Windows In-Place Upgrade
Dental Environment
Document Type: Standard Operating Procedure Audience: Helpdesk Technicians (L1 / L2 / L3) Last Updated: February 2026 Version: 1.0
1. Purpose
This SOP provides a structured procedure for performing a Windows in-place upgrade (repair install) on workstations and servers running in dental practice environments. An in-place upgrade reinstalls Windows system files while preserving installed applications, user data, and system settings — making it the preferred escalation path when standard troubleshooting has been exhausted but a full reimage is not yet warranted.
⚠️ This is an L2/L3 procedure. L1 technicians should escalate to L2/L3 after confirming the decision criteria in Section 2 are met.
2. When to Use In-Place Upgrade
2.1 Decision Criteria
An in-place upgrade is appropriate when ALL of the following are true:
Criteria | Rationale |
|---|---|
Standard troubleshooting exhausted | SFC, DISM, driver reinstalls, profile recreation have all failed |
Issue is system-level, not application-level | Problem persists across profiles, survives clean profile creation, or affects core Windows components |
Full reimage is disproportionate | Practice has complex LOB software stack (PMS, imaging, sensors) that would require significant rebuild time |
Backup is confirmed | Veeam image-level or MSP360 backup verified and restorable |
2.2 Common Trigger Scenarios in Dental Environments
Scenario | Symptoms | Reference |
|---|---|---|
User-specific system corruption | Login delays, black screens, shell failures that survive profile recreation | HALO 1117316 — Potomac Pediatric Dentistry |
Windows Installer subsystem corruption | LOB app installs/upgrades fail with error -1603 or 0x80070643; .NET framework won't install | HALO 1121433 — Delmarva Dental Services |
Windows component store corruption | DISM /RestoreHealth fails or finds irreparable corruption; SFC finds errors it cannot fix | General pattern |
Post-update system instability | Windows Update applied but left system in degraded state; boot loops, services failing | General pattern |
Imaging software launch failures | CS Imaging, DEXIS, Eaglesoft Imaging, or EzDent-i fail to launch across all users after ruling out application-level causes | General pattern |
Persistent TWAIN/driver failures | Sensor drivers install but TWAIN subsystem won't register devices; persists after clean driver reinstall | General pattern |
2.3 When NOT to Use In-Place Upgrade
Scenario | Better Approach |
|---|---|
Application-specific issue (single app broken) | Reinstall the application |
Hardware failure (bad disk, RAM errors) | Replace hardware first |
Active malware infection | Isolate, remediate, then evaluate |
OS version upgrade needed (Win 10 → 11) | Plan as a separate project with full testing |
Server role corruption (AD, DNS, DHCP) | Restore from Veeam/BDR; do not in-place upgrade domain controllers |
3. Tier Responsibilities
Phase | L1 | L2 | L3 |
|---|---|---|---|
Identify symptoms & initial triage | ✅ Own | — | — |
Run SFC / DISM / standard fixes | ✅ Own | — | — |
Confirm decision criteria met (Section 2) | ✅ Document | ✅ Approve | — |
Perform backup verification | — | ✅ Own | — |
Execute in-place upgrade | — | ✅ Own | ✅ Consult |
Dental software post-upgrade verification | — | ✅ Own | ✅ Escalation |
Troubleshoot failed upgrade / rollback | — | — | ✅ Own |
4. Pre-Upgrade Requirements
4.1 Backup Verification — MANDATORY HARD STOP
⛔ DO NOT PROCEED without a verified backup. No exceptions.
Backup Infrastructure | Verification Steps |
|---|---|
Veeam BDR on-site | Confirm latest image-level backup completed successfully in Veeam console. Verify restore point is within 24 hours. If available, take a VM checkpoint of the target machine before proceeding. |
MSP360 (no BDR) | Confirm latest image-level backup completed successfully in MSP360 portal. Verify both image backup AND file-level backup are current. Confirm cloud restore has been tested or is known-good for this client. |
What the backup protects:
- Full system restore — If in-place upgrade fails catastrophically, restore entire machine from Veeam image or MSP360 image backup
- Individual file recovery — If specific dental imaging files, config files, or databases need recovery post-upgrade, use Veeam file-level restore or MSP360 file backup
4.2 System Information Collection
Collect and document the following before starting. Paste into HALO ticket notes.
# OS version and build
systeminfo | findstr /B /C:"OS Name" /C:"OS Version" /C:"System Type" /C:"Original Install Date"
# Installed dental software (capture names and versions)
Get-WmiObject -Class Win32_Product | Where-Object {
$_.Name -match "Dentrix|Eaglesoft|DEXIS|Carestream|Vatech|EzDent|TDO|PBS|Dolphin|Romexis|Apteryx|Open Dental|Schick|IOSS|Sidexis|XDR|MiPACS"
} | Select-Object Name, Version | Format-Table -AutoSize
# Disk space (need 20GB+ free on C:)
Get-PSDrive C | Select-Object @{N='Free(GB)';E={[math]::Round($_.Free/1GB,2)}}, @{N='Used(GB)';E={[math]::Round($_.Used/1GB,2)}}
# Pending reboots check
Test-Path "HKLM:\SOFTWARE\Microsoft\Windows\CurrentVersion\Component Based Servicing\RebootPending"
Test-Path "HKLM:\SOFTWARE\Microsoft\Windows\CurrentVersion\WindowsUpdate\Auto Update\RebootRequired"
# TWAIN drivers registered (imaging-critical)
Get-ItemProperty "HKLM:\SOFTWARE\WOW6432Node\Microsoft\Windows\CurrentVersion\SharedDLLs" -ErrorAction SilentlyContinue |
Get-Member -MemberType NoteProperty | Where-Object { $_.Name -match "twain" }4.3 Pre-Flight Checklist
Complete ALL items before proceeding:
# | Item | Status |
|---|---|---|
1 | Backup verified (Veeam image or MSP360 image + file) | ☐ |
2 | VM checkpoint taken (if virtualized or BDR supports it) | ☐ |
3 | Minimum 20 GB free on C: drive | ☐ |
4 | System info documented in HALO ticket | ☐ |
5 | Dental software versions documented | ☐ |
6 | TWAIN driver inventory captured | ☐ |
7 | Sensor model(s) noted per workstation | ☐ |
8 | External USB devices disconnected (sensors, cameras — leave KB/mouse) | ☐ |
9 | AV/EDR temporarily disabled or exclusion set for setup.exe | ☐ |
10 | Machine plugged into power (no battery operation) | ☐ |
11 | All users logged off; no active patient sessions in PMS | ☐ |
12 | Scheduled after business hours or during approved maintenance window | ☐ |
13 | Firmware current within 12 months (see HALO 1121433 pattern) | ☐ |
14 | Pending Windows Updates installed and rebooted (clean state) | ☐ |
5. In-Place Upgrade Procedure
5.1 Obtain Windows Installation Media
Method 1 — ISO Download (Preferred)
- Go to microsoft.com/software-download/windows11 (or windows10 for Win10 machines)
- Under Download Windows 11 Disk Image (ISO), select the edition matching the installed OS
- Select language — MUST match the current Windows display language or the "Keep personal files and apps" option will be greyed out
- Download the ISO to a local folder (e.g.,
C:\Temp\)
Method 2 — Media Creation Tool
- Download the Media Creation Tool from the same Microsoft page
- Run the tool → Select Create installation media for another PC
- Choose ISO file (not USB)
- Save to local folder
⚠️ CRITICAL: The ISO edition (Home/Pro/Enterprise) and language must match what is currently installed. Mismatches will prevent the "Keep personal files and apps" option from appearing.
5.2 Mount and Execute
- Right-click the downloaded ISO → Mount
- Open the mounted drive in File Explorer
- Run setup.exe as Administrator
- At the "Get updates, drivers, and optional features" screen → Select "Not right now"
- Do NOT let it download updates during upgrade — this adds time and introduces variables
- Accept license terms
- At the "Choose what to keep" screen → Select "Keep personal files and apps"
- If this option is greyed out, STOP — see Section 7.1
5.3 Upgrade Execution
- Click Install
- The machine will restart multiple times — this is expected
- DO NOT power off or interrupt the process
- Typical duration: 30–90 minutes depending on hardware and installed software
- After completion, Windows will boot to the login screen
5.4 Immediate Post-Upgrade Steps
- Log in with a local admin account first (not the affected user account if troubleshooting a user-specific issue)
- Verify Windows boots cleanly and desktop loads
- Open Settings → Windows Update → Check for updates → Install any pending updates
- Reboot after updates complete
- Verify network connectivity (domain join intact, DNS resolution working, mapped drives accessible)
6. Dental Software Post-Upgrade Verification
⚠️ This is the most critical section of the SOP. An in-place upgrade can silently break dental imaging drivers, TWAIN registrations, and database connections. Verify EVERY item below before closing the ticket.
6.1 Practice Management Software (PMS)
PMS | What to Verify | How to Verify |
|---|---|---|
Dentrix | Launches, connects to database, can open patient records | Open Dentrix → navigate to patient chart → verify data loads |
Eaglesoft | Launches, SQLAnywhere service running, patient data accessible | Open Eaglesoft → search a patient → open clinical record |
Open Dental | Connects to MySQL/MariaDB, patient data loads | Open Dental → verify connection string → open patient |
TDO | Connects to TDOfficeData, patient records load | Open TDO → verify server connection → open chart |
PBS Endo |
intact, connects to server service | Check
is not blank (see PBS Endo Config Wipe SOP). Launch PBS Endo → verify data access. |
Softdent | Launches, connects to data server | Open Softdent → verify patient search works |
6.2 Imaging Software
Software | Verification Steps |
|---|---|
DEXIS Imaging | Launch DEXIS → Verify sensor dashboard shows sensor connected (green) → Take test exposure if possible → Verify Dentrix/Eaglesoft bridge launches DEXIS with patient context |
Carestream CS Imaging 8 | Launch CS Imaging → Verify database connection → Check Service Tab accessible (password:
) → Verify sensor detected in acquisition mode |
Vatech EzDent-i | Launch EzDent-i → Verify EzServer connection → Confirm sensor detected → Test MultiCapture mode |
Romexis | Launch Romexis → Verify Planmeca device connections → Test sensor acquisition |
Eaglesoft Advanced Imaging | Open Eaglesoft imaging pane → Verify sensor detected → Test capture |
Apteryx/XVWeb | Launch application → Verify database connection → Confirm TWAIN source available |
i-Dixel | Launch i-Dixel → Verify CBCT/Pan unit connection → Test image retrieval |
XDR Radiology | Launch XDR → Verify sensor and PMS bridge (PBS Endo/TDO) |
Dolphin Imaging | Launch Dolphin → Verify Pan/Ceph connection → Test capture |
6.3 Sensor & Driver Verification
Check | Command/Method | Expected Result |
|---|---|---|
USB sensor detection | Device Manager → Imaging Devices or USB controllers | Sensor appears without yellow exclamation |
TWAIN driver registration | Open imaging software → TWAIN source selection | Correct TWAIN source appears in dropdown |
IOSS driver (Schick sensors) | Check
exists and service running | IOSS service running; sensor detected in Eaglesoft/Dentrix |
Sensor calibration files | Open imaging software → Sensor dashboard/status | Calibration shows current/valid (green indicator in DEXIS) |
CBCT/Pan communication | Verify IP connectivity to extraoral unit |
succeeds; imaging software detects unit |
6.4 System-Level Verification
Check | Method |
|---|---|
Domain connectivity |
— returns DC info |
Group Policy |
— completes without errors |
Mapped drives | Verify all network drives map at login |
Printers (GPO) | Verify GPO-deployed printers reappear after login |
Windows services |
— verify dental-related services are running (SQL, EzServer/VTFileManager, PBS Endo Server, etc.) |
AV/EDR | Re-enable if disabled; verify dental software exclusions still in place |
Windows Activation |
— confirm activation status |
6.5 User-Specific Verification
If the in-place upgrade was performed to resolve a user-specific issue (reference HALO 1117316):
- Log in as the affected user account — not just admin
- Verify the original symptom is resolved (e.g., login delay, black screen, shell crash)
- Verify dental software launches correctly under that user context
- Verify imaging acquisition works under that user's login
- Test for 2–3 login/logout cycles to confirm stability
7. Troubleshooting
7.1 "Keep Personal Files and Apps" Option Greyed Out
Cause | Resolution |
|---|---|
ISO language mismatch | Re-download ISO in the exact language matching
|
ISO edition mismatch | Verify ISO matches installed edition (Pro vs Enterprise vs Home). Run
to check. |
Insufficient disk space | Free up space on C: — need minimum 20 GB free |
Pending reboot | Reboot the machine, then retry |
Corrupted component store | Run
then retry |
7.2 Upgrade Fails Mid-Process
Scenario | Action |
|---|---|
Automatic rollback occurs | Windows will revert to previous state. Review
for failure reason. Address the logged issue and retry. |
Machine stuck on "Working on updates" > 2 hours | Force reboot. Windows should auto-rollback. If boot loop, restore from Veeam/MSP360 image backup. |
Blue screen during upgrade | L3 escalation. Document BSOD stop code. Restore from backup and evaluate if reimage is required. |
7.3 Post-Upgrade Dental Software Issues
Issue | Likely Cause | Resolution |
|---|---|---|
PMS won't connect to database | SQL service not running or connection string reset | Verify SQL service running. Re-enter server connection info if prompted. |
Sensor not detected | USB driver re-enumerated; TWAIN deregistered | Unplug sensor, reboot, replug. Reinstall sensor driver if needed. Re-register TWAIN source in imaging software. |
Imaging software won't launch | .NET dependency broken by upgrade | Verify .NET versions installed. Repair/reinstall required .NET version. Reference HALO 1121433 pattern — check firmware first if .NET install fails. |
IOSS service not running | Service disabled during upgrade |
|
PBS Endo blank config file | Config wiped during process | Restore
from backup per PBS Endo Config Wipe SOP |
Mapped drives missing | GPO not yet reapplied | Run
and re-login |
GPO printers missing | Print spooler reset during upgrade | Verify Print Spooler service running. Run
. Printers should redeploy from server. |
Veeam agent lost connection | Agent service reset | Verify Veeam Agent service running. Re-register with Veeam server if needed. |
EzDent-i can't connect to EzServer | VTFileManager/PostgreSQL service stopped | Verify both services running on server. Reconnect EzDent-i to server IP. |
8. Rollback Procedure
If the in-place upgrade causes more problems than it solves:
8.1 Windows Built-In Rollback (Within 10 Days)
- Settings → System → Recovery → Go Back
- Only available within 10 days of upgrade
- Reverts all system changes; preserves user data
8.2 Full Image Restore (L3 Only)
Infrastructure | Procedure |
|---|---|
Veeam BDR | Perform instant recovery from the pre-upgrade image-level backup. Since it's image-level, all data, applications, and configurations restore as they were. |
MSP360 (no BDR) | Restore from MSP360 image backup. More time-intensive than Veeam instant recovery — plan for extended downtime. Verify restore includes all dental application data paths. |
⚠️ After any restore, verify dental software functionality using the full checklist in Section 6.
9. Documentation Requirements
After completing the in-place upgrade, update the HALO ticket with:
Field | Content |
|---|---|
Root cause | What led to the decision to perform in-place upgrade |
Troubleshooting attempted | All steps tried before escalating to in-place upgrade |
Pre-upgrade state | OS version/build, installed dental software versions, backup confirmation |
Upgrade result | Success or failure; if failure, what happened |
Post-upgrade verification | Which items from Section 6 were verified and their status |
Time spent | Total billable time including backup verification, upgrade, and verification |
Lessons learned | Any patterns worth noting for future reference |
10. Related HALO PSA Tickets
Ticket # | Client | Description | Resolution | Pattern |
|---|---|---|---|---|
1117316 | Potomac Pediatric Dentistry | User-specific 5-minute black screen at login. Clean new profile = same problem. Snipping Tool broken system-wide. | In-place Windows upgrade resolved the user-specific login issue. Snipping Tool fixed separately via AppX reset. | System-level corruption tied to account SID/identity — not profile data. In-place upgrade is the correct escalation when profile recreation fails. |
1121433 | Delmarva Dental Services | Dentrix upgrade failing with error -1603. .NET 8.0 install failing with 0x80070643. | Firmware upgrades resolved underlying instability. .NET Runtime then installed successfully. Dentrix upgrade completed. | Dependency chain failure — surface symptom (Dentrix) traced to .NET, traced to firmware. Always check foundation (firmware → OS → runtime → application). |
1125653 | Guardian Dentistry / DHCNV | C: drive at 96.1% — orphaned Windows Installer patches consuming disk. | Cleaned Windows Installer folder. | Pre-flight relevance — disk space issues prevent in-place upgrade. Always verify 20%+ free before attempting. |
11. Related SOPs
SOP | Relevance |
|---|---|
PBS Endo Enterprise — Workstation Update / Config File Wipe SOP |
can be wiped during system-level changes. Verify after in-place upgrade. |
PBS Endo Enterprise — Config Wipe Root Cause Analysis | Technical deep-dive on WCF service channel corruption from config loss. |
TDO Version 12 — Server & Workstation Update SOP | TDO update procedures; verify TDO functionality post-upgrade. |
Carestream CS Imaging 8 — Service Tool & Features SOP | Service Tab password (
), SQL configuration, and backup verification procedures. |
Eaglesoft Service Code Management SOP | Post-upgrade, verify service codes are accessible and not inadvertently inactivated. |
DEXIS Imaging Suite — Sensor Compatibility SOP | Sensor driver and TWAIN verification procedures. |
Vatech EzServer Database Migration SOP | EzServer service verification; VTFileManager and PostgreSQL service checks. |
Dentrix Document Center — Auto File Acquire SOP | Watch folder and scanner configurations to verify post-upgrade. |
12. Quick Reference Card
FOR FIELD USE — Tear-off / Print
Decision: Should I In-Place Upgrade?
1. Have I exhausted SFC, DISM, driver reinstalls, profile recreation?
NO → Keep troubleshooting
YES → Continue
2. Does the issue persist across users/profiles OR affect core Windows components?
NO → Likely application-level. Reinstall the app.
YES → Continue
3. Is a verified Veeam or MSP360 image backup available?
NO → STOP. Take backup first.
YES → Continue
4. Is this a domain controller?
YES → DO NOT in-place upgrade. Restore from backup instead.
NO → Proceed with in-place upgrade (L2/L3)Post-Upgrade Rapid Check (5 minutes)
☐ Windows boots clean, desktop loads
☐ Domain login works (nltest /dsgetdc:DOMAIN)
☐ PMS launches and connects to database
☐ Imaging software launches
☐ Sensor detected (check Device Manager + imaging software)
☐ GPO printers reappeared
☐ Mapped drives accessible
☐ Original symptom resolved13. Document Control
Version | Date | Author | Changes |
|---|---|---|---|
1.0 | February 2026 | IT Support Engineering | Initial release — derived from HALO 1117316 and 1121433 resolution patterns, dental environment field experience, and Microsoft in-place upgrade documentation |
Confidential — Internal Use Only