CLINICAL PHOTOGRAPHY INORTHODONTICS

DR. SABA BASITMCPS RESIDENT

ORTHODONTICS

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Outline: Why we need Photography? Requirements for Photography Recent Developments Intra-oral Photography Extra-oral Photography

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Why we need Photography in Orthodontics?

1. Treatment Planning2. Case Discussions3. As an Aid during Treatment4. Patient Reminder5. Practice Builder and Marketing Tool6. As a Defense Tool in Medico-Legal

Conflicts

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Requirements :

Orthodontic Retractors Orthodontic Mirrors FLASH LIGHTING Digital Cameras

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Why go Digital?

Ease of use of such cameras Ability to repeat/delete photographs

on spot No need for film development Cost effective Generous memory Ability to enhance and post process

images

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Orthodontic Cheek Retractors It is essential to have two sizes of

double-ended cheek retractors. For the front intraoral view the large end

of the larger retractor is appropriate in 95% of cases.

It is extremely important to instruct the person doing the retraction to pull the retractors not only laterally but also forward, away from the patient to allow them to close up comfortably

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Mirrors

Intraoral mouth mirrors are essential for occlusal views of the maxillary and mandibular arches.

The mirror recommended is the long-handled mirror

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Flash Lightening

Ring flash Point flash

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Digital Cameras

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Recent Developments:

Recommended photographic system Dental Eye III Camera is smaller and substantially

lighter than its predecessors Few adjustments are required during

use Improved ease of focusing

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Extra-oral Photographs

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• Natural Head Position• Teeth and jaws relaxed• Shot is to be taken perpendicular to midline• Ensure leveled interpupillary line• Encompassing area – crown to collar bone

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• Same guidelines as for face frontal except for • Teeth visible.• Pt. should smile in a natural way.

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• Canthus to superior attachment of ear.• Encompassing area crown to collar bone.• Frankfort horizontal line to be sure that the head is leveled

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• Gives visible information about smile esthetics• Teeth should be visible.

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Intra-oral Photographs

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Positioning the Patient:

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Operatory Dental Light

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• Pt. in dental chair is raised to clinician elbow level.• Assistant stands behind the patient.• Retracting pt. lips sideways• 90 degree to facial midline using upper frenum as a guide• Full extension of sulci are needed.• High f value required for maximum depth of field.

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• Flip the retractor to narrower side• Patient is asked to turn there head towards left.• Last erupted molar to be visualized• 90 degree to canine-premolar area

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• Similar to that of right buccal• Switch to larger retractor to patients right and narrower

retractor to pt. left• 90 degree to canine premolar area

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• Retractors are inserted in “V” shape to retract upper lip• Mirror with wider end inside the mouth• Pt. Is instructed to lower the head slightly• Shot to be taken 90 degree to the plane of mirror• Mid palatal raphe as a guide for orientation• There should be minimum retractor show• No fingers should be seen

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• Retractors in reverse ‘V” shape• Clinician should hold mirror upwards to visualize lower arch• Patient is asked to lift the chin up• And also asked to hold back the tongue.

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References.. British Journal of Orthodontics/Vol. 26/1999/269–272 Sandler PJ, Murray AM. Clinical photographs—The gold

standard. J Ortho 2002;29:158–67. Sandler PJ, Sira S, Murray AM. A photographic Kesling

Setup. J Ortho 2005; 32:85–8. Halazonetis DJ. Guidelines for preparing and submitting

images for publication. Am J Orthod Dentofacial Ortho 2001; 20:445–7.

A Short Clinical Guide to Digital Photography

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