tab

Help Opens Help for the |Letters| Tab

There is no context menu or the |Letters| tab work space.

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9.2.1.3.5 Tab Forms

The |Forms| tab allows recording and managing of image-related information in the form ofindividual questionnaires. The layout of the forms has to be generated by means of external DHMLeditors by the user himself.

Thus, OnyxCeph™ primarily being an imaging application, an effective work flow requires recording,managing and displaying of specific not image-based patient data within the program. For thesepurposes HTML/DHTML forms generated by external editors can be imported and applied in the |Forms| index card. The form drafts can be stored in the categories

Medical HistoryFunctional DiagnosticsClinical DocumentationOthers

( see also: Settings|Forms tab ). Active drafts can be selected and called by the icon button[New] of the Forms dialog via Category and Form layout name.

The selected form is displayed, completed and saved under selectably name by the [Save Data]button within the browser window. Already saved (completed) forms can be displayed and edited bythe icon button [Open]. In addition the saved forms appear in the document tree on the |Patient| tab

and, similar to all other entries, can be directly called there.

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Icon Button Description

Save Data save Completed Form

New Empty Form Draft

Open Open Saved (Completed) Form

Reload Update Browser Window

Close Closes the Current Form

Delete Remove Current Form from Database

Toggle RecycleTab

Activates/deactivates the Display of the Recycle Tab

Help Opens help for the |Forms| Tab

DHTML forms are displayed in the workspace of the |Forms| tab by means of an internet-browserwindow. The IE functionality used is adjusted to the version installed on your computer. Via contextmenu browser-specific calls are available.

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9.2.1.3.6 Tab Online

The |Online| tab provides an internal internet-browser window for quick access to online informationout of the program.

Backward Jump to the Previous Website in the Browser History

Forward Jump to the Next Website in the Browser History

Go Jump to the Website Specified in the Address Bar

Start Report ¹ Report Preview within the Browser Window

Toggle RecycleTab

Activates/Deactivates the Display of the Recycle Tab

Help Opens Help for the |Online| Tab

¹ deactivated in Version 3.1

The called internet pages are displayed by means of an internet-explorer window within theworkspace of the |Online| tab. The IE functionality used is adjusted to the version installed on yourcomputer. Via context menu browser-specific calls are available.

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9.2.1.3.7 Tab Recycle

In the |Recycle| tab all image records, presentations and other important data deleted by theprogram functtions are preserved until they are finally restored or deleted.

Subordinate Tab Explanation

Global Data Unused at Present

2D Images Shows all 2D Image Records to be Deleted

3D Images Shows all 3D Image Records to be Deleted

Slides Shows all Presentation Records to be Deleted

All functionality available in the subordinate tabs can be called via icon buttons or context menuabove the objects to be deleted.

Refresh Updates the Recycle Bin's Contents

Restore Restores the Highlighted Object at its Original Position

DeletePermanently

Finally Deletes the Highlighted Object

Toggle RecycleTab

Activates/Deactivates the Display of the Recycle Tab

Help Opens the Help for the Recycle Tab

Context Menu Item Description

Restore [Ins] Restores the Highlighted Object at its Original Position

Delete [Del] Finally Deletes the Selected Object

Thumbnail Size Setting of Fix Thumbnail Sizes: 48x48 | 64x64 | 80x80 | 96x96

Sort By Sort Criterion for Display in the Record Series: Type | Date | No

Sort Direction Sort Direction as per Sort Criterion: Ascending | Descending

Select All [Ctrl+A] Select All the Objects

Select None Select None of the Objects

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9.2.2 Settings

The system options dialog allows adjusting the program OnyxCeph™ to the practice's individual workflow and to the available hard- and software environment. Network- as well as workstation-specificparameters can be selected and altered. The parameters are grouped on tabs as per their functionalcohesion. Changes have to be saved or cancelled prior to switching to another tab or closing thedialog.

|Patient Data| Tab|Sessions| Tab|Image Types| Tab|Galleries| Tab|Presentations| Tab|Print| Tab|Forms| Tab|Digitize| Tab|Interfaces| Tab|Third Party Tools| Tab

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9.2.2.1 Patient Data Tab

The |Patient Data Tab| allows settings concerning the |Patient| index card of the main programOnyxCeph™.

Show Image Types Panel

The Show Image Types panel allows specifying of the two images to be displayed on the |Patient|index card.

VDDS Media Panel

The VDDS Media panel enables settings concerning the VDDS interface for exchange of patient - orimage data between dental software applications.

Setting Description

Adoption of MasterData via VDDS

Activates Adoption of Master Data from VDDS Partners

Adopt Master Data Master Data is Adopted from All VDS Partners

Adopt Master Datafrom:

Master Data is Adopted from Specified VDDS Partners

Slides with Tracing ... Onyx Thumbnails of Pre-Set Size are Transferred to VDDS Partners

Original Images Onyx Original Images are Transferred to VDDS Partners

[VDDS - ImageSources]

Opens the Settings Dialog for VDDS Image Sources (see |Interfaces|tab)

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Flags Panel

In the Flags panel the flags on the |Patient| tab are assigned their meaning that is displayed as hintthere. .

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9.2.2.2 Sessions Tab

The |Sessions| tab allows re-naming and re-arranging of pre-defined session types.

All image records acquired in OnyxCeph™ are arranged in sessions that are specified by sessiontype and date. Any session type may appear more several times as long as different dates are usedfor sessions of the same type. OnyxCeph³™ uses five pre-defined session types. They can be re-named via [Edit Entry) button. The session types' sequence in the album of the |Images| tab isconsistent with the sequence in the Available Sessions panel of the |Sessions| tab. This sequencecan be modified by the arrow buttons. Session types that are not required can be hidden by meansof the respective checkbox.

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9.2.2.3 Image Types Tab

The |Image Types| tab allows setting of import - and view options for the pre-defined image types.

The image types (2D|3D) pre-defined in OnyxCeph™ can be adjusted as to their import - and view-/evaluation options. Defining of new image types by the user is not supported due to compatibilityreasons. If additional image types are required the manufacturer will add them. New image typesare transferred to the existing installation by means of patches, updates and container exchange.

The image types' sequence in the album of the |Images| tab is consistent with the sequence of the |Image Types| tab. This sequence can be modified by the arrow buttons. Image types that are notrequired can be hidden by means of the respective checkbox. The properties of the item selected inthe list can be modified by means of the (Edit) button.

General Panel

In the general panel different standard settings are possible.

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Setting Description

Image Type Name Name of the Image Type

Image Type Category Assignment to one of the Image Type Categories Available (Image |Intraoral | X-Ray | Model)

Thumbnail [Load...] Loading of a New Image type Icon (Recommended Size 256 x 256 Pixels)

Thumbnail [Delete] Deleting of an Unused Image Type Icon

Image Acquisition (2D) Panel

The Image Acquisition (2D) panel allows specifying of settings concerning acquisition and alignmentof 2D images.

Setting Description

Maximum Image Size ¹ Maximum Size of the Larger Dimension (Width, Height) to which theOriginal Image Size is Reduced During Import While the Aspect Ratio isKept

Image Aspect Ratio(%) ²

Definition of a Standard Aspect Ratio (Width:Height | Aspect Ratio) in %

Horizontal Guideline(%) ²

Definition of a Standard Reference Line for Horizontal Image Alignment

Vertical Guideline (%) ² Definition of a Standard Reference Line for Vertical Image Alignment

Rotate Image ¹ Rotation (0°|90°|180°|270°) that is Automatically Effected when the ImageType is Assigned

Fit Image to Frame ² Integration (Automatic|Height|Width) of the Original Image into the Pre-Defined Aspect Ratio

Mirror ImageHorizontally ¹

Horizontal Mirroring Automatically Effected when the Image Type isAssigned

Mirror Image Vertically¹

Vertical Mirroring Automatically Effected when the Image Type isAssigned

Adjust Aspect Ratio ¹ Applies Option "Fit Image to Frame" when 2D Images are Saved, Even if |Adjust Image| Option was not Used.

¹ these settings are assigned when the image type is assigned or when the image is saved.

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² these settings are assigned when the image is adjusted.

Image Acquisition (3D) Panel

The Image Acquisition (3D) allows setting of the maximum number of separate objects managed inthe internal ii3 image record. The Default-Layout checkbox enables the separate display of first andsecond object of the object list in partial windows of the image acquisition and adjustment function.

Tracing (2D) Panel

In the Tracing (2D) panel the 2D tracing type (Tracing Type) and the analyses to be preferentiallyused (Analyses) are set. These settings are relevant for the evaluation methods provided in theDigitize 2D module.

Tracing (3D) panel

In the Tracing (3D) panel the corresponding 2D image types and the 3D tracing types (Tracing Types)

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are set. These settings are relevant for the evaluation methods provided in the Digitize 3D module.

Slide View Panel

In the Slide View panel the standard analysis used for the thumbnail view as well as the print form tobe preferentially used are set.

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9.2.2.4 Galleries Tab

The |Galleries| tab allows creating, editing and managing of gallery drafts for image acquisition inthe |Images| index card.

Available Gelleries Panel

The galleries' sequence in respective dialogs is consistent with the sequence of the |Galleries| tab. This sequence can be modified by the arrow buttons. Galleries that are not required can be hiddenby means of the respective checkbox. The properties of the item selected in the list can bemodified, deleted or exported as patch file by means of the icon buttons.

Icon Description

Moves the List Item Selected Up

Moves the List Item selected Down

Generates a New Gallery Draft. This Can be Saved Under Any Name and Appears in theList of Available Galleries. see: Editors

Opens the Gallery Draft Selected in the List for Editing. Changed Drafts Can be SavedUnder New Name in Order to Get Different Modifications of One and the same Layout. see: Editors

Deletes no Longer Required Drafts from the List. Display and Use of Presentations on the |Presentation| Tab Generated on the Basis of the Deleted Draft Stays Possible.

Export of Gallery Layout Drafts as Patch File (File Extension *.O3P). Allows Exchange ofLayout Drafts Between OnyxCeph™ Users.

Presentation Options Panel

In the Presentation Options panel the resolution of the images in the gallery draft is set. Alternativeto setting a maximum number of pixels for the largest image dimension the thumbnail stored in the

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image record (equal to max. image size 256) can be used.

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9.2.2.5 Presentation Tab

The |Presentation| tab allows creating, editing and managing of presentation drafts for the |Presentation| index card.

Available Presentations Panel

The presentations' sequence in the respective dialogs is consistent with the sequence of the |Presentation| tab. This sequence can be modified by the arrow buttons. Presentations that are notrequired can be hidden by means of the respective checkbox. The properties of the item selected inthe list can be modified, deleted or exported as patch file by means of the icon buttons.

Icon Description

Moves the List Item Selected Down

Generates a New Presentation Draft. This Can be Saved Under Any Name and Appears inthe List of Available Presentations. see: Editors

Opens the Presentation Draft Selected in the List for Editing. Changed Drafts Can be SavedUnder New Name in Order to Get Different Modifications of One and the Same Layout. see: Editors

Deletes no Longer Required Drafts from the List. Display and Use of Presentations on the |Presentation| Tab Generated on the Basis of the Deleted Draft Stays Possible.

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Export of Presentation Layout Drafts as Patch File (File Extension *.O3P). AllowsExchange of Layout Drafts Between OnyxCeph™ Users.

Via the Sequences select field the list of single layouts is exchanged by the list of pre-definedpresentation sequences. By means of the icon buttons [New] and [Edit] the presentation sequencescan be configured from available gallery and presentation layouts. These sequences enable quickand easy generation of complex screen presentations in the |Presentation| tab.

Relations Panel

The specification in the Relations panel allow configuring of automatic presentation generationdepending on assigned patient attributes on the |Presentation| tab.

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9.2.2.6 Printouts Tab

The |Printouts| tab allows creating, editing and managing of print form drafts for the |Letters| indexcard.

Available Print Forms Panel

The print forms' sequence in the respective dialogs is consistent with the sequence of the |Letters|tab. This sequence can be modified by the arrow buttons. Print forms that are not required can behidden by means of the respective checkbox. The properties of the item selected in the list can bemodified, deleted or exported as patch file by means of the icon buttons.

Icon Description

Moves the List Item Selected Down

Generates a New Print Form Draft. This Can be Saved Under Any Name and Appears in theList of Available Print Forms. see: Editors

Opens the Print Form Draft Selected in the List for Editing. Changed Drafts Can be SavedUnder New Name in Order to Get Different Modifications of One and the Same Layout. see: Editors

Deletes no Longer Required Drafts from the List. Display and Use of Letters Generated onthe Basis of the Deleted Draft Stays Possible.

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Export of Print Form Drafts as Patch File (File Extension *.O3P). Allows Exchange ofLayout Drafts Between OnyxCeph™ Users.

Print Options Panel

In the Print Options panel 3 standard printers and the print options to be used for printing of analysisgraphics with these printers can be specified. In the Print Quality drop-down the maximum printresolution can be set.

Via [Edit Text Block] button an Editor Window is opened that allows defining a text blockconsisting of field variables. The text pre-defined and -formatted in tis way can be inserted as fieldvariable "text block" into arbitrary text fields.

The button [Edit Letterhead] allows pre-defining and -formatting of another text field that can beinserted into print forms as uniform letterhead via "Load Letterhead" button of the print editor.

The checkboxes "Deactivate Stream" and "Activate Stretch Mode represent service options forsolving of problems with certain printers and, unless otherwise recommended by the support, shouldnormally be deactivated.

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9.2.2.7 Forms Tab

The |Forms| tab allows loading and managing of DHTML form drafts for the |Forms| index card.

Thus, OnyxCeph™ primarily being an imaging application, an effective work flow requires recording,managing and displaying of specific not image-based patient data within the program. For thesepurposes HTML/DHTML forms generated by external editors can be imported and applied in the |Forms| index card. The form drafts can be stored in the categories

Medical HistoryFunctional DiagnosticsClinical DocumentationOthers

The pre-defined form layouts' sequence in the respective pull-downs is consistent with the sequenceof the |Forms| tab. This sequence can be modified by the arrow buttons. Layouts that are notrequired can be hidden by means of the respective checkbox. Loading and deleting of HTML/DHTMLform drafts is possible via icon buttons.

For generating of HTML/DHTML forms external editors (e.g. DFM2HTML) have to be used. Allelements required for proper display of index.html in the browser window must be on one and thesame directory level. If the content of this directory is compressed as ZIP file it can be imported toone of the four categories under selectable name by the [Add] button.

HTML/DHTML forms are not translated but have to be generated for the language required bymeans of an external editor. If wildcards are used for the field names of the form they are replacedby patient-specific data from the OnyxCeph³™ database:

Onyx_Patient_Name Name

Onyx_Patient_First First Name

Onyx_Patient_Age Age

Onyx_Patient_Birth Birthday

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Onyx_Patient_ID Patient's ID

Onyx_Patient_Sex Gender

Onyx_Patient_Title Title

Onyx_Patient_Middle Middle Name

Onyx_Patient_Race Ethnic Group

Onyx_Patient_Address Address

Onyx_Patient_ZIP Zip Code

Onyx_Patient_City Residence

Onyx_Patient_State Federal State

Onyx_Patient_HomePhone Private Phone Number

Onyx_Patient_WorkePhone Business Phone Number

Onyx_Patient_CellPhone Mobile Phone Number

Onyx_Patient_Email E-Mail Address

Onyx_Patient_RefDoctor Referring Doctor

Onyx_Patient_InitContactDate Date of the First Appointment

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9.2.2.8 Digitize Tab

The |Digitize| tab allows settings concerning the cephalometric evaluation of images.

Tracing Panel

By the [Options] button of the tracing panel the settings dialog for view options affecting the Digitize(2D|3D) module is opened. The different parameters are grouped on different tabs.

Tab Description

Templates Activating/Deactivating of the Available Templates Grouped by ImageCategories and Tracing Types. The Settings are Applied in the DigitizeModule but Can be Overwritten There.

Variables Display Options (Color, Line Size) for Variable Algorithm Graphics

Points Display Options (Color, Line Size) for Landmark Algorithm Graphics

3D Display Options (Background Color, Dimensioning) for Point and VariableGraphics on 3D Surfaces

Input Window Display Options (Font, Color, Line Sizes) for Template Graphics

Auxiliary Windows Display Options (Colors, Line Sizes) for Points in the Tracing Sketch

Surface General Settings (Colors, Cursor Graphic, Other Parameters) Concerningthe Digitize Window

Analyses Panel

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In the cephalometric (2D|3D) area of OnyxCeph³™ it is differentiated between system analyses andindividual analyse. Individual analyses are ignored during updates and can be exported as patch toother OnyxCeph³™ users or deleted by means of the buttons [Export Analysis] and [DeleteAnalysis]. The [Landmark Sequence] button allows customizing of the global landmark sequence forany tracing type. The button [Import 2.7 Analysis] can be used for importing of analyses of theprevious version OnyxCeph™ 2.7.

We advise not to customize the landmarks' sequence owing to the fact that the graphic inputwizards depend on all required landmarks being digitized before, which may no longer be providedafter re-sorting. In addition, the landmark sequence may get confusing in case of adding of newlandmarks during update as the new points are sorted at the end of the list.

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9.2.2.9 Interfaces Tab

The |Interfaces| tab allows configuring of interfaces for image sources, document export and e-mailexport.

External Image Sources Panel

The settings dialogs for different groups of 2D and 3D image sources can be opened via theappropriate buttons. The interfaces' concrete configuration is explained in the technical manual.

Button Explanation

Digital XRay (2D) Settings Dialog for 2D XRay-Devices

Digital Camera (2D) Settings Dialog for Remote Controlled Digital Cameras (Canon)

VDDS - Image Sources(2D)

Settings Dialog for 2D VDDS-Image Sources

CT Scanner (3D) Settings Dialog for 3D Volumen Scanners (e.g. CT, CBCT)

Face Scanner (3D) Settings Dialog for 3D Surface Scanners

VDDS - Image Sources(3D)

Settings Dialog for 3D VDDS-Image Sources

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Archive Panel

OnyxCeph³™ supports recording and managing of external documents concerning the patient. Forthis a path available in the entire network can be specified. There the external documents arepatient-related stored. The document types to be used are pre-defined via [Document Types]button.

In order to enable e-mail dispatch of image series out of the program the images selected in thethumbnail view of the |Images| tab can be exported to the local or global e-mail path stated in thearchive panel via context menu. The exported images are stored there under the stated namegrouped as per image type and session compressed as ZIP file.

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9.2.2.10 Third Party Tools Tab

Beside the data exchange with the practice management software the |Third Party Tools| allowsconfiguring of up to four additional applications.

Name and menu activation of the praxis management system or the third party program is enteredinto the upper panel. Under this name the link to the program call appears in the Go To menu item ofthe main menu.

Panel Explanation

Program Name and Menu Activation of the Third Party Program

1. Hand over Master DataSelect the Type of [Patient's-] Master Data that is Handed overwhen the Program is Started

2. Bring active Program to theForeground

Compelled Display of the Program Window when it is Started

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3. Send Windows-MessageSends a Pre-Defined Message to the Third Party Program when itis Started

4. Start Program / Open File Storage Location and Start Parameters of the Third PartyProgram

Patient Image Folder Definition of a patient-related image folder structure (Image Import)

Parameters for Start Program / Open File and patient-related image folder

Parameter Action

\%0 PatID - Patient number 08/15

\%1 PatID - Patient number corrcted acc. to printable characterse.g. 08~615 (where "/" is replaced by "~6")

Folgende Zeichen werden bei der Korrektur ersetzt:"\" replaced by "~0""*" replaced by "~1""?" replaced by "~2""@" replaced by "~3"":" replaced by "~4"""" replaced by "~5""/" replaced by "~6" "<" replaced by "~7"">" replaced by "~8""|" replaced by "~9"

\%2 Patient Name

\%3 Patient First Name

\%4 Day of Birth - Format: YYYYMMDDe.g. 19960313 for 13.3.1996

\%5 Gender / Sex allowed values:

"X": unknown"M": Male"F": Female"MC": Male Converted"FC": Female Converted

\%6* Image filename starting from image folder on server

e.g. 08~615\08~615SBIX.jpg

\%7* Image codee.g. 08~615SBIX

\%8 Patient Name w/o empty spaces

\%9 Patient First name w/o empty spaces

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\%% "%" sign (if needed)

* only to be used as parameters for starting programs/open filesMacro commands for specific interfaces**

Parameter Action

\<FDK_D> replaced by the image folder name acc. to KFO-Office-encryption using DoB

\<FDK_I> replaced by the image folder name acc. to KFO-Office-encryption using Patient ID

\<TNTand> replaced by string "NameFirstName" w/o empty spacese.g. "Muller-HerbstSamuelJohn" for Samuel John Muller-Herbst

** only to be used as parameters for defining image folders

In addition, macros for string manipulation can be defined to address more complex folder andsubfolder constructs. Please, contact Image Instruments directly if such macro needs to be provided.

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9.2.3 Editors

The templates for galleries (align images), presentations (present images and results) and print forms(generate print forms) used in OnyxCeph™ can be created and maintained by means of internaleditors. The functioning of all three editors is identical. Merely the objects available and theirconfiguration differ slightly.

UseGallery-EditorPresentation-EditorPrint-Editor Media-Editor

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9.2.3.1 Use

The editors for gallery -, presentation - and print drafts are allocated in a modal program window. They are usually called from the respective tabs of the Options|System Options settings dialog. The editors may, however, also be used for adjusting of forms that are already assigned concreteprint objects (e.g. finding images).

The basic work flow for creation or adjustment of layouts consists of defining the desired object typevia icon bar or context menu item New Object, placing it at the respective area of the editor field byDrag&Drop and assigning the required appearance via object-specific properties dialogs. Objectsmay be copied, pasted from clipboard or deleted by means of the [Copy Current Object], [PasteCurrent Object] and [Delete] icon buttons. Further icon buttons allow fading in of a grid of reference lines and adjusting the resolution of the grid

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used for alignment of objects between 1x1 and 10x10 pixels.

Editor Main Menu

New Opens New (Empty) editor Window

Edit Closes Editor Window and Allows Opening of an Existing Layout from theList

Save Saves Current Status Under Current Layout Name

Save as ... saves Current Status Under Selectable Name

Exit Closes Editor Window

Copy Copies Selected Object

Paste Pastes Object from Clipboard

Delete Deletes Selected Object

Mark All Selects All Objects

Properties Opens Properties Dialog for Selected Object

Grid Activates/Deactivates Grid of Reference Lines

Options

Grid Size Distance betw. the Reference Lines (4 | 5 | 8 | 10 | 16 | 20)

Grid Distance betw. the Grid Lines for Object Alignment (1 | 2 | 4 | 6 | 8 | 10)

Page View Portrait | Landscape | Desktop

Info ... Opens Manual for Editor Use

Editor Context Menu

Menu - Layout Hides Editor Header with Menu and Icon Bar

Mark All Selects All Objects

New Object Generates a New Object ( see also: Gallery-Editor | Presentation-Editor | Print-Editor )

Grid Activates/Deactivates Grid of Reference Lines

Reference Line Adds Horizontal and Vertical Reference Line of Selectable Colors

Background Specification of Background Colors for Layout and Objects

229 231

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Help Opens Manual for Editor Use

Save As ... Saves Current Status Under Selectable Name

Exit Closes Editor Window

Icon Bar Edit Functions

Opens New (Empty) Editor Window

Closes Editor Window and Allows Opening of an Existing Layout from the List

Saves Current Status Under Selectable Name

Preview of the Current Status

Cursor Mode (Select)

Copies Selected Object

Pastes Object from Clipboard

Deletes Selected Object

Activates/Deactivates Grid of Reference Lines

Distance betw. Grid Lines for Object Alignment (1 | 2 | 4 | 6 | 8 | 10)

Opens Properties Dialog for Selected Object

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9.2.3.2 Gallery Editor

Galleries are load templates that facilitate mutual alignment of images of different image types bymeans of corresponding criteria. Gallery layouts can also be used as presentation drafts.

Icon Bar Gallery Objects

Cursor Mode Add Image

Cursor Mode Add Text Field

Cursor Mode Add Logo

When a finding image is inserted the image type to be used (e.g. X-Ray|Lateral Ceph) is queried. The display options can be set in the properties dialog. The object's size and position can beadjusted via Drag&Drop of its frame or by the parameters of the properties dialog.

When a text field is inserted it is displayed in the text edit mode. This mode, that can be reopenedafter leaving via double-click within the text field, allows inserting of static text via keyboard and/or offield variables via context menu. If the field variables contain image type-depending references theimage type is queried after first leaving of the edit mode. The display options of the text field can be

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set in the properties dialog, while adjusting text parameters (font, size, color, etc.) is effected in thetext edit mode. The object's size and position can be adjusted via Drag&Drop of its frame or by theparameters of the properties dialog.

For inserting a logo a graphic select list of all logos available in the database is displayed. If the logoto be used is not in the list it can be loaded via icon button [Add]. The display options can be set inthe properties dialog. The object's size and position can be adjusted via Drag&Drop of its frame orby the parameters of the properties dialog. For receiving an optimum resolution for reproduction youare recommended to choose an original size of the logo that allows 1:1 presentation. Via contextmenu item 1:1 the logo is displayed in original size in the editor field.

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9.2.3.3 Presentation Editor

Presentations are layout drafts for sheets on the |Presentation| tab that allow arranging ofdiagnostic -, planning - and other patient-related information in a desktop presentation for patienteducation and case documentation.

Icon Bar Presentation Objects

Cursor Mode Add Finding Image ¹

Cursor Mode Add Text Field ¹

Cursor Mode Add Table

Cursor Mode Add Logo ¹

Cursor Mode Add Harmony Box

Cursor Mode Add Facial Growth Diagram

Cursor Mode Add Rectangle

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Cursor Mode Add Movie

¹ see: Gallery Editor

When a table is inserted a query appears if an empty (not image-related) or an image-related table isto be generated. For image-related tables the appropriate image type has to be stated as the nextstep. This can be an image already used within the draft or a new image. The display options of thetable can be set in the properties dialog. The object's size and position can be adjusted viaDrag&Drop of its frame or by the parameters of the properties dialog. In order to edit the table'scontent double-click on the table and define rows, blank lines, columns and column widths in theeditor. Select the analysis in the properties dialog before opening the table editor so that theappropriate variables are displayed in the editor.

When harmony boxes, facial growth diagrams or rectangles are inserted the display options can beset in the properties dialog again. The objects harmony box and facial growth diagram are onlyavailable for lateral ceph images and for the analyses that contain such diagrams for resultpresentation. The objects' size and position can be adjusted via Drag&Drop of their frame or by theparameters of the properties dialog..

For inserting a movie, similar to the logos, a graphic select list of all movies available in the databaseis displayed. If the movie to be inserted is not enclosed there it can be loaded as file via |Add]button. The movie's display options can be set in the properties dialog. The object's context menuallows setting for playing the movie.

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9.2.3.4 Print Editor

Print forms comprise pre-defined arrangements of diagnostic, planning, and other patient-relatedinformation for printable documentation. These can be saved in the database or, by virtual PDFprinter, stored as electronic document.

Image Instruments

Icon Bar Print Objects

Image Instruments

Cursor Mode Add Finding Image ¹

Cursor Mode Add Text Field ¹

Cursor Mode Add Table ²

Cursor Mode Add Letterhead

Cursor Mode Add Logo ¹

Cursor Mode Add Harmony Box ²

Cursor Mode Add Facial Growth Diagram ²

Cursor Mode Add Rectangle ²

¹ see: Gallery Editor ² see: Presentation Editor

Adding a letterhead object results in the letterhead pre-formatted in the |Print| tab being inserted astext field at the respective position of the layout. The display options of the letterhead field can beset analogous to usual text fields in the properties dialog. The object's size and position can beadjusted via Drag&Drop of its frame or by the parameters of the properties dialog.

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9.2.3.5 Media Editor

The tree structures with example images and animations (Media) generated by the Media Editorcan be used for patient education in the |Presentation| tab's subordinate |Media| tab.

By the help of the [New Tree Structure] icon button of the subordinate |Media| tab you define the newstructure's name that is to appear in the drop-down select list. Via icon button |Edit Tree Structure|the edit mode is opened. It shows further icons above the media tree. These icons allow designingthe media tree's structure as well as loading of images and animations for the separate branches.

Icon Bar Media editor

Add New Branch

Edit Selected Branch: Add New Image | New Animation

Delete Selected Branch

Move Selected Branch to the Left

Move Selected Branch Up

Move Selected Branch Down

Move Selected Branch to the Right

Duplicate clicking on a branch allows editing its name. The icon button |Save Tree Structure| savesthe current status of the tree in the database.

Image Instruments

9.3 OnyxRegister

The service utility OnyxRegister is required for first and repeated unlocking of the softwareOnyxCeph³™ as licensed application. Activation is valid for the server installation and allworkstations of the appropriate network. The installation in the network and at an additional singleworkstation that is possible within the scope of the license requires separate unlocking underidentical practice name. Program start is effected in the program group OnyxCeph³™ of the workstation's (client's)Windows Start menu.

Authorization (unlocking) of an OnyxCeph³™ installation is done by input of the 25-digit activationcode (key) in step 3 of the registration program OnyxRegister. The key is generated by themanufacturer based on the registration data entered in step 1 and and forwarded in step 2. Registration as user, authorization request and unlocking of the software is described underRegistration Process .

If you receive the 25-digit activation code (license key) as *.OnL file, load this file via the "LoadLicense Key" button in step 3 of the registration dialog. If the key was sent by e-mail, copy it tothe clipboard and paste its content via "License Key" button in step 3 of the registration dialog. Alternatively the key can also be typed on the keyboard.

Image Instruments

9.4 OnyxUninstall

The service routine OnyxUninstall can be used for removal of a workstation's installation. The program is started out of the program group OnyxCeph³™ of the Windows Start menu at theworkstation (Client).

In order to completely remove a workstation's OnyxCeph™ 3 installation, use the call OnyxUninstallof the OnyxCeph³™ program group. It removes the local program directory Onyx3Client as well asthe local program group OnyxCeph™ 3.

Image Instruments

9.5 Further Links

OnyxCeph³™ on the Internet

The OnyxCeph³™ shortcut on the internet opens the OnyxCeph™ homepage in the installedstandard browser. Use this link to inform yourself about the current program version and the latestdevelopments of the software.

OnyxSupport

The OnyxSupport link allows quick and easy calling of the telemaintenance's customer module.Submit the 9 digit session ID to the support partner to allow online access to your computer.

Support

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10 Support

For questions concerning installation and/or use of the software different support options areavailable. The use of these options depends on the license purchased. In principle you may use

Internet Support E-Mail Support Phone SupportOnline Support

for your queries. Additional information is also available on the internet on the OnyxCeph³™homepage www.onyxceph.com. Any support is available only during office time Moday to Friday 9.00am and 5.00pm excl. Germanlegal holidays.

Internet Support

General questions about functionality, prices and further topics associated with the softwareOnyxCeph³™ can be posed via support contact form available on menu item Support / Request Formof the product homepage www.onyxceph.com. Describe the required information as precise aspossible and state an address fro our reply. Support queries via internet do not depend on your registration as user. We answer the questions ofregistered users by return, all other queries are answered as soon as any support capacity isavailable. Also visit topic About / FAQs on www.onyxceph.com to see if answers to your questions can befound in this section already.

E-Mail Support

Questions about OnyxCeph³™ also can be asked by e-mail to info@onyx-ceph.de. Describe theproblem as precise as possible and state an address for our answer if it is not the forwarder's one. Support queries by e-mail do also not depend on your registration as user. We answer thequestions of registered users by return, all other queries are answered as soon as any supportcapacity is available.

Phone Support

If you need short notice help in case of technical problems, call us at +49 371 9093140. Please notethat technical queries about OnyxCeph³™ are forwarded to our developers so that capacity-causeddelay is possible.

Online Support

Step 1 - Phone Contact Call our Support on +49 371 9093140 to describe the support request. In many cases, the fastestsolution for a support issue is desktop sharing by online accessing your computer. All you need is to

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be connected to the Internet.

Step 2 - Get Connected

When invited to an online session by our Support, simply launch the QuickSupport1. Depending onyour Internet browser software, you will be able to run (IE) or download and then run (Firefox) thelinked application onyxhelp.exe. There will be several security hints before you finally will see thesession ID which should submitted by phone or email.

Security Hint No software needs to be installed on your end. During the online session, you stay in full control ofyour computer. You can end the online session at any time by clicking the Exit icon on the right.

1 How to launch QuickSupport

From inside OnyxCeph³™ On Tab Online, click on the phone icon

From the Windows DesktopUse Link OnyxHelp

From the Windows program group OnyxCeph³™Use Link OnyxHelp

From website www.onyxceph.comUse Link Online Support in the panel on the right

OnyxCeph³™ Software Development:

Image Instruments GmbHOlbernhauer Str. 509125 ChemnitzGermanyPhone +49 371 9093 140Fax +49 371 9093 149Email info@image-instruments.de

OnyxCeph3™ Software Manual · 2D and 3D image records in dental institutions – in particular...

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