Clinical photography

CLINICAL PHOTOGRAPHY INORTHODONTICS

DR. SABA BASITMCPS RESIDENT

ORTHODONTICS

05/01/2023 2

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

05/01/2023 3

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

05/01/2023 4

Requirements :

Orthodontic Retractors Orthodontic Mirrors FLASH LIGHTING Digital Cameras

05/01/2023 5

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

05/01/2023 6

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

05/01/2023 7

05/01/2023 8

Mirrors

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

The mirror recommended is the long-handled mirror

05/01/2023 9

Flash Lightening

Ring flash Point flash

05/01/2023 10

Digital Cameras

05/01/2023 11

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

05/01/2023 12

Extra-oral Photographs

05/01/2023 13

• 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

05/01/2023 14

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

05/01/2023 15

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

05/01/2023 16

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

05/01/2023 17

Intra-oral Photographs

05/01/2023 18

Positioning the Patient:

05/01/2023 19

Operatory Dental Light

05/01/2023 20

• 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.

05/01/2023 21

• 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

05/01/2023 22

• 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

05/01/2023 23

• 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

05/01/2023 24

• 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.

05/01/2023 25

05/01/2023 26

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

05/01/2023 27