Photography is an extremely valuable tool for practicing dentists, orthodontists and dental educators.
The old adage that "a picture is worth a thousand words" was never truer then when discussing a patient's
dental concerns.
Portrait photos, usually combined with intraoral photographs on a template, are permanent records. These
can be reviewed later with the patient to illustrate planned procedures and the progress of treatment over
time. By using new technologies in digital photography to communicate with patients, labs, insurance providers,
specialists and other dentists, a great deal of information can be shared faster and easier than ever before.
Traditionally, photographs are taken of the patient with a regular 35 mm single lens reflex (SLR) camera.
The film is developed off-site and if the prints are of acceptable quality, they are trimmed and mounted onto
a black cardboard mount. Unfortunately, if any of the images are blurred or do not meet the dentist requirements,
the patient is called back to repeat the photo session. Obviously, using 35 mm print film is an expensive and
time-consuming process to make these photographic templates.
With the emergence of high quality relatively inexpensive digital cameras, the low cost of computing power, and
impressive printer output, the older traditional methods of dental photography are becoming just that ... a thing
of the past. Digital photography and digital mounting holds the promise of improved product quality, reduced
preparation time and has marketing appeal to enhance a practice.
There are five major elements to a clinic's digital photography system:
- Image acquisition
- Image processing
- Image manipulation
- Image storage and retrieval
- Image output
Image acquisition
Obviously, the most important step to digital imaging is taking a picture with a digital camera.
The best type of digital camera should incorporate a single-lens reflex (SLR) lens system. It allows
the photographer to review the subject before pressing the button.
One of these cameras have been used at all of ddi's clinics, namely the Olympus C-2500L. Designed with
the professional photographer in mind, the fully featured and versatile camera uses an exclusive 2/3-inch
Charge-Coupled Device (CCD) with an impressive 2.5 million pixel count and a resolution of 1712 x 1368 pixels.
It delivers the accurate color, gradation and contrast of a true photograph.
The camera's SLR viewfinder displays 95%-centered view of the image area and is easy to use. In automatic
mode it is as simple as point and shoot. It also utilizes a 122,000 pixel high resolution LCD with automatic
playback, 2x and 4x magnification inspection mode to allow the photographer to immediately review the images.
The camera includes one 32MB SmartMediaTM removable memory card which can hold dozens of images in their
compressed JPEG format. At least two additional 32 MB cards should be made available so that cases can be
mounted while the camera is still in use.
The camera is powered using an AC adaptor with a 15-foot extension and is be mounted on a professional-grade
tripod for portrait shots. The tripod standardizes the image scaling and increases the sharpness since vibration
or camera movement is minimized. The camera is light enough to be hand-held during the intraoral photographs
and can be manipulated with one hand. The other had can be used to assist the patient with retractors or mirrors.
To ensure the digital images represent true colors without shadows, care must be taken in the lighting methodology.
Although most digital cameras have dedicated flashes, these typically perform poorly when trying to obtain true color
images in the fluorescent office environments and even worse when attempting intraoral shots.
For portrait shots, a dedicated slave flash, which triggers immediately after the camera's integral flash, should
be used to enhance the lighting of the patient. It should be mounted on the floor and configured to illuminate a
matte white screen behind the patient. Additional incandescent flood lighting may be used increase the general
lighting and maintain the patient's color balance. A slaved integral ring flash should be used to eliminate shadows
while taking intraoral photographs. A professional lighting expert should evaluate the lighting configuration
once the photographic station is defined.
Once the photographs for the digital mount are acquired, they should be transferred to the PC using the 32 MB
SmartMediaTM data card for image processing.
Image processing
Preliminary processing is instantaneous when you capture images digitally. The Olympus is designed with an
Application Specific Integrated Circuit (ASIC), allowing the C-2500L to manage the image in the camera for
truer color, white balance, contrast, and gradation producing a more realistic color photograph. The camera
should be calibrated in the clinic using standard color test patterns. The camera utilizes all the pixel
information to produce detailed photographs with a smoother photographic appearance.
If required, additional image processing for white balance, contrast, or brightness could be done at the image
processing station using standard image editing software like Adobe Photoshop.
Image Manipulation
Digital photos can be arranged and manipulated with traditional photo-editing software such as Adobe Photoshop.
By itself, Adobe Photoshop, like many others high-end software packages, are difficult learn for novice and even
intermediate computer users. Because of this, ddi utilized the efforts of Biomex Consulting to develop a set of
tools for Adobe Photoshop to make building these templates a fast and easy to learn process.
The easy-to-learn set of tools includes single-click operations for standardized color corrections, rotating, and
scaling the photos. Images are copied into the cells or openings of the mount and can be adjusted independent of
the other images inside the mount.
Custom sets of digital templates can be developed by Biomex Consulting for the clinic and could include the Company
logo and clinic's address as well as all pertinent patient information. All text can be printed on the mount to save
time and prevent incorrect labeling.
On average the mounting procedure takes about 6 minutes to complete from start to finish, and in ideal circumstances
can be done in less than 5 minutes. This allows for 'While-U-Wait' service, previously impossible using traditional
photograph mounting.
One key ingredient for preparing these digital mounts quickly and effortlessly is to have a high-end computer with
capabilities focused on graphics. This currently includes at 21-inch flat screen monitor with a 32 MB video card.
The Imaging PC discussed earlier should be used for the post processing.
Image Storage and Retrieval
Once the mounting is complete, the images are compressed so that three or four completed mounts can be stored on
a standard 3.5" floppy diskette for distribution or archival. This compression will allow over 1,800 completed
cases on a single recordable CD for archival purposes.
The image can be stored using the JPEG format which is Internet and web browser friendly. These can also be
inserted into reports or directly emailed to patients, labs, insurance providers, specialists or other dentists
allowing the clinics to disseminate the information faster and easier than ever before.
Image Output
A permanent record of the mount is usually required to archive a patient's progress throughout the treatment
process. This process may last years so making sure the original prints maintain their color is an important
issue. ddi's currently uses products that are ultra-violet (UV) light resistant and have an expected life span
of 30+ years.
The printer output from the dye-sublimation printer is cropped to meet the industry standard 8-inch x 10-inch
layouts. These will then be placed into plastic sleeves so that the print is protected against mechanical wear
and tear.
Summary
Digital photography and digital mounting holds the promise of improved product quality, reduced preparation time
and has marketing appeal to enhance a practice. |
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