Photography in Orthodontics

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Dr. RAJESHWAR SINGH (P.G I yr.)

DEPARTMENT OF ORTHODONTICS

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Photography is the process of recording images

on sensitized material by action of light and

chemical process of sensitized material to

produce a print.

The word photography is derived from Greek

word meaning to write or draw with light

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Ancient Greek Philosopher

Aristotle observed that light

passing through a small hole in

the wall of a room framed on

dawn image of an object.

Until 1500AD this character of

light was not used.

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In Italy first crude camera,

called a camera obscure (dark

chamber) was made.

It consisted of a huge base with

tiny opening in one side that

admitted light and on opposite

side, the light formed an

inverted image of scene outside.

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1727 :

German physicist Johann H. Schulte discovered

that silver salts turn dark when exposed to light.

About 50 years later CarlScheeje, a Swedish

chemist, showed that changes caused in salts by

light made permanent by chemical.

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1826 :

Frenchman, Joseph

N.N coated a metal

plate with light

sensitive chemical and

then exposed the plate

in the camera obscura

for 8 hrs.

Resulting picture wasthe worlds first

photograph.

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1830 :

Louis Daguerre, a French

man, exposed a sheet of

silver coated copper,

developed the image

with mercury vapour and

fixed it with table salt.

Daguerreotyper (15 to

30 sec.)

Produce sharp and

detailed images.

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1839:

Britisher W.H Fox

Talbot invented a light

sensitive paper which

produce a negative

from which positive

prints could be made

Use sodium

thiosulphate as a fixingagent

Invention called

Photography

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1851 :

British Photographer Frederick S.Archer Coated a glass with mixture of silver salts and an

emulsion made of wet, sticky substance

Coloidion

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1871:

Richard L. Maddox a British doctor

Used an emulsion of gelatin to coat

photographic plates.

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1888 :

George Eastman,

introduced Kodak Box

Camera.

This Camera has a roll

of gelatin coated film.

Mass production.

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1924 :

Leica companyintroduced a 33mm

pocket camera.

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1931:

Electric flash bulb was introduced.

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1935 :

Colour film was introduced commercially.

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Angle of view:

The particular portion of a scene that is

covered by a camera lens. The area is

determined by the focal length of the lens.

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Focal length :

The distance between the rear nodal point of

the lens and focal plane when focus is set at

infinity.

Nodal point :

Point where the ray of light appear to have

come after passing through lens.

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Aperture:

The opening in a lens system through which light

passes. The size of the aperture may be fixed or

adjustable. Lens openings are usually calibrated

in numbers.

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Auto focus :

Camera adjusts the lens for correct focus on the

subject automatically.

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Back ground :

The part of the scene that appears behind the

main subject of the picture.

For extra oral photographs background should beeither a solid-white background, or a solid-dark

color such as dark blue.

Multiple objects in background should be

avoided.

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Blow up :

An enlargement; a

print that is made

bigger than the

negative or slide.

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Camera angle :

It marks the specificlocation at whichcamera is placed to

take a shot.

Types :

Birds Eye

High Angle Eye Level

Low Angle

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Candid pictures :

Imposed pictures,

often takes without

the subjects

knowledge.

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Double exposure :

Two pictures taken on one

frame of film or two images

printed on one piece of

photographic paper.

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Emulsion :

A thin coating of light

sensitive material,

usually silver halide in

gelatin, in which the

image is framed on

film and photographic

paper.

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Exposure :

Amount of light required to take a photo.

OR

The quantity of light allowed to act on a

photographic material.

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Film speed :

The measure of a

sensitivity of a given film

to light.

Determined by various

numerical scales.

A closely related ISO

system is used tomeasure the sensitivity

of digital imaging

systems.

ISO 100 is ideal film.

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Over exposure :

A condition in which

too much light reaches

the film, producing a

dense negative as awashed out print.

Panorama :

A broad view, usuallyscenic.

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Range finder :

A device included on a

camera as an aid in

focusing.

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Parallax :

This is the effect of

looking through a

viewfinder that is

distinct from camera

lens itself.

It increases as going

closer to subject.

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Shutter :

It is movable cover ina camera whichcontrols the timeduring which lightreaches the film.

Zoom lens : A lens in which the

focal length can beadjusted over a widerange.

With zoom, camera iscloser to objectwithout movingphysically closer.

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The aim of dental photography is to record a

maximum of information under conditions, which

should be as reproducible as possible. It helps in ;

Patient education

Legal records for facial features for pre and post

treatment.

Excellent tool for teaching.

Excellent tool for communication.

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Photographs for comparison over time can be

obtained only if the conditions under which they

are taken are reproducible.

Position of patient during photography should be

standardized.

The photographic equipment used, the framing

of the picture, the scale of reproduction and

lighting should be constant.

If all these conditions are standardized it is

possible to take intra oral and extra oral

photographs, which allows direct comparisons.

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Natural head position

Line from outer canthus of eye to superior

attachment of ear should be parallel to frankfurt

horizontal plane.

Inter pupillary line should be parallel tohorizontal plane.

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Camera :

The types of cameras that can be used for

clinical photography include :

Orthoscan camera Polaroid cameras

35 mm, single lens reflex with 100 mm macro or

100-150 mm, short manual lenses on automatic

bulbs Single or twin lens reflex cameras, which uses

120 film and 150 to 180 mm lenses.

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The earliest intraoral camera to use is the

orthoscan camera.

It produces a 1:1 ratio in a properly oriented

perspective (right is right, left is left) of full

upper or full lower arches on Polaroid film only.

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Polaroid type 107 film yields a black and white

print in 15 seconds.

Polaroid 105 film prints a black and white print

in 60 seconds, plus a black and white negative

which has to be cleared in sodium sulfitesolution, washed and dried.

Polaroid 108 film produces a colour print in 60

seconds

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The most suitable and frequently used

clinical camera for dental photographs.

It has advantages over view finder

cameras for the problem of parallax in

close working conditions.

In this both the focus and depth of field

can be observed visually on the viewing

screen.

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The most critical item of equipment is the lens.

The characteristics of the lens determines

whether a camera can be used for dental

photography.

Two parameters of particular importance are

determined by the types of lens employed.

They are ;

The scale of reproduction

The clear working distance

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To prevent shadows :

Small rectangular reflecting panel of .35x.7m is

used.

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Frontal view :

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Oblique view :

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Lateral view :

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1-Instruct the patient how to use reflecting panel

and adjust height on stool, close to background

panel.

2-Set the standard time/diaphram couple with the

monolight adjusted to full-power light emission.

3- Position the patient head for extended and

basal views with unchanged monolight position.

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4- Position the Patient for right oblique views,

monolight should be oriented.

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5- Position the patient for right profile view,

close to background panel and shoot the

photo.

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Lateral Flash : The simplest and most common arrangement is

lateral mounting of the flash unit.

This results in high contrast pictures obtainedwith a minimum of technical complexity.

For taking intra-oral photographs a lateral flashsource can create problems.

If the working distance is too short, theillumination will be uneven.

For this reason, when lateral flash is used theclear working distance should be long enoughand the flash unit should be rotatable to aposition directly beside the lens.

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Ring Flash :

Ring flash is extremelypopular especially in

intra-oral photography.

The flash reflection

takes the form of a ring

surrounding the lens.

In this light axis and

the optical axis of the

camera coincides,

giving a shadowlessillumination.

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Advantages :

Highly inaccessible areas are well and uniformly

illuminated.

Permits uniform illumination even at large scales

of magnification and with short object distances.

Disadvantages :

Illumination is that the photographs lacksmodeling, i.e. they do not clearly show surface

texture

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Double Lateral Flash :

A combination of two laterally positioned flash

sources gives evenly illuminated pictures, which

also show some degree of modeling.

Colour structure of teeth is reproduced better

with lateral illumination than with axial lighting

from a ring flash.

Advantage :

Adapt to the surface of the particular subject

Illustrate the particular point the picture is to

convey.

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Recommended principal standard suitable for all

aspects of dental photography are ;

35 mm single lens reflex camera.

Macrolens of 100 135 mm focal length, allowing

reproduction on a scale of 1:1 or preferably 2:1.

Lateral flash : Single or preferably double, ring

flash can also be used for intra oral photography.

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Suitable mirrors as well as lip retractors areessential for high quality intraoral photographs.

Intraoral Mirrors :

For good images, surface coated glass mirrorsare required.

Intra oral mirrors with handles are preferred

Extraoral Retractors : Two sets of double-ended retractors

Small set

Double set

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For maximum benefit and information nine

pretreatment and nine post treatment

photographs should be obtained.

Four extraoral photographs and five intraoral

photographs should be obtained beforetreatment.

Mid treatment photographs should be obtained

at change of every arch wire.

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Consist of following four shots :

1- Face-Frontal (lips relaxed)

2- Face-Frontal (Smiling)

3- profile (Right side preferably- Lips relaxed)4- 45 degree profile or ( profile smiling)

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First,framing of shotshould cover the patientsface and neck,withreasonable margin allaround.

Patient should stand withtheir head in NHP, witheyes looking into cameralens.

Patient should hold their

teeth and jaw in a relaxed(rest) position, with lips incontact and in relaxedposition.

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Make sure patients head is not tilted or their

face rotated to either side; shot should be taken

at 90 degree to facial midline from front.

Ensuring the patients inter-pupillary line is

leveled

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In this patient should

be smiling in a natural

way with teeth

visible.

This photo greatly

aids in visualizing the

patients smile

esthetics and soft

tissue proportions

during smiling.

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In this, patient is

asked to bodily turn

to their left.

Head should be in

natural head position,

with eyes fixed

horizontally.

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Patient is asked to

turn their heads

slightly to their right

while keeping their

body forward.

Patient is instructed

to look into camera

by turning their eyes

to right to meet the

lens and then smile.

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For these shots, the use of special cheek

retractors and dental mirrors are required.

There are five required intra-oral

photographs.

1- Frontal in occlusion

2- Right Buccal in occlusion

3- Left Buccal in occlusion

4- Upper Occlusal

5- Lower Occlusal

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Lips retract by largerretractor sideways andaway from gingivae,towards clinician.

This is important to

allow maximumvisualization of allteeth and alveolarridges

Photo should be taken

90 degree to facialmid-line using upperfrenal attachment as aguide.

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Flip the right retractor tonarrow side

Left retractor remains in

place as for previous

frontal shot.

Right side of patient head

should be towards

clinician.

Clinician holds the rightretractor and stretches it

to extent that last

present molar is visible.

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It is similar to right buccal shot

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Retractors inserted in a v shape.


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Smaller retractors used

Retractors are inserted in a v-

shape to retract the upperlips sideways and away fromteeth.

Insert the mirrors with its

wider end inwards to capturemax. width of archposteriorly, and pull it slightlydownward .

Shot can be taken 90 degreeto the plane of mirror formore visibility

Mid-palatal raphe used as aguide for orientation of shot.

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For lower occlusal retractors should be inreverse v shape position.


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Assistant would now

lower the smallerretractors into a reverse

v shape to retract

lower lips sideways and

away from teeth.

Lift the mirror upwards

for reflection of lower

arch, and patient is

asked to lift chin up

slightly.

Shot should be taken 90

degree to the plane of

mirror.

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Short guide to clinical digital photography

Clinical Digital Photography

Clinical Facial Analysis

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Photography in Orthodontics

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