Images, CBCT scans & 3D viewer

Inside the patient record you can file images, X-rays and PDFs, upload CBCT scans and open them in an advanced viewer with three planes, 3D reconstruction and a panoramic, and view the 3D models from the intraoral scanner, bite included.

There are two tabs and each file lives in only one: 📁 Documents (images, PDFs, DICOM and the CBCT scan) and 🧊 3D viewer (STL and PLY only).

Available on every plan. The Admin, Doctors, Assistants, Front desk and Imaging can view and upload; deleting is reserved for the Admin, Doctors and Assistants.

Uploading images or PDFs

In 📁 Documents → 📁 Upload document pick the file — you can select several at once — write a description and press ⬆ Upload. They upload one at a time and, if one fails, the rest still go through and the notice tells you which ones didn't.

You can also upload an image tied to one specific tooth from the odontogram.

The usual image formats are accepted (JPG, PNG, WebP, HEIC, TIFF…), plus PDF, DICOM files and STL/PLY models. The cap per file is 120 MB.

Downloading a file

Every card in the record has a ⬇️ button, and the full-screen viewer carries ⬇️ Download next to ↗️ Open separately.

That button exists because of the iPad. When the system is installed as an app, the browser doesn't offer its own download menu, so an X-ray the server was serving perfectly had no way of being saved. If you use an iPad, that arrow is your only route.

CBCT scans

1. In 📁 Documents, press 🦷 Upload CBCT folder.
2. Pick the whole folder the CBCT machine gave you. The system takes only the slices and leaves out the Windows viewer that usually comes inside.
3. When it finishes it tells you how many slices went in and how much was discarded.

To view it, tap the card marked CBCT SCAN. It opens halfway through the study and you move through it with the slider, the mouse wheel or the arrow keys. It has four views: Axial, Coronal, Sagittal and Arch.

Measuring: two taps on a slice draw a segment with its measurement in millimetres.

Coronal and Sagittal don't come from the CBCT machine: the system reconstructs them. The first time you'll see "Preparing the study… only the first time"; on a large study it can take a while, and if several people ask for reconstructions at once, the later ones wait their turn.

The advanced viewer

At the bottom of the CBCT viewer is the 🩻 Advanced viewer button, which opens the study in a new tab — on purpose, so you don't lose sight of the record you have in front of you.

There, over the study, you have:

• Four screen layouts (1×1, 1×2, 2×1 and 2×2) and a strip of thumbnails, one per series.
• Brightness and contrast with your finger, invert, and presets: Bone, Dental/implants, Soft tissue, Brain, Airway and Lung.
• Measurements: length and bidirectional, in the study's real millimetres.
• Angles: simple and Cobb.
• Areas (ROI): freehand, rectangle, ellipse, circle and density probe.
• Annotations: arrow with text, and free text.
• Cine mode, from 1 to 60 slices per second.

Three planes (MPR)

The MPR button assembles the study as a volume and gives you synchronized axial, coronal and sagittal, with a reference crosshair: move the aiming point in one and the other two follow.

• Rotate plane turns the crosshair, so you can pull oblique slices.
• Slice thickness from 0 to 50 mm, with maximum, minimum or average intensity projection.
• Eight layouts, including MPR + 3D, 3D only and Planning (axial, panoramic, cross-section and 3D; see below).
• Each panel carries its radiological orientation letters.

3D reconstruction

The 3D button (or 3D render inside MPR) raises the volume. The five presets sit in plain view at the bottom of the 3D panel: Bone only, Bone and teeth, Soft tissue, Muscle and Maximum intensity; tap one to see only bone, only teeth or the soft tissue. You rotate, zoom and pan it with your finger or the mouse.

Arch, panoramic and cross-sections

In Arch, mark 5 or 6 points following the arch on the axial slice and press Save arch. The system generates a panoramic — with whatever band width you choose — and a strip of perpendicular cross-sections, with adjustable spacing and thickness.

The curve stays saved and both screens share it, so there's no need to trace it again. If you want to change it, Re-trace the arch.

Re-tracing the arch deletes the cross-section measurements. Each measurement is placed along the curve, so with a new curve it would land on a different tooth. If there are any, when you save the new arch the system tells you how many and asks before going on. Implants are not deleted: they're placed in the patient, not on the curve, and stay where they were.

The panoramic is not for measuring: its width is distance travelled along the arch, not real distance. To measure, use a cross-section.

Measuring on the cross-section and jumping from the panoramic

Above the cross-section there's a bar with Ruler, Cross, ⌫ Clear measurements, Implant and Capture.

• Ruler: two taps on the slice and you get the distance in millimetres.
• Cross: two crossed rulers (four taps) that give two measurements, for example bone height and width: "12.4 × 7.8 mm".
• Tapping a measurement with its tool active selects it; Clear measurements removes the selected one or, if none is selected, all of them.

Measurements live in millimetres on the slice, so they survive changing the spacing or thickness and save themselves with the study, like every other measurement.

Tapping the panoramic jumps to the cross-section at that point. The blue line marks which slice you're on and the ticks every five slices help you find your bearings.

Capture

The Capture button sits on the 2D toolbar (it captures the active window), on the cross-section, on the panoramic and in the MPR bar (there it captures the active panel, the last one you touched). It produces a PNG of what you see: the image, the measurements, the implants and the study label.

• On a computer it downloads.
• On an iPad or phone the share sheet opens (WhatsApp, Mail, AirDrop…); if you close it, nothing happens.
• The file is named estudio-<id>-<view>-<date>-N.png and does not carry the patient's name.

Implant planning

• Catalogue: it ships with generic sizes (Ø 3.3 to 6.0 × 8 to 15 mm) and the clinic adds brand sizes with Add size (brand, model, diameter and length).
• Place: the Implant button on the cross-section or in the MPR — or ＋ Place in the side panel — opens the catalogue; pick a size and tap the slice where the platform goes. It's born with the apex pointing down (mandible); for the maxilla, Flip.
• Move: drag the body. Tilt: drag the apex handle. Length and diameter: the selectors in the side panel, with the catalogue sizes or free in 0.5 mm steps. Remove deletes it.
• How it looks in each plane: a circle on the axial, the profile on coronal, sagittal and cross-section, and the silhouette over the bone in 3D. It's drawn solid when the plane cuts it, faint a few millimetres away and gone when far, so you don't see "ghost" implants on slices that aren't theirs. Tapping one in the list jumps to its cross-section.
• Implants save with the study and appear in captures. Read-only users see them but can't place or move them.

The implant is a cylinder with the catalogue sizes: it doesn't reproduce the thread or the manufacturer's real geometry, and the system doesn't warn about collisions with the nerve or between implants. It's a planning aid, not a surgical guide.

"Planning" layout: inside MPR, under Layout, it appears on screens 1100 px wide or more: on a computer, and on an iPad in landscape only if it's one of the large ones (a 10.2" iPad in landscape is 1080 px wide and doesn't show it). It shows axial, panoramic, cross-section and 3D at once; the panoramic and the cross-section are the same ones as on the Arch screen — same slice, same measurements, same implants — so whatever you place on the cross-section shows up instantly on the axial and in 3D. If the arch hasn't been traced yet, the panel tells you so with a button to trace it. On narrower screens (including any iPad in portrait) the option doesn't appear and it falls back to MPR + 3D.

Measurements save themselves

There's no save button: whatever you draw is saved into the study a second and a half after the last change, and again when you close the tab. At the top you'll see "✓ N measurements saved" with the time.

When you reopen the study, the viewer tells you how many measurements there are and who edited them last. The History tab lists the patient's other studies with their date, slice count and size.

If two people trace the arch at the same time, the last one wins, and the system records who that was.

What doesn't work the way its name suggests today

Three honest warnings so you don't waste time looking:

The "Download DICOM" button doesn't download a DICOM. It downloads the study's whole ZIP exactly as it was uploaded. It doesn't export the slice you're looking at, nor an individual series.

The "Report" tab isn't the study's report. It lists every PDF in the patient's record, unrelated to the CBCT scan you have open, and it doesn't generate any report from your measurements. It's there so you can have the radiologist's report to hand while you look at the study, nothing more.

Front desk and Imaging can draw but can't save. The viewer lets them use every tool, and when they try to save, a notice says it couldn't be done. That's the record's permission working; the screen simply doesn't warn them beforehand. If they need measurements on file, a Doctor, an Assistant or the Admin has to do it.

When measuring or reconstructing isn't possible

The Arch, MPR and 3D buttons always appear, but not every study supports them. If the study doesn't qualify, the viewer tells you when you tap them instead of staying silent:

• No declared scale → no ruler. If the study doesn't say how much a pixel measures, or the spacing between slices can't be verified, the viewer removes the ruler and says so. It's deliberate: measuring with a scale nobody verified is worse than not measuring.
• A study with more than one series loses the scale, and with it the arch and the panoramic. The three planes and the 2D viewer keep working. At the clinic this affects a minority of studies, but it's worth knowing before you go looking for the problem somewhere else.
• 8-bit studies: they look fine, but they carry no densities (Hounsfield), so the bone or tissue presets don't apply and the 3D is shown as a maximum intensity projection.
• Few slices, or no declared position → planes can't be reconstructed.

On a tablet, the volume is built from every other slice and the viewer says so on screen. It isn't a defect: a large study in full exceeds the memory Safari grants a tab and would close it.

3D models from the scanner

In 🧊 3D viewer → 🧊 Upload 3D model upload the STL or PLY files. Prefer .ply: they carry the scanner's colour. If they arrived in a ZIP, unzip it first.

The scanner usually exports three files — maxilla, mandible and bite registration. Upload all of them: then the Maxilla, Mandible, Bite and Occlusion buttons appear, the last one drawing both arches together. That's the usual cause of "the bite didn't upload completely": one file of three had been uploaded.

This model viewer doesn't measure: it reports the size of the piece and little else. The millimetre ruler lives in the CBCT viewer.

Notes

• A ZIP is only accepted if it really is a CBCT scan, and that's checked by looking inside, not by the name. If it holds 3D models, the system tells you and asks you to upload them loose.
• A loose DICOM file (.dcm) can be uploaded, but it doesn't open in the viewer: it downloads. The viewers work over the study's whole folder.
• "Upload folder" doesn't work in the iPad or iPhone browser; there the route is a ZIP containing only the folder of slices. From a computer it works normally.
• Deleting a file really deletes it: there's no trash. Bear in mind that the clinical record is subject to NOM-004 (Mexican standard) — see Consents & compliance.
• Files are stored outside the public part of the site and only open with a signed-in session.