Digital Clinical PHOTOGRAPHY
Basic Guidelines |
INTRODUCTION
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Good quality clinical pictures and other dental records are important and indispensable components of a practice during clinical examination and case presentations. Proper selection of camera equipment, good picture composition skills, the fine art of making use of light source, and proper use of lenses are basic elements of good clinical photography. All these need to be meticulously learnt, both, at the conceptual and practical level.
Use of Photography in clinical practice has many practical, profitable, and satisfying applications. Considering the current technological advances and proliferation of new techniques, the Digital SLR camera which was supposed to yesterday's luxury item,. has become an integral part of today's modern dentistry. |
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CLINICAL PHOTOGRAPHY - BENEFITS |
A set of extra-oral and intra-oral photographs taken during various stages of treatment provide accurate visual documentation.
Photography can be used for lecturing at conferences, study clubs etc. It can be used in publication of articles. Presentations to civic clubs and other organizations are greatly enhanced when photographs are used. Pre and post treatment photographs can be displayed in the office to be seen by other patients.
By reviewing the photographs of various dental procedures performed in the past, certain pitfalls, imperfections over looked by the clinician can be improved. Such feedback is an excellent learning device and would serve as an effective quality control measure.
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SELECTION OF CAMERA EQUIPMENT |
The greatest problem faced by a dentist interested in taking clinical photographs apart from actual
photography skills, is the selections and purchase of suitable camera equipment. It is the author's belief that when the correct photographic equipment and exposure data are given to a person, he can produce good quality photographs with minimal knowledge and effort. It is impossible to do quality photography with inadequate and poor cameras, lens and lighting equipment as it is to do dentistry with poor instruments and inferior material. Before selecting the camera equipments one should know what to expect from it in order to produce quality photographs. |
BASIC ARMAMENTARIUM |
The camera system for clinical photography should ideally be a Digital SLR camera, a 100mm macro lens, a dedicated flash with both ring and point capabilities, and accessories such as mirrors, lip and cheek retractors and batteries. |
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STANDARD PHOTOGRAPHIC TECHNIQUE |
Consistency in camera setting, and shot selection create photographs that are more apt to be useful. Even changing to a different camera can sometimes change the overall appearance of the photograph..A good photograph is the result of proper equipment, organization, a procedural check list, and a good technique. |
INTRA-ORAL TECHNIQUE |
The basis of an excellent clinical photograph is clean and accurate rendering of the subject area free of visually distracting influences such as saliva, poor use of mirrors, retractors etc. |
| COMON VIEWS USED IN DENTAL PHOTOGRAPHY |
- Anterior view
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Buccal views
- Maxillary occlusal view
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Mandibular occlusal view |
ANTERIOR (FRONTAL) VIEW |
After going through the check list to prevent any kind of technical error, seat the patient comfortably in a semi-upright position. Retractors are placed at the corners of the mouth to pull the buccal tissues away from the teeth. Hold the camera in such a way that the occlusal plane is perpendicular and centered to the plane of the camera sensor. The patient's midline should be in the centre of the frame. Compose the photograph to include all relevant structures, choose the proper magnification, focus the camera and release the shutter (keeping it absolutely steady) |
BUCCAL VIEWS |
After the patient is seated comfortably in a semi-upright position, right and left buccal views are taken with or without using the mirrors. Place the retractor at the corner of the mouth, and pull it distally on the side that is to be photographed while passively holding the retractor on the other side. If buccal mirror is used, position it distal to the last tooth and move it as laterally as possible while retracting the lip at the same time. Place a single retractor on the opposite side of the mirror. Compose the photograph to include relevant structures from the distal of the cuspid to the most posterior tooth, focus the camera in the premolar region and release the shutter. |
MAXILLARY OCCUSAL VIEW |
In order to capture the occlusal aspect of the whole maxillary arch, patient is seated in a semi-upright position. Place retractors at the corner of the mouth and rotate them upwards and outward. Position the full arch occlusal mirror in the mouth in such a way that it rests on the maxillary tuberosity and diverges from the occlusal plane so that the camera can be held at 90 degrees to the plane of the mirror. Align the midline of the palate with centre of the frame, compose the photograph, choose the appropriate magnification, focus and release the shutter. |
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MANDIBULAR OCCLUSAL VIEW |
Patient should be seated in supine position and the head should be tipped slightly back so that the occlusal plane becomes parallel to the floor. Occlusal mirror is positioned in such a way that it rests on the retromolar pad and the diverges from the occlusal plane so that the camera can be held at 90 degrees to the plane of the mirror. Midline of the arch is aligned with the centre of the frame; the photograph is composed with the appropriate magnification, focused on the premolar area. |
EXTRAORAL TECHNIQUE |
Full Face View
Extra-oral full face and profile photographs are made with a pleasant colour background. As the patient is now a few feet away from the camera., the aperture (f-stop) setting should be altered. Position the patient approximately 18-24 inches in front of the background for best shadow control, with ala tragus line parallel to the floor.
The flash should be at 12 O'clock position over the lens. Compose the photograph to include from the inferior border of the hyoid to the top of the head, focus the camera on the patient's eyes and release the shutter. It is a good practice to take a second photograph with the patient smiling.
Profile View
For a profile view, the above mentioned procedures for full face view should be followed except that the point source should be on the side of the lens to get a clean profile outline. Set the magnification, focus the camera and release the shutter. |
CONCLUSION |
Clinical photography plays a very important role in patient communication, education and marketing your practice. Proper camera equipment, component selection and understanding the basic principles involved are essential to obtain consistent and professional quality records, It can be a great asset to your practice! However keeping abreast with rapidly advancing technology and trends in this field is an absolute must, The author strongly believes that "Clinical Photography Protocal and equipment recommendations are expected to evolve with advances in technology" |
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