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How to use cloud-based imaging to work more efficiently


XVWeb® by Apteryx Imaging offers secure, open architecture cloud-based treatment planning.

Most of us use the cloud for everyday tasks and it can be accessed wherever there is an internet connection via a computer or smart device. In today’s digital dental office, the cloud is driving tech-enabled change so your staff can work more efficiently. The cloud is where integration and software connect, promising a bigger future. I sat down with Jonathan Penchas, DMD, of Midtown Dentistry in Houston, Texas, to discuss the advantages cloud technology has brought to his practice.


  • Open-architecture works with practice management software and imaging devices
  • Centralized image storage and
    third-party image sharing
  • Off-site backup with enhanced security

Apteryx Imaging
877-APTERYX (278-3799)
| apteryx.com

What is cloud-based imaging software?

“This is software as a service,” Penchas says. “Images are acquired locally, uploaded to a remote server, and then stored in a single cloud environment. There is no longer a need for multiple databases as all of your 2D, 3D, clinical photos, and intraoral scan files can be stored in one database. Images are stored in an open format that allows you to both store and retrieve images from a webpage or any DICOM-compatible imaging program over a secure internet connection.”

Penchas uses XVWeb by Apteryx Imaging for his cloud-based imaging. According to Penchas, he made the switch to XVWeb for three reasons:

  • Open architecture
  • Data security
  • Accessibility and remote treatment planning

While not all imaging systems utilize an open architecture, XVWeb does. Open architecture means you have the freedom to choose the best practice management and imaging devices for your office now and in the future. You are not locked into a limited upgrade path based on a manufacturer’s decisions.

The same holds true with file formats. You can store and view your images in standard DICOM format, which is the free open source way images are acquired and shared by practitioners. It is not necessary to convert file formats. This makes HIPAA-compliant sharing of all images simple and easy, as everything needed to do so is included in your monthly fee.

Why was open architecture an important aspect of your decision to move to the cloud?

“An open platform is a wonderful thing. If I ever want to switch my practice management system or use a different brand of sensor or [panoramic] unit, I can,” Penchas says. “While I love the systems we have currently, the idea of being independent gives me a level of comfort in being able to use whatever technology we decide fits our practice best. If that changes down the road, we can adjust one aspect of our systems without wholesale changes.”

Why is cloud-based imaging more secure?

“Cloud-based imaging utilizes secure, remote servers so your database does not physically exist in your office. Each individual in a practice has controlled access to the imagining database for HIPAA compliance, so we know exactly who logged in and viewed which images in the log,” Penchas says. “The cloud servers are backed up in multiple locations for data redundancy so you can be assured that your data [are] safe.”

On the topic of security, he says he has seen colleagues lose data to natural disasters, ransomware attacks, and faulty data backups.

“I personally know practices that had their data stolen in ransomware attacks, where they were extorted for $20,000 by hackers to get their data back. Here in Houston, Hurricane Harvey flooded many dental practices. Friends with on-premise data storage lost their servers, and even practices that had off-site backups with local IT groups were impacted because those remote servers were lost to flooding, as well,” Penchas says. “With XVWeb, we have our data stored in data centers with redundancies built in, so we are confident that our data is safe, regardless of what might happen locally.”

How do accessibility and remote treatment planning affect your practice?

“Our practice, Midtown Dentistry, has five locations, and cloud imaging allows me to aid in treatment planning for all of our practices remotely. As a prosthodontist, I can use XVWeb to quickly view 2D and 3D images acquired from any of our practice locations,” Penchas explains. “So, if one of my colleagues across town needs to consult with me or requests a pricing estimate for treatment, I can easily log into XVWeb, view the images, and make an immediate recommendation. This provides great efficiency for both our clinicians and patients.”

A cloud-based imaging database can be accessed by any doctor or staff member any time, anywhere. Multiple staff members can access an image at the same time, even from different locations. All you need are your login credentials and an internet connection. The access is device-agnostic, meaning you can use any secure web browser on any platform to view your images. For example, you could view images on your mobile phone if you get an emergency call while at the beach.

Do you have an example of using cloud technology to share?

“XVWeb makes case collaboration with our associates more efficient, which expedites patient care. Here is an example of a recent implant placement utilizing XVWeb for treatment planning:

  • Cone beam computed tomography (CBCT) was taken in one of our remote offices prior to discussing implant placement with the patient (Fig. 1).
  • A remote, real-time diagnosis was performed to determine the viability of the proposed treatment plan and whether there was need for a sinus lift procedure. This collaboration occurred remotely via XVWeb (Fig. 2).
  • Other findings were noted during the reading of the CBCT that could potentially affect future treatment. The left maxillary second molar root is in the sinus, and the tooth also has an MB2 canal with an apical lesion. The canal was marked on the CBCT in XVWeb so the treating dentist is aware of it to ensure the issue is addressed (Fig. 3).
  • Implant planning was performed in the cloud via XVWeb. A third-party software was used to design a surgical guide, which was sent to a lab for fabrication.
  • Placement of the implant was a success.
  • Follow-up radiographs and treatment planning information are saved in XVWeb for documentation and future use.

Final thoughts on the cloud

Cloud-based imaging takes advantage of technological advancements that are not possible with on-premise solutions. With the rise of teledentistry, which has increased due to the coronavirus disease 2019 pandemic, cloud-based imaging is just another piece of the remote dentistry puzzle. It allows you to view images remotely and securely collaborate with other dentists and specialists.

I would like to thank Penchas for his input and insight into cloud imaging technology. It’s great to hear real-world experience that can be used when deciding if your practice is ready to make the jump into the cloud. If you would like to connect with Penchas, email him at drpenchas@midtowndentistry.com or visit www.midtowndentistry.com. 

About the Interviewee

Dr. Jonathan Penchas is a prosthodontic specialist and founder of Midtown Dentistry in Houston, Texas. He received his DMD degree from Hebrew University and completed his specialization in prosthodontics at Louisiana State University. Penchas also holds a Master’s in Education from the University of New Orleans and completed a fellowship in dental oncology and maxillofacial prosthetics at M.D. Anderson Cancer Center in Houston. In his free time, Penchas enjoys spending time with his family, traveling, beekeeping, and SCUBA diving.

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