114 American Journal of Orthodontics and Dentofacial Orthopedics/July 1999

Orthognathic surgery for the correction of severe maloc-clusions is ever increasing. With such use of orthognathic sur-gical techniques, the demands on the planning skills of ortho-dontists and the surgeons have increased as well. Variouscomputer software packages are available for analyzingskeletal, dental, and facial profiles and for predicting the out-come of proposed treatments. Dentofacial Planner and Dol-phin are popular IBM compatible systems, whereas QuickCeph is the main Apple Macintosh program. With the everincreasing use of computers in the orthodontic office there isgrowing use of computer-aided treatment planning. New soft-ware packages are appearing in response to this. The trend isset to continue not just in teaching environments but also inthe orthodontic office.

The most significant use of such systems is for multidis-ciplinary communication with allied colleagues in treatmentplanning. These systems offer tremendous guidance forpatients who are contemplating treatment. The visual natureof these imaging systems also provides valuable educationaluse.

The purpose of this article is to describe a popular com-puter planning software and how its images can be incorpo-rated into a lecture presentation software to avoid the need forlecture slides mounted in carousels.

PROBLEM WITH TRADITIONAL PRESENTATIONS

The task of preparing a presentation to orthodonticcolleagues, allied specialists, referring dentists, or par-ents and patients may need to be given at short notice.For a traditional presentation, there is usually a timedelay in getting slides returned from processing. Ideasare no longer fresh by the time the slides are ready fora presentation. Only when completed slides arereturned can faults be detected, and any changes willincur further delays. Processing charges make prepara-tions expensive. Furthermore these space occupyingslide images can deteriorate with time during storage orbecome lost.

Once the slides are available and correctly producedthey need to be mounted in carousels and transported tothe lecture venue. During the lecture, carousels need tobe changed and slides may become trapped in the pro-

jector. This puts the lecturer under further pressure andtakes from the quality of the presentation.

POWER POINT

It is ideal to use a computer projection system toplace images and text on the lecture screen. This involvesuse of a presentation software such as Microsoft PowerPoint. Slides can be created and then projected onto lec-ture screens through a projection device attached to acomputer. This avoids the need for projectors with slidesmounted on carousels. The hazards of slides mounted incarousels are avoided, and a more versatile slideshowpresentation is possible. The presentation format canallow sound, video, and bullets to be inserted into slides.There is a large capacity to customize text, colors, andbackgrounds with little effort or computer ability. Slidesare simple and quick to make and can be easily altered.Any errors can even be changed on the same day as thelecture. The lecturer is in full control of the projectionimages. and there is less need for audiovisual support.

Storing the presentation on a computer disk is spacesaving, guarantees image quality stability, and allowsperiodic updating for future repeat presentations.

DENTOFACIAL PLANNER PLUS

Dentofacial Planner Plus or DFP Plus is a softwarefor profile analysis and treatment prediction in ortho-dontics and maxillofacial surgery. There are manyexamples of DFP Plus being used for planning andevaluating the treatment effects of orthognathicsurgeryl and studying dentofacial morphology2 andgrowth3 and the treatment effects of various orthodon-tic appliances.4,5 Its accuracy of predicting soft tissueprofile changes has also been examined.6

Cephalometric x-rays are digitized on a compatibledigitizing tablet, such as the Numonic Accugrid. Variousanalyses are then possible to evaluate dentofacial mor-phology. Dentofacial Showcase is the accompanyingsoftware for acquiring and processing photographicimages before their export into DFP Plus. When animage has been incorporated into DFP Plus it can belinked to the cephalometric x-ray. This allows x-rayalterations to be transmitted to the linked photographand vice versa. Thus interactive treatment planning withpatients and colleagues is possible so as to arrive at the

ORTHO BYTES

The use of computers, computer programs, and other computerized equipment to assist in the orthodontic practice willbe reported under this section of the American Journal of Orthodontics and Dentofacial Orthopedics. Manuscripts andcomments may be submitted to Dr Martin Abelson, 14720 N Shotgun Pl, Tucson, AZ 85737.

Presentations with Dentofacial Planner ImagesDavid Hegarty, BDS, FDS RCS(Eng), MOrth RCS(Edin), MDS, FDSOrth a

Manchester, England

aSenior Registrar in Orthodontics, Orthodontic Department, University ofManchester.

American Journal of Orthodontics and Dentofacial Orthopedics Ortho Bytes115Volume 116, Number 1

most appropriate treatment plan. It may even be used forteleconferenciong with colleagues at remote sites.

Anticipated CO-CR conversions, facial growth,skeletal changes, and dental changes can be incorporatedinto a Visual Treatment Objective (VTO). Expected hardtissue and soft tissue images can be produced forpatients as a counselling for the esthetic benefits of treat-ment. Furthermore, patients can have an input as to howthey wish to look after treatment.

MATERIAL AND METHODS

Color slides or prints from a conventional clinical cam-era can be scanned into the PC system for image acquisi-

tion. Digital and video cameras are also possible for imageswhich are directly inputted into the computer. An exampleof the equipment used could consist of:

Hardware•Pentium 32 MB RAM hard disk computer •Numonic Accugrid digitizing tablet •Nikon Coolscan II 32 Slide Scanner •HP Deskscan II 2.4 Flatbed scanner •Yashica Dental Eye II Camera

Software•Windows 95 or 98•Dentofacial Planner Plus Version 2.01 (Dentofacial Soft-

ware Inc, Toronto, Canada)

Fig 1. Dentofacial Planner cephalometric and lateralprofile photograph before treatment.

Fig 2. Proposed Dentofacial Planner image after simu-lated orthodontic treatment and bimaxillary surgery.

Fig 3. PowerPoint lecture slide of photographic changes with treatment.

116 Ortho Bytes American Journal of Orthodontics and Dentofacial OrthopedicsJuly 1999

before and after planning, having selected the appropriatePowerPoint template (Figs 3 and 4).

SUMMARY

A system has been described for the incorporationof DFP Plus images into a Microsoft PowerPoint com-puter slideshow. It provides a simple and reliablemeans to produce such visual images without loss ofquality or definition. Such images are easily edited,modified, and stored. State of the art presentations withan enhanced clinical content are then possible, thuseliminating the need for traditional projection slides.

REFERENCES

1. Van Sickels JE, Larsen A J, Thrash WJ. A retrospective study of relapse in rigidly fix-ated sagittal split osteotomies: contributing factors. Am J Orthod Dentofacial Orthop1988;93:413-8.

2. Janson GR, Metaxas A, Woodside DG. Variation in maxillary and mandibular molarand incisor vertical dimension in 12-year-old subjects with excess, normal, and shortlower anterior face height. Am J Orthod Dentofacial Orthop 1994;106:409-18.

3. Pollard LE, Mamandras AH. Male postpubertal facial growth in Class II malocclu-sions. Am J Orthod Dentofacial Orthop 1995;108:62-8.

4. Pancherz H. The nature of Class II relapse after Herbst appliance treatment: a cephalo-metric long-term investigation. Am J Orthod Dentofacial Orthop 1991;100:220-33.

5. O’Reilly MT, Nanda SK, Close J. Comparison of effects of cervical and oblique head-gear. Am J Orthod Dentofacial Orthop 1993;103:504-9.

6. Konstiantos KA, O’Reilly MT, Close J. The validity of the prediction of soft tissueprofile changes after Le Fort I osteotomy using the dentofacial planner. Am J OrthodDentofacial Orthop 1994;105:241-8.

•Dentofacial Showcase Version 1.5 (Dentofacial Software Inc)•Microsoft PowerPoint for Windows 95 Version 7.0b

GETTING DENTOFACIAL PLANNER IMAGES INTOPOWERPOINT: THE STEPS

1. Select the DFPlus image appropriate for use in the pre-sentation. Click on the black box picture icon at the bot-tom of the screen (as in Figs 1 and 2).

2. Click on SNAPSHOT. Save image as SCREEN 1. Click onOK and you should hear two “beep” noises. Repeat for anyother desirable images saving them as SCREEN 2, 3, etc.

3. Exit DFPlus and open the Showcase program.4. Double click on FILE and IMPORT from the DFPlus

folder import bitmap.5. Double click on SCREEN 1 to import the image onto the

screen. Double click on this new image to explore it. Clickon IMAGE and CROP. Click and drag the mouse acrossthe screen to crop off the unwanted border and patientidentifying features. You can print a color image at thispoint if you wish.

6. Click on EDIT and COPY.7. Open PowerPoint and select a slide format for pictures/clip

art. Click on EDIT and PASTE to import the DFPlus imageinto PowerPoint. You can prepare a slide with 2 images, eg,

Fig 4. PowerPoint lecture slide of cephalometric and photographic changes with treatment.