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 was the 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 fixing agent 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 company introduced 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 be either 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 specific location at which camera 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 to measure 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 a washed out print.

Panorama : A broad view, usually scenic.

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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 in a camera which controls the time during which light reaches the film.

Zoom lens : A lens in which the focal length can be adjusted over a wide range. With zoom, camera is closer to object without moving physically 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

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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 sulfite solution, 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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Scale of reproduction : It is the ratio of image size to subject size.

Clear working distance : It is the distance from the subject to the front surface of the lens.

For dental photographic purposes maximum scales of reproduction of 1:1 or 2:1 are required. The scale of reproduction together with the focal length of the lens determine the clear working distance.
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Most demanding aspect of clinical photography are patient lighting. For best quality, monolight flash should be mounted in a corner of a room. A rectangular .75 x.35m soft box fits on the flash unit in horizontal position. Distance from the monolight to subject is fixed about (1.1-1.2m)

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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 obtained with a minimum of technical complexity. For taking intra-oral photographs a lateral flash source can create problems. If the working distance is too short, the illumination will be uneven. For this reason, when lateral flash is used the clear working distance should be long enough and the flash unit should be rotatable to a position directly beside the lens.

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Ring Flash :

Ring flash is extremely popular 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 shadowless illumination.

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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 lacks modeling, 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 are essential for high quality intraoral photographs.

Intraoral Mirrors : For good images, surface coated glass mirrors are 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 before treatment. 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 shot should cover the patients face and neck,with reasonable margin all around. Patient should stand with their head in NHP, with eyes looking into camera lens. Patient should hold their teeth and jaw in a relaxed (rest) position, with lips in contact and in relaxed position.

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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 larger retractor sideways and away from gingivae, towards clinician. This is important to allow maximum visualization of all teeth and alveolar ridges Photo should be taken 90 degree to facial mid-line using upper frenal attachment as a guide.

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Flip the right retractor to narrow side Left retractor remains in place as for previous frontal shot. Right side of patient head should be towards clinician. Clinician holds the right retractor 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 vshape to retract the upper lips sideways and away from teeth. Insert the mirrors with its wider end inwards to capture max. width of arch posteriorly, and pull it slightly downward . Shot can be taken 90 degree to the plane of mirror for more visibility Mid-palatal raphe used as a guide for orientation of shot.
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 For

lower occlusal retractors should be in reverse v shape position.

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Assistant would now lower the smaller retractors 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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