Clinical photography in dentistry

4,528 views

Published on

This presentation will provide you with basic knowledge to take clinical photographs in dentistry, with any digital camera like point and shoot or a DSLR camera..

0 Comments
16 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
4,528
On SlideShare
0
From Embeds
0
Number of Embeds
8
Actions
Shares
0
Downloads
417
Comments
0
Likes
16
Embeds 0
No embeds

No notes for slide

Clinical photography in dentistry

  1. 1. 1
  2. 2. Dr. Onkar B. Khot PG (Orthodontics) 2
  3. 3.  Introduction  Why take orthodontic photographic records  Why go DIGITAL  Basic terms  Resolution  Focal Depth  Shutter speed  Macro function / lens 3
  4. 4.  Clinical requirements for photographic records  Digital camera setup / ring flash / Macro Lens  Special cheek retractors  Dental mirrors  Taking clinical photographs  Extra-oral  Patient positioning  Clinician positioning  Intra-oral  Patient positioning  Clinician / Assistant positioning 4
  5. 5.  Post processing your digital images  Cropping of images  Enhancing the images  Exposure  Brightness / contrast  Color 5
  6. 6.  Study models, properly trimmed, dental stone – cast moulds  Radiographs, usually OPG and Lateral cephalogram  Clinical photographs – a luxury..??  Time has changed – emphasis on achieving balanced facial harmony  Carefully study existing patients soft tissue pattern  Lip morphology and tonicity, smile arc & smile esthetics  In absence of patient 6
  7. 7.  Ease of use of digital cameras  Ability to repeat / delete unsuitable images  No need to wait till the film is developed  Cost effective  A one time investment  VTO 7
  8. 8.  Resolution  How much detail an image can hold  Pixel count and bit depth of each pixel  As the number of pixels increases, the image’s detail becomes sharper  Number of megapixels – camera’s resolution  Display’s resolution – expressed in pixels per inch (ppi) 8
  9. 9.  Focal length  Lens’s magnification power  Longer the focal length – more the magnification power 9
  10. 10.  Macro photography – close-up photography  Reproduction ratio of life size i.e. 1 : 1 10
  11. 11.  Shutter speed  Amount of time the shutter is open or digital image sensor is activated  Displayed as fraction of a second, such as 1/8 0r 1/250 11
  12. 12.  Aperture  A hole in the lens through which light passes on its way from subject to the film  DOF – depth of field  To make one object stand out of a wide view  Reduce aperture size Increase in depth in a picture 12
  13. 13.  How much picture comes out sharply and how much doesn’t  This zone of sharpness is called as depth of field  Can be controlled by 3 main factors –  Aperture – smaller the aperture more extensive the DOF  Focal length – shorter the focal length, greater the DOF  Camera to subject distance – greater the distance, deeper the DOF 13
  14. 14.  Shallow depth of field  Greater depth of field  1/30th of a second  1.5 second exposure exposure  f 3.5 aperture value  f 22 aperture value 14
  15. 15.  Digital camera setup  Point & shoot  DSLRs 15
  16. 16.  Ring flash eliminates shadows  Allows more even and thorough distribution of light 16
  17. 17.  A dedicated macro lens that can be attached to the cameras and adjusted as needed is by far a superior choice 17
  18. 18.  Double ended retractors 18
  19. 19. 19
  20. 20.  Extra-oral Photographs  Face-frontal (lips relaxed)  Face-frontal (smiling)  Profile (right side preferably – lips relaxed)  (45 °) Profile (also known as ¾ Profile – Smiling)  Intra-oral photographs  Frontal – in occlusion  Right buccal - in occlusion  Left buccal – in occlusion  Upper occlusal  Lower occlusal 20
  21. 21.  Face-frontal (lips relaxed)  outer canthus to superior attachment of the ear (C-SA line)  Interpupillary line  Encompassing area (crown to collarbone)  Head in NHP 21
  22. 22.  Face-frontal (smiling)  Same guidelines  Smiling in a natural way with the teeth visible  Aids in visualizing patients smile esthetics and soft tissue properties 22
  23. 23.  Profile (right side preferably – lips relaxed)  canthus to superior attachment of ear  encompassing area of crown to collarbone  chin and neck should show, preferably up to the clavicles  Frankfort horizontal line to be sure that head is level 23
  24. 24.  (45 °) Profile  Social interaction  Visible information about smile esthetics  Turn the head to right about ¾ of the way  Teeth should be visible 25
  25. 25.  The position of the patient is important to the camera view and to the operator’s ease in making the view  For most straight anterior views, the patient should be in a semi upright position with a slight tilt backwards  In a contour chair, the patient must turn his head to the side so that the operator does not have to lean sideways over the chair and patient. 26
  26. 26.  It should not be directly on the teeth  Keep the light on the side of the cheek and out of the mouth  The light is only needed to give enough light to focus by  When the dental light is bright or strong on the side of the arch that should have the greatest contrast, it will kill the contrast produced by the flash. 27
  27. 27.  Frontal – in occlusion  Patient in dental chair, raised to clinicians elbow level  Assistant standing behind the patient  Retract patients lips sideways  90° to facial midline using upper frenum as a guide  Full extension of sulci  High “f” value for maximum depth of field 28
  28. 28.  Right buccal - in occlusion  Flip the right retractor to the narrower side  Patient is asked to turn their head to left  Clinician then holds the right side retractor and pulls it to visualize the last erupted molar as much as possible  90° to canine-premolar area 29
  29. 29.  Left buccal – in occlusion  Similar to that of the right buccal  Switch the larger retractor to patients right and narrow end to patients left  Patient turns head slightly towards their right  90° to canine-premolar area 30
  30. 30.  Upper occlusal  Retractors are inserted in “V” shape to retract upper lip       sideways and away from the teeth Mirror with wider end inside the mouth Patient is instructed to lower the head slightly Shot can be taken 90° to the plane of the mirror Mid-palatal raphe as a guide for orientation Minimum retractor show No fingers should be seen 31
  31. 31.  Lower occlusal  Retractors in reverse “V” shape  Clinician holds the mirror upwards to visualize lower arch  Patient is asked to lift the chin up  And also asked to roll back the tongue 32
  32. 32. UPPER OCCLUSAL SHOT 33
  33. 33. LOWER OCCLUSAL SHOT 34
  34. 34. 35
  35. 35. 36
  36. 36. 37
  37. 37.  Direction of pull of retractors is always sideways and slightly forward, away from gingival tissue  Wetting the retractors just before insertion eases the process of positioning them with minimum patient discomfort  Taking occlusal mirror shots, slightly warming the mirror in warm water prior to insertion helps prevent fogging of the mirror  Saliva ejector can be used to eliminate saliva prior to taking each photograph 38
  38. 38.  During occlusal mirror shots, instruct the patient to open wide just prior to pressing the camera button. This helps in obtaining maximum mouth opening at the right moment, and minimizes patient’s fatigue during the procedure  It is recommended that all photographic records to be taken before impression making, to eliminate the possibility of impression material being stuck between the teeth or the face during the procedure 39
  39. 39.  Minimum camera resolution for orthodontic purpose would be around 3-4 megapixels  DSLR cameras are highly recommended for taking orthodontic photographic records  Patient should be standing in front of a plain white background when taking extra-oral shots 40
  40. 40.  Immediate back-up ensures a complete back-up of all the original, unprocessed image files  Flipping – relative to occlusal plane and mid line  De-rotation  Cropping 41
  41. 41.  Clinical photography in dentistry ; Matrishva B. Vyas ; Jaypee publication  A Short Guide to Clinical Digital Photography in Orthodontics ; Shadi S. Samawi  Orthodontics Current Principles Techniques ; Graber, Vanarsdall, Vig ; 4th Edt 42
  42. 42. 43

×