Photography in Dentistry Theory and Techniques in Modern Documentation Pasquale Loiacono, pps Private Practice, Tropea, italy Luca Pascoletti, ops Private Practice, Udine, Italy Translated from Italian by Rosemary Barber Meligrana Qcopyright 201 by QuintssenzaEdzons vig Cio Ment, 6 ~20077 Rho (M1) tay TH439.02.93:18 08.21 - Fax 39.02.95:8.6159 E-mal:infosquintessrzaedzon.it nu qulntssenzaediion com SAN 88-7492269-1 978-88-7492"160-0 Aleit resve Tis bok oy part there may tater, sted inate ston, oF teamed ney fmerby any means, cr mechanical, potocopyig thrust pie Uren emission oe pusher (Graphic designer Valentina Avogadro PrintediattalyContents Contents Foreword. a Preface... 3 “acknowledgments 2 Pare one ‘Theory as Chapters General Principles of Photography... (Close-up Photography : Basic Components of the Camera. Compact and Reflex Cameras Components of a Digital Camera ‘Analog and digital sensors ‘Sensor format ‘Aperture or dlaphiragm..... Shutter and shutter speed Reciprocity aw i Viewsinder Live view and video modes... Lens. Exposure meter ‘Tarough-the-lens metering Correct Handling of the camera .. ‘Camera Choice on the Basis of Documentation. mo: ‘The Optical system. Principles of Vision .. Focal Length... ‘Angle of View and Magnification Factor Concept of Normality and Classification of Lenses ‘Meaning and Interpretation of the Magnification Ratio, Elements of Visual Tension .. ft Golden Questions Importance ofthe Distance Between Lens and subject Perspective Distortion ‘Macro Lensesee — Contents “The Gola Standaed for Lenses in Dentistry Visualization of the Magnification Ratio. FAA incon “The Concept of Exposure Definition of Exposure. Role ofthe Exposure Meter... ‘Through-the-Lens Reading... Exposure Lock and Measuring Procedures. Reflectance and the Standard 18% Cray Card. Exposure Correction .. se Physiology of Vision: Contiast Effects. 180 speed... Perception of Color and Color Temperature ‘White Balance Photography forthe Communication of Color. Be eh Prinelpls of Digital Photography Sensors in Analog Photography Digital Sengorse. Paotsite, Potters Pies. Felsen Foe ergth and the Malpiation Factor Image Cle and te Vignetag Concept Zetland Nominal Magnification Rao ‘halogto-Digal Converter. Tage fle ormats Tei tonmat. fw format 2 Tegal alu of hea frat image Processing Shoot mens pesotution and image Quay Time Dep and Calor Space Chromatic nterpeaion Memory Cards tmage Nansfer ta Personal Computer. 2 a 13 226 225 8 20Chapters ‘The Role of Photography in Clinical Practice. ‘A New Concept: The Photograph As a Diagnostic instrument. Communication with the Patient ‘Medicolegal Value of Photographic Documentation Communication with the Scientific Community Photography As an Instrument for Self-Assessment Photogeaphy for Communication with the Dental Laboratory Chapters Camera Settings for Dentistry. ‘Automatic Exposure Settings ‘Automatic Focus Settings Depth of Field Factors That influence Depth of Feld. CCrcles of confusion Diffraction mottling. Relationship Between Focal Length and Depth of Field Camera Settings Related to Clinical Requirements, Chaptery ‘The Orthography of mages Concept of Framing Accessories for Intraoral Photography: Retractors and Mirrors Characteristics of Mirrors for Dental Photography Aiming and Focal Points .. Focusing Technique. ‘Spatiality of the Frame and Orthography of images ‘The Fundamental Rule for the Orthography of Images: Zero Coordinate er0-Coordinate Rule Applied to Various images Creative Photographs. Contrast in Photography. Contrastors. Intrinsic Optical Properties of Teeth: Transiucency Extrinsic Optical Properties of Teeth: Surface Characteristics. Chapters Flash Units... ‘Traditional Flash Unies Ring Flashes. ‘Twin Flashes Creative Use of Fashes Flash Synchronization... [Exposure and Flash: TTL Mode. ‘Manual Mode .. Contents m3 234 2136 138 ago. 40 a 146 246 +182 2185 2358 2358 2159 160 363, 164 $164 166 86 168 Sa Sa v8 9 182 382 184 Chass 195 196 203 204 208 207Chaptero Photographing Radiographs. Radiographic Masks «.-..-- ‘Camera Settings. Correct Framing, Part Two ‘Techniques .. CChapterio Equipment and Accessories Cameras and Accessories Intraoral mirrors Cheek retractors.. ‘Additional accessories Image Quality. Synergy Between Practitioner and Assistant . Chapter Extraoral Series View 1 Frontal Face, Smiling and with Lips Relaxed View 2 Profile, Smiling and with Lips Relaxed. View 3 Slight, average, and Maximum Smiles View q Lateral smile . Chaptertz Intraoral Series View § Right Overjet View 6 Left Overjet View 7 Full Arches in Normal Occlusion. View 8 Anterior Sextants in Normal Occlusion View 9 Right Quadrants in Occlusion .. View 10 Right Posterior Sextants in Occlusion View Right Quadrantsin Ocdsion fr Orthoontc Bocumentaton : View 2 Left Quadrants in Occlusion ‘ View 13 Left Posterior Sextants in Occlusion View 1g Left Quadrants in Occlusion for Orthodontic Documentation View 5 Complete Maxillary Dentition: Occlusal View : View 16 Maxillary Anterior Sextant: Incisal View .. View 17 Maxillary Anterior Sextant: Palatal View View 8 Maxillary Anterior Sextant: Facial View -.. View 19 Complete Mandibular Dentition: Occlusal View View 20 Mandibular Anterior Sextant: Incisal View.. View 21 Mandibular Anterior Sextant: Lingual View view 22 Mandibular Anterior Sextant: Facial View... a oa 26 2 ca Cas 28 28iow 23 Maxillary Right Posterior Sextant: Occlusal View. iow 2a Maxillary Right Posterior Sextant: Palatal View .. View 25 Mandibular Left Posterior Sextant: Occlusal View View 26 Mandibular Left Posterior Sexcant: Lingual View. View 27 Maxillary Left Posterior Sextant: Occlusal View. View 28 Maxillary Left Posterior Sextant: Palatal View .. View 29 Mandibular Right Posterior Sextant: Occlusal View View 30 Mandibular Right Posterior Sextant; Lingual View Chapters Photographic Documentation, oxthodontic Documentation, Periodontal Documentation. Prosthetic Documentation .. Conservative Dentistry Documentation. Photographing with rubber dam. Communication with the Dental Laboratory Technician Recommended Reading... ‘Image reats Contents 292 204 296 298 300 302 308 306 309 an. 35 319 319 a 226 329 33Dedication Tomy two wonderful daughters, Martina {and Nicoletta, May they aways believe the Beauty oftheir dreams and havethe Strength to reaize them, Pasquale Loiacono Tomy beloved daughter ice, an lireplaceatle source of energy, and tomy area fiend and master of tie, Sandro Redara, sca PasolettForeword Writing the foreword to a text requires a great ‘moral and ethical commitment and, I would add, isan important responsibility toward both the authors and the readers, When my friends, Pasquale Loiacono and Luca Pascoletti, the authors of Photography in Detisy, asked me to write the foreword to their book, I was pleased and honored to give a brief introduction to this, work for two reasons. First, I have known the authors for several years and have followed the path oftheir professional growth; second, they Aare dear friends, and I feel a particular bond of affection toward them. ‘Tne major innovation represented by this text {s the formation ofthe team of the two authors, who possess extraordinary qualities and gifts. ‘This fine union of distinct talents has resulted fin a work that is scientific and, at the same time, practical. The authors have interacted well together co create a text that is cohesive and extremely useful from a didactic point of view. It provides the reader—the novice ot Foreword expert dentist-photographer—with a complete ‘guide for obtaining excellent photographic documentation. can only express my most sincere compll- ‘ments to the two authors for achieving a work ‘in which the content and form Is well rounded, complete, and supported by excellent ius trations in other words, a work that 1 would hhave been pleased to have written myself. 1 am, therefore, convinced that this book will be ‘greatly appreciated and put to good use by both novice dentists, aiming to acquire the tech- niques of photography, and skilled clinicians, ‘who will certainly find theories and ideas to put into practice straightaway. ‘With my most sincere compliments, Domenico Massironl, MD, DMD Drivate Practice ‘lan, talyPreface ‘The idea of creating a manual of photography for dentists originated from a specific cultural frame of reference, the Massizoni Study Club, which is based upon the philosophy and ‘teachings of Dr Domenico Massironi ‘We consider this work to be one of the many fruits borne from the tireless and visionary ‘work of our “Maestro.” We are aware that he is not keen on being defined in this manner; however, the influence of his teachings and his scientific rigor leads us to consider him ‘with such profound affection and respect that we are unable to express ourselves in any other way. Thus, a warm thank you goes to him and to all filends of the Massizoni Study Club with whom we share an exciting journey of personal and professional growth. ‘Why a book on photography? First, we love and strongly believe in pho tography as 2 fundamental means toward four professional evolution, On a daily basis, it allows us to verify the path of our learning and to relate, in a positive way, to patlents and colleagues alike, Our love of photography, together with our love of our profession, hhas always led us to wonder how so many competent professionals consider chemselves ‘unable to take photographs that are comparable to the quality of their own work, This false conviction deprives them of the opportunity Preface to be appreciated by a wider audience or, more simply, to record thelr own professional path ‘Our second fundamental motivation is an awareness that the current approach toward ental photography is totally lacking in stan: dardized procedures or agreed-upon rules, ‘which are present in all other traditional dental disciplines. Many colleagues tum to nonspe cialized photographers to obtain information oF to learn how to take dental photographs. However, the answers they receive are vague and often based on strictly commercial inter ests rather than the outcome of rigorous scien- {fl reasoning, ‘We believe tat any dentist can quickly acquire the rudimentary skills needed to take more-than- adequate photographs or, with very litte extra effort, even excellent ones. The real problem is that there are very few compzehensive books on photography designed and written by dentists for dentists, Because we believe that only an Insider can be aware of the day-to-day problems that we face In our profession, we were keen to put our knowledge at the disposal of our colleagues, in the hopes of spreading the use of valuable instrument. Pasquale Loiacono and Luca Pasoett B‘Acknowledgments, Acknowledgments ‘My thoughts of gratitude and immense affection go first to my family: to my wife, Marianna, and my daughters, Martina and ‘Nicoletta, for all the time 1 have taken away from them and, in particular, to my daughters for thelr contribution as models in this book. 1 would also like to thank Dr Domenico Massironi forthe great affection with which he has always supported, guided, and motivated me in both my personal and_ professional growth; my friend, Dr Bruno Alia, for his competent advice on medicolegal ‘matters; Professors Luciano Meligrana and Aurelio Pisera, for their masterly stylistic advice; my dental technicians, Marcello Aiello, Gianluca land Francesco Barbagallo, and Evio Sirianni, {or the professional passion and friendship that wwe share; Rosemary Barber, for her valuable collaboration in the translation of the text; ‘Marco Foreli, for the skills that he has put at sy disposal; Fabio Rodaro, for the attention he thas devoted to my ideas and the care and skill ‘with which he has executed the Mustrations; iy friend, Salvatore Accorinti, for the long and valuable conversations about computing and various methodologic and technical details. Another thank you goes to my close friend, Nando Ricciardi, the first person to believe in this project, for the support and affection he has always shown toward me, Pasquale Loiacono 1 would lke to thank my great friend and Mae~ stro, Dr Domenico Massironi, who has proved to be an invaluable guide both in my life and my profession, He has believed in and support fed this project, providing us from the outset with important and essential advice. 1 would also Uke to thank my model, Sara Lirussi, who hhas willingly and patiently’sat for numerous photographic sessions. Other thanks go to expert professional pho tographer Alberto Cuoco, for the simplicity with Which he has performed the often tricky pho- ‘graphic saquences and the skill with which he ‘has demonstrated the positioning ofthe operators and the photographic equipment; to our lustra- tot and friend Fabio Rodaro, who, with wisdom and intultion, has managed to transform often ‘ultratechnical images into pleasing and original drawings. ‘A heartfelt thanks goes to our orthodontist {lend Luca Conoscenti, for his valuable collabo ‘ation, which has always proved helpful in devel- ‘oping and achieving often ambitious projects; to lero Corsi, an irveplaceable friend with whom 1 share much of my fre time, for his visual ideas for teaching and the unconditional friendship ‘that he has always shown toward me. ‘A particular thank you to my assistants, sil- vvia Della Ricea, whe has actively collaborated in the realization ofthis book as assistant photog- rapher, and Daniela Balutei, with whom Ihave shared my entire professional life and growth, for her help and patience. Luca PascotettPasquale Loiacono Part One TheoryChapter1 General Principles of PhotographyPhotography in Dentistry _ Scientific commanication ean only take plac if supporting documents are created using tniverslly accepted standards, which enable them to be easly and readily understood and compared overtime. photographic image's a visual document and, as such, must be taken following precise rules, which render ic accessible tothe entire scientific community. “There has been a radical evolution aver the past few decades in our manner of thinking, living, land relating to others; notably, these changes have been taking place—and are continuing to do so—ever more rapidly with respect to the past, Setting aside all moral or ethical consid eratlonsas to the compatibility of these innova- tions with an actual improvement in the qual ity of life itis obvious that the possibility of ‘communicating rapidly and effectively—for ex- ‘ample, by means of mobile phones or the inter- neti transforming our way of life, Although, these changes offer extraordinary possibilities, they create problems in understanding and handling new techniques. The rapid exchange of data is dependent upon the presumption that it does, In fact, exist and is written in a language that is, hopefully, accessible to the majority of users, In the scientific world, this need is even ‘more pressing. Therefore, data that the scien tific community uses to spread knowledge and stimulate debate must be of a documentary nature: easily legible, certifiable, comparable, and written in a clear language with universal: ly shared procedures. Data that is documenta ry im nature is useful internationally and over the course of time and thus becomes a heritage of knowledge for mankind. The Vocabulary of the allan Language by Aldo Gabrielli defines a docu ‘ment asa meaiurn—generally written—which attests and confirms the reality ofa fact.” Aur prising comment in the marvelous book by S. (Chis, Fundamentals of Color: Shade Matching and Com ‘munication in Esthetic Dentistry, Ted to a reflection ‘on the status of photography; in discussing the value of digital cameras in communicating color, the author states, “Ar present, the use of digital photography in dentistry has no set nomenclature, procedure codes, standards, or continuity." This statement regarding the lack ff shared rules and procedures in the field of photography effectively sums up 2 widespread ‘and not unfounded feeling among operators. believe, and aim to demonstrate with my ar guments and work, chat this view of photogra- phy belongs in the past, and that today dental photography can, and indeed must, be granted ‘the dignity ofa technique with its own codified and reproducible rules, universally accepted by the sclentific community. While the written ‘word is obviously used to produce documents, ‘medicine is the result of the observation of li- ving structures and their phenomena; we aze ‘bound to admit that che power of an image is fan irreplaceable means of communication in ‘the field of medicine. ‘The word photography comes from two Greek ‘words meaning, “to write with light.” Leam- ing to write wich light isno longer the privilege of a few experts, but instead is a necessity for all those who are passionate about their profes- sion and keen to continue to reap greater sat isfaction from it It is absolutely indispensable for the practitioner to master the fundamental principles of photography to fully understand the problems linked to clinical practice and, subsequently, to become independent in han- dling the photographic medium. As always, the ability to judge both the means being used. and the results obtained is the key to profes- sional growth,_— General Principles f Photography The rules concerning specialized dental photography are based on general technique. cis necessary to havea basic understanding of general photographic principles and techniques to, abtain excellent results in a deliberate manner that i neither random nor accidental Photography can be defined as the detection and conservation of the light reflected from a puticular scene at a given moment, This pro- cess requites a light-impervious container fit ted with a mechanism that regulates both the ‘quantity of light allowed to penetrate the de- vice and impress the sensor, and the precise ‘moment at which it does so, This device can be defined generically as a camera. The frst few chapters of this book are dedicated to familiar- ising the operator with this instrument and to Fame Fre vst: this image allows te procter oss the | onan ofene sof tssies, hte, ona the pate’ ‘genera a purely technical aspects, which will be Mlus- trated in detail for the sake of completeness. This technical information will be approached ‘with clarity, focusing only on clinically useful material. Chapters § through 13 deal specifically with clinical aspects of photography. This book at- tempts to explain and emphasize how light— the real protagonist of esthetic restorations— interacts with the dental substrate tocreate the phenomenon known as tooth shade. ig etal of mesilary ontrr tnt stows the power of ‘expression as highighted bythe harmonious proportion ‘etweer the length and with of teeth, 9Photography in Dentistry ——__ Close-up photography, or macrophotography, isa specialized dental technique. The closeness ofthe subject necessitates special phetographicequipment and devicesto obtain apprepriate mages and documentation sutabl for clinical needs and scientific communication. Close-up Photography It is important to emphasize that dental pho- tography i, without doubt, a highly special ized field, with specific requirements that necessitate a different approach than that of conventional photography. Dental photogra- phy belongs to the field of close-up photogra phy, or macrophatography (Figs 1 and 12) It is quite possible to master the correct technique for taking excellent photographs of sporting events, ceremonies, scenery, of por traits and not be capable of obtaining compa rable results in the field of close-up photogra igre ‘aa of te reatinship betwen upper lip and its. 20 phy. Similarly, a specialist in implane surgery, who has only worked in this discipline, could not be expected to perform excellent endodon- tic therapy. Briefly, in a macrophotograph or close-up photograph, the dimensions of the subject are eproduced onto a sensor with a magnification ratio ranging from 1011 toa:20. This definition requires further explanation, because an un derstanding of the magnification ratio is abso- hutely essential to complete comprehension of ental photography; chapter 2 clearly explains this concept. Fg yed Fmony between tho ipsCeneral Principles of PhotographyPhotography in Dentistry Se ‘All cameras have atleast five essential components in conimon: a sensor, a diaphragm oF ‘apertuve, a shutter @ system of lenses, and a viewfinder. Mast modern cameras also have 4 built-in light meter We can distinguish between the varius types of cameras by the characteristics ofthese fundamental components, Basic Components of the Camera ‘apart from the hermetically light-sealed rigid outer case, called the body, a camera consists of five essential elements: sensor, diaphragin or aperture, shutter, lens system, and viewsinder. ‘All modern cameras also have a sixth compo- nent, the light meter, which is now considered ‘an integral part of the camera, ‘These components will be analyzed in detail ‘to arrive at an overall understanding of theit function and importance within the discipline of dental photography. ‘compact and Reflex Cameras First we must distinguish between cameras for general use, which are used in dentistry, land cameras for special use, such as those designed for aerial photography and used for cartographical and topographical studies. For reasons felating to cost and use, the later have characteristics and require fllms and sensors of ‘a completely different nature than those of the ‘amateur or professional photographer. In fact, there are cameras that use 200 x 250-mm fl. to achieve maximum detail in large frames. Digital sensors are available in special formats as well. Kodak produces st * 39-mm sensors, ‘which are capable of greater than so megapixels and approximately 360 MB per photograph. ‘Cameras for general use can be divided into ‘wo large families: compactcamerasandsingle- lens reflex (SLR) cameras (Figs 13 and 14). ‘Compact cameras were developed in responseto technical demands for simplification and cost reduction, They are characterized by special automatic devices that perform various tasks for the operator, thus making them suitable for inexpert users; even a child can take a ‘wonderful photograph! “This advantage of compact cameras is also fa drawback, because it prevents the expert operator from employing optional. settings that, as we will see later, are essential to the requitements of the practitioner. SLR cameras are more costly and complex to handle but Allow the operator a virtually unlimited choice of parameters, including lens choice. In fact, fone of the furidamental characteristics of SLR ‘cameras is the possibility of selecting lenses of various focal lengths, which provide different angles of view and thus different magnification Dentists often ask, “Which equipment do 1 need to take a good dental photograph?” The cor- rect response is that the operator must choose each instrument withthe final result in ming. To answer this question accurately and thoroughly Tequires a detailed analysis of the components and the functions of the two types of cameras, For a complete understanding of available equipment, the operator should be aware that an intermediate category exists between compact and SLR cameras: the professional-consumer or so-called prosumer type. Prosumer cameras, also called SAL-ite cameras, have hybrid characteristics; they allow greater control over the procedures for acquiring the image, but lack interchangeabilt tyof the lens, Atpresent, some manufacturing companies are aunching a new type of hybridGeneral Principles of Photography Tocheose an appropriate camera fra particular tas, it is necessary to analyze the modes of function and characteristics of the various types of cameras and their usefulness in relation to clinical needs. The categories from which to choose the most sutable camera for dental photography are compact and single-lens refex (SLR. ‘camera onto the market, based on a format de- veloped by Olympusand Panasonic, called Mico Four Third in reference to its sensor format and its smaller bayonet lens attachment, which is built without a mirror or the pentaprism that typifies SLR cameras, These components have been replaced by an electronic viewfinder, As in other SLR cameras, the lenses of Micro Four ‘Thirds cameras are interchangeable. The same manufacturers are also marketing adapter ‘ings to allow the use of preexisting SLR Tenses | nas The rede compact Nikon Cosi St caters, without Gellar vewinae Is equipped wth a aul cyl | aplaycoy panel forte ew made by the new generation of cameras. The Micro Four Thirds system came into existence, the- refore, with the intention of reducing the en- ‘cumbrance and weight of SLR cameras while maintaining the option of lens substitution. All innovations that the market currently of- fers, and will offer in the future, should be jud- ‘ged on thelr basic usefulness for the peculiar needs of the dental field and its clearly defined ‘equipment needs and correlated techniques. Fars ‘dita on 0300 cmera equipped with Complementary meal. siesemiconsto MOS) sensor Ina asieAdvanced Photo Syste (APS-C) fratPhotography in Dentistry —__ “The sensor of a camera isthe device that instantly registers the brightness of the scene to be photographed. The sensor can be analog, a coating of siver halide placed onto celluloid film ‘or digital, a specialize electronic device. There are various types of digital sensors; compact ‘cameras are generally ited with the 43 sensor format and are therefore less expensive. ‘Components of 2 Digital Camera Analog and digital sensors ‘An analysis of the components of the camera should begin with what is commonly called the sensor, the sensitive device that registers the light conditions of a scene at particular ‘moment, The semsor is equivalent to the retina of the eye. Originally, the sensitive element consisted of layers of silver halide emulsion fon glass or thin celluloid strips, hence the term fl, However, over the past few years the use of digital sensor technology has become ‘widespread, One advantage of digital technology is instant visualization of the image. It is {important to point out that the principles and techniques of photography did not change upon the introduction of digital sensors; however, the immediate availability of and ease in handling, the imagewere significant changes. oneshould ‘choose to photograph using film, splendid resules definitely can be obtained, and this medium still maintains all its original fascination and usefulness, However, given the versatility of digital photography as applied to dentistzy, it {s advisable to expand one's knowledge of this, technology. ‘The structural and functional characteristics of the digital sensor will be illustrated in chapter, Atthis point, however, itisnecessary to emphasize certain concepts concerning the differences between digital sensors in compact and SLR cameras ‘A main difference between the two, given equal megapixels, is the general dimensions of the sensor and of the individual light-sensitive clements, To eeanomize space, a smallerformat sensor is used in compact digital cameras than in SLR digital cameras. The photodiodes or pho- todetectors, the light-sensitive elements, are also ‘smaller in compact cameras: approximately 1.8 to2 um, as compared to 6.8 to 7 um in the SLR ‘camera Sensor, This varlation in size does not affect the nominal resolution ofthe photograph ‘as expressed in megapixels. It does, however, affect the final overall quality ofthe photograph; fm fact, smaller light-sensitive elements require greater amplification of the electrical signal and hus resule in the appearance of undesired visual effects, called stone noise. It should also be noted that few compact cameras allow the recording of image files in the aw image format, ‘which, as well seelater, isthe only format that {is considered to have medicolegal value.‘General Principles of Photography “The light-sensitive elements of compact camera sensors are smaller and of poorer quality ‘than those of SLR cameras. The nominal resolution ofa sensor is nt, in itself, suficint t0 ‘express overall picture quality; the utimate quality of an Image i the combined result ofthe ‘characteristics ofthe sensor, the lenses, and other components ofthe camera, Sensor format ‘The term sensor format refers to both the general size of the sensitive element, indicated by the product of the measurement of the horizontal and vertical sides of the sensor, and the shape ‘or proportion between the sides, known as the aspect ratio (Figs 1 to 17). A precise definition fof sensor format, whether in flm or electronic Gevices, 1s essential because it has important conceptual and practical implications. or film, the format can be expressed in ‘numbersoretters. Forexample, thedesignation 35 refers to 2g x 36-mm film; 126 refers to 30 x 3o-mm film; Advanced Photo System (APS) ‘dentfies a17 x 30-mm film (Table), ‘Thesonsor formatcan alsobe describedby the aspect ratio, which is the proportion between ‘the two sides. in a 1:1 format, the two sides “able +4 Various fm formats are equal; other formats include 4:3 and 2:3 Generally, a 2:3 formats considered standard, because ft represents the proportions of the 24 x 36-mm format, which is the most common {format for amateur and professional use. 4 4:3 {ormat is typically used in compact cameras, Digital sensor formats are described in the same way as traditional film sensors, although they may vary slightly from the established measurements for film standards. ‘The most commonly used format in digital SLR cameras is the classic APS (APS-C) sensor, The classic 2:3 format measures about 16 x 24 mm, ‘Manufacturers may install sensors that vary slightly from this measurement, while still being classifiable as APS-C. For example, Nikon makes 2.15.6 x 23,6-mm APS-C sensor ‘that they call DX format, and Canon produces 21g,8 x22,2-mm APS-C sensor (see Fig 1-6) ima Format (nm) Aca neasuenest (nm) Rati between si | _ APS-C (classic) Wx 2510167 32 05-0 (panraig a2 951902 ZI mn) 24x36 24x36 23 | = poxw us 1 wo 45x60 1x9 x | 0 éox6o 29 a Fat set sxinches 203x254 4s 5Photography in Dentistry Meson format (Nodak KAF 3900 sensor) fn 50.7380 ‘else comparion 1977 nm termes he ders of crevasse woh tote trea nh pesos thedmerso ofa « SEnmfine efi fame Iocan neamansenset trestfoeof sar tse reo nae Theloer estos the ‘onpctconea sear fate oe ier teams ter scot ge Stans spemprss tna fene eres thea s-0m oma Avi Reena os poe these une of a = PasesenArsClomat” ya 125" eeeeaecet 76x57 mm —7.18x5.32 mm = 5.76x4.29 mm ee 48mm 38mm 25 mm? fessreronintice ious erp theconapt nares) APS-C (Canon) Facey en fae Semmes ‘own fms 329 mn? 35 mm “full fame” ——_APS-H (Canon) ‘APS-C (Nikon) 56x24 mm 28,7419 mm 864 mn! 548 an? 26‘The term format indicates the product ofthe linear measurements of the tw sides of the sensor and the ato between them. Figse ‘anon VOS dita sensor cbse fom the point of lew ofthe wth heir ase athe ster ope Tisclowsthesensarsealceto become. sama! ferspecsof auto oer mia teal tose cn te “esr thse operas lack spats on ines waht olgrund oer camers re eqloes wen astra fees forceoing te sensor uhh oe exer sel nahh commence. Figs7a ‘Antuderwater photograph taken with Niton O80 Camara, Milder macofens with = Gorm (ko), {= V65s Ths magelsin2' format, which presses ‘ret eovtyond Norman, ae won the 2008 sacl {isa potas cnompionshp. Fars The format of is Canon Mos sensor con be epresseas theproducto te ingor measurements of ese ses (agssa22mn}orastheratn bane to ies, 23the Fa betweeg 8 anda). Far The same image copped in a3 fomat, cer ofers ess impressive visual pat because of he arent Proportions the sides ”Photography in Dentistry ‘The diaphragm, commonly referred to as the aperture, is represented by the symbol {/ followed by numeric value. The aperture isa device wth a variable opening that regulates ‘the amount of ight that reaches the sensor. The higher the numeric value or Fstop, the more Closed the aperture and the less light that reackes the sensor On the contrary, lower Fstop values reflect greater aperture and a greater amount of light reaching the sensor Aperture or diaphragm ‘the aperture, also called the daptragm, is a ‘mechanism of thin plates built into the lens that regulates the amount of light reaching the sensor according to its degree of opening, Ir can be compared to the pupil of the eye, Which regulates Its degree of aperture in response to varying light conditions (Fig 18) In SLR cameras, the aperture is always set on ‘maximum toallow the image on the viewfinder to beas clear as possible. It adjusts toa selected value only at the moment of taking the shot 1m the field of photography, the degree of aperture is indicated by the symbol f followed by a number that represents the relative aperture, Relative aperture is the focal length ‘of alens divided by the diameter ofa particular Fors tl oft tin bade that ore theopere The ‘pertrelson ‘oxmum lsu, ote that wan clse cose the image testes oftietagraph sppeartobecuned nd distorted ater thansteg tsi we drown opal insoe aperture (Fig 19). Relative aperture is also called the number or the Fstop alu. “Thus, ifan aperture is listed as 1/8, the aper- ‘ure value goes into the focal length ofthat par- ‘cular lens eight times; stated differently, the aperture corresponds to one-eighth of the focal length. Relative aperture isa fractional concept; the higher the numeric value of an Fstop, the smaller, or more closed, the aperture. similarly, a smaller numeric fstop value corresponds to a larger or wider aperture (Fig -10). The maximum aperture value, generally {nseribed on the front rim of the lens, indicates the lens speed. & lens marked f/2 will have a maximum aperture diameter corresponding to ‘exactly half the focal length. Its interesting to note that the fastest lenses in the world are the so-mm Noctilux (Leica) and the so-mm Dream Faro 4 “The Fstop values focal length of re fended by 2a General Principles of Photography The value, or number, of the aperture represents the numberof times a particular linear measurement of aperture goes into the focal length ofthe lens. A particular amount of light corresponds to the numeric value of the aperture. Each lower or preceding aperture value corresponds toa doubling of the amount of light reaching the sensor; each higher ar subsequent aperture value reduces the amount of light by half Lens (Canon), which have maximum apertures technological achievement, and any further of f/0.95, Far an optical engineer to achieve improvement in brightness in the future will such 2 level of brightness represents 2 true prove extremely dificult, Figrice Fg raed igre ‘imam aperture: he os) Intermed oper ‘aim apecre which length ofthese by his ‘eresponstoieens peed fis Imensrerent ny ties, ond mmeasuremert 35mm, on thes Theraretheapereure wil havea asc enc of som, eens high numeric wae ‘sped Deejuol 050 25= aa, more simpy 2 ete tha the hum aue se Ineting seater ape 29Photographiy in Dentistry ‘The shutter, which is normally ina closed position, exposes the sensor tothe light coming from the len. The shutterelease button controls its opening and closing, and its sped is versely proportional to the exposure time of the sensor. Each shutter speed corespands toa specific exposure time and thus toa particular amount of light reaching the sensor. The exposure time is Inversely proportional athe shutter sped. ‘Shutter and shutter speed ‘me shutter is a device for exposing the sensor, directly related to the aperture, It is mobile ‘and built into the body of the camera in front of the sensor, Normally, the shutter is closed, ‘but when it opens, as controlled by the shuter- release button, light coming from the lens is, allowed to reach the sensor (Fig 123). Exposure time is the length of time that the shutter stays, ‘open and the sensor remains exposed to the light coming from the lens, shutter speed is the term commonly used to describe exposure time. itis inversely proportional tothe exposure time; halving the shutter speed doubles the exposure, 'An important characteristic ofthe shutter is ‘thatits speed can beselected by theoperatorand can range from a few seconds to hundredths or thousandths of a second. An average: to high: quality SLR eamera can achieve a shutter speed. of 18000 s, Some cameras are equipped with ‘2 B setting, or bulb exposure, which allows the shutter to stay open indefinitely. This option is ‘useful for nighttime photographs requiring a very long exposure time. Each shutter speed value determines the amotunt of light that strikes the sensor. When the lengeh of exposure time is doubled, the amount of Nght that reaches the sensitive flement also doubles. Similarly, when the exposure time is halved, the light reaching the sensor is halved (Fig 2) x {A time value of 125 means that the shutter will stay open for 125 s. The next time value ‘will be x/as0 s, meaning that the shutter speed doubles and the exposure time is halved. The ‘time value that precedes 2/25 § will indicate a halving of the shutter speed and, consequently, a doubling of the exposure time, corresponding, t01/62.58; by convention, this speed is rounded to u60 s, Each increment represents a halving or doubling of the exposure, ‘The same concept applies to the aperture: each Fstop, of aperture value, indicates a halving or a doubling of the amount of light that passes through it. If we compare light reaching the sensor to 2 liguid, the aperture Js the device that regulates the rate of flow of that liquid within a duct (the lens), wile the shutter represents the tap that opens or closes the duct itself ata precise moment.Reciprocity law ‘The diaphragm and the shutter work together in. strct synergy to produce exposure combinations that effectively determine the total amount of light that strikes the sensor, The exposure ‘combinations are regulated by the reipeety lw, ‘which states that various combinations of smutter speed and aperture will provide the same total amount of light (Fig 113) ithe shutter speed is ‘doubled, the time that the shutter remains open. is halved, and the amount of light that reaches the sensor is also reduced by half, To maintain, the original amountof light reaching the sensor, the degree of aperture must be increased by one stop (or value), In the same way, ifthe aperture is decreased by two stops, the amount of light reaching the sensor can be maintained by increasing the exposure time by two values. Fara The ack of shut observed fom the pot of view fie sens ints mal closed postion, These of pening ofthe curtln, ond ths the eng tine ors ght the esa represent the exposure General Principles of Photography ‘The criteria by which the exposure pair is selected depends on the subject. rapidly moving object needs a very short exposure time, so che aperture is sacrificed to allow the necessary amount of light to impress the sensor, Tals condition is called shutter prioity mode (Fig3-1). If the aperture must be reduced, the exposure time must be lengthened, a condition called ‘aperture roity mad. If the total amount of light resulting from the combination of these factors Js insufficient for correct exposure, additional sources of light, such as the flash, are needed. ‘The concept of the synergy between the shutter and theaperture forms the basis of the automatic devices of the camera, which can be either shutter priority or aperture priority mode. Figs ‘Tat open shcter eats thelight coming far the ‘apt of teen To chee tia, he shut eos Button wes ei doum netting, of alo. ‘ese nts moe teste stays pen as ong os ‘heshutenralote tone he down byte operate, ‘eich maybe necessary vey poor ign conditionsPhotography in Dentistry Fare Fikiecan bused ictone thereatinship between Shcer Speed and eosuretine Atap Ietopen fora vey shart tine, soo. presente byte Sapuate)comesponds 0 highspeed for csue of tetap (represen by thetochymete, ‘Thequoty of ud that eahes thecontalner nina the ‘petuecines doube, has halving he sped he quar fuer idole There afte shutter inexposures idee. Doubling te sped means tat te aperture nes ‘toctiy hae, ais the quantity org whch eoces the sensor Fagen Fits can bused irae ‘recipe Toi eloss ‘won eal quaney wae theratecf flow fot the faucet canbe varie by means he aegre of aperture othe {aparby mdiyng relat of tinethe tp spare rou fembinations ftp aperture tnd opening time give ental reutsintemsofthequony Offlidsuplea With acomer, thesame conven ust he {atl qunay fight that reves he sensor regula Dytneapertareand tre shute, 2Fury Aninage tae wt hu {evoteana ef Seombol a ray mod ao shte sped VBDo cota the rating oo wave andthe deta of he spay unset svsblein he ctgrund, +38 fom abe Tape, Cali, ay.Photography in Dentistry ‘The viewfinder of the camera allows the photographer to compose or frame the image. ‘compact cameras are fitted with a Galleon viewfinder or, more recently, with aliquid crystal display panel, which avoids the preblem of parallax. SLR comeras enable the operator to choose the frame by directly abserving the scene through the viewfinder, thus obtaining a reater degree of precision and accuracy. Viewfinder ‘Theviewfinderofthecameraisthelensthrough which the photographer observes what the sensor sees at the moment of recording the image. Therefore, it allows the photographer to choose or compose the frame correctly according to his or her requirements or taste. “Tere are two types of viewfinders, Galilean and prismatic; the former is used in compact cameras, and the latter in SLR cameras. ‘The Galilean viewfinder is a lens generally locatedabovetheshutterofthecompactcamera. Itallows the operator to percelve approximately ‘what the sensor will record at the moment of the aperture of the shutter. This approximation isa result ofthe substantia difference between. ‘what the lens “sees” and what the viewfinder “sees.” They have different perspectives because of the different angle from which they view ‘he subject in the frame. This phenomenon is, called, in optical terms, parallax (Fig 145). The problem of parallax has been overcome by the latest generation of compact cameras, which Ihave lve vw mode. In this mode, the frame to be recorded through the lens is previewed on a Liguid crystal display (LCD) on the back of the “the prismatic viewfinder contains a penta- ‘prism, or ive-sided prism. To understand how a pentaprism works requires knowledge of the ‘manner in which an SLR camera works. “These cameras are called releccamerns because they are fitted with a mirror. Afterlight passes ‘through the lens, a mirror reflects the light, tuming the image upside down. ‘he light travels to the pentaprism, which reverses it again to obtain the correctly oriented final ‘mage, At the moment of exposure, the mirror rises, offering light to the sensor and at the same time cutting off the vision ofthe image in the viewfinder; this produces the charactetistic click ofthe release button (Fig 116). ‘The image seen through the prismatic viewfinder is identical to that perceived by the sensor, without parallax error. The image seen through the viewfinder is normally slightly reduced with respect to that perceived by the sensor; the viewfinder has an inferior frame coverage, about 95% of that perceived by the sensor, Tis problem Is not present in the most expensive cameras, whose refined ‘components allow total coverage of the scene in the viewsinder, SLR cameras usually display Important ‘information on the lower part ofthe viewfinder, such as the time, the f-stop, and the exposure ‘meter readings. This allows the operator to vary the settings without taking his or her eyes off of the viewfinder itself, Some cameras, such as the Nikon Dzoo, display a reference grid in the viewfinder, which can prove extremely useful in avoiding unwanted inclinations of the frame.Fars (aoc) Poa ori caused by he afer angles Sfvow of thetens ond tevewfnde aval the ae as g =. lb Figs Fgvy (rae functioning of on SLR camera. () The ght ‘Theva of pice ene ovale for LR cameras isa antates the ens, (selected ont the iar, eat advantage for thar aser especialy consi the (pases tough he outing en anda) Barclarprotogrophi needs cf he deal fi fendesation ster, = tune vee dum bythe enapris, ands aly splayed on the vender pn pressing he shut eease button, the mir wil inde shucerwil ope, (ang testo General Principles of Photography 3BPhotography in Dentistry “Te ve view mode elows the operatrto view the scene being framed ona screen at the back of thecomera; itis an alteative othe optical viewfinder, bu t can cause difficulty nth framing ‘and is therefore inadvisable for use inthe dental eld. The option of changing lenses, selecting ‘themast appropriate toa particular need, sone of the mast advantageous characteristics ofthe sLRcamera Live view and video modes Inve view mode, it is possible to instantly view the scene framed on the display at the back of thecamera; this function, which hasbeen pres- fent in compact cameras for some time, has te- cently been added to digital SLR cameras, View. ing the subject on an LCD sereen offers several ‘advantages: the operator can compose a scene directly, holding the cameraata distance, with arms stretched out or, in macrophotography, placing the camera at ground level. Techno: logic evolution has led to the manufacture of ‘mobile display screens with adjustable inclina- tion, which further improve the versatility of the SLR camera while maintaining high-qual- ity results. ‘In addition to the live view mode, modern ‘cameras also produce high-definition videos ‘hat may, in the future, serve as a useful com- plementary form of documentation. Howev- er, they do not seem to be essential for dental needs at present. In fact, the duration of these video sessions is extremely limited, as is the ‘mono sound quality. They are not comparable to high-definition video cameras. Because of ‘the complexity of focusing the camera and for reasons of stability, it is far preferable in the dental field not to use the live view mode} it is ‘more appropriate to support the camera in the classic manner, holding it firmly with both hands and framing the scene through the optic viewtnder. 36 Lens Another major difference between compactand SUR cameras i the characteristic of the lenses tsed ta direct light tothe sensor. In compact Cameras, the lenses are not interchangeable Snd generally have a shor foal length, but they do nave a 200m function chat enables the ‘operator to vary the focal length adapt 0 a variety of situations. However, such options involve making concessions in qually; with somany options, the operator must choose the best compromise fora pariclse situation, Dut by so doing, he or she forfeits the opportunity a achieving excellence, which is the exact oP posite of our working phitosapy. (On the other hand, the lenses are inter changeabie in Si cameras allowing the ope Sor to maintain the highest quality in vazious Situations, The most up-to-date photographer, ‘whether amateur ot profesional, can choose the most suitable lens for his or er own re- auirements (Fig 7). “he subject of SLR camera lenses is tm portant that it warrants in-depth analysis, tich is caried out in chapter. The choice of the right lens, together with its corect us, is fone ofthe most critical fctos in enabling ex Cellence in the photographic fe. cis worth mentioning again that a new kind of compact camer, the Micro Four Thirds, has been re- cently introduce it acks the mirror or penta prism pica of SiR cameras, but allows for the Fubstitition oflensesGeneral Principles of Photography “The exposure meter isthe electronic device that measures the light present in the fromed scene. Its nearly always bull into the camera ise. The through-the-lens (TTL) reading is ‘a measurement of light taken through the camera's own lenses Exposure meter “The exposure meter is an electronic device ot sensor consisting of photosensitive semicon- ducting elements, typically built into the cam- ra. Such adevice measures the exposure, of total amouat of light present ata precise moment in the area framed by the lens, This measurement enables the camera's processor to calculate the optimal shutter speed-aperture combination, or exposure combination, to obtain a corzectly ‘exposed photograph with the right brightness, Figs ‘photograph that canbe sidered a good documents esl eiblefer dep of ed ‘anaes then acoaing {caret spatial res, ondthereorerepeatoe tertime An imege wth these characterises canbe Presta at any sete eeferenee without erposig ‘hephorogropertoany baste ‘TMhrough-the-lens metering ‘as discussed above, the exposure meter is built into the body of the camera itself, allowing the device to measure light by means of the same lens used by the camera, technically referred 10 as through-the-lens (TTL) metering. The same concept of TFL metering is used in controlof the flash. The flash system works in synergy with the exposure meter of the camera to control the amount of light emitted by the flash to achieve ‘optimal exposure (Fig 1-18). v7Photography in Dentistry —eEe- —. ‘The corect handling ofa camera is fundamental to achieving the best results in minimal time and withthe least effort. The operator's arms should be kept clase tothe body to serve ‘05.0 support. The posture shouldbe such thatthe center of gravity of he torso can be moved backward or forward without losing the required stability Correct Handling of the Camera Ergonomics and optimal management of avail- able resources are equally important in photog raphy and in normal clinical practice, The most precious resources are the practitioner's time ‘and mental and physical energy. In fact, the {following practices have been studied with par- ticular care and attention by the author to opti- size the time needed to take photographs and ‘tp avoid wasting the practitioner's energy. As in ‘other areas of dentistry, the correct handling of the instrument in einical photography isa deci sive aspect for achieving maximum results with ‘minimum effort and time. “The camera must be held firmly in the right hand, which has the fundamental function of supporting and stabilizing it; itis essential to bbe able to reach the shutter-release button eas- ily and to activate it with the index finger of the same hand (Fig -39a). Theleft hand, facing ‘upwards, supports the lens and, at the same time, with the thumb on the opposite side to the index and middle fingers, rotates the fo- ccusing ring to set the focus (Fig -19b). Camera ‘handling must be done naturally and smooth ly, but also with firmness, so as to be fully in control of the instrument. “The elbows and arms rust be close together, pressing lightly against the body for greater 8 stability, 10 allow composition of the picture ‘with optimal results (Fig za9¢). ‘The need for stability is why itis not advisable to use the live view function. ‘The focusing technique particular to dental photography requires the practitioner to make ‘movements toward and avay from the subject (see chapter), with the feet apart to allow the full range of movement of the torso backward and forward “me practitioner must place one leg slightly flexed in front of the other, with the feet at an angle of 80 degrees; this increases stability and offers a wide range of back-and-forth move- ‘ments of the torso. This posture is similar to that of athletes in the sport of wing shooting, who use chis technique for the same reason. ‘Te camera should rest firmly against the face during the composition of the picture, ‘which allows the operator to experience the ‘camera asan extension ofthe body; in the sport ‘of wing shooting, the athlete, having taken up position wich the weapon, has only to follow the target with his or her eyes to strike it. The photographer-dentist needs to establish such a close rapport with hiis camera that it becomes fan extension of his or her own eyes, just as ‘practitioners use a periodontal probe as an en- ftoscope in mentally visualizing and mapping ‘the periodontal condition,Ceneral Principles of Photography ‘The most stable position of the torso can be achieved by placing the lower limbs a certain distance apart one onto the other, so thatthe operator's feet form an angle of 80 degrees. The right hand holds and stabilizes the camera; te left hand, with te pol facing upwards, supports the lens and focuses the image Fama Theriht hand ols the camera fits thet the inde {inger machete shutter le uton with ese, whe thethamb regulates an agusements Figsge ‘heaperatar holds the camera conecty fri pressinait against he (ace beng careful afer the rms cls othe thay, chs pesto alow the use ofthe limbe aso natural support or pod for tecamer, One ofthe operator gs Seuld be postianed soso ormando-dgre angle wth thefeet allowing he cee f gon of ets to move back and frond eing with core focusing Fig | Thelen, aim pwd, supports he enc and, with thumb and inde ond mide frges,camforaby ates thefocsing ing 3Photography in Dentistry RE Photogrophy isa valid instrument for creating visual scentfc documents. Because such documents should be easily understood and compared, they must be created according to certain universally shared and repeatable rules. camera Choice on the Basis of Documentation Examination of the components and main functions of the camera (Table 12) has answered the question posed at the beginning. of this chapter: “What equipment do we need to take a good clinical photograph?” A good ‘working philosophy is that a. satisfactory photograph succeeds in representing a certain. Clinical situation promptly and effectively with, the right characteristics to become a universal document. ‘What does the term to document mean? im the scientific Geld, documentation refers to ‘the recording and preservation of data that atest ordemonstrate the reality ofelinica facts andthe ‘communication of this data ina clear language, with codified procedures accepted by the entire scientific commaunity. Dental photographs must fulfil certain fundamental requirements: correct exposure, framing, focusing, and depth of fel. FPurthermore—and this isessential—they mustbe repeatable and, therefore, comparable ver time. “The photograph must be taken from a perspective that is superimposable at the beginning and at ‘the end ofthe treatment and, subsequently, ver the course of years, for necessary follow-ups. ‘A critical examination of a series of images will shed light on the characteristics of the functioning and the performance of compact cameras (Fig 120). ‘Compact cameras are designed so that their various functions are almost totally automatic; ie is extremely difficult to formulate criteria 0 for achieving repeatability of an image and a ‘magnification ratio, The largest magnification ratiopossibleiscertainlynotadequateto clinical reeds and can be achieved only by significantly distorting the perspective. Currently available compact cameras do not have the option of tusinga ring-type flash; the Nikon Coolpix 4500 camera body and Nikon 58-29 ring flash bave been discontinued, Therefore, the lighting of the image to be recorded is not optimal with compact cameras. ‘Another problem is shot delay, also known as stutter lag: the camera, at the moment of pressing the shutter-release button, does not {instantly carry out the command, but instead takes fractions of a second or even seconds to calculate the exposure and focus. ‘Moreover, compact cameras do not allow the ‘operator to effectively decide the focal point and, consequently, the depth of field of an mage. The actual dimensions of the minimum aperture in compact cameras allow for good ‘depth of feld (see chapter 6) ‘Compact cameras are fitted with smaller format sensors and smaller photosensitive elements, which do not create a high-quality jimage. The sensor has a 4:3 format, which is ‘why compact-camera images appear squarer in ‘comparison tothestandard2:3formatuniversally used in scientific presentations. Moreover, and ‘most importantly, they do not allow for the substitution and use of specialized lenses. ‘in conciusion, it is extremely difficult to achieve and control a proper magnification ratio fusing a compact camera, It is only with greatGeneral Principles of Photography Compact cameras donot respond as effectively as SLR cameras to scientific documentation requirements. The attr are considered the gold standard for dental photography. = regurad toners the magnification factor Me addtional ins 0 focal muti The iret etonhp between ergo and magento is Elearveien.Photography in Dentistry ‘lens can be refered toas normal or standard when its focal ength sequal tothe measurement ‘ofthe diagonal of the sensor onto which theimageis projected. n ths situation, the angle of view perceived bythe lnsis similar to chat ofthe human eye and the magnification factors x, Lenses ‘an be classified on the basis ofthe ato between thei focal length and te ize ofthe diagonal of thesensor, Concept of Normality and Classification of Lenses Before discussing magnification ratio, which {is the fundamental photographic parameter in the field of close-up photography, the most common lenses and thelr relative focal lengths will be described (Figs 2-1 and 232). However, ‘magnification ratlo remains the fundamental working and constructive parameter that distinguishes and classifies lenses, ‘Ihe frst lens to be considered as a reference point is the standard lens or navmalins, Ic is often ‘assumed that a normal lens has the same angle of view as the human eye; this is true, but only because of a technical point that requires explanation, & normal lens has a focal length that corresponds to the length of the diagonal of the sensor (Fig 23). & lens with this characteristic has a very similar angle of view to that ofthe human eye, so that itnelther enlarges nor reduces images with respect to the natural vision of the eye, ‘Normality ofa lens is, therefore, a character- {istic that depends on the ratio between the focal length and the diagonal dimension of the sensor and not, intrinsically, on the lens itself. There is no one lens that can be considered, in absolute terms, normal forall film or sensor formats; each ‘sensor format wil recognize Its own normal lens (Table 22). For example, the normal lens forthe Nikon DX format sensor (15.6 x 23.6 mm) will have a focal length of 28 mm, which is the ap- proximate value corresponding to the 28.3-mm diagonal length; alens with f= 50mm is normal fora 2g x 36-mm sensor format, but this so-mim 36 Jens is equivalent toa telephoto lens when com- bined with a DX format sensor, This concept of equivalent focal length is lustrated in chapter 4 ‘The concept of normality allows lenses to be classified into three categories: standard, wide-angle, and telephoto. If the focal length {s decreased with respect to the normal lens, the angle of view is increased, reducing the ‘dimensions of the subject in the frame; a short focal-length lens is referred to as a wide-angle lens because it increases the angle of view. If the focal length is increased with respect to the ‘normal lens, the angle of view is decreased and ‘the subject is enlarged, corresponding to an increase in the magnification factor; this lens is classified as a telephoto lens, and it allows the details of distant objects tobe seen clearly. ‘lens with variable focal length is called a zoom lens because the focal length can berapidly changed (Fig 24). A zoom Jens is manufactured so that different focal lengths are available in a single lens, While versatile, they sometimes result in lower optical quality as compared with lenses with a set focal length, Zoom lenses are characterlzed by thelr focal range, the pair of numeric values that indicate the two extremes of focal length available for that particular lens, ‘8 7o-300-mm zoom lens has a minimum focal length of 70 mm and a maximum of 300 mm and includes all intermediate focal lengths. The focal range can also be expressed in multiples of the shortest focal length. The nominal focal range ofthe lens inthe above example would be fdentified as 4.3x (300 + 70 » 4.3). This value is ‘nominal, because itis an intrinsic characteristic of the lens itself and does not take into accountThe Optical system Ifthe length of anormal lens is taken asthe reference poin fora particular sensor, alens con be deffned as wide-angle when its focal lath is shorter than that ofthe normal ens and as telephoto fits foal length is longer than that of the normal lens. Wide-angle enses tend to ‘make the image male, thus diminishing the magnification facter, whereas telephoto lenses have the opposite effect. making the image larger and increasing the magnification factor. the effect of the sensor format combined with it, For practical purposes, the actual achievable ‘magnification factors ore important than the focal range, so itis useful to ealeulate the focal range with reference to the specific behavior of the lens-sensor combination. This defines the actual focal range, a term that highlights and explains more clearly the concept of the | ‘magnification factor linked to the focal length. | The 70300-mm lens (nominal range 4.3), when combined with a 24 x 36-mm sensor, produces an actual magnification factor from aS 1. t06x (70 +50=1.4; 300 +50 "6). Recall that ‘iin got i canon2-nm 2 lens with f= 50 am isormal fora 24 36-mm Hise nish estan. Sensor. Te 7o-300-mam lens enlarges the scene ae en cece cance framed, with vepectta the normal so-Tam ens, bynaxto6e Toblea- Relationship between hefomat oft sm its lagen ond onespondng normal lenses | sensor format (mm) Sensor diagonal (mm) ‘Normal ens (mm) | Ss re 2 |= satel oe i ‘An example of oral nes fo iret formats: ns wich deen foc gts, when sed witha sense of “roropntedmension, inten nemall a ave tual te same angle view ond us tesame image Note howe parlor lens, which can bewtdeangle fo oneype Fas -gat034¢ “The exposure can be corrected after recording the image by means of special programe at the processing or postproduction stage, However, a photograph should be excellent at the stage ‘of image acquisition; it is unacceptable to manipulate an image to make it appear suitable for a particular purpose, even if software allowsit, The basicaim isto faithfully document reality, not to manipulate it to ‘make it appear better than itis, It is nelther ethical nor scientifically correct to manipulate images beyond slight corrections of exposure, contrast, or color; minor modifications, such as slight cropping or rotating of the Image, are admissible to correct the magnification ratio or the orientation of the image, A oot s photographed agains referent backgrounds ith no eposie coctin. The too agent the white background apearsles ght, whe the whit bocaroun ite ook ay. Agathe lack bckgoand the tooth ‘appenrs mach whe and more uminous than nthe she mages, nat pers more nara ins hes got ‘hesaybacaround The exosure meter as erpeted the white background standard gry othe camers hos, etl underexposed the nage. Te opposite as occured egal he ck bckgroundreaultng in eteposue THE ferent eights vole tects he prety parometer preety the human je, mh more shan Ce fferenc in olor ofthe tot, Tiss fundamental concept imesh estrtons. Ths series of photoset ‘ences he slag phenomenon smultansourvaluecotase, aThe Concept of Exposure 4 Figs edo 39f Theses of ie photographs repeated ith nepasure coco of exposure vale (VY) Against he white baclaround, he toe represented maerealsicaly, bt ogrst he ck Detground veep has rated (ected poorer quay a NLL a » i Fgsqagto re! The sree ie potgrphelreeed with amex conction of EV. Agent te whe background, the magect thetuth poo the moe sch tir xs gat he Wack bao feet exposie stings eh ‘oseralevarucnin heparin of te igs of thetacthAsinple prea at arede mead oars iromaron est the bigness of he th To comaytheaee eat oe shoud be potted wth atprograteepoaneemeconsaengsde on aber nou ites twin condecompre sth os sk ay heise pocgaps sts eine 4 bighress one Tocomey ofthe tooth self against cferen backgrounds, an "EV ogo te bck and na charge in EV a9 i silage peromenan of ve conras tightness owing coretions were made: EV aginst he white backround, reid fone gray. Te perce dflrencen brghes depen on %Photography in Dentistry Fgxse TeeSouescieofonion ee Sper Doo isin gradations of dT al Ve reading neat an Promdes information abt the brightness inthe rome. Te rumberundemeath the ensure Seale lndeates te numberof Shs emai, BE i Fgasb rg3se Theeapesue ofthis ikon Doo canbe Atverexposueof aout +4 EV has Imoafed by manual eting higher beensleted to oheanthecret leer bute ‘posure of ight sitet such esa ferea och. TReexosiremete wl Siplyts oun messorerets, ote tamer’ processor wl assumeconot foachiewea sign ovreposre The Symbol atthe bottom ofthe spay Shows thet a coretion ta theese | hasbeen activated Fgxsd Figase The fash eos ofthe Nikon Dseo _TRecaection tthe flash exposes can bemoafed with his button Shown on te dsploy The stat athe | tom ofthe csp shows thats recon hos ber activated 8Physiology of Vision: Contrast Effects ‘theworking ogicof he exposure meter, which tends tostandardiz the brightnesslevelin the fame, is very similar to that of the combined eye-brain system. The cerebral cortex tends to process and harmonize visual perceptions, often resulting in phenomena that are fefined as optical ilsins. Other phenomena fre connected to the functional breakdown of the retinal photoreceptors. When the retina {s stimulated for a prolonged period of time, "Modopsin in the receptors for the perception of a particular color is temporarily depleted, This leads to sensitization of the Inactive cones, a process that is the basis of the physiologic Phenomenon known as conast Contrast can be simultaneous or successive and can relate to value (brightness), hu (clo), for chroma (degree of saturation). Successive contrast effects can be positive, by analogy, or negative, by contast. These phenomena axe caused by the physiology of the visual receptors and subsequent eorteal processing. _ The Concept of Exposure Justas background conditions may affect the accurate perception ofthe brightness and color of an object by the expasure meter, s0 also can surrounding conditions affect human vision. ‘These phenomena are called contrast effects, and they can be simultaneous or successive and affect perception ofthe vale, hve, or chroma, ‘Moreover, they are related to the composition of the hue, he effect of combined hues differs in the presence of an additive sythess, as in the case of colored lights, ora subtractive synthesis, as {in colored pigments. Simultaneous value contrast causes a tooth to be perceived as whiter if observed on a dark background and vice versa, similar to the ex- posure errors of the camera (see Fig 3-8). Si- rmultaneous hur contrast afects the perception of a particular nuance of hue in an object in the presence of a background of a complemen tary shade, Every color recognizes its own par- ticular complement; red is complementary to green, blue to orange, yellow to purple. A characteristic of complementary colors is that they become gray when mixed. simultaneous hnue contrast is very important in discriminat- ing tooth shades. For example, in the pres- fence of bright red lipstick, a greenish nuance will be perceived in the color of the teeth; if the furniture in a photography studio is bright navy blue, the teeth will appear to have an or- ange hue (Figs 3-62 to 3-6). 8Photography in Dentistry —___ CChroma contrast affects the perception of brightness of an object when placed on two diferent backgrounds of the same hve with afferent saturations such as light pink and bright red. Value contrast offects the perception ofthe brightness ofan object placed on two backgrounds offering brightness such as white and black, (Chroma contast affects the perception of color intensity, so the same object against two backgrounds of the same color but different saturation will appear less chromatic on the more intense Dackground and vice versa (Figs 43-6g and 3-sh), For example, in the presence of very inflamed gingiva, a red of high chroma, ‘the teeth will appear less chromatic and therefore whiter. Successive chroma contrast ‘occurs after observing a very chromatic object. ‘The effect willbe positive aftera brief viewing of | the object; after looking away from the abject, new objects will be percelved as the same color as the previous one, because of sensitization of the specific photoreceptors for that hue. Successive chroma contrast will be negative after Tong observation of an object ofa particular hhue; objects viewed immediately afterwards ‘willbe perceived in the color complementary to the previous one, because photoreceptors for the original color have been desensitized.Hue contrast isthe perception of afferent hues when viewing the same object placed on ‘two backgrounds of a complementary hue such as ed and green. This phenomenon is very Important in dentistry because it alters the correct perception of hues and con therefore interfere with the acquisition of ata eating to colors forte creation of esthetic restoration. po TO OT EEE Fig26at036f ‘Ths eres of phetgtaps ows the phenomenon fsmultaneDs hue contast These oth placed iby side onto ‘ho backround of complementary hel be perce with nuances hcl cmpemertay tote Cakgrou ‘ranges complementary ta be, green ore, andr oye " Eg ‘igs-g and s-oh Chroma cots causes the sme object, photographed uit ential camera stings, to appear ks cromaticana more Inez backround and vie ves, &Photography in Dentistry - The Intemational Standards Organization (SO) speed is the parameter that measures the sensitivity ofthe device to be exposed. The higher the ISO value the ess the amount of ight ‘needed to obtain correct exposure. Because high ISO value result in less sharpness, altering the image, low 150 values are necessary in the presence ofa flash che use of @ flash is not possible, high ISO values may be chosen, 180 speea ‘The ISO system was established to unify two standardization scales, the American. Stan- dards Association (ASA) and the Deutsches In- stitutfirNormung (DIN). The ISO scale defines the degree of sensitivity of a sensor to light. Sensitivity Is defined by the speed at which the sensor is exposed: the faster the sensor, the Jess the amount of light needed to obtain cor- rect exposure. An ISO speed of 100 represents average sensitivity. Each successively larger ‘number on the scale, 200, 400, 800, etc, in- dicates a doubling of the sensitivity of the pre- vious number. Successively smaller values, 50,5, etc, indicate a halving of the sensitivity of the previous number. ‘Thisis trueforboth flmsand digital sensors. For film, the sensitivity or 150 speed is chosen by the manufacturer during the production process, and the composition of the sensitive emulsion cannot be modified. The sensitivity of a digital sensor can be rapidly adjusted because the camera’s software can modify the amplification of electrical signals from the sensor itself. an ISO 100-speed sensor, standard sensitivity, needsaparticularamount of light to achieve optimal exposure. Ifthe 60 setting is changed to 200, the same exposure can be achieved with half the amount of light, as if the value of the aperture were increased by one stop or the shutter time was doubled, ‘A negative aspect of an increase in sensitivity, common to both kinds of sensors, is its effect on the graininess of the image. Faster films require the use of larger silver halide grains that modify mote rapidly when struck by light, with che end result being a loss of image detail and an appearance of graininess upon image enlargement. Increasing the 150 speed of the digital sensor requires amplification of the electrical signals coming from the sensor, causing artifacts called background electronic noise that resemble film graininess (Fig 37). Electronic signal amplification and fluctuation cause a variation in brightness among the pixels that 4s not present on the object itself, Increasing the ISO speed is not ideal in ‘optimal light conditions or in the presence of a flash, butt isan indispensible option when a lack of light risks serious underexposure of the photograph or a blurred image because of an excessively long shutter time in combination with a rapidly moving subject. Moreover, increasing the 1SO speed is useful when photographing radiographs on illuminated view boxes,F937 Candgh she nly igh source for hese photographs an witha Nikon Dic; they re Undeexpozed. An extremely igh 9 spent of 40 wos ned a capture hese ages a) eh t,he graiiess ot vl (8) however, granness Becomes evident upon greater 89Photography in Dentistry White light is the sum of electromagnetic waves of different lengths, each of which has its ‘own chromatic characteristic. The prevalence ofa particular wavelength is shown by the ‘chromatic quality ofthe ight perceived, ols called color temperature, Orange-red long waves correspond to low temperatures, and violet-blue short waves correspond to high temperatures Perception of Color and Color Temperature ‘A general principle of optics is that perceived light is the synthesis of electromagnetic waves of different lengths, which manifest themselves in 2 particular color. The human eye perceives light waves a8o t0 760 nm in length; the interval between these two values is known as the vise igh spectrum. In nature, this is represented by the rainbow, which is, ‘the result of the refraction of white light into the spectrum of electromagnetic waves that compose It, through minute drops of water suspended in the atmosphere (Fig3-8). Each wavelength of visible light corresponds toa color. Long wavelengths are seen as orange or red and short ones as violet or blue, Color vision isbased on the perception of wavelengths reflected by an object after the object has been. struck by light (Fig 3-9). Color is not, therefore, a property of matter, but is instead linked to the behavior of light in relation to an object with peculiar intrinsic characteristics suchas opacity, ‘wansparency, and translucency, and extrinsic ‘or surface characteristics (see chapter). The intrinsic properties of the object can determine total reflection of light, regardless of ed ‘wavelength, making the object appear completely White. The total absorption of light will make an ‘object appear completely black. The reflectance or degree of reflection ofan incident light ray can De measured quantitatively and, important, (qualitatively. Partial and selective reflection of specific wavelengths from the object gives rise to the physiologic phenomenon of color perception. The extrinsic or surface characteristics are Important with regard to the angle of reflection of light, which can be mirrorike, called specular cor dfwe, Diffase reflection of light reduees the Gegree of translucency because it increases the degree of reflectance (Fig 310). The effect of surface characteristics on the reflectance of an object has a great impact on the perception of light and color; dental laboratory technicians, ‘who put much care and effort into creating the deal surface texture for restorations, know this only too well. Light sources can emit a spectrum of ‘waves in which some wavelengths are more prevalent than others; these wavelengths are called dominant, For example, the common Jncandescent light bulb primarily emits waves {in the orange-red part of the spectrum, and xenon light sources primarily emit blue waves,: The Concept of Exposure ‘The phenomenon of colors the expression ofa specific wave reflected off an objec. A white object reflects all the waves of various lengths, ond a black object absorbs them completely 4 colored object reflects the specific wavelength that is perceived by the observer as color, resulting na phenomenon of selective reflection ofthe light rays. wh ] ‘doublerainbow shows the ratrlefaction fight ingots ing ig-wave | component mason Faomm fo, S020, | tae Faxa AB) bh eres rarkf Soave 2Photography in Dentistry For constructive reasons, every artificial source of light has its own particular color temperature. In natural light, depending on the time of day or atmospheric conditions, ‘one specific typeof light wave corresponding to a characteristic color temperature willbe prevalent and will appear inthe photograph as dominant. Colortemperatureisa way tocharacterize various light sources. This numeric value, exptessed in degrees kelvin (‘K), after the physicist who veloped the absolute temperature scale, is the temperature at which a black object must bbe heated to become incandescent and radiate light of the same hue as the light source. ‘The higher the color temperature, the more prevalent the blue-violet short waves; the lower the color temperature, the more prevalent the red-orange long waves. ‘All light sources have their own color temperature based on the spectral composition fof the light emitted from that source. The light ‘fom an ordinary candle has a color temperature of about 1,g00°K, and a common tungsten light bulb emits light at about 3,000°K. Daylight at midday on a partially cloudy day has a color temperature of about 5,500°K (© 6,000°K; its Fax10 ‘componentsarebalanced, andlightingengineers describe itas natural ight. ‘Thecompositionoflightisextremely smportant ‘in photography because a particulany prevalent ‘wavelength in ight can appear asa dominant in photograph. Thiseffoctisnot alwaysnegativeor ‘undesirable; a photograph of a beautiful sunset ‘will show a pleasing, warm orange dominant, ‘which will render the photograph particularly evocative Fig 31). 'A photograph taken in full daylight, with a clear sky, willhave avery high colortemperature, ‘witha prevalence of azure waves, and isdescribed as old light Fig 312). 1 is clear that the term color temperature does not refer to the intrinsic heat of the object that reflects it; itis the temperature to which a back object must be heated to emit the same hue of Hightas the light source. 92 (03 The dtuserefcton fat sus fromthe Imorolgi characteris fhe tooth surface. The ‘hectic of the toot sufacecan bedded into hoot rcroteure ceed bythe ste of Feu and veto (macoteture crete byobes and escape goo aspects. The teturef te surface, then eemeascap coneavies ond convenes, causes frre tectonic seat conte fotnepeception of natural tooth, Thisfuseecton Increases the degre of refletarce ee suaceanathas dninshestetronaucony ofthe tot () Progressive loerofsurfece ttre esutsin spear ection ft, ‘wich reduces the atrat ond oof appearance of he {etn andoteo conte othe ouerng ofthe veThe Concept of Exposure Figsn Te vacanofstombol is seen at sunset roma beach nTopea; th orange dominant present becuse of the prevlence ofred-range ang waves, Inogetoken witha canon EOS £00, f= tom, fs, BO 400, t= Ws005, menulepsure made Figs Pliage take inthe morning shows preolnce of zu hor wave. ogetaken with ‘Canon EOS yooD, = 35mm 8, SD oo, ¢=V2008.Toemhance clr satan and ‘inate reflec, pelarzng eras een sePhotography in Dentistry White balance isthe functian on cameras that allows us to correct the color temperature present inthe frame, orto select the quolity as required. White Balance Reflected light perceived by the human eye and by the camera has a certain color temperature, ‘The human eye is always able to perceive white as white, even in different color-temperature Conditions. Because ofthe interaction between the eye and information provided by experience and memory, humans are able to contextualize color data, “Tnedigitalsensorhasdifficulty discriminating the correct white in the presence ofa particular color temperature, and this difficulty is manifested by the appearance of undesired chromatic dominants. To avoid or lessen the appearance of undesired dominants, part of the Sensor’s photosensitive elements are entirely devoted to the correct calculation of the color ‘temperature, and thus to the color white Alternatively, a separate sensor can be added, dedicated exclusively to this function, in addition to these manufactured devices, the software ofthe camera can be set to correct the dominants using the white balance command. Predefined options can be set for the most frequent color-temperature situations. For example, in the presence of an incandescent light, fluorescent light, or fashbulb light, the camera can be set to adequately compensate for the color temperature in advance, Another ‘camera option called auto white balance analyzes the color temperature and automatically comects the dominants. This is the option that generally meets most photographers’ requirements. in the camera's menu (Fig 3213), various situations are listed: bright sun, elowdy sky, of shade, and incandescent, neon, or flash lighting. It is also possible to select the color temperature within a range ftom about 43,000°K to 10,000°K for greater accuracy or to insert particular dominants, ‘A fourth option is to set the camera at a particular type of white, chosen by the operator asa benchmark, Moreover, correction of the chromatic ominants can be performed after recording the image, with image-processing programs (Fig 3.14). However, only unprocessed raw {mage formats have medicolegal value, so any subsequent processing in a different’ format ‘will have no value from a legal-documentation point of view. This problem is avoided by keeping an original raw image file and only processing copies ofthe image.‘The Concept of Exposure White balance Auto Thee bal Canon 400 camera stows fie al Fincon has ben sete Other ptonson theme aebgesn, ang shades, Frutti ig, flooescent ig, flesh, castomedwhiteoloce stings, nd th tenth expose meter setngsPhotography in Dentistry ‘The photograph is a precious instrument far understanding and communicating surface ‘characteristics and transtucency, parameters of dental anatony that contribute to determining the color of teeth. Color can only be determined precisely and repentedy with appropiate spectrophatametes for clinical use. These wo techniques may eventually be incegrated so that \weare able to obtain optimal resus inthe communication of color. Photography for the Communication of Color ‘The phenomenon of color, regardless of the observer's emotional experience and contrast effects, is the result of a complex interaction between numerous parameters, which those ‘who perform esthetic dentistzy know only too ‘well, It is adifficult subject and requires an in- depth approach. Color is not to be chosen or taken, nor can it be transmitted by means of simple numeric formulas. 1t requires a precise iagnostic and strictly scientific path to be determined with accuracy, ‘To make a correct diagnosis of color, the op- erator must be aware ofall parameters that con- tribute to its definition. The most important are hhue, chroma, and value (the three dimensions of color according to Munsell) and pigmenta- tion (the fourth dimension according to Mula) Equally importantare the intrinsic optical prop erties of the object, opacity and translucency, and the extrinsic optical properties of the tooth surface, such as texture and microscopic can- cavities and convexities, The operator must un- derstand that some parameters can be measured and documented in a tigorously objective man- ner, and some can only be represented and docu ‘mented photographically ina more or les effec ‘tiveand subjective way, Because of the problems related to exposure variablesand the functioning of the camera itself, itis impossible to measure and document the hue, chroma, and value of a ‘woth with absolute objectivity with the camera; this can only be achieved with a certain degree of approximation, ‘Thecameraisnotameasuringdevice, because it only creates a representation of reality; the process of acquiring the image is influenced by numerous parameters that are not entizely controllable, including the amount and uality of the lighting, the shooting angle, and general and intrinsic manufacturing characteristics of all types of cameras, Opacity and translucency can be effectively documented, mainly by using contrastors, {as can the optical properties connected with surface characteristics (Fig 315). The difficulty in perceiving the thiee main dimensions of color can be partly overcome by the use of contextual benchmarks with a known hue, chroma, and degree of value. By comparing the characteristics of the chroma of the teeth on the photographic image itself wich the sample benchmark represented, for example, by an element on the shade guide, the correct hnue and brightness can be determined with some accuracy.‘The spectrophotometer is the most scientific and accurate method to determine and docu- ‘ment the main color dimensions, This device ‘measures the specific length of the visible elec- tromagnetic waves, Portable polarized-light spectrophotometers, specially designed and particularly suitable for dentistry, already ex- {st on the market. These devices allow for ef- {fective registration and communication of data concerning colorto the laboratory. However, all data should be supported by good photographic images. Photographs complete the color diagnosis by recording characteristics of the surface and Fass Surface tau isveryinpoton nthe tception of clr Te compet {hesurfoceof tesenataral tet grevly ‘ones tothe perception ofthe beauty ‘ind harmony of te tnt chess Thsimageigigts how studying © ptr alow the practitioners Uriveota dagosisando understand {he poler’'atual dena sustion ‘24ay of photographs ase iproves ne roctiooners powers of dscenmentofan ‘ages most ince deta. Thesurface terre deterines te ype of gna Teflon rom te tart sroce When the tooth surfaces flat ond eglr nota {ellghe rs arereflected fom ese ‘na poratel fasion, suing specular ‘election. telight rays are efecto ‘disorder way becuse of the suace’s lngutaresr completes an observer vil preva ifs reflrton andes leonslceny of he oth A pronounces surface texture epcl of ong eth is ‘rauay st overtime orasaresucor Sagresvebnsting The Concept of Exposure structure of teeth, general facial features, and oral cavity tissues, giving the dentist ‘detailed information about the overall context of the patient. Photographs capture nuances, details, emotions, and impressions relating to a particular clinical situation and patient, ‘which no other device, however sophisticated, can, In conclusion, ‘the two devices, the spectrophotometer and the camera, should de complementary in achieving excellence in esthetic dentistry; while technology is a fundamental aid, the sensitivity, taste, and experience of the operator must be considered of primary importance.Chapter 4 Principles of Digital Photography — | | | ae |Photography in Dentistry While the fundamental principles of photography do not vary whether analog or digital ‘equipment i used, onl digital technology allows the operator to view and quickly manage the image in a versatile manner. I allows for rapid correction of any errors and thus helps the operator to improve his or her personal technique. Digital technology also enables the storage of large quantities of visual documents ‘The difference between analog and digital photography lies in the characteristics of the sensor, the device that is struck by the light. In analog photography, the sensor is the film, ‘but in digital photography, an electronic device replaces the film and can be thought of as an “electronic film.” This basic difference is separate from and does nat preclude the general principles o photography, such as composition ofthe frame, lighting, and the use of lenses. ‘he ease and versatility with which a digital image can be used, however, represents a sig- nificant departure from film-based photogra- phy. This aspect, together with continual and rapid improvement in the technology itself, is the key to the success of this form of photogra- phy. In particular, a decisive factor is the huge Advantage of instant viewing and analysis of the image and the option to immediately re- take the photograph if it is judged to be unsat- isfactory. ‘This advantage is somewhat of a double- ‘edged sword; an awareness that retaking ‘an image costs nothing, and that it can be retaken innumerable times, can lead the operator, in error, to photograph with only cursory ‘attention, rather than the level of care required to take an adequate photograph the first time. Because time is a precious commodity in dentistry, and to do something ‘well takes the same time as to do it badly, the dentist must always photograph with’ the same level of attention that would be used if ‘the work were being presented at an important scientific conference. Every visual document acquired could be precious for legal or scientific purposes, and the most important photographs might tum out tobe those not taken ‘Another advantage of digital photography is acceleration of the learning curve. The option to instantly assess the image taken using a basic knowledge of photography allows us to ‘understand and consequently correct mistakes. ‘As a result, photographic techniques can be rapidly and effectively refined, Moreover, large ‘quantities of digital images canbe easily stored, contributing to the creation of a valuable personal data bank. For these reasons, a photographic handbook for dentistry should explain clearly and thor- oughly both general photographic techniques and, in particular, digital techniques, To un- derstand and use the extraordinary capabill- ties of digital photography equipment, it is necessary to analyze their characteristics and ‘working logic, Although the text that follows ‘may seem technical and weighty in nature, the {information will be very beneficial to aspiring photographersPrinciples of Digital Photograpy Traditional analog or film-based photography retains its fascination and vitality, itis @ ‘mistake to consideritan outdated technique orto tink that t should be completely replaced by digital technology. Sensors in Analog Photography analog photography uses photosensitive film. ‘The sensitive element and the source of the {orm film is the silver halide emulsion on a very thin transparent support. ‘When the silver halide erystals come into contact with light, they undergo an irreversible ‘change, becoming denser in direct proportion to the intensity of the light that strikes them, ‘After exposing the film, itis necessary to soak it in suitable chemical reagents to remove the ‘unmodified crystals and to stabilize those that Faas ‘Aphotearoph eftnestrombot volcano aplume of [Smateviableon the Smet explo: type ‘ftisvleano. Ie image was taken rth Fulerome sensi. 150 00 dayigh-type ‘mond Ysnco Toes vz005 remain behind, This procedure is known as film developing and xing, and it creates a negative, ‘After appropriate processing in a darkroom, the image exposed on the film is printed ‘onto sensitive paper; the result is the classic photograph, Film for slides can be manipulated to directly create a positive image on the transparency. These images can be projected without being first printed onto paper, although they may be printed if desired. Slide film is called rewrsble fm, because the image can be conwerted from negative to positive (Fig 4)Photography in Dentistry Thedigital sensor transforms luminous energy into electric energy va the photovoltaic effect; this process does not involv irreversible physical or chemical variations in the sensor which can therefore be exposed indefinitely Digital Sensors ‘The digital sensor, an electronic version of fim, functions in a completely different manner than analog fllm. Light, or more specifically, luminous flux is directed onto photosensitive semiconductor elements, which produce very ‘weak electric currents in direct proportion to the number of lumens present; this is the photoelectric effect. A very similar principle, called the photovoltaic effect, applies to the functioning of solar panels, which produce electric energy by exploiting the sun's rays, The ‘man who discovered the photoelectric effect was the famous scientist Albert Einsteln, who in 1995 published his work on the particle nature ‘of light, in which he proposed and explained the existence of the photoelectric effect, Ic is not common knowledge that the 1g21 Nobel Prize in Physics was not conferred on him for his fundamental work on the theory of relativity, published the previous year, but was awarded for his work concerning the nature of light and the photoelectric effect. The prize was awarded, according to the citation, “for his services to Theoretical Physics, and especially for his discovery ofthe law of the photoelectric effect.” ‘The photosensitive elements, photodiodes for photodetectors, are applied to a silicon Wafer. The electric signals coming from the photodetectorsare extremely weak, sothey must be suitably amplified before being digitalized, or transformed into a series of numeric binary: code values. The exposure of the sensor Is reversible, which means that, theoretically, it can be repeated indefinitely, unlike traditional film, which is irreversibly exposed to ight and ‘cannot be reused, ‘Thus, the digital sensor can be considered the heart of the camera; for this reason, itis useful ‘to become familiar with itsbasic workings. Two types of sensors are used in digital cameras. The first one to be created in 1969 was the charge coupled device (CCD), the result of the work of two American scientists, Willlam S, Boyle and George E. Smith, For their labor, they were awarded the Nabal Prize in Physics on October 6, 2009, “for the invention of an imaging semiconductor cireuit—the CCD sensor.” ‘The sensitive elements of a CCD sensor are arranged in a line, and each element transfers the charge produced by the photovaltaic effect ‘to the nextone; the timed sequence of impulses ‘generatesan electricsignal, which can beused to create digital data (Pig 2a). The sensor consists ‘of numerous lines of photosensitive elements, each with its own supply for the amplification of the signal. This arrangement creates uniform amplification and low background noise, ‘drawback of CCD sensors is the need to construct ‘a complex amplification system, which is costly {or the manufacture of larger sensors ‘To overcome this disadvantage, the comple- mentary metaloride semiconductor (CMOS) was developed (Fig 42b), In this type of sensor, each photosensitive element has its own signal” amplification system, so large CMOS sensors are less expensive tomanufacture than CCD sensors. ‘A arawbackof CMOS sensors s their tendency t0 create background noise and color dominants, ‘These problems can generally be overcome by the camera's sophisticated software,Currently, the only major manufacturers of average: to high-priced cameras, including those used in dentistry, are oriented toward the production and marketing of CMOS-type sen sors. Manufacturers have found that the cost of producing a CCD-type sensor with the same ‘dimensions as 24 x 36-mm film is prohibitive Sensors with 24 » 36-mm dimensions are also called 35mm ot ea format, after the German op- tics manufacturer who first marketed it; this is considered the standard for common use today. Principles of Digital Photograpy Digital sensors that correspond to the 24 x 36-mm format are also called full flame sensors and, given their cst, are mainly found in high- priced cameras, For cameras In the average: t0 high-priced bracket, manufacturers install smaller, cheaper CMOS sensors such as the classic Advanced Photo System (APS-C) sensor, which measures 15.8 x 23.6 mm in the Nikon D3oo camera and 14.8 x 22.2 mm in the Canon. 0S goD camera, Fgsao Inthe Cope sens, electri charges trove na ier fasion and the grt [Sampled fron ene liner sector. Tis promotes anpifiaion conformity and ew peckground nose ach care Secor corresponds ane potas, which ancontan anor more potodetetore ‘corn othe ecology being used. The Calor ray representsthe Bayer ite, which “Saree thevonauswvlongtns and Coney eamposes tector Each tor responds 98 pe onthe lage The reson ofthe photograph represent byte tea numberof es. The eins potatos, response fr coo vison, Aton a silar manne, because thy oe ‘pecalaedferthe ascrimination oe Same iar coors re, re, and ble Thereeampoeton an fil vsialton of {olor takes place curing sbsequert cereal processing of te pepheal information Fa aae Inthe CMOS type sensor each sense flemert sample. alouang te mensions ofthe sensor to enlarged ‘hile minimizing cess, withthe fisabvantage hat rela tendency Tour the cretion of background noise ond ‘olor dominate Howser thesophiststed Sontwere ofthe camera an compensate fer ccD 103Photography in Dentistry Se ‘The two types of digital sensors, CCD and CMOS, are distinguished by their design and manner of operation. For the practitioner, the most important characteristic of the sensors its format, or the dimension ofits two sides and the proportion between them. ‘the manufacture and marketing of digital ‘cameras is in such rapid evolution that it is foolish to even think of keeping up with the constant changes in equipment, which tend to confuse rather than facilitate the task of the photographer. For example, Leica is introducing ‘anew format of digital sensor, 30 x 45 mm with a capacity of 37 megapixels, with the intention of replacing the classic format they established fn the past. However, a good APS-C-format camera of average oraverage-to-high qualityané price can easily satisfy the most conscientious practitioner's needs for several years. Moreover, it should not be forgotten that outstanding ‘photographs and irreproachable documents can be taken with a traditional flm-based camera. ‘Rapid technologic development has cut pro- duction costs so that today full‘frame-sensor 04 cameras are available at accessible prices. Ho- ‘wever, the quality attained by smaller-frame sensors is such that we can confident rely on. them to achieve splendid photos. On the basis of working characteristics and the practitioner's heeds, the difference between the two is not fundamental, because distinguishing between ‘a photograph taken with an APS-C-type sensor and one taken with a full-frame-type sensor ‘would require much experience and technical skill in reading the image (Figs 4-3 and 4-4). ‘A photograph for dental purposes should be judged by other parameters. The spatiality, the ‘magnification ratio, and the correct depth of field are the best criteria with which to evaluate the beauty of a photograph in the field of dentistry.inciples of Digital Photograpy Figaso “an iage ten with Canon EOS dtl singe-lenseflexcameraequpred ith fl fem COS senso Canon o-m macr ler, and Canon Meg ng Pash Figs ‘Thetame mage taken with Coren EOS 400 camer fed with an APS senso Canon too-im macroens, and MR-4eXrig fash. Te patclr behavior ofeach comer the reason forthe sgh derencesin posure, which oecarectable 1sPhotographiy in Dentistry ro Fig a-aePhotosites, Photodetectors, and Pixels ‘The light information coming from the spe- cific portion of physical space occupied by the framed object is composed by the lenses onto ‘a specific physical space on the sensor called a photoste, which contains one ormore miniature photosensitive electronic devices called photode- fectrs, The photosite isthe physical place where the tiniest details of the image are captured. ‘Thus, the surface of the sensor is subdivided {nto numerous microscopic spatial sectors, each of which contain one or more photodetec- tors, also called photodiodes, which are semicon ducting elements with the function of trans forming luminous energy into proportional electric currents, These extremely weak elec tric currents are sent to a processor inside the camera called an analog-o-dgtal converter, which, transforms the electric signals into numeric data, executing the digitalization ofthe data, Each photosite corresponds to a matrix of elementary visual information or an element of the image called a pie! (a contraction of the ‘words pctue and element). Its strange to think that these elements, che pixels, were invented thousands of years ago by ancient artists, wito, with tesserae of various colors, learned to ‘compose complex images such as mosaics (Fig 43). Similar to an antique mosaic, the final ‘image of a digital photograph is made up of thousands of pixels, as fit were visual mosaic ‘composed of mimute tesserae. Each pixel shows one, and only one, color and one intensity of brightness, but together many pixels make up a complete mosaic of innumerable nuances of Principles of Digital Potograpy ‘The terminology and concepts relating to digital sensors must be explained so that the ‘operator can better understand the working logic ofthe sensor itsef and cun use these terms \with the propriety and accuracy that scintiffe documentation requires brightness and hues. The single or multiple photodetectors present on a photosite provide the necessary information to produce a single element ofthe image, one pixel “The photodetectors cannot distinguish be: tween the different wavelengths that produce various colors because they only perceive the intensity ofthe lurminous ux. For this reason, ‘each photosite is covered by a selective filter, called a Bayer iter or a color filter array, whnich al- lows the photosite toacquire the light intensity relative to only one ofthe three primary colors, red, green, or blue, A Bayer filter consists of a rmosale of filters for each of the three primary colors and is positioned on the photodetector grid according to a particular and precise pat- tem (see Fig 4-2) ‘The photoreceptors of the human eye ‘work together in a similar way. One type of photoreceptor, the cone, is speciatized In discriminating between ‘the three primary colors, while the other type, the rod, perceives only the degree of brightness in absolute terms. The cones for the detection of color function best in bright light (photopic vision), Dut the rods are activated by even very weak light (scotopic vision. in classic digital sensors, because each pho tosite is filtered for one of the three primary colors, the data from a single photodetector cannot fully determine on its own the color present on the pixels, Color information must be completed by a mathematic procedure known as interpolation, which calculates miss- {ng or insufficient data by exploiting the infor- ‘mation from nearby photodetectors, vo?Photography in Dentistry Pee ws Tete + PHOTOSITE: Spatial area that contains the photosensitive element of the sensor Wate aaa Setter Saree eae Other types of sensors have been designed ‘to improve the definition and quality of the image. For example, the Foveon X3 sensor (National Semiconductor) is constructed so ‘that the three photodetectors needed to obtain 2 complete color description of the pixels are superimposedontoasolephotosite; thus, there is no need for reconstruction of the missing chromatic components by interpolation, According to the manufacturers, this sensor provides better color accuracy. ‘To summarize the concept ofthe pixel, ight strikes one or more photodetectors present on a sensor's photosite; through the photovoltaic effect, proportional currents are generated and transformed into numerical data by the fanalog-to-digital converter, obtaining the number of bytes that are needed to describe a pixel. Although even prestigious photography magazines may state that a particular sensor “has” or “is made up of" a certain number of megapixels, it would be more correct to say that a sensor supplies the megapixels. For example, the Foveon X3 sensor has about 10.2 million photodiodes laid out on 3.4 million photosites, supplying 3.4 megapixels. The number of pixels does not coincide with the number of bytes needed to describe it. In fact, the number of bytes required to describe a pixel Is ditectly proportional to the color space and to the intrinsic quality of the pixel itself, Fewer bytes are required to describe a completely white pixel than to describea pixel ofa particular shade of violet. Percent See eta) Te photwsite Is a spatial concept that ‘describes an area of the sensor where light is ‘captured; the photodetector is a functional concept, describing a microscopic electronic device. Byte is a computing concept, and a pixel is a visual concept or the elementary part of an image. Although these concepts are interdependent, each has its own specificity ‘and must not be confused. Foes ‘Thisaniert Roman mossiclscmpozed of teste, Justasa dita mages made po pels. (Courtesy of the Arhaclgica Museum, Tarn, tay)fs equivalent Focal Length and the Multiplication Factor tn using @ camera with an APS-C format, such as a Nikon D3c0 or a Canton EOS 40D, {cis important to know that the behavior of the lens will change in the presence of these smaller-format sensors, because of theeffect of the relationship between the diagonal length. cof the sensor and the focal length of the lens, “The concept of the normality of the lens was ‘iscussed in chapter 2. Thereisalwaysanormal lens for each particular sensor format, and a normal lens fora 15.6% 23.6-mm APS-C sensor will have a focal length equal to about 28 mam. fan f so-mm lens is used on a camera with a sensor of this format, there will be a virtual lengthening of the focal length of the lens. Becauseagreaterfocallengthcorrespondstoa greater magnification factor, this relationship can be expressed by a multiplication factor, which indicates how much the magnification factor will increase. For Nikon DX-format cameras, the multiplication factor will be 1.5%; hence an f= 5o-mm lens will have an actual focal length of 75 mm (50 x1.5 =75). The actual focal length times the multiplication actor gives the equivalent focal length ‘Manufacturers indicate the multiplication factor of all cameras equipped with smaller- ____ Principles of Digital Photograpy ecause of the strict relationship between sensor format, focal length, and lens behavior, an so-mm lens (normal fora full-flame senso) used with asmale-format sensor vil obtain o ‘greater actual focal ength and o greater magnification factor. An equivalent focal length can be Calulated by multiplying the lens’ actual focal length in mm by the multiplication factor. format sensors among the technical specifica- tons. This is useful for calculating the equiva- Jent focal length of the lenses. To summarize, alens with 2 focal length of 50 mm, consid fered normal for a 24 x 36-mun full-frame sen: sor, when fitted onto a DX-sensor camera, will ‘havea focal length equivalent to about 7 mam, ‘Thus, it will behave like a telephoto lens, with known consequences on the magnification factor, A Canon APS-C sensor measures 14.8, x 22.2 mm and has a multiplication factor of 2.6. An f= 300-mm lens, combined with this sensor, will have an equivalent focal length of 480 min (00 1.6 » 480) Using an f= 100-mm macro lens with a smaller-format sensor, the operator can attain a magnification ratio of about 1.5: for 2,631 depending on the size of the sensor, far greater than the 1:1 ratio attained with the same lens and a full-frame sensor, With analog single-lens reflex (SLR) cameras designed for dentistry, such as the Yashica Dental Eye, an additional lens is required to attain a greater magnification ratio, With the reduced size of the APS-C format sensor and the higher multiplication factor, the operator hhas a greater magnification ratio at his or her disposal without resorting to additional lenses; in the field of close-up photography, this undoubtedly is a great advantage.Photography in Dentistry Each lens projects an image circle ofa defined size onto the sensor. When the image circle ‘is larger than the size ofthe sensor, there iso magnification effect because the image itself |s cropped. One advantage ofthis effec is that it uses the central part ofthe image ctcle, which for optical reasons i aways ofa better quality than te periphery, Image Circle and the Vignetting Concept In addition to the equivalent focal length con- cept, a second factor influences the magnifica~ tion ratio: the projection of an image circle onto the sensor, This image citce is the result of the recomposition ofthe light rays from the framed scene onto the plane of the sensor by the system of lenses, A lens designed for a24 x 35-mam for- ‘mat projects an image circle precisely related to these dimensions. When the same image circle is projected onto a sensor with smaller dlmen- sions, only the central part of the image circle will be used, resulting in a cropping of the pro- jected area and a magnification of the image it- self (Fig 4-6). The main advantage of this effect is that, when using lonss designed for a 25 x .36-mm format on smaller format sensors, only the central part of the image circle is record- fd, avoiding the digital vignetting effect and achieving abetter image quality. Because dental photegraphy is a magnification ratio-priority technique, the effects of equivalent focal length and cropping, derived from the use ofa smaller sensor, are beneficial. » Fas The ara of on APS-C formar sensor (a) I smalerthan he magecice De ic poeta yan jm racolens desired fore 36-rm rms mene). Thee !agrifcaton cond an mprvenentin he ora aul of the mage ese ec porc of he Image cles se andthe digtel geting ers eimted. Tecan portion of the mages 2 ‘ir ua than theprhereecausef occa geting. 10Principles of Digital Photograpy “The vigneting effect isthe lass of brightness in the comers of an image; it can be mechanical, ) ‘optical, rail in engin, Using a lens designed fora 4 » 36-mm sensor on camera with a “smaller format sensor avoids aigital and optical vignetting, Using alens designed fora smaler- Format sensor on a camera with ofull-fame senso will result in unacceptable mechanical and optical vignetting, Conversely, it is not advisable to use lenses for smaller-format sensors on cameras ‘with full-frame sensors because the image circle projected by the lens will not cover the entire area of the sensor, creating vignetting at the ‘comers of the image Fig +7). Vignettng is 2 reduction in image brightness at the periphery of an image as compared with the center. In this case, vignetting is caused by the insufficiency of the image cicle in covering the entire area of the sensor. Mechanical vignetting Is caused by external physical objects, such as filters or lens hoods, and optic elements 12 ‘dae ce ct jected forte fot) niece vets) Tesi msn gnc oe ges epee noe thet peent evens ged ir SEE htt sro che lon cane compte mam ands sna rat iZitergtinide peel once Nore pe eae eri eae oma seta ef ane enecone eet ena geting “naloss of mage quality make his opan eile positioned inside the lens for design purposes. Optical vignetting is the attenuation of the lightat the periphery ofthe image because ofan ‘excessive angulation ofthe peripheral light rays ‘with respect to the optical axis, Digital vignetting fs connected to the way the photosensitive ‘elements are built; each one can be represented by a photonic well, ofa “little bowl," which is completely filled by light rays only when they ‘come from directly above. The more obliquely ‘the light ay strikes the photonic well, the more it is intercepted by the edges of the well itself ‘and thus attenuated, mPhotography in Dentistry When used with a smalle-format sensor, a lens with a focal length of 00 mm will hve 2 fonger actual focal length and a different actual magnficatien rato than indicated on the focusing ing. The specifications inscribed on the focusing ring need to be corrected and Interpreted in ight ofthis concept. ‘Actual and Nominal Magnification Ratio A traditional f = 109-mm macro lens gives both the selected magnification ratio and the maximum possible magnification factor (the first numeric value, usually 2, of the ratio) on the focusing ring. These figures reflect the 25 x .36-mm sensor format for which itwas designed (Figs 48 and 4-09), Because of the equivalent focal length concept, ifan APS-C-format sensoris used with this lens, the specific multiplication factor of the camera mustbe applied, and thus theactual ‘magnification factor will be 1.5:1 forthe Nikon D300 and 1.6:1 for the Canon FOS 40D (Figs 4-sb and 4-92). The nominal magnifieation ratio is {indicated on the focusing ring, but the actual ‘magnification ratio will differ depending on the format of the sensor used in combination with thatens (Fig 4-10). Its not possible to provide information, in absolute terms, about the magnification ratio foes | insists te magni fore beep a eet | Se eerie eta | elon Gagne genes Te ayehea ort ae | orn L_ to be used, because it is strictly linked to the specificdimensionsofthe subjectin the frame. Tor this reason, ie is not particularly useful to give strict guidelines regarding either the ‘magnification ratio tobe set on the lens or the distance from the object. After a few attempts and a little practice, an operater will have no difficulty deciding which magnification ratio to set preliminarily on the focusing ting (Table 41) and will easily understand at what distance from the subject he or she should be positioned to obtain the correct magnification for the desired image. In onctusion, the use of smaller-format sen- sors is advantageous in dental photography. However, this advantage is lost when a wide- angle lens with a short focal length is used. The use of staller-format sensors is contrary to the {intrinsic aim of the wide-angle lens, which is ‘wattain a wide angle of view and a lesser mag- nification ratio,a 1 Figese wt NH il ‘Amgen rat atsined witha fl frome sms thisisthe some magnification toa Shown on then Fcuing ng. rg I nH a Figesb ‘THs meg as ben taken with Nikon 0300 amera ana ior f= 05-m maces, tent faising eng et on magneton av Thecomera nasa format esr (056236mm, wnichhasamutplation fect ofgeandon actual maximum ‘magnifeatin rato of. The maghfation rat shown on hens Ttasing in scary Iomina ond not ectua, because eres toa St 3o-nm Sensor Dviaing the sor with iy thei Smagnfeation ate, reted tothe ‘erent almensonsefthesensr foe, results nang remus mage. HV] ATT Fosse The same image as been token wth an su cole a8 22mm anon seo which aso mation factor fv and actu aun Imagaicacon rato of6' The magaifation [egret than thot town nigga beuee then image width dded by 6 gives Image wath o25 mm Theimage s 6 tmes sreater ha te object, the outcome ofthe 1Photography in Dentistry F400 Fiano Thlsimogehas en taten witha Canon ESD camera __‘Thlsmage as ben ake with Canon EOS 400 uippedwttho OOS ful-fame sensorand/=toa-mm camera quipped witha CUOSAPS-C format enor hove lene Amagnfestonrateoftsisinaeaetor endanf“rad-mm macolens Amagh Retin rota he oesing ing Of sindated onthe ousing ing, bu the oct) ‘mognifeauon rac greater because of te equaent fecal lngon concep: Te atu magnfeaen ratio bout bnemse 535.6 deseo ig aoe Fgerod ‘Thsimagehas ben token with Canon EOSS0 camera __‘TRismage hasbeen taken witha Canon EOS 400 camera {qulpped it CMOS fulome sensor aan ‘quppe thas CHOSAPS-C format ear anon fEoo-mmmacrlene Amognyieatonatoof1, tle F=?0o-nm marl. A nominal magneton eo Say sndeated on thefocisingring Enchactaolrmmof of lsindeted on he fcusing ring, ut te atl thecbjectcomespondstovrmanthesncar Thsiethe | Magnan greater each 1mm measured the ‘exinum magnieaton possible with his iens combined Sensor Sx gente than exch actual mmf the object. Witntisemene Thisimage evry simiartofig gab. ‘Thsisthemoxmum magna posse with eis ens Combined wth ne conor onta describe the image. Analog-to-Digital Converter ‘To obtain digital information, the electric signals provided by the photodetectors of the sensor must be converted into digital, ‘numeric values by a device called an analag- tondigital converter. This physleally transforms electric currents into numeric data that are stored on the camera's memory card. The combination of sensor and analog-to-digital convertor transforms light into numbers. These numbers represent elementary, binary, digital information, using only two numbers (0 and 2), each of which is called abit. A bicrepresents the smallest unit of information; typically, ‘eight bits are grouped together to form a byte, the basic unit of memory size, A quantity of bytes, and therefore of information, is usually discussed in terms of its multiples: kilo, mega, siga, tera, etc. Principles of Digital Photograpy The anatog-to-digital converte transforms the electric currents generated by the sensor into the numeric values ofthe binary code. These tw numbers supply te information necessary ‘The analog-to-digital converter has a certain sampling frequency, which is an indicator of performance and quality; a converter that samples at 12 bits per channel (or per photodetector) can express 4,096 different levels of brightness on the same pixel. The hhigherthenumberofbits perchannel, the more accurate the return of the tonal shades onto the image. Some cameras, such as the Nikon ‘D300, allow the operator to choose between ‘wo analog-to-digital conversion options: 22 (or 14 bits per channel. This difference might appear minimal, but instead it is significant; 42 bits per channel can express 4,096 different levels of brightness, while 14 bits per channel can express an amazing 16,384 different levels, ofbrightness. “Toble 4 Preliminary magneton stings acarding tthe subj inhe rome sunjec megSamrenner Ave senor Compaen m5 1a | ‘Anterior teeth a 4A race "5 a nsPhotography in Dentistry = “The pathway from subject to image (Fg 4-1) the ight strikes the sensor, which generates extremely weak electric curents via the photelecteffct, proportional to the intensity ofthe light. The currents are measured and transformed int bnary-code numbers bythe analog-to- Aigtal converter. Te dita dota is processed and stored on the camera's memary car, whichis transfered tothe computer the ial medium fr viewing an image. Figen Paty fom faming asubet tostonng the mageon the fomouner 16Image ile formats are the codes that transform data from digital to visual. Various types exist, but the most common are raw, Joint Photographic Experts Group (JPEG), and Tagged Image Fle Format (TIFF), An imagels described by an ordered set of bits— simple numbers—so a convention ot code is, necessary to interpret the correct meaning of the bit sequence. This code is called the image Ile format and is identified by initials or by an extension, which is a dat anda series of letters listed after the name ofthe file, There are three commen formats. ‘The raw format is a particular method of storing the data needed to describe an image. its fundamental characteristic is that there is no loss of data or image quality when the fle is uansferred to a storage medium. PEG is an acronym for Joint Photographic Experts Group, committee of experts who defined the first International standards forimagecompression. Presently, JPEG Is the most widely used format for image compression. The tagged image Mle format (TIFF) Is a roncompressed universal image format, which Is quite commonly used because it allows the specification of numerous added indications land Information regarding color calibration, TIFFis widely used by the press and professional printers. This format is highly appreciated for its ability to maintain perfect image quality each time the image is saved (Fig 412). A rawback co this high quality, however, is the vast storage size of the files, so a practitioner ‘may ptefer to abandon TIFF in favor of the raw or PEC formats. Fagg ‘ose up nogecf thecommon house M7Photography in Dentistry {JPEG is the most versatile and widely used image file format. It provides an excellent balance between quality and storage size, JPEG accommodates various levels of compression, but the corresponding decline in quality i a drawback to this format. JPEG format ‘The versatile and widely used JPEG format compresses the image data into smaller files so thata larger number of images can be stored on. the memory card. Furthermore, itperforms the necessary compression for rapid and efficient twansmission of image files via the Internet, ‘Image compression eliminates repetitive or redundant data or predictable content within a file and cancels visual information that 4g dimcult to perceive with the human eye. JPEG compression thus involves the loss of data and, subsequently, quality. Ifthe degree fof compression is minimal, this data loss is insignificant and concerns) nonfundamental information, This imperceptible decline in quality is called lossless compression. Higher levels ‘of compression correspond to a progressive and significant loss of information and quality called losy compression Each time we open a file, it becomes decompressed, and at every closure, it becomes recompressed. Ifa Mle is opened in an editing ‘program rather than a normal reading mode, and slight modifications to the fle are carried out, the le will be compressed yet again ‘upon saving the changes. This compression, different from the previous one, will result {in a progressive decline in the quality of the image and the appearance of artifacts and imperfections. Even a simple rotation of the image causes 2 different compression upon saving the file, Ie is therefore advisable to ‘maintain two files, one ina raw format and one in the JPEG format, 18 Raw format ‘The data supplied by the analog-to-digital convertor isin a raw format andiis like digital ‘yersion ofa film negative. This format includes the entire amount of information acquired by the sensor. 1m raw image files, the actual resolution of the image, or the total number of pixels comprising the image, coincides with that of the senser, This file is referred to as raw because the image, captured by the camera's sensor, is registered in its numeric form after conversion from analog to digital, without further processing or correction by the camera, Raw files contain many bytes: a12-megapixel sensor can generate a raw file of 20 MB or ‘more, which uses much storage space on the camera's memory card. ‘A disadvantage of the raw file format is that these files can only be viewed with specific software provided by the camera manufacturer for with advanced retouching programs. If the operator intends to send a raw file, the recipient must have suitable software to view It, To overcome this difficulty, the software company Adobe Systems has begun providing a free digital negative (DNG) converter utility program, which is able to convert raw data specific to a make (for example, Nikon defines raw files with the extension .nef) into a raw format usable by ordinary image-processing software such as Photoshop (Adobe Systems) It ig important to note that the conversion from the raw format into DNC isa form of im: age processing that might, froma medicolegallossin quality, with special software stance, detract from the value of the data. Be- cause subsequent corrections are possible, the raw formatallows the acquisition of less-than- optimal images regarding exposure, white balance, ete. This processing, or so-called Lightroom development, allows the operator to make reversible corrections to the settings while maintaining image quality atthe high- estlevel (Fg ¢-13). Obviously, some parameters Fnac Advended touching programs can impeveaphoagroph, sich as these fuer, lng oer capeurotheimage ‘Raw files represent the native format of the analog-to-digital converter and are o true “digital negative” This format preserves the entire amount of information acquired by the sensor and enables the operator ta make reversiblemodifications tothe images, without any of an image are irreversible; depth of feld, fo- ‘cus, and perspective must be optimal at the stage of image capture because they cannot be subsequently corrected. The software for view= ing raw files provided by the camera manu- facturers usually permits the photographer to perform a certain amount of processing and correction of the image without resorting to ‘mote complex software, 19Photography in Dentistry Unless medicolegal standards change, we can assume that image file in raw format hold the same legal value as traditional film, The camera i ited with a processor able to transform ‘the native rawsformat data into files of other formats that are easier to handle. cis always @ ‘good idea to store the images nthe raw format and, ifthe camera permits atthe same time create a PEG file ofthe image. Legal value of the raw format Im addition to stuaying the technical aspects of digital technology, it is also important to reflect on the legal value of digital images in ‘general and, in particular, images in the raw ‘le format. Digital images lend themselves ‘to manipulation with extreme ease using the ‘numerous retouching programs. A photograph ‘an be modified according to one's personal requirements or possibly even for fraudulent ‘purposes. It seems clear that digital images ‘cannot have the legal value of a corresponding ‘analog image recorded on film, although this is notalwaystrue, because even traditional analog photographs can be modified or manipulated {orillicit purposes. ‘As a matter of relatively recent technologic ‘innovation, there has yet tobe any consolidated legislation in the field of éigital photography. It should first be pointed out that there is no law ‘that forbids digital data-recording methods for documentary purposes, As in any other field, suspicions of falsification by modification ‘or alteration can only be supported when there is certain proof that the alteration has 0 indeed occurzed, and the burden of proof is fon the accuser. In light of this statement, paradoxically, it is the raw fle format, rather than the analog image, that offers the greatest ‘guarantee of authenticity. It is an original format, which, by definition and intrinsic characteristics, has not undergone any ‘manipulation following its simple acquisition. ‘In the raw file format, information relating to the image and the camera that captured it is written into the digital-image flle—the date, the time, and many other technical parameters—providing a means to verify the reliablityofthefileand, inthefield ofdentistry, {ts objective reality, 1t is inconceivable that lawmakers would ignore innovations, would rot take into account the advantages offered by technology, and would net keep up with the ‘times; eventually, legislative Dodies will have to address this technology, as they have done ‘on other occasions and with other innovations. For now, however, we can assume that the ‘medicolegal value ‘of image files in the raw format cannot be contested, at least not until ‘there isa coordinated effort to the contrary on the part of lawmakers or the law.Image Processing Digital cameras are equipped with a second processor, in addition to the analog-to-digital convertor, that converts raw-format files to the JPEG format to facilitate the viewing of the images: This conversion procedure involves a compression oftheimage file, which isusefulin reducing file sizeand storage space usage in the ‘memory and optimizing the number of shots available. In this second phase of processing, corrections to the image also generally take place, either via the manufacturers’ default settings, of by the operator to suit his or her personal taste (see""Shooting menus"). ‘The camera's quality stings command is used to select the degree of compression and, therefore, the degree of image quality. It is important to remember that each successive ‘manipulationorcompression ofthe)PEGMlewill result in an irreversible loss of data and image ‘quality. If image corrections or processing are anticipated, itis always a good idea to make a ‘master file, Modern cameras have the option of recording raw and JPEC files atthe same time, ‘which automaticaly creates an original master file and a default JPEG format for processing, ‘which seems to be the most suitable solution for dental purposes. Another advantage of this ‘option is that the JPEG file obtained from the raw file will be of higher quality, after use of retouching program like Photashop, than one taken directly from the camera itself. Principles of Digital Photograpy ‘Shooting menus are used to vary certain characteristics ofthe images, depending on the taste ofthe operator; however, because the dentist needs to document reality as faithfully as ‘possible, it is advisableta intervene as litle as possible in these parameters. ‘Shooting menus ‘Traditional analog-photography film has char- acteristics relating to color and image sharpness that vary from manufacturer to manufacturer. ‘Tese qualities cannot be modified because they are determined by the manufacturing pro- cess. Other factors affecting an individual roll of film include the state of its preservation over ‘me and minute variations in the chemical re- agents used for the production of single batches of film, ‘This variability means that certain films are more suitable than others in particular situations. For example, Ektachrome (Kodak) conveys the aaure of the sky extremely well Fig ‘414); Kodachrome 64 KR (Kodak) guarantees an excellent reproduction of the complexion and of colors, with a very accurate grain and high contrast; Agfachtome (Agia) captures. grays Foam “risonalog photograph of snoring seagull wostken {ing Ektachrome fm, which coptves te azar ofthe shy cexrenety wel PyPhotography in Dentistry The resolving power of an optical system isthe ability ofthe system itself to perceive as distinct two paints extremely close ta each ather. This parameter can be useful in assessing the efficiency ofthe eye or, more often, a microscope. and complexions very well; and Fujichrome (ujifim) brings out shades of green, Characteristics that are not modifiable for traditional film are variable in digital photography, Apart from the degree of compression, the in-camera system processes the images according to parameters set by the ‘operator using the shooting menu, The parameters that can be controlled via menu options are sharpness, contrast, color saturation, and hue, The photographer can also Fags nthe bigh-esaluton image, nda hairs cam be dieinguishedon the thro af tebe. opt for a monochrome image of black and white on a scale of grays. Moreover, the original raw Image format allows these characteristics to be further manipulated at the postproduction sage. Because a dental photographic image should be a document that conforms as closely as possible to reality, itis better to select few alterations among the various options on the menu, However, a slight increase in the sharpness ofthe Image—the degree of definition at the edges ofthe object—is recommended.Principles of Digital Photograpy Fora digital image, the term resolution indicates the quantity of pels that describe the image. iis an ingicaco of moge quality; a greater number of pixels corresponds toa sharper image thats richerin information. Te esolution value can be calculated by multiplying the number a pixels along the horizontal and vertical sides ofthe image. Resolution and Image Quality ‘The final quality of an image Is related to ‘humerous factors, including the number of pixels provided by the sensor, the quality of the lenses and the camera's processor, the structure and format of the sensor, and the degree of compression of the image. Image resolution Is closely related to image quality, 0 this concept requires clarification. ‘The term resolution can have different ‘meanings dependingon thecontextin whichit {sused and, because this can cause confusion, it is necessary to clarify the various meanings ‘the term can express. he expression power of resolution ofan optical system refers to the ability to perceive as distinct two very close points: the greater the resolution power, the shorter the distance between two points that can still be perceived as distinct, When this distance {sg less than the power of resolution of the {instrument ar optical system, the points will, appear to be joined. The power of a microscope Js, cherefore, assessed by means ofits ability © perceive as distinct two very close points. The word rsaive has its origins in the word dissolve, to separate, On average, a healthy human eye can istinguish six lines per mm; a calculation of the spaces between the lines gives a resolution of a2 lines or dots per mm, corresponding to bout 120 dots per cm or 360 dots per inch; Deyond this density, the dotsappearasa single ‘uninterrupted line. In photography, resolution refers to the quan- tiey of pixels forming the image; resolution is the parameter by which we communicate the ‘quantity of visual information present on an image (Fig 4-15). The digital sensor contains a defined number of photodetectors, whiich will ‘generate a certain quantity of pixels. The num- Der of megapixels that a sensor provides is one of ts most publiezed and important character- istics and hasa significant effect on its market- ing potential. Thus, che resolution of a digital image is ‘given by the quantity of pixels, or quantity of information, in its two spatial dimensions. ‘with traditional film, the resolution of an image is calculated by multiplying the dots present on the horizontal and vertical sides, For a digital image, the resolution, of the quantity of megapixels, is calculated by multiplying the pixels present on the horizontal and vertical sides. This calculation is analogous to the dimensions of the film format, in the sense that an image with a higher number of megapixels corresponds toa film with a larger format, which is thus richer in Information. A fundamental difference is that the sensitive surface of film is always entirely exposed, while the exposed area of the digital sensor can be reduced or enlarged using the in-camera processor, thus changing the number of pixels. Tae ability to vary the image format, and thus the resolution of the image, Is established at the image-acquisition stage, ‘when the dimensions of the so-called digitalPhotography in Dentistry Digital sensors provide images with difering resolutions or image formats: smal, medium, or large. The term format also refers othe proportions between the two sides ofthe image, similar tothe format ofthe sensor. negative are selected, Moreover, the image can be captured by the camera in various formats large, medium, or small Fig 4-16) Resolution is important to the way the image is made available for viewing; the higher the Tesolution, the larger the size of the print that can be made while maintaining excellent image quality. It is not impossible to obtain a large-format print from a small-fermat negative, Dut a loss of sharpness of the image ‘will result, which increases the graininess of the photo. By moving the pixels further apart to obtain a larger print, the eye will begin to perceive the space between each pixel, giving the viewer a grainy impression of the image. ‘AnLimage with a specific resolution or digital format can be printed onto paper of different sizes. The paper size will dictate the space between the pixels, whether closer together or further apart. Thus, another meaning of ‘the term resolution applies to the methods and quality of printing. Print resolution refers to the density of pixels on a print, measured in dots per linear inch (dpi) or plxels per inch (ppi). ‘Ihe higher the dpi value ofa print, the sharper the image will be (Table 4-2), The maximum. resolution perceptible to the human eye is ‘about 300 dpi, or approximately 120 dots per cm; itis useless to print ata higher resolution, ‘When progressively lower dpi values are used for printing, a mote and more grainy image will result, as the eye perceives the individual dots of the image. The dpi value is also used to ‘express the resolution capacity of a screen. Its ‘quantity of pixels determines the sharpness of its images and, consequently its quality. Ifa print of a specific size and resolution is desired, the required pixel resolution of the digital image can be calculated prior to taking the shot. For example, a 20 x 30- em photograph with 300-dpi_ resolution is planned. The following steps should be taken to determine the quantity of pixels needed to obtain the desired result. First, the centimeters are converted into inches (inch 2.5m). The print corresponds to 87.9 x12.8- {in format. These values are multiplied by 360, the density of dots required; 2,400 x 3,600 dots is about 8 million dots. Therefore, a20 x 30-cm. photograph with 300-dpi resolution requires an image of about & megapixels. ‘The same calculation can be done in reverse to {determine the size and quality ofa print, given the resolution of the image. An &-megapixel image has a pixel resolution of about 2,400 x 3,600, Three different formats of varying quality can be printed from this file. ‘The pixel resolution is divided by the desired print resolution to artive at the dimensions of the print. Ata print resolution of 100 dpi, the print ‘will 2g x 36 inches (61 x 92 cm). At a 200-dpi print resolution, the print will be 12 «18 inches (Go x 45 cm), Decause 2,400 : 200 = 12 and 3,600 +200 =18, At a print resolution af 300 dpi, the print will be8 x12 inches (20 x 30 cm)Principles of Digital Potograpy Fora print, the term resolution indicates the degree of sharpness ofthe print. Printing on large-format paper requires image les of large dimensions. An image file can be printed at various degrees of resolution. Ifa print ofa specific degree of quality or dp is planned, the image resolution canbe calculated in advance. Table 42 Relationship between image resto an prin eat The anon 0S Duo has many cies [arimage ormet.Thefarlfecolumn Quality Piss lesyeompeeion Theos feaveE eS Mtae SCE ae fGeutsot tesa tne toad) Bea) a) sain eiiaesume Sfrthesnal ow Byes M2) | fh th sone pbes te tee =a erie ontebo icra Pec Re Pees papelpetie Ari | Sart eons SS anit es) {etre degree of esoution elo the nage fom Ce | Bs,Photography in Dentistry —_ Image depth isa parameter that expresses the intrinsic quality of pitts, or the quantity of Figs £2) Penton Ra shyt compiz ofan SU-So0 commander unit, mounted (nthe hot shoe above the como, and to Sas flsh unt mauradon aig 0 thefront of theless en hee thefts ants ore ostoned a he ond -obck frst (0) The lshunts feocate at a tonce om helen oan, Frmingan ale tat reutsimdetr spt pseataton oe imageFlash Units Rotating the lash units auty fom the -andg-oock position, or Bo degrees apart, allows the practitioner to explore new image spatates and to create photographs of great documentary valve. Moreover, added flash units introduce light fram unusual angles; the intensity and the direction ofthe ight sources can be varied at wil to discover spciol and impressive eects restive Use of Flashes ‘Artificial light can be used in unusual ways 10 ‘reat effect. Fist, because the light sources are ‘mounted on a ring, they can be rotated around the lens, The standard placement for two light sources is Wo degrees apartatthe- and -o'clock positions (see Figs 8-8a and 8-12), but they can ‘be moved to the vertical 6 and 12-o'clock posi tions, maintaining their 180-degree relation- ship (see Figs 8-ga and 8a2b). This variation in the angle of origin results in a different light reflection on the oral surfaces, bringing out spa- tial characteristics or surface textures not gen ally visible with normal lateral lighting. Second, one or more additional flash units ‘ean be placed on apposite sides of the lens, de- Figs-90 ‘renunsB-Rac0 fash Unksof onic aster are Seen inthe and -teck shins io dees pore Figs e9cand 654 “The flesh nts can se afong the mounting nga cher postons ming Smale ants sho 90 Sgr Or 4s eres pending on the operator's taste; these so-called servo flash units enrich the overall lighting and {improve the perception ofthe tooth's spatially. ‘A third option is to increase or decrease the intensity ofthe light sources to obtain particu lar effects, All modem macrophatography flash units, whether ring or twin, can be adjusted in this way. This modification can be done in both ‘Uhrough-the-lens (TTL) or manual exposure ‘modes, Experimenting with various light sourc is gratifying, especially when photographing. areas with extremely high esthetic value, where the perfection of well-executed restoration can. only be improved by an unusual perspective. ‘There are many richly captivating possibilities offered by such lighting systems for whomever ‘wishes to play with light and create exceptional photos. Fgeo0 ‘adienal fish wits con eased athe rnting tg. 205Photography in Dentistry The emission of light from the flash unit must take place within a definite interval, called flash sync speed. n modern cameras with dedicated flash units, this ccurs automaticaly; otherwise, a shutter speed of v/25s shouldbe set Flash Synchronization ‘The presence ofa Nash affects how exposure must ‘be handled; the amount of artificial light emit- ‘ted, together with environmental lighting, must ‘be adequate for the requirements ofthe shot. ‘The total amountof light emitted by the flash unit must be regulated according to the re- quired exposure, To obtain this result, the du- ration of the lash, but not its intensity, can be controlled with exposure settings, This has two consequences: first, the camera must be able to intervene in the setting of the flash; second, the flash pulse must take place within specific lapse of time. Infact, ifthe shutter speed is too rapid, theemission of light by the Nash may oc- ‘cur after the shutter has closed or before it has opened, Therefore, itis essential for the flash to be synchronized with the shutter speed, Which is set ata specific value called flask sync gs 8.00 and 8.10 speed, Because intrzoral shots are always taken with a small aperture, the exposure setting is controlled, not by the shutter speed, but by the length of the flash’s light emission, called the {ash pus This synchronization occurs automaat- cally with a dedicated flash unit that is produced by the same manufacturer as the camera and is thus able to communicate with it, Otherwise, the shutter speed mustbe setati/ias sto ensure that the shutter stays open long enough to al- low the light of the flash to reach the sensor. Because the subject in the frame is generally stationary, the photograph will not be blurreé, leven with a somewhat slow speed of 2125 8. Exposure and Flash: TTL Mode mn practice, the practioner has two choices for exposure: relying on the lash’s TTL readings ot ‘using manual mode. InTTL.exposuremode, the ‘a inst Nesh uncon be tied on tsown Figtce Detlef ehe mumtng mechanism ofan a ago unitate pan araundunihehe 204eras nits Fgs-n0 "Thisimage wes token with he on 9) tn fash system, with wo S8-Raoo units paced Modegreecoportat the: and dlc poston Figs . FOUrSB-a00 us, placed go degrees apart atthe, 6 and 9-lockpoklons, cea erful andimpresiveiahing eects 20sPhotography in Dentistry Fig o20 IC Se Raoo lsh uni can oferta rato is 9m thering suppor Intis image, te conauetion of he ight sours ings ot the tecueof the ns, toe eerment ofthe posteior areas. The photog = Sight unererposed on vortion neh one a nig of he gt ce Nee ‘aavantagesanddsasartges, which why heat cede wh ‘spec of the mage aor Foon Inti phorgrph tw ach ans hove en postioned vertical atthe and otlckpestion: Nee how thereon ingot eet of he Sos teare sonar 206___ Flash Units When the flash unit is controlled by TTL light readings, exposure is measured through the camera's lens system itself for maximum precision. In manual mode, on the other hand, the operator selects, aecording to his or her oun personal requirements the exact duration ofthe fash pulse camera and the flash are designed to communi- cate rapidly with each other. Depending on the amount of light that passes through the lens and strikes the sensor, the camera decides on ‘the exposure and very rapidly informs the fash processor when to interrupt the flash pulse (Fig, ‘8332). This automatic mode is extremely useful {in most situations, but certain circumstances ‘can affect its accuracy. For example, the presence of metallic ob- jects in the frame, such as dental dam camps, shade guide supports, or even implant compo: rents, can cause reflections that can falsify the camera readings and create undesirable under exposure. In practice, the light of the reflection Aeceives the exposure meter, which overesti- mates the amount of light and interrupts the flash pulse before correct exposure has been achieved (Figs 8-i4a and 8-152) Fate ‘Theflsh un dp starting stthetoplftand comer che ‘awinieateaconnan ‘ithaca ts thefower ndeatesterace forcement Tee Iteeosremde, he eters A ant Bindeatethe mai fgesouce soup te aint ht enogevpsaesetartesane ower thesjnba Creates the reo requereyonwhihtre unt (reams tg sours he Symbainatestethé goup of Fashunes wichopeae ese nian ase ‘Manual Mode ‘Toavoid the possibility of underexpesure, all ash units have a completely manual mode, which al- lows the operator to determine the duration of the fash pulse (ig 830) It is important to recognize that the TTL light- reading system can fai fora number of reasons, s0 the practitioner must know low to assess correct. exposure and, inthe presence of incorrectreadings by the camera, overcome the problem by cnoosing to work inmanual mode. n such situations, twill ‘be the practitioner who, by wial and errr, will es- ‘tablish the correct amount of light; in general, it ‘will only take two o three attempts to achieve the desired result, avoiding the overly brief fash pulse set according to the TTL reading (Figs @-ub and 850). Photography is a creative medium that is ‘noninvasive fr the patient, so the practitioner can always search for new possiblities in documenta tion, Fgenb ‘Thee tthe tp ofthese ndaes {atmaniel mode astm The por Forech ight saucegeupcan bese uth ‘onscutering 4 207Photography in Dentistry 208 Figsva Inhisphtographcaen in TL mode of stagetwo surgery with vestibulor connective sue ‘grating, meal efectos fem eon abutments Rae cused the mage to be undeeose, Fae-uo Thesame image token wth thelash in manaa mae, corey expose_ lash Units Fig sso "The metalic reflection ofthe shade ule supor has caused his photograph ken nT fash ‘node to be undereposed. The efecto as lied the epee meter eesurenet. ied Pa Fg asb "Thesame image taken withthe flash manual moe, oppeors cone eposed 209Photographing RadiographsPhotography in Dentistry Radiographic images canbe directly acquired in digital format and then managed with this ‘modern technology, which also allows for easy transmission ofthe images via te Internet. ‘The photography of radiographs a simple, economic way of transferring these images from 4a traditional format to digital ile, which isan easier way to store, transmit, and utilize diagnostic data. Normally, radiographs are converted to a digital format using a backlit scanner, which, unlike an ordinary scanner, detects both reflected and transmitted light. ordinary scanners use only reflected light; the light source is positioned from the same observation pointas the image sensor, which perceives the light reflected from the scanned object. ‘Backlit scanners have a second light source ‘on the part of the scanner behind the object, so lights transmitted through the radiograph in addition to being reflected, Obviously, the ‘object to be scanned must be translucent for light to pass partially through it. The light transmitted through the object to the sensor, together with normally reflected light, allows an optimal reading of the details of the radiographic image. ‘One of the interesting applications of digital photography is the transfer of a radiographic Image to a digital format without using a dedicated scanner. This step is not necessary ifthe radiographs have been acquired directly in a digital format and subsequently printed. However, it may be useful to photograph a printed digital radiograph waen 2 particular derail has been highlighted, so that it can be emailed to a colleague for consultation or advie. m Recent studies have shown that the conversion of a radiographic image to a digital fledoesnotcausealossofdetailorinformation; these studies reported a resolution of 1,280 960 pixels, which is more than adequate to correctly digitalize the images. Radiographic Masks When a radiograph is placed on a lighted viewbox to be photographed, the light around the edges of the radiograph is relatively brighter than the transmitted light, which leads to the image being underexposed. A very simple, economle method of preventing ‘underexposize is to make a mask with black cardboard, A window that corresponds to the ‘dimensions of the radiograph is cut in the cardboard (Fig 93). lm mounts for periodontal images are generally dark in color and are also easy to use as a mask fora single intraoral radiograph. If multiple radiographs must be photographed, the black cardboard can be easily cut and adapted to meet the needs of the practitioner.Light around) reading, which leads to an under are simply contrast mediums mac Periphery ofa radiograph on aviewbox interfer posed image thats difficult to read. Radiographic masks 5 black cardboard, useful for eliminating peripheral ight _— Photographing Radiographs withthe expos ‘around a radiograph; their use promotes optimal exposure ofthe image. camera Settings If a backlit scanner is not available, the simplest and most economic method of transferring and storing a radiographic image ima digital format is to photograph it. The best way to obtain a good image of a radiograph {is to photograph it when illuminated by transmitted light. This requires that the radiograph be placed onto a lighted viewbox. Setting the camera to obtain the best results Js problematic. Technically, there are advan- Figo | Thelorge window inthis radiographic mas, seni boston on ighed eos, efor photographing Danoromierographs ages and disadvantages of photographing ra- diographs, as compared to photographing pa- tients, One advantage is that there is no need touse mirrors or cheek retractors. Most impor tantly, the subject is immobile; furthermore, it isa two-dimensional abject with no depth, ‘A disadvantage Is that flash cannot be used because it creates reflections that would make the image unreadable, Therefore, an ordinary lighted “viewbox for’ reading radiographs, available in all dental offices, must be used. However, the absence of a flash unit leads to Figo Thisroiograpic meskes e smal window suitable Forphotogreting an tao radagraph Tears oes a fly corte vewbo sue and ihc be Seer edge The mass ere made om sets of DackAs cardboard whichis inexpensive ond easy cto the Eetau of any asioroph format. uPhotography in Dentistry ‘The camera settings used in clinical practice ar not suitable for photographing radiographs. For this special kind of photography, the fully programmed modes recommended, with the autofocus function activated and the ISO speed increased to a seting between 800 and 1600. To avoid the presence of chromatic dominants and ta standardize the images taken, the monochrome image mode shouldbe selected. problems with the exposure setting. If the settings for clinical situations are used, the light transmitted from the viewbox through. the radiograph will be Insufficient for correct exposure, so the practitioner must search for other solutions, Because there is no need for a significant depth of field, a wide-open aperture can be ‘used to allow a greater amount of light to reach the sensor. Furthermore, because the subject is immobile, a longer exposure time can be used; however, there is stil a risk of the photo being blurred because lengthier exposure times may allow hand vibrations to become perceptible upon pressing the shutter ‘button, Blurring can be avoided by increasing the sensitivity of the sensor to an 150 speed of ‘800 or more; this high value is till compatible with an acceptable amount of background noise. The fully programmed exposure mode (®) is recommended to let the camera decide ‘the best aperture-shutter speed combination, If the effect of micromotion is still perceptible on the photograph with these shooting parameters, there are three options: use a more powerful lighted viewbox, increase SUMMARY OF SETTINGS the ISO speed to 1600, or use a tripod and the self-timer function to avoid further vibrations when pressing the shutter-release button. If these changes are made, the practitioner will certainly obtain the desired results itis important to be aware that undesirable color dominants may appear on the image They can be avoided by selecting the black- and-white or monochrome mode on the camera's shooting menn, The image will then vary only in the Intensity of brightness on a scale of grays, without any variations of hue or unnatural chromatic deminants (Fig 9-2), In theory, the white balance function can be set on a fluorescent-lighting mode, but the monochrome mode makes this setting superfluous. White balance functions are devoted to the correct calculation of the calor temperature, which is related to the quality of light; the color temperature varies according to the wavelength, and therefore the hue, of the light waves emitted. The monochrome ‘mode instead favors the amount of brightness, or the intensity of gray on various areas of a radiograph, which allows the observer to perceive details in the image. made) Diackeand-white Exposure program Image mode Autofocus function Flash White balance ISO speed —ralyagrnelMontomest Atweted “Gf —~ auunite Roots teoo balance 4___ Photographing Radiographs Figo "Ts panoramic oigroph hasbeen photographed usin various camera stings. (2) The recommended stings have beon ‘sf Peaposuremode with tesef-mer funtion taro, SO 800, manacreme made and auto white ance Is sropscle mage, those an dstinuisnonataal drs pert wich rests na please rad. (2) The ‘ete function as ban set on he urescen-ghting mode More suns have ben changed The mages ‘nesters to Fig a.) The stander image made es ben estado oncom made ond te witblance anion tas eens on flues ging Acaesu he lagescarcteree by an unplesan ue doinnt, Whhs ‘otcomplety uniform trougnoat he nage () The Standard mageand ao whe alancemadeshoveben sled. THe ‘ren dominant ints ie sess nates than he be denart of i 9c, util racing ond uns.Photography in Dentistry General concepts relating to spatiality have already been ilstrated for intraoral and extraoral images. The ero-coardinate rule forthe two planes of reference also must be followed when Photographing radiographs. Correct Framing ‘Thecorrect spatality when framinganintraoral for extraoral image has been defined with the zero-coordinaterule, Similarly, the practitioner ‘must also choose the correct perspective when photographing radiograph, ‘The zero-cooedinate rule is also relevant to photography of radiographs, Practitioners must position themselves so that they correctly per ceive the horizontal and vertical planes of the radiograph, These two planes are perpendicu- Jarto each other, and, most importantly, both are perpendicular to a third plane, the surface of the lighted viewbox. This rule requires that practitioners position themselves directly in front of the illuminated surface, so that the optical axis of the camera lens or eyes is 90 de- grees to the surface of the viewbox, and both the horizontal and vertical planes are perceived as lines (Fig 9-42). When the optical axis is not perpendicular tothe plane of the viewbox or the radiograph, undesirable distortions of the im- ‘age may result (Fig 930) ‘By analogy, Rinn radiograph-positioning instruments are used to ensue that the x-ray ‘beam is aimed correctly. These tools have been specially designed to precisely position the radiograph or digital sensor parallel to the ‘mesiodistal plane of the tooth. The radiograph holder together with the extraoral aiming ring 26 are used to perfectly position the x-ray tube perpendicular to the radiograph or sensor, avoiding undesirable distortions upon image acquisition, The concept of image distortion can be ‘understood by thinking about what happens at sunset; 2s the sun gradually sinks behind the horizon, its angle with the zenith point directly overhead increases, and the light creates longer and longer shadows. Similarly, greater inclination of the radiograph or digital sensor tw the axis of the x-ray beam causes greater lengthening and distortion ofthe radiographic ‘mage, Ifthe camera is inclined with respect to the surface ofthe viewbox, the same distortion can occur, Both errors wil falsify the image 1m summary, inclination of the camera's op- tical axis can be varied with respect to the plane of the radiograph, which leads to distortions in both the vertical and horizontal dimensions (igs 9-4 and 9-5), To achieve excellent results practitioners must consistently visualize and ‘use sultable reference planes in all aspects of ‘professional practice Itis the author's belief that one of the greatest Initial difficulties in photography, as in most clinical procedures, is adopting the habit of ‘mentally visualizing the appropriate reference planes; it requires constant practice and a desire for self-improvement, which will prove rewarding forthe practitioner in the long run.UA corpse oto dees toth se of te ba, te eric nd Torna lars re paced sine lanes user eect tol an super perspec, ewe rece panes eco 7Ph a8 jotography in Dentistry Fase Whenthe postion ofthe ober changes nuit respect tothe harzonta pane, tha plane i preci asimior Inclnation of perspective occurs at temament of toling the shot a dstrted mage wil result. nts example, he ‘ria plane remains ot an angle of deres tothe ose ees Fgoab When the optical sis obsarve froma tera perspective, Iestolé appear perpendicular tothe safe of ewe theoptcol sis poston corey wth epee tthe harzetal plane of reference. Foose Wher the comer isincrect postions wth spect to Beer ae eeepc cage dose___ Photographing Radiographs Fgoso When te poston of he obser change ony wth espero che vertical plane, tha lanes perceive fasion Incnattonefperspethe acer ot the memento aking te Shot, estore imogeul sue In ths xp the arco pone remains aan ane a gees ta the 2bsere ee. Fosse Wher the cameras incre poston with spect tate veri plone, an undesebte perspectives Ineduced and sarin of theimag wl ret Fgos) When te camer anauleubor are obsaed from det ‘hove the comere'sopticl avs shouldbe exact Perpendiuar tothe planecf te veto 29Part Two TechniquesEquipment and AccessoriesPhotography in Dentistry ‘The frst part of this book presented the theory of photography in dentistry, the many advan- ‘tages of photographic documentation, and the importance of excellent quality; furthermare, the general principles of photography and spe cialized techniques were described, ‘This part of the book focuses on technique; procedures for creating visual documents in an effective and, most importantly, efficient way ‘will be demonstrated, To achieve excellence, priority must begiven toergonomicsandtothe correct management of technical equipment and auxiliaty devices. ‘With the advent of digital technology, itis possible todocument and storea huge quantity ‘of photographic material after a modest outlay of funds. Maintaining a collection of patient photographs is extremely useful for a number of reasons, In clinical practice, photography is not always easy, especially with patients who are not very cooperative, or who have a small ‘mouth opening. Objectively, some anatomical situations are unfavorable and may be impossible to overcome, such as particular dimensions of the arch or lips. Furthermore, some patients do not immediately understand ‘the need for a photographic examination and, therefore, do not appreciate the maneuvers with mirrors or cheek retractors necessary to ‘brain good results, Without a clear and efficient protocol, all photographic procedures will waste time in the Jong run, which can be discouraging for the practitioner. As already noted, a critical assessment of the results of one's work can prove frustrating, butitisa necessity for those ‘who wish to make professional progress. All operative procedures must be effective and efficient, producing the desired results within reasonable time and with relative ease, 24 ‘The aim of photography is to create docu- ments for various purposes: © Diagnosis © Communication © Modicolegal documentation © Creation of operative protocols © Education Assessment and verification of the quality (of one's work «© Creation of photographic archives Following this line of reasoning, three distinct topics will be developed: ‘© Choice of suitable instruments Criteria for the quality of the visual document «© Synergy between operator and assistant cameras and Accessories In clinical practice, the author uses Nikon equipment: a D2oo digital single-lens reflex (SLR) camera, equipped with a Micro-Nikkor {2.86 VR (vibration reduction) 105-mm macro Jens, an SU-800 commander unit, and two SB- R00 Speedlight twin lash units (Fig 10). The magnification ratio inscribed on the focusing ring of the 105-mm macro lens always refers to a full-frame aq x 36-mm sensor, Itis important to remember that the actual magnification ratio will be greater when using the same lens on a camera with a classic Advanced Photo ‘System (APS-C) sensor format, such as the 200 (see chapter 4) Therefore, the recommended magnification ratio values for each photograph listed in chapters 1 and 12 are nominal rather than actual, becaise they are specif to the camera listed above, which has a smaller format sensor, ‘The magnification ratios inscribed on the lens*Figo Te following Mika camera components ond acceszres can even clnclpotoyrcpy. (4) D200 cameo boy. (bhi ntdore sovR 05 mm macro ns. sess emote SB Rago Spedlgn fish uns (2) Su-800 onmanerun or wiles Spenights. 2) SW n extreme case up postuning adept 0) Thelen andthe S800 fonmaner nite attachedeothe camera by The twin lh unts oe anchored tan SX attachment ig tht ncuron thelr) inthis mage twos adepehave bem addetta the atachment ng tes oe exelent fr Intcora cose up sats of the poster eth nsPhotography in Dentistry —_ focusing ring only correspond to reality when used with a camera with a full-frame sensor. Dental photography requires the use of accessory devices, some of which are more ‘crucial than others. There are two pieces of ‘equipment that are indispensible; these are available in various shapes and sizes to suit 2 variety of situations: Intraoral mirrors ‘© Cheek retractors ‘me practitioner will find other accessories particularly useful: Heat source, such asa Bunsen burner Alr-water spray «Saliva efector Contrastor, either cardboard or metal A detailed analysis of the characteristics of each of these devices and instructions for their use follow. Intraoral mirrors ‘The need to respect the spatiality of the image, as dictated by the zero-coordinate mule, makes ‘the use of intraoral mizrors indispensible in cer- tain shots. For example, without the use of a mirror, It would be impossible to corzecty frame fuall-arch occlusal photographs because of the ‘anatomical limitations te mouth opening, 26 Intraoral mirrors for dental photography are available in three basic shapes (Fig 10-2); «Large figure eight-shaped small figure eight-shaped «Bean shaped ‘he figure eight-shaped mirrors are indicated for the fllowing images: © Occlusal full-arch views « Incisal views of the anterior sextants Palatal and lingual views of the anterior sextants ‘he figure eight shaped mirrors come in two sizes. Both sizes have ends of different widths and a narrower middle part. For photographs of the complete arch, the width of the mouth opening at the level ofthe labial commissures determines the end to be used. The wider fend is preferable whenever possible for two reasons: a larger area of the molar region will bbe included, and i will be less likely that the edges of the mirror, a source of visual tension, are visible in the image (Fig 103) ‘The bean-shaped mirror is indicated for the following images: ‘© Occlusal views of the posterior sextants «Lingual and palatal views of the posteriorFin02 (3101) A vrety of nvaoral minors recvlole on the mrt on are appropriate fr most noses. nchoasing which ‘ror to use beh the oea tobe red andthe ores tobe Mluminated Should be conser. The mor shoud be as Wide ‘apssbe to enable re ight abe flected inthe best possible way. Fotis ean, large mits ate econ 27Photography in Dentistry ‘To simplify matters, the two ends of the mis- ror, the drop-shaped énd and the tapered end, are considered separately, Furthermore, each fend has two edges: for the drop-shaped end, a convex and a fat edge; for the tapered end, a convex and a concave-convex edge (Fig 10-4). Cheek retractors “These accessories remove the cheeks and lips from the framed image. Various shapes and sizes are available to satisfy the practitioner's ‘requirements: self-tetracting or handheld, large or small (Fig 10-5). The self-retracting version has two wings connected by an arch; the handheld retractor has one or two wings fon a support handle. For some images, it is necessary to modify these accessories to Fgros0 Dimensions fo large pare ight -saped minor (Fessler) nxtmurs lenge mm maximum ‘th rm: imu eh, 67m. Faro-40 Ot ety taped ne perder lower agescome 038 Bhnenfs ban hpi Gti ‘matin gin sm wih oper ee {orth tte cepsnontens. rn mri wate eis 30 Faro (te apeed nd the upper edges concave conver lower ge scone.(Check eactrsareavblen mony stapes ond ses. (3) Te ail erator (Ome) deal for photoraphing poster teeth fom atea view forothoontic ocunentato.Tserctaralws he racitoer wo photoraph sa backs ‘hepermanent fst mla witout asing amr (o) The Spandex reactor age eran) Sse to potegraph tea) ‘ews with emir and onal ews inoclso.() The Optve retractor (rere the psandchesse he same time () The onde) tracing chest etactors seas aterotveftwo handheld reactors fret ews bf thearces moc.) A double nde handhe eat (0) witha sa reracting eect te practiont ‘anak photographs evr uithou eng suppated inthe posterior gions. (g) The Spandex sefretractng checkretractor ‘with modified wings sel fr flac cial photographs; t makes the use oftarge miro posible y nt intefing ‘wth ther placemat (B) Ts Sponderetactor rth modes wings appropnte foro ng and peat ews Thermalright ond mandbuar eft posterr sons (i) Tis Spends etroctr ith modified wings apropate for ‘clus lng ad pasta views of the aul ft and mandbulor ight poster seans Equipment and Accessories 2gPhotography in Dentistry obtain optimum tissue retraction; these ‘modifications are simple operations and can be carried out in the clinic. For example, fa self-retracting cheek retractor is used for the photograph of the occlusal surfaces of 2 complete arch; however, the retracting wings ‘may interfere with placement of the mirror or framing of the image. If the retractor is ‘modified by removing half of each wing, it can be used to retract the cheeks adequately, position the mirror, and capture the image, ‘he handheld retractor can be modified in the same way. However, itis important to bear in ‘mind that this will produce two retractors that, are mirror images of each other: one for the maxillary right and mandibular left sextants, and the other for the maxillary left and mandibular right sextants. It is important to be able to differentiate between the modified retractors, for ease and rapidity of use, A tungsten carbide disk mounted ontoa straight handpiece or a small saw should be used to ‘cut the retractor. The edges must be carefully polished with rubber wheels and brushes 50 ‘that irregularities do not cause the patient any discomfort. ‘To modify a retractor for images of the ‘maxillary right and mandibular left sextants, the following steps should be taken: first, the retractor is positioned with the handle facing down and the U-shaped wing facing up; second, half of the right wing is cut off. To ‘modify a retractor for images of the maxillary left and mandibular right sextants, the left half is removed, For short arches, such as in ‘children or in distal edentulous areas, aspe retractor with very concave wings can be used, ‘which allows the practitioner to forgo the use (of mirrors in lateral photographs in occlusion. ‘This technique provides better visualization of ‘the teath and direct framing of the image. 230 Additional accessories ‘tn addition to the instruments described above, other accessories are also very useful (Fig 10-6), The saliva ejector and the alr-water spray Keep the misrors dry and the teeth and mucosa free from saliva, Contrastors are needed to create a background that brings out the shape and, especially, the various degrees of translucency of the tooth, which is a fundamentally important aspect of esthetic restorations. A source of heat, such as hot water ora flame generated by an alcohol lamp ora Bunsen burner, is necessary to prevent the mirrors from fogging. ‘me ergonomics of dental practice necessi- tates rational storage of these accessories to {facilitate ease of use; therefore, they should be labeled and stored in ready-to-use containers (Fig 207), Asa general rule, itis a good idea ‘to use the same instruments as much as pos- sible because changing instruments makes for loss of precious time, For example, after tak- {ng occlusal and palatal photographs of the maxillary right posterior sextant, it is logical to proceed to the occlusal and lingual views of the mandibular left posterior sextant because they require the same instruments. It is rec- ‘ommended to maintain atleast three contain- ers of photography supplies to avold delays caused by sterilization.Equipment and Accessories . t Figi0s (and ) eta contrasts (ke) ras fr creating aback backround whenever the practioner wishesto phase he shape and clr of tet) Disposable lack cardboard conastrsareclscvlale(@). has soucels {adto warm nemirareto prevent aging.) Tne crater spray eindpense oer nting te buble of sla that netaty form betwen the tet} Asal gears se oelimiatng sale and preening the mites aPhotography in Dentistry Image Quality Because the concepts of spatiality and the orthography ofthe image presented inthe first partof this book ate fundamental prerequisites to obtaining excellent images, it should be emphasized that all efforts by the practitioner must be directed toward these concepts. ‘To better aim the camera with respect to the planes of reference (see chapter 7), i is extremely useful to display the viewsinder grid, if the camera has this option (Fig 10-8). ‘The quality of the images obtained depends on respecting the rules already set out in the Figio70 Contin areaspensbleforrganiing alte ecescary oct e{sago0d et have see) Idec containers with lems eee othe varous Image sees. 2 ‘theoretical part of this book, which prioritize ‘magnification ratio and depth of field. These rules can be summarized in the fundamental questions; fe Have I framed everything 1 need to show? ‘© Can 1 see anything in the frame that creates visual tension? “Ine photographs must not include anything distracting, such as fingers, mirror edges, parts of retractors, saliva electors, teeth of the opposing arch, tongue, saliva, ips, or Figio76 ‘rope container shows the packed and scarizedEquipment and Accessories 4 e f Fgi08 (to 0 Invcoral mages ustrate the cect uso te gs nthe ewe naming an image according othe z0- ‘soraneteePhotography in Dentistry nostrils. The photograph must be correctly exposed, and, above all, there must be no areas out of focus; the image must respect the second fundamental rule, depth of field priority. Apart from these parameters, which are fundamental to framing the image, there are other, less important details, which can, ‘onetheless, prevent the correct reading of the image. These factors, which can cause visual tension, mainly involve the management of the photographic field or the mirrors: halos, saliva, or scratches on the surface of the ‘mirror spoil the image and frustrate the efforts of the practitioner. Likewise, excessive saliva, residual plaque, orfood on thetoothsurfacesare ‘disturbing elements, unless the photographs are to serve as pretreatment documentation, ‘To avoid reducing the value of the image, the mirrors must be kept clean with a soft cloth and heated before using to prevent fogging from the patient's breath. The consistent use of a saliva ejector, positioned where saliva is most Likely to collect, Is extremely useful in avoiding a buildup of saliva. Use of an air- ‘water spray is also recommended to keep the surface of the teeth dry and, if necessary, to lean the mirror, Although image-retouching programs can be used to correct unwanted details, the act of retouching or cropping may alter the quality or the proportions of the image. If the practitioner must retouch a photograph, he or she needs to be careful to always keep the original, preferably in the raw {mage file format. ‘Synergy Between Practitioner and Assistant Previous discussion has established that a visual document should be acquired in a standardized manner, as rapidly as possible for the sake of efficiency and to avoid stress. for both the patient and the practitioner. ‘Ihe collaboration of the dental assistant is fundamental in effectively and efficiently photographing the patient. ‘The assistant is responsible forthe following. tasks: fePosition the backrest of the dental ‘treatment chair correctly for each view fe Instruct the patient as to the position of the head and tongue © Choose and correctly handle the retractors and mirrors during the shot ‘he assistant should be well positioned, preferably seated, for maximum stability and to be able to grasp the mirror as firmly as possible. Mirrors should be held by their edges, as far away as possible from the area to be framed, so a8 to not obstruct the light from the flash units (Fig 10-9). This maneuver is not easy and requires a great deal of strength, s0 it can be extremely titing for the assistant. For this reason, constant practice is absolutely essential, and it is a good idea to photograph onadaily basis, The assistant must be familiar ‘with the photography procedures to anticipate the practitioner’s needs, getting into position quickly and correctly and with the appropriate" accessories readily available. The assistant's role is fundamental to achieving the desired results, and, like other dental procedures, photography’ must be considered a four- handed job. In summary, fast and efficient photography requires perfect knowledge of the camera settings, and also of every position of the patient, assistant, and practitioner. Contrary’ to other authors’ beliefs, the patient should not actively participate in the taking of the photograph, butshould passively follow the instructions given by the assistant. This will save the time it inevitably takes to instruct the patient, and, most importantly, it ‘will avoid possible interference by the patient Fu09 Equipment and Accessories during positioning of the accessories. As a ‘general rule, the practitioner, in addition to beingoriented forcorrect ramingoftheimage, must ensure the stability ofthe position of the patient and accessories. Ideally, photography should be done from a seated position, but should this not be possible, the practitioner should rest on a stable support, preferably the structure of the dental treatment chair. ‘in the series of photographs that follow chapters 11 and 22, the descriptions of the positioning of the patient and the image are ‘often repetitive; however, it is very useful to ‘haveall the information required for each shot listed in one place. (toc me covet gasp tener mirorinsarous postions shown. is esse forthe assistant to have fm ‘ton thee leavin the maxon srface aa efor efecto ge from the lash uns Ts erasp can be Cu route ofthe srengeh neces howe, uith constant pace, exellent est ca Boba, 25Chapter 11 Extraoral SeriesPhotography in Dentistry —____— Neither accessories nor the aid of an assistant are needed for extraoral views. Wheeled swivel Are used to allow easy adjustment of position (Pig 12). To ensure that the image is repeat able, itis important to always use the same ‘background, Moreover, the same operator- subject distance should be used to preserve the ‘magnification ratio, It may be helpful to make rote of this distance in the patient chart, The ‘photographs in chapters 11 and 12 were taken ‘using a camera with a classic Advanced Photo System (APS-C) format, so the magnification ratio inscribed on the lens’ focusing ring is yhominal rather than actual. The magnification ratio changes when a smaller-format sensor is used becatise of the concept of equivalent focal length (see chapter 4) ‘Documenting the patient's profile isa useftl ‘technique in dentistry. To highlight the profile of a fairskinned patient, a dark background fan be used, although a lighter background will Fam (Garand b) Weed save! ‘Root ore used foreose {movement rng ‘tera potearephs: eT bring out the radiance of the face, Gray-colored backgrounds are a good compromise for all fextraotal photos (Fig 3-2). Photographs can be ‘standardized even further by using a tripod that {salways placed in the same position. ‘The use of the through-the-lens (TTL) exposure ‘mode and at least two flash sources is recom- ‘mended. The flash units should be inclined so that a beam of light converges towatd the focal point, Moxeover, the use of auxiliary lateral flash ‘unitsisadvised, tominimize the inevitable shad- ‘ows that form on the background. Alternatively, the distance between the subject and the back- ‘ground can be increased, which avoids the use of ‘additional flash units ifthe room is well lit; how- fever, this procedure isnot recommended because ‘the quality ofthe lighting willbe too variable and the repeatability ofthe image willbe lost. For the protocols that follow, the degree of difficulty of teach shot is rated on a scale from to according tothe experience of the author. 238——— Extraoral Series 4a ¢ 4 Fons pon vewing il fce image agains ros backround ts cle the igh ole bacarounds (ante drat heuer! ttntion ny fom te deta tobehighighed Neat bacgrun (banda) eremoresutsleforbrogng aut deta thet drag testo thee 239Photography in Dentistry __ _ VIEW Degree of ict: Pastion ofthe patient Seated opposite the practioner ona sv stool with ead and esac stat hed Postion ofthe asistant: Not appliable Position ofthe practioner: » Sented on a hese save stol about 5 m (in font of thepatent Camera settings: ama verily Magnification ato to 19, apertue fn ining pon onthe median neve ith he lowe eb ris cl point on he ygoma gna) Flash units atthe 3-and-dck postions gt) ‘Typeof cheek retractor: Notappiable ‘ypeet mir: Notapplicable Fanae Fara m7 ‘Topas one ede si sl weigh pal tf, oat ese ca cane pn tata pales ne pacteeaeopgete on a reed sli sea ly ate. Tt fons ae ih cme ed ata amegt eel foetal heat a om nc sary om oe Frh sco ope is esahaioenh 240Fama ronal ew of fce with he ips lane, Fans rc postion often ond prattone fr this view Gracia Frontal Face, Smiling and with Lips Relaxed q PyPhotography in Dentistry —————— VIEW2 Degree of diicuty: Peston of the patient: Seated oppate the pratoner on a sel soo Drone so degrees aay fm the frat view to the Fight ret ada esac stag ahead Postion ofthe assistant: Notappicble Position ofthe practitioner: Seated on a whee sie stool about 15m 5 tral tothepanent camera stings: Caneel vertically agrifiaton aio to 10; aperture ff Aiming pint pester tothe agora atthe level ofthe Tone ral fc point on the ygoma (Fg 72) ashi atthe 3- and dock posibons (Fg) “Typeof cheek retractor: Notappicable “Typeof mito Not appicable Fignye Figne “Trputieti ssteons wl ni so hh pl ot othr scan charge stn er pl vs wat ating [psfne gion vd osteo a tase a eran aty fever Te anit le he wo tn wh i en Potengi, ane has veel ante ep be hast bee nh and eres Forte ead ele ‘eri ashe un oe Tee zp hous bern wr sar rapa std fr ta Veo ‘etholee rast hee esi desoneTheraphson ao va soudbe carded acs sibeget speiecats Paps crExtraoral Series Profile, Smiling and with Lips Relaxed 2 ° Fors ght (a) ond ()pofle ul Yce ews with ee ps rcs * . Figg r ot) one () poe fulecevews wate sie. @ —? ; 3 oi a 6 Figns0 (lana) come: postion ef paint nd practioner for hs Wew The ve of where swine stools pedes this prcedre 23Photography in Dentistry —_ VIEW 3 Degre of icy: Postion ofthe patent: Seated oppose the racitoneronaswiel stool with ead and ees facing strat ahead Postion ofthe assistant Notapplcable Postion ofthe practioner: Seated on a whee save stl abut soc (2 inches) ayo the patent Camera settings: Camera el hana but oc nce fhe feat agpitcatn ao aperture th nina aperture) Aig pint atthe metho hcl css fo poi thee cortat etn he tal eo ard the canine a) Fshuitsl the 3-and dock pestis) “Type of cheek retractor: Notapplble Type of mito: Notapplcable ‘Tetra heel el th igh palo oon oh et te char psn ab pale ae wit oth tp. The pation ed opera cna Wace at are of ornate che bce abe ed Dect (tr nation oa. para ato sa es hs = by xe ei en an eee {nde amamnor tonal thos os agen De ptner camer este ala ee. 2aExtraoral Series id Maximum Smiles i ay 2 Fignxb Sight sme Corect postion fortis view ql Fignb Core poston or thisvew. at Kal Fone Fignub ‘imam sie rect estan for thiview 24sPhotography in Dentistry << VIEW 4 Degree of dict: Postion ofthe patient: Seated oppaste the practioner on a. sel too od Peston go degrees aay frm the frontal view to the Fight ort ead and es facng sagt ahead Postion ofthe assistant: Natapplcable Postion ofthe practitioner: Seated ona hese sil sto about 0c 20 inches) ‘aay the patie Camera setings: Camera ld hart about 40cm inches) fo the focal paint agitation ratio aperture (minimum aperture) Aiming pint atthe el of contact beeen the tea inasr andthe canine oa pointon the pane thelr incr Fig) ashunitsat the 3-and-'dok postions Fg st) ‘Typeof chek retractor: |e Notappicable ‘ypeof miro: Notaplcable ‘The palow axon wh sil wh hes pr he fon ath Se can charg pation tat vw wi grag Inthe stone lead ccta cna vine ta ree antral) vem es eel xa hg Magione Tt tie cal hs a enn orem Rote pean, nhl oq ie ie ‘Songer post 246ee __ Extraoral Series Lateral Smile Fara greater sie Fg neo Letra sme Oi Dae ae Ki. ON dd Fam (and 9) carec poston ores view ee 27Chapter 12 Intraoral SeriesPhotography in Dentistry Unlike the extraoral series, the intraoral series requires the assistant's help, Another difference is that the patient must be seated in the dental treatment chair. ‘An important consideration is that the ‘mirrors should be warmed to prevent them from fogging. 1fnecessary, the mirrors can be cleaned. ‘with a soft cloth to remove traces of saliva. ‘Moreover, its essential to keep the saliva ejector inthe oral cavity. Not all patients are easy subjects to photograph, for reasons relating to anatomy for character, Generally, it is more difficult to photograph the mandible because of the presence of saliva, which tends to collet in the backofthemouth. For maximum efficiency, the protocols that follow are grouped according to ‘two criteria: che inclination of the dental chair and the type of accessories required, ‘All photographs are taken with the chair inclined in one of tree positions: 20, 135, 0180 250 ‘degrees, This allows the practitioner to quickly take all photographs ina certain position before adjusting the chair, avoiding unnecessary and ‘Uresome movements, Tor photographs taken at 110 degrees, which are not particularly taxing, the assistant can remain standing; the other two positions (335 and 10 degrees) require more engagement on the part of the assistant, who should be seated for greater stability. ‘The second priority is to limit how frequently the necessary accessories must be switched ‘between shots. The shots are organized in a sequence that minimizes putting down and picking up accessories. For example, for views of the posterior sextant, the maxillary right shots are taken, followed by the mandibular left, because they require the same accessories. Similarly, the ‘maxillary eftand mandibular right sextantsare photographed together. views Right overt views Left overt view? Fallachesin normal ocusion views ‘Anterior setantsin normal cxcuson__— Intraoral Series DENTAL CHAIR INCLINED AT 110 DEGREESPhotography in Dentistry = VIEW 5. Degree offical: 2 Postion ofthe patent: «Backrest of the treatment char inned no eres Fg a) «Patented and ees facing tight aed Teethin normal owduson | Position ofthe assistant: ‘ tading at the othock poston (gsasaand ast) (Two chee tacos reused by ull the handles award the heels, 0 cheek reactrheldin erg hand anéacontastr hein the ‘thd are se to ett the isand cheeks Pasion ofthe practitioner ‘Standing cr sated at the ¢'ock poston (gsi and wb) camera settings: Camel inal n(n fr theft S Magcaton ats ape (mum apo} ‘ Fashnteathe}- andor pstins 2) ‘ming oot tafe igh eral esr fel pinto the Ded eight ra nr). Type of cheekretractor: ‘To handhel cheek reacts, © One ces evactr and one contastor Type of ior Not pliable RIES NEEDED Fgz20 Sale ecto and c-wae spray. Fg ab Me s ctor | ‘ Fig mac a ere tcgrend athe same one Fgnead ‘coc nl nee ee 09 “— tera bo ug arn freonIntraoral Series Right Overjet GIs ‘Tanith a tow apt stn hn te pers rat se, Froriet nanan a hares teas Ghee ore fe ‘lew ef ea front coat nig Be soaps ‘sar cnc be te myo Ios ser heme Fasteners a woe a Bad elgein Fans ig over. am Flas Theassitans postion when using toetest tats Fgmab TS ew shows the pasion of {heprectioner when framing ee shoe Portis le mpovare tomanaina dark uniform backround ALTERNATIVE MetHo0 Fone Theessican’spastion when sing ne chee evactarandone Figwsb ‘This shows the postion of the rotooner when faming he sha. 2sPhotography in Dentistry —__ — — VIEW 6 Degree of itty: Poston ofthe pant: Backrest te uestmen earn dees Fg) ‘Pater shed andes fag stag ate Teeth innomal cuson Pesition ofthe assistant "Standing a the cc poston (gsi and) 2‘ Twochee reacts reused by pling the hands toward the heels, oF «Aches erator hl nthe et hand anda contastr alin the rhc hand ae sa to eva the ipsand cheks Position of the practitioner: Standing or seated athe 3-odeck poston igs ead 68) camera stings: «Camera ed het 3m (inches) fo the foal point «© bagniation ations aperture (rinimum aperture) (Rash nist he - and oc'dck postions Fig n-69 «ig point at ital Fhe eft central ins oa point on the plane hele tral cso (gw) pe ofceekretractor: ‘Ts handheld cheek acs, “© One chek retrace andne onrastor ‘ypeot mir: ' Not applicable Fane Salva ectorand aster sro. A For ail ne che rca e gore : 4 “heconrotrisusfl beaut Teeth ipand oer nie den aciground Fad Me seme mich wan ea om reser 258Intraoral Series Left Overjet Ti an a te shown poston Septet 8 Prose starts mara ogres tak castors theca ih gt eee osendeoent hits ste ror dens buon e malay 6 ‘ns soe Te rol eta Fotos seater dasa Sec . Fgne oven | Figwse ‘Theassican pasion when sing theo cheek ret Figuse ‘Ths shows the postin of the practioner en Foming she Soe Forth view tis rportat ‘omaintamedor uniform chron, Avrenarive MeT#oD Figr100 Theesszan postion when Using ne chee evactarandone Contosar shown Figm00 Tiisview shows the psn of the practioner when framing the et. i 35Photography in Dentistry - VIEW7 Degeof ty. vont epavere Backes ofthe etme hiro deges(iges) Persad esting sgh Peston ties Sandgate ops Psa anion) fang cesar feet bene otietande Sang tee ck ston gs anda neers ee ih Tehaesatnageat dodges Peston te pation Sandgate adakpastn ese wom) Cameastings © nero semis) femefaaloet Megat ao apt (num apet) co Bshurisathe ad th postins eon) fg prea be rsa tbemeon Tesi eocdes areoalpntantie phnedte asa anmetigiot) “ped cheered Ones etacing orto tanh wean pesmi Fig ran Sua gerorand ai-wate soy Figrb Sef retactng cea tact. Fim Handed tek retractor Fig Thecorect ngleaf thet cheek rarest each ever aout 60 x —--” 236Intraoral Series Full Arches in Normal Occlusion ‘Tae ee merce of ting is Yop, iyo ares ore se | ‘akg Gua ae, bbe for Frio san sar ea, {natepritone ist eke oct ‘et ss patie at (lech nd esa ard rr Georarese per farvesa te | ‘eri oe ha ged on Vong ‘Seaman carato be res Clermont re and | (heeled ag, Fg laches in nome clin Fig msca Cort raspof te hone of ve Sseveractng check react. Figmub ‘The poston ofthe practioner wren raming his view ALTERNATIVE METHOD me as cae oe rr Fig 5b ae a7Photography in Dentistry — VIEW 8 Degree oft Postar ofthe patent: Bes cthetrement ch ne epee Feu) 2 Fatee'shesdand es xing stag aed Poston ofteasistant Sandgate ids Figs ad ove stacng keane theese thehande cr Sandgate pti Fes aniieedi wate edceracns ae vsedthtetndesatanage to cages Poston theron: *Anreatectedoaten eos i camer setings ‘© Geena soon ixtesiom tefl agian aperture frie peru) Fauna yard gt postions i) co Amingpantatneiteeti often Ineandthe octal calpt nthe pect atari) “Wpeot chek revacor Ones etary arto tances tats ‘Wpeot mire: Fave Solo dectorond sewer spay Fon SHFretracting cheek actor rigm-re Hondbeldchek retractor Figura Te coc one of the two eek Intact: teach the abot 0 : < cee 258Intraoral Series Anterior Sextants in Normal Occlusion The popu nr 7, ‘geht git (gare sete acs faa img gota 9 verang eck rect, he emer ‘ro eas st 2 eh, fbn wbaiped poh Figroat ‘rte teeth innarmal econ Figrenge ores rasof te han ene sferactng cas acta. Figres9b ‘Thepostion of te practioner hen rang sew ‘Acrernarive METHo0 Figo0 ret esto and orp ef te Sandel cet ect une a) trae ews they ee etched outwas fom hefo ry Figa0b | ‘The position ofthe practitioner =| hen fain sew | 259Photography in Dentistry 260 views Right quadrants in acelusion viewi0 Right posterorsetantsin clusion vewn Right quadrants in oclsion for orthodontic documentation view Left quadrantsin occlusion views. Left posterior sextant in clusion view Left quadrants in occlusion for ‘thodonti documentation_ DENTAL CHAIR INCLINED | AT 135 DEGREESPhotography in Dentistry VIEW 9 Position ofthe asistnt: «Seated at the otock poston Fgstzaand ab) Chek retractor edn thet hand ior inthe ight and Position ofthe practitioner: . tania the. tokpstion igs ea and 8) Camera setings Camera ell branaly 45cm (8 inches fro theo pont © Magnicaten ato 27, aperture (rin aperture Fash units place side by seat the do poston (ig m-2e) ng an cl pit one ay fe ear ig oa ‘Typeof chee retract: Handheld chekreractr Type of miro: ‘Beanshaps miro ape end used Fg rez Sala ctor an a-wae sry ig ean Handa chet tact gaa Be stop io! gan reat banner grease The conc postin ofthe miroris south conav-conereigeaf tear tndispastone abe uth thecanver are bei!EME Figs “sims ofthe rant quodrats in normal occlu, fom teen ier the second lo suitable orerthogontc dacumetation. = we =F Agua Fgiaab ‘Thecoret pestionof acess and proper The caret poston of the practioner and esp of stamens the lash ants. ‘Avrenarive Merio0 S tie De Intraoral Series Right Quadrants in Occlusion he ah of he oti tat Bi ‘Stereo en eat en oe mec a teks ‘SSaunduttlomrareepeprail ‘acon tse eS Remarc epee Ins pea, essa ats Ihelgs oe treed so eg | the mwa eee te. Te Sopaheet ide ears fares had nd oes asa rs be mnt ul 2 fons he ttl he see ma [iReport epee om hand toast phen Po tira ces wig {2 digesting cane at ‘naa be ray vests To ptt Sten aed fy coe eet ‘hou craig fe ree race, ‘end ta aoa trae Ft rer eh a pa de {2 be mud our ed ond fe: Sesk Tie pore oes Imus verte eth {ode rato ef $0 dees a ton ge of he a fie o hoch Spa tartare meee Teaser et batt ht fre fh ch rhe sie Tari te ee tara Tho pte Bodine sot hop tetean ay (MP ese et ade aval ‘Seyauegbeasintiona tongs ‘Brass om eto nad Seve tre Figreage use this sac reuse sistant to apply ages del of Strength, amirorweh an eee! handle can be uses. | Figiash The coc poston ofthe practoneand te paler, whose ead must beconerty tated 263Photography in Dentistry VIEW10 Degree of iculys Poston ofthe patent: Backrest of the retment car incined ns depres (Fig 2262) Head tune 70 dees toward the practioner Postion ofthe asistant: Seated the ock postin (gs 2a and 28h) ‘Chek retraced th eft and more inthe ight hand Psion ofthe practitioner: Standing the ‘dock postion gs 268 and 68) Camera stings: aera ed hrariall 3 (inches) fom theo it fain ao, aperture (inrum peste) «© Fash nits placed ily sd atthe dock poston i126) * Amigpomtardoaroatcnbenestbca capt te naay ‘ght stl Fig2 28) Type of chee retractor: ‘Handheld chek retarto Type mito: Bear-shaped mir, apse end used TT ig mayalva decor and iets Fg map Honcho rc gmap toonshaped moe Fg may xeon mir frat Fg aye The conect mina postions ‘So concave cone 0 lepwedendicpostioned abe, wh the ‘exon te 264Intraoral Series Right Posterior Sextants in Occlusion i “Te phage na en 3, be fennel he mages ‘gris na al be tet 7 i i = . Figs Thera posterior cet oclson a w =F De, Figiease Fgu2b ‘Thecorect poston of acesariesand proper The coret poston ef thepractoner and sgraspof insur she lsh nts ‘AvreRnavive METHOD Figt2a00 Becusethis shot requeste sistant co apy age de of Strout, aminorwithan eternal ana can bese Figrsg0b The coc postion of the practtaner andthe patent, ose Fad must becorety tated | | 1Photography in Dentistry VIEWTI Degree of icy: 2 Postion ofthe patient: ‘Bast ofthe eatment car incned 3 pees (2-33) Head tum 70 dees toward the pracitons Postion ofthe assistant Seated atthe 2o'dock postion gs ayaa eg) 2 Natl cheek reactor hin the right han; anda handheld retractor inthe ft hand Postion of the practioner: « Standing o siting atthe dock poston Figs yaad eg) Camera setings: ‘Camera hrzmtal go cm (chs fmthefecal print Magnification rtiov2 2: apetur 2 (ininum aperture) aunts laced side by sce a th sa'ock poston Fig tet] «ing point and fol point on test peal ge) ‘Typeot reactor haidand standard handheld retracts Typeot minor: ' Not pliabe Figs Fg ab rigesee Moser ‘Sols etorandel-wacer spray ‘Stands nendel cheek retractor. 266Intraoral Series Right Quadrants in Occlusion for Orthodontic Documentation The pe of pho ele te Comin‘ etc cae ‘cht sed ete hae tel er a Se ‘tote ml Tess (Sssaes ate 200 pos a tees win gna fw settee cat Trost | Nene pray grand een, | 2s fame ti ‘oe sen 8 Soolichaeiadetcontekshed | smn tes oman ota toe eee tht {te So Arex xr a ces eahe hepa my otisbe {ho lassen ‘gai fon male he coe ‘eter de etme Foon The ofthe night quadrant i pomal ccs fm th cent iio tathe mesial the ‘eeondmaaresuteleororthodoedoeametaton Arar at useores sh wer a Fos “Thecores poston of accesories and prope grasp of instruments Figuab ‘Thecomet poston ef the practioner andthe lash unisPhotography in Dentistry - VIEW 12 Degree offic s Postion ofthe patent: ‘Backrest the ueatnent chained 5 degrees i358) «Head tue o degrees toward the practioner Position of the asistant Seated atthe 1-'ockposton gs 2354 and 2350) Cheek reactor ed inthe ight hang mor hein the ft and Peston ofthe practioner: « Standing or satedat th oclock poston Figs isa and 3st) camera setings: «Camel briana 45cm 8 inches fromthe point «Magnification ratio27-aprtutf/(rinimur pete) «Fash nts paced ie by deat the dockpaston (Figs) fe Aiming paint and foal point on the malay lt fist prea Gers) Type of chee retractor: Handheld chek react Type of mir: «Bean shaped mor apse end used SI — ig w96a aa gjectarondirwter pay ig 9b Handheld crea Fig we earshoped mie gnataiirerutronctenalnonde ir grate Te covet poston of te mire |SShown te conceal he tapered postined above wt the ‘meen 268Intraoral Series Left Quadrants in Occlusion ‘estieuyatheert attend ‘a vn Be an cheno Sanka tm sel rele veerag Depmdio techs Pence Shlaietsanaraised perpen | ihe peasdse, te ass acts ‘helps ont oni ace ‘tat uihasceeetown The gep ‘fot br bape mars feuntekthedacnanecownly Fig This image ofthe let quart in normal oclso, from tecertral incisor the second lay suitable for orthodoti documentation, ‘Sirs pose tan tetoan bee be valet 382 “Thecorett pose of cess andproper The comet poston othe procter and resp of nse he lash uns. ALTERNATIVE MeTHoD _ - ry / igr350 ech shor eaues the assistant apply grec del of Strength, amino withan eternal and can bese Fig a0 Thecorect postion of the pracitonerand the pete, whose Fad must becovety tate, 269ee — Photography in Dentistry VIEW 13 Degree fait: § Position ofthe patient: ‘Backrest ofthe ease chained ees (Fg 2408) ¢ Head incnd tad the practioner Peston ofthe assistant ‘Standing orsatedatthe lc poston Figs 2-4oaand 2-406) {ches el inthe ight ang; mirr elim heeft and Peston ofthe practitioner: ‘Standing or std at theg-cck poston Figs 2-4 ant v-40b) Camera settings: "¢Camra ed hrzntaly 3 (inches) rom tefocal poine 6 Nagnication ato; aperture (minimum aperture) Ras nts placed dey sidat te -'dock postion (Fg 2-40) {ming pit an oa point on the contact between the manly second premolar and rst moar Fg 400) ‘ype of reactor "Handheld checker ypeot minor Bean shaped ior: tapered end sed Fg wane dtr andar soy pres hondhetesk ctr FgiearcBeo-saped mime Fg tend terrane rior frat =< Fg ie The conc iro postonis shown thecocoecomexcigecftetaperesensis i esto bare wen ebecomveone bow.al Series Left Posterior Sextants in Occlusion Fons Thee posterior eethincecuson + iS Fgwae Fgmab Thecoree postion foccessories ond proper TRecarec poston fhe practitioner eng sgaspof sume theflash uns ALTERNATIVE METHOD Meperet ices 2 ponmumeessss eect ed Steiner’ imeetbennae Soames eet mateo paeueweerst Seinen or Semeg cree Sete mecca snubee omen bere Sesto een esata eaenmeanes Roanarieetis ceeeraatire eS aeons Rane ance ieeaecos anipeces cinta tonearm Seen ieererrermans Scere Recess eed Fg ase Becuse ns sho request sistant to app great dal of Strange orton ee) ane can bese, Fg masb Thecorect poston othe Practone’ andthe pacer, whose fend must be foing stig shes nmPhotography in Dentistry VIEW IA Degree of difficulty: 2 Peston eater tad theme hed dees 43) Heine degen epi Position ofthe asistnt: Seated atte x0 deck poston igs sa and) Mail check rector hel inthe et hand; standard handheld retvxtor inthe ight hand Pasion ofthe practioner: «Standing or sting at the7'dck postin (gs 4s and 4st) camera settings: «© Camera horny go om (since) fom tefl pint Magrifeation ratio 2: aperture fz (inimum apere) Fash units placed seb eat the occk poston Figs) ‘Aiming pot and foal pot onthe malay fst premolr Fig asd) Type of retractor: " Nail ard standard handheld rac ‘Typeof minor: “eNotappliate Fig negsa Save ettorand aise sry. Farase ‘Maal erator: Figrash ‘Sandrd hendelcnekretrctr.Intraoral Series Left Quadrants in Occlusion for Orthodontic Documentation erate dt of tre Fig? ‘Tis ewof heft qoesrontsin normal cin fom he cea incisor to the mesial of the secandotr is sutablefor orthotic scurentation A morse use or these Fagrmate Fignaso ‘Thecoret postion of cess nd proper Tecomet pesto of the practioner nd sraspef stamens Inefoshunts. Te petenes end must be rotated award the patna aPhotography in Dentistry ‘EW '5 Complete maxilary denon: ocusal view views Mallar anterior sextant incisal ew view ‘Masry anterior sextant: palatal ew view Marly anteor sextant facil view 2 ‘ewig Complete mandibular dentin: ocusal view view20 Mandibular anterior ‘sextant incisal view view Mandibular antesor sextant ngual view view 22 Mandibular anterior sextant: facia ew views aviary sight posterior sextant oclsal view View 24 Marla sight postvior seta: alata view views Mandibular ef posterior sextant: ocusal view ‘ew 25 Mandibular eft posterior sextant: ingual view view27 Maclay let postion sextant oclusal view view28 aailary let posterior sextant: palatal view view29 Mandibular ight posterior stant oclsal view vews30 andiplar ight posterior sextant: lingual viewDENTAL CHAIR INCLINED AT 180 DEGREESPhotography in Dentistry VIEW 15 Degre of dict: 4 Pasion ofthe patent: Backrest of thtrestmentca inca Bo dees (Gg z4) Heald straight wth hin ted ight Position of the assistant: «Sete at the clock poston gst-gga and 498) Retactr ted in he righthand wt handle toward the ‘ae’ os, mol in the et hard Peston ofthe practioner: ‘Standing at the 0 dock poston (gs ga and ash) camera stings: ‘aera oral 50cm ons) othe fo pont «Magnan ati. aperture (nium aperture) (Fas untst tex and dck postions grea) ‘© Amingpontontheredanineattheleofteprelas: foc pnt onthe plane of thepremola papi (4%) Type of cheek retractor: "Modified stein cheek reactor TWpe of mir: Large gue iht-shaped iar Ee <= = 276 a Fig i-s00 ‘Sala ecto and ie water spay. Fig rssob Figure eght-shped mio. Figwsoc Fore eht-shoped mia with handle (nn. Fg wssod ‘edie sleetracting check retractorIntraoral Series Complete Maxillary Dentition: Occlusal View Im The i wssosty dak i Petey enaaty Pe sat Feast es econ ands ody her ol rc nth ot ‘ecto atomaloe iste Biitcwat esnnnmasann se ‘amet fe uparip site rods irony sapostitun beh aoerg Se anepmam vo ek ‘Nae of te mor feu be este ‘lt mah st re at eseorindunantesar tae, {he rer ule pes i a ‘Semin an 8 ange aro ‘reste ay eee ‘katz fe ed ston rat and Sing te ta todd a {Sree be aa checks ond orn era es ste nthe ona of kg esa Te pron {lepton a 1 doch Inet sre tobe fecha (goa ay Tears we ‘sat and th postr of he mie {nd mt ob aed teens Foz : = Celt view ofthe compete mac dentin, bieram eres et he tot arcalpinn Wane pss (teases east thle open rah ae Fost ad a vere sgh ems pti th i weit Btn he gt om ees Baca Ihaposre molesagea oa aes (ar bepaet nd ee Sah oad ‘ier Testo materan ‘noe ra aay sal ne opel fe iF . Fagrsaa Fash ‘Thecatc postion of ocessores nd proper The crc postion ofthe pacttioney the srapefinseuments {Camera ond the shane Thee eld ‘suis the eure for sab. ALTERNATIVE METHOD (gs we and sb ‘Ths shat canbe taken ian ental menner sing oir we hana a7Photography in Dentistry VIEW 16 Degree of fic: 2 Peston ofthe patient Bacst ofthe treatrent harincined fo depres (gn) Mea el straight with chin fed sight Pasion ofthe assistant Sead lhe 3'ock postin (eps andl) « Rtactoreldinthe ight handvith hand tatd hepa’ roe; mor bein thee hand Pasion ofthe practioner: «Standing at the lock poston igs a-staand es) Camerasettings: ‘Camera el hrzrtaly go cm inches the foal pone ‘ Maghication rai 2.2; aperture fz (inmum aperture) «Fash unit atthe and tock postions (ig) «© Aiming pint atthe ince pnila fal point on the pane of ‘the pale between the cnt and ate incor Fg 2-0) Type of retractor: «Modif stactng cheek reactor Typeof mor: Lagefigueeiht-saped ior * 6 Fg nsssa Saluogetorond i-woter spray Fg rssh Figure ah-staped miro. Fase Figure agh-staped minorwit handle Fansst « ‘ odie se retracting chek revoIntraoral Series Maxillary Anterior Sextant: Incisal View 1 se ce rege ae ‘echt me char acco oe {itiecargl tay eran Theo) ‘overeat at eno et fre i fe pero, veal ae eat 2 ir mio tangy th paso te epos iw wore fe tit mae ie ‘se ter Sa mine nme ‘este Theat ald mae {ne ofthe merc pire 1250 oe le ewng cra ‘aoe rand wth Ar nome Thecanaas raglan abe ube pci ed Sts Rott (ere feo Testa ete ‘ean ead ey a tr 1 Foe gel tera Figise ‘neal ew of he malo onterir ett Fgsra Thee pasion of ecesoes cand pepe sraspof insur Fons ‘The coec postion oe practioner the camera, ondehe fash units nee used aint ‘hehe for stably ALTERNATIVE METHOD Fguss : Thsshot can brakeman Laem omer using a miror tien hone 29———~E&So”*—“" .. Photography in Dentistry —_ ae — VIEW I? Degree of ifculty:2 Peston ofthe paint: ‘ Backrest ofthe eaten cinco dees Fig) (ea el stig with hinted sigh Postion ofthe assistant: Senedak poston Figs tesa and ssh) © hiro eli teeta incontactwth the manu teth atan angle 6o degrees to temanly oc ane Peston of the practioner: ‘ lading a the cle poston (gs sand 25h) camera setings: ‘ Camel hriertaly 4 on (ince) om the oa point {© Magnan rao 2, apr (niin pet) ‘Fash unitsatthe 3 and ooce poston (Fig) Aiming point at the contact between centr incon foc pot ‘onthe plano thepngivaof theater incisors F590) "ype of retractor: Not aplicle Typeof minor: agefgueeiht-shaped nor ae Fg 600 Fala gertorand oleate spray | Figmsoo rep taped ior wie handle (Orn). Fig roc ange figure eght-shoped 280Intraoral Series ‘COMMENTS: this eit a the hat ‘neta Man bo mye eit Te Sty ores qi a ney the ran nd ng He no 8 Sgt sa) fom be tay cea fw gree 2 gd Mi ete fairest Ho sro ne ‘ep of rire cea ak Becigand uote adel sea {ectimri fot yPe be o ferme ne pe Ip fom ha rage Ser Sound sa mei atest (Ge figto bared hamash ‘Smtatttacn tao ipernged em tainapntisnay Pe ‘certo de had easy Decne aor Ra cone [rere htt ia ears ‘iba te lo papmdcur 0 fe fatal sho aan. he ae Beco tno ronan race ol ay ‘alin operet eeggel emma, Figen Thecorect position of cesses andpope graspof suet for ‘hepa er Fgmee ‘Thecoreet postin of the practioner the camera andthe fishies Fgsr-630 and n-630 This sha comb token nan (Gene! maner sing ao Shopadmivorwtha Rendle Maxillary Anterior Sextant: Palatal View 281Photography in Dentistry —___ VIEW 18 Degree of difficulty: 2 Pelton ete ater ade bem ha ded Bo ees 26) * edge Postion of the assistant: «Seated atthe 3clock poston Figs a and wa) «Chest etactr held inthe igh and cotrastr hel nthe Position ofthe practioner «Standing at the clot poston (gs 2-52 and 2 4b) Camera settings: «© Camera ed orzo g cr (16 nce) fo theo pot 2 Magnification rato 22; aperture (rium aperture) Fash unital the and god postions (Fig 640) Aiming point at the contact between cna nsx; focal point on the plano theater incisors wa) pe ofreractor Modi se retracting cheekrevacor Tipe of miro © Not applicable Fig mesa Salva get and ai-wte Spray. a 5 A Foes) ‘Se Shaped meta cnr Me). Figs. Diese bok crdowd ‘one nerve oe net . 4 Figo food Modied sa etracig chek aeIntraoral Series Maxillary Anterior Sextant: Facial View | ‘aint ret th mand ta de cto lh are ‘sur pismo lt fbcsan be ash basgourd at asd Seta prapon ope carers (it oh corse ab a {2's ayy ton to ese pa, ht ts petce mt mace on, ptf and pela ‘logue tat extra ed oud i al 9 al ore Figme6 lal view of the malar ater sxzant Figo ‘Thecoret poston of the acessories eld bye asta ‘Thedposoble black ardaar din curved postion ta revere ‘etecter, nich woul ne produce ‘uniform sock background fonen | Shetietesnen | | First Thesame image can beobained ea Spade shaped meta ‘AcTERNATIVE METHOD. | Fig sab | Theconec poston othe Practoner he comer, ond he Fash nts. 283Photography in Dentistry VIEW 19 Degre of dict: 5 Pasion ofthe patient «© Bares of the treatment char incned o degres (Figs) Head tum towar thepracine ih chin ed sight Position ofthe asistant: «Seated atthe 30 dok poston igs maa and ab) ¢ Rtactor eld inthe et hand with ane oad the patient's chin, miro eléin the ight and Pasion ofthe practitioner: «Standing at the7-'dok postion Figs Goad sh), camera settings: «Camere hry 0c 0 inches fo theca pait Marian ato: aperture inimum ape) «Fash units tthe and clack postions 26) « Aining pit onthe mean ne tthe lee the preolas fia ponton hela cf prem pape (50) Typeofrevactor 1 Modified strain cheek reactor ‘ypeof miro: Lage gue eight-shaped miror FZ — Sav Geto an aise spray Figure ihe-shopet ioe Fa Figure iaht-stoped miror wit andl Modified set-etrctng cheek retroto 284Intraoral Series Complete Mandibular Dentition: Occlusal View “ng is tt an be cmp ace Cle ay pots trae amet asa te grec seat he te brn ae od up race rod Fetoratte adh tin tama: Federman, wien be pte spe bo sth era) We, Be estat ay {Spee tn itn Be oe Ip storey doce ava tombe ‘tad mere sete ‘Sl anh ne pashobe td {et fe mae ecot mane 8 ‘hie Than ened a3 et {Fa he the rode eck ret fangs ch wth Panter ara ae Te shou puta pe Fouts re hema ‘ect anit ante ‘Senate oat oye tothe ‘arr esa par. re pai Foun ape a lew of the complete mandibular derion tec, te bide mi ‘oat apn he nh oe Beir me 2 te ptne s h ‘Sard im weeny Seo Reg, Palette tr poselheurgu “* > PP Fig ab The coc poston of eceszaresandraper Thecaec poskon fhe camera onthe grespof stamens ash ois, ALTERNATIVE METHOD 285Photography in Dentistry VIEW 20 ein ‘© Backrest of the treatment chair inlined o degrees (Fig 24a) Peston ofthe assistant: Seated atthe 31k poston (Festa 23nd 240) Reactor held inthe and wit handle twa the patie’ hin mir held inthe and Postion ofthe practtione: | Sanding athe pasion gsm a and) aera setigs: Cams torartaly 3 che fom tefl pit Magnfaten ator age (imum apse) Fass the and oc potions (ig) ‘Aang poe tte ints pap fal ont en the pane ‘fhe papa betwen he cela tera sors ga) Typeof reactor Modifieds eating check reactor Type of mor: Lage gue eight-shaped ior —T a a Fig rsa ‘Salva Geto andae-water prey Figs Figure aht-shoped miro. Fa mase Figure eghe-shoped mio with handle Fg rasa Motil sf etrecting chekrerctrIntraoral Series Mandibular Anterior Sextant: Incisal View on isnot eet ei ie ‘ksh mel ater xcs on {i cope md Geo. The hy taco be gent meson fae Te ir ay ved, ad Istckaim sahows oan amet 3) oyetonfemcur ccc ‘he inage Wi rece Pe oer fect cae e eae pe Iga rena Te eb, ae st ea lr me orne tie ch net eu raps 12 te act dbo nde a see ‘eects bow gs ms ‘evele ho aha a ood 25 eatpern he ty ‘e tae. ie tue aapd ‘ld nah Fh ot inane ed oh ot Slt pete he atone st ia wih als apa {fs hes Sabi Sean Faure Brains bef ote ety be Ine vew of the mandbular arteror stant. eee (ope ‘earn spay om tne an Fgnze Far ‘awa fee ghee te thes em cst The cect poston of ecessoresand proper The carecposkon ofthe camera andthe srspof instrament fashunts ven oe ih ptlos Wo he ‘ec eal Avrennarie MeTH00 Forsezeeantrsb Mesorconbeteninon | Lenco mare isrgamiet cheno 287Photography in Dentistry view 21 | Degree of dict: Peston ofthe patient ‘ Backes ofthe tatment chr inn wo degrees (Fg 278) Head ume tomar the practioner with chi ited Postion ofthe assistant ‘Seated at the 3a'ack poston (igs t27pand 27) ‘ Miro ell inthe ight hand constr bel inthe hand Position ofthe practioner ‘Standing at the ock poston igs12 73 and sb) Camera settings: ‘Camera hed hon 35cm (inches) fromthe focal pont ‘ Magnication tov aperture (imam peru) ‘Fash untsatthe}-and 9 o'eck postions Fig 7ac) ‘ Ain pt at the contac between te certains fap ‘nthe pare of te ppilae between tecertal and teal ncisrs Gens) pe ofetractor: Not aplcable pe of mir Lage gue eght-staped minor Fig oa Salo eetr and awe spy. AA Figo at bp sheer Roecoseant Seadoo! AM Be npc ptr | Poaceae ag a z 288EE EI Mandibular Anterior Sextant: Lingual View Sit may ven li ha, Feastounenvea sessed owe he eno mr ‘ee ed 2 pe ‘eh entno comrt ah ih ‘let ad sto en i ba Epseiicnoneeen cates Barth gat oer seh, ‘hohe ese nao oo {She a sho ay ovens bona ee fe pc ade ner apart th ce cet Sth fhe tion er ten e ‘tea ik mt eo a Fgmn Lal vew of the mandbular antrr sextont Figs ‘he cone postion of aceon and prope eas of struments, Fg mab The corer pston ofthe camera andthe fosh unis Fons | Th token nan deel manner sing mor Figisa3p Thespade-shaped etl contrastor en besisteatd forthe 289Photography in Dentistry VIEW 22 Degre of gmiuty: 2 Peston ofthe patient: «Backrest ofthe teatment charlie Eo ders Fig ta) Head tuned towar the practioner with hin ited Position ofthe assistant: Seated atthe sclck poston Figs ea and 28) Modi se reracing chek retractor heidi than east heldintherght and Position ofthe practitioner: Sandngat the 7clock poston gst and v8) Camera settings: Camera el harzontally 35 rm nhs) fo tha focal point Magnifcaton ato 5, apertutf)(rinimum petu) Fash nitsathe 3 and dock posts (Fig wc) Aiming point a thecotat between the ceralincso cl point nthe plane theater nso (Fg a) TWpe of retractor: Modified elf racing cheek reactor ‘ypeot minor: Not aplale o a a Ea ‘Shan setorandoewatr say Fig mes ‘Spade shoped metal convasor. ¥ Fig 2830 Fama Dispose back cardboard cotrastr Fag mast a Modis retracting cnekretroctr 290Figs tial vew of the mandbular anterior sextant Avrerwaive MeTHOD Intraoral Seri ies Mandibular Anterior Sextant: Facial View it oe ange oma ei the macogrgi in: sana vase (opel andeeteeeort # 2 depo ost cabo coma 4 tis prt ba sat ‘hode Sire tand te a aaa fo Ur at ign Te ope taro vg lee a ‘este hates a, Fansre Tecoret postion of accessories ‘and proper gas of struments. Fer theosistant suing he ‘Spateshepedconasior Fame Thecoret pos ef thecamero anathefiash nt gs -880 ond 88h TMs Shot cone be token tha posable lak eardoeard, cured leaden elas on 2mPhotographyin Dentistry VIEW 23 a2 Degree of dficuty: 3 Position ofthe patent: «Backes of thetreatment chain «Head tured toward the practioner Position ofthe asistant: «Stated atthe 3 oceck poston Figs «Reactor ein ght and itor ed in thee hand Postion ofthe practioner ‘Standing a thes dock poston (Figs 28a sh) camera setings © Camera ronal 37cm (inches frm thee pent © Magnification ato 18, aperture 2 (niimur aperture) Fash uns bysideat the 30'od Aiming pi at mes fos ofthe tm fcl pit on the Paneth pl als even rr) ‘ypeof retractor ‘© Reacr modified forthe madly right and mandibular let sextant Typeof minor: ‘Bean shaped mor, ropshaped end Sr = eo degre igi) 8 ant 838) postion (Fg 2850) the sean pela fist <= —< Fargo Sohusaeeterond eewoer spay Fg sob Ber shaped minor Figo Fevactr mdiedfor the mailary "heand manila estosMaxillary Right Posterior Sextant: Occlusal View Intraoral Series Fim ft view ofthe maxillary right posterior secant Xe) Fousa “ a \ Figsib "Theconee postion and propergaspofthe Theoret poston thecomera nde 4 ME > * fash ut ee EI hs ss ler ue a at thongs may rg tml stra 2 ad Sins oe. Trina ah nine eo wg ob it dormers {ein of et 8 apes tr Hal ae ii gel ek pez ig: ii Ft rigregya Cre prson adap resp ‘erect’ ond mor Teche ‘actor spostined wth ee ofeeimacnng tei aa ‘mmisre he maded ee near theincsos, sseetched two Fons ‘Theconmecefg of te dep shaped ndofthe mies tued ouats heen 293Photography in Dentistry —_ = 7 —— VIEW 24 Degree of dit: 3 Peston ofthe patient: ‘ Bast ofthe teatment chained lo degres (Fig ta) Head ol straight, looking dec aheaé Postion ofthe assistant Seated tthe 20 ck postin (gs sia and wat) ‘Retractor ein ight hang: mir hein thet and Poston ofthe practioner Stang a te ck poston igs ten and) Camera stings: «Cameras hora 37m (4 ines othe oc poi agafcton ato 8 aperture rin ape) shots sie deat he do tion ig) © Amina fal pointsat the meslngual gto a thet mtr Fensi Type retractor: ‘Reactor modified forthe maslny right and mandibular eft stats Typeof mor: © Bean taped mint op-staged end © Fgosso _—_ Sthneectarendarvate sae s Fors) ‘ear opain Farsse Hovhereacor mods the sila and mand sears TE 294— Intraoral Series Maxillary Right Posterior Sextant: Palatal View as. ioe ad gem nie I sss sce 2s a ee Sipeccareed Snwesres Socernegiis coca Hipshiteerecer Sonera tees Serene See Sign co 8 = ‘Me gosto te rire i sit ow 23 bt cme eee {eta spe ea Chek ho crear ee btn no isa he mre wt bn ens an re gel he (rainy te enw ea ew rie 2 en he 1 poeta pt eet ‘eee fee ak Thor Sud Fe deed wut ages othe Faas ‘esol vw ard Se 10 eages Palatal ev of the madly at poster sera. yk bg se eth ‘Stl he he mrt potions a 5 oc) mpl ah re Sh ot veel ‘Sinope tenga oe Pestonlb cans ata Be I Posnetek Figrsra Fiona ‘Thecoret postion ond prope gaspofthe The covet postion othe camer onde rector andro. fash unis de te mirorstamedtoverd ‘hepalte andthe minors nelned ‘uaa temaor Tego the > ‘cbmusbetweenthemmerstagends | 'spostionevetuen te convaltea ‘aninandfis prema a angus Satiears eatas| a; Sonecmemet } poeta ~— aes on : ry roe ee cee teereptPhotography in Dentistry —_ VIEW 25 [cep eau Peston of he pate: « Bakes.of te trestnent cance odes 2-93) © Weadhelé rag wih hin te sight okng decane Pasion ofthe assistant Seated atthe j'dok positon (Figs sgaand 40) «Reactor eld nthe fan minor hl the gh hand Position ofthe practitioner: «slanting atthe dock postion gs n-g2and 2-38) Camera stings «Camera hanna 3.0m ince othe point Nagin at apse rin apse) shuns sey se atte po dok postion m9) fining git tes sa the rt ma, foal pat 0 the pan the gal ila eves the Sere pel an it od Fg 2550) “pect evacoe Retator modi forthe malay ght ané mandibular et senanis ‘ype of miro Bean shaped miro, ropstapd nt ee Figr2000 ‘Sah ecto and arate spray Fg ced seer shaped mina Fgrsrooe = Reractor odie fo te mxiary ‘ight ond mondo fear 296else vw of the mendbuler ef postr stant The cae postion and proper ras ofthe or fo The coc postion ofthe cameaand he fs - Intraoral Series Mandibular Left Posterior Sextant: Occlusal View ‘tyre oa sry are ru athe pt ko Be Sr say ope ete ey Pls macs bak oe ra, ‘hoy teeth ele enrol soc Figre1030 Thecheck stators positioned th he itat ge fe wing ‘tthe et bol commie the ‘modified edge, nertre andlor Ics, stretched outwar Figtsonb Theconecaige ofthe Atop-shopedend oft miris ‘me oword the chee, 297Photography in Dentistry — VIEW 26 Degree of dificult: ¢ Prsition ofthe patient Head tuned toma the pracinar Position ofthe asistnt: «Seated at the dock poston Figs «Retractor eld inthe Rainer Peston ofthe practioner Camera setings: gras) Type of retractor: stants Wpe of minor: © Ber-shapd mir, dimp-saped end oe = 298 «© Bact of the ueatment cir incined Bo degres (Fig 2043) «Standing at the7-'dok postion (Figs 2togzand 204) «© Cameaheld horionaly 3 (4 inches rom the focal peint 2 Magnifcation tio aperture 2 (rinimum aperture) «Fash nts sieby sid atthe gcd poston Figr3040) Aiming and focal pots atthe mesa fosa of the fist malar ‘eRetacor modified fr the mally sight and mandibular et raya and woah) eld inthe ght hard Figran050 Sahu eran irate spray. Figiaosb Baa shaped minor Fgiose état modified forthe maxilary right and mandibular lef stantsIntraoral Series Mandibular Left Posterior Sextant: Lingual View Tn ‘ase eae vw tac ‘eects hd a Be sae ‘muta oa tinine sar rte itn othr er ers ‘por sno eee et (SS ommeave tse it (Etec Ipc god vin {Fhe ae a,b ec ou oe ‘Sea on fame, Oe et Fare mrs ret ‘enabled hater Sas dp apd oir ‘er he ol tT sae Fign06 ing vew of the mendiulr ft posteror secant. ¥ ‘ate te bese ke Fg sore Fg07b Theconetpostinndproperavspofthe Theconet postin of theca andthe sh rmecterand ior mis goose Trechekewactr spatial ith hemaaidegee he wing ate é —— wrt ‘etlabol cammissr the mac ec, texte nso Sree —o cate Foret ‘econ fee eden shaped ‘wife ste tote french ad eee . . ‘tind hermosa en Ispastenedberwem ieconlten! Canine afro 299Photography in Dentistry VIEW 27 Degree offic: 3 Postion ofthe patient: ‘ Badest ofthe eatment car inne Bo dees (Fg 298) Head el straight, ooking det ahead Position oftheassstant Seated atthe dak postion Figs 28a 209) Reactor eldin tele had miro ld intherght and Pasion ofthe practioner: Standing athe cock poston Figs waosa ad 03) Camera stings: «Camera ronal 37cm inches) fom the focal point 2 Magaifcation ato v8 aperture fina aperture) «© ashunits ie by sida te. dork postion gm 059) ing pon at mesial fsa ofthe fst mola, fa aint onthe Fae ofthe ging ppila between the second premolar and rst roar go) Type of retractor: ‘eRevacor modified forthe maxily lt and mandibular ight sevtants Type of miro: ‘ Beanshaped min, cop shaped end © Fignn00 Sain detorand ai-ote spay. Fgunop Bear shaped miro Figunee Ratrator modifies forte manly ft ond mondbulor ight sean_ Intraoral series Maxillary Left Posterior Sextant: Occlusal View Ws et au te thee he on wn Sr ter nade the ‘ny an ens ss $s co Ha eng Pk ppg ton a tara Wh ‘SErncong tt eno cess tain re pees gan Ihe mitre bt a fig Cll vw ofthe aia poser sean. Store caaldremt nae rm meee siege antes te a. Suacanen tK Eerenaueerraees roe re | Ret psn inreeeceaa eee a = | . ae 4 eared tacit ae foci eecrrnaiy tow Me ceaictmtomt | erent eras b > 3aPhotography in Dentistry —_ = VIEW 28 Degree of ficult: 3 Position ofthe patent: ‘ Bate ofthe eau char inn Bo dees (Fe Ma) «Hea nme toma the prcitoner Position ofthe assistant «Seated atthe 12-'cockpston Figs ea and sb) © Rtactr eld theft han mire inthe ght Rand Poston ofthe racttione: | Standing atthe cock postion (Figs ua and at) camera setings: 2 Camera orortaly 3m (us inches rom thecal pot Magica ratio. aperture rnin aperture) Flash unt sidey side at the tcl pston Fg 240) Aiming an focal pins the mescngual groove heist molar gnu) Typeofretractor ‘Reactor modified forthe masily lt and mandbubr right sevtants Typeof mito: ‘ Ben-staped mir ro-shaped nd ease Fars Sal deter ond irate spray 2 Fg asp : eon stoped min guense Retrctr modified fr ehe moxiary ie andmandbula gt secantFagus Palotl view ofthe macifry et posterior secant Fauanye gum iS ‘Thecoret poston and proper grasp ofthe Tecan pstionf thecomer onthe ie/ ash oni, Intraoral Series Maxillary Left Posterior Sextant: Palatal View [enodiit mdagront ots is Sharma re cece anal | ‘mc i go wr aa Tero pene ther more {on tl ie Pio po he ste oee Seve een om grr ng aire ea he ta (a eat be eh fot pnie ‘bal 1 cages ay tm re 2s te ah tal ha Yo et ‘Srl al a br a porstfon ‘ig-nsathecheckeractoris Dastianed wit eine edge ea the mandouar ness the Inodied edge fre wing at he (abel emma atte Fag tzn0Tecomeceige ofthe topshopesenso heirs {med toward the plate The edge atthe narowest parts posed Ceween hectare canine andthe fis penta 303Photography in Dentistry VIEW 29 Degree fica: ¢ Postion ofthe patient ‘Bake ofthe tauren chained Bo depres Fg 1293) Head straight, che sigh fe, king dey ahead Assistant's postion: Seated atthe doc postion gs nga and 9) ‘eRetactoreldintheight hand mor hein the eft and Position ofthe practitioner: « tandngat the cock postion (Figs aga and wash) Camera settigs: ‘Caer elhoraoraly 3 on (inchs fom tec pit Manito ati aperture (rinmum apart) (Fash nts sdby ite at the poston Fg 280) © fing pata esl sa othefist ofa itn the plane oe gga papa between te second preolar ants. rok gel). TWpe ofetractor: ‘Retractor maf forthe mary and manda ight sevtants ‘ype of mor: ‘ Beashaped min, op shaped end Se a a . es Figen saliva gectorand ie weter Ep ray Fg tab Ban shape ior a Figrmoe Rector nets forthe ailny let and mandibular ae 304 Figw98: — Intraoral Series Mandibular Right Posterior Sextant: Occlusal View ‘ele ove vr 28 cae he cms res se fe Se, Fig wan (Ceca vew of the mandibular ia posterior secant wm ~< ~ Fig m0 Fg amb ‘Thecaec postion ond proper graspofthe The arc paskon of thecamerasnd he reretorend mira fashunts: | Fignase ‘Thecheck tates posioned wien the ntortedgeat oe rare . lob comissre the modfied geo te wing, ear che Imondeular nes este Fgnans Thecomecedgeofthedrop-shped | endef the mimo tumed oust “ i heceet 305Photography in Dentistry VIEW 30 Degree of ict: ¢ Postion ofthe pant: ‘Bacest of thetreatment tance depres (Fg ea) Head stag, ooking recy ahead Assitant’spostion: Sete atthe w-o'ock postin (gs ayaa 24) 2 Retactr held nthe hand ior in thee hand | Postion ofthe practioner |e stantingat the cock poston Figs 21jaand wad) camera settings: ‘Camera ld renal 37cm (inches) rom the fc point |e Magicaton ation aperture ini aperture) {Tash nis ide y side athe 0 dock poston Fig) ‘Aiming and fc points atthe mesa fos ofthe fs molar (ena) Typeof retractor: "Relator rade forthe maxi lt and mandbuar night sertants Typeof min: ‘ Bean-stapd mina op-shaped end Fgneaso Sshunqetorandiewate spay rignap Bau shaped mio Fig asase Raractor modied fr the malay et fndmandbl righ secant - —Fons Lingual view ofthe mandir ght posterior secant. Fgmzs ‘recone potion and propergrasp othe racer andi Fig Ter ion teed eh a Intraoral Series Mandibular Right Posterior Sextant: Lingual View prorated ete asaramaa Fig ata Te cekretacris (ne wh thea eof hewing nar te mary es themodfededge ot tena cil ‘onmisuriseetches ower. Fgne-ush Teconvenedget tne topshapdendof the mire tured tore foro he nth ond [cee otthenanowet arts rere the colt canine nd fistpemotr 37 |Chapter 13 Photographic DocumentationPhotography in Dentistry —‘he various dental disciplines have specific Gocumentary requirements; for this reason, ic is not always necessary to record every view presented in chapters 11 and 12. For example, documentation of orthodontic cases does not require multiple images of the posterior regions of the mouth; similarly, documentation of a periodontal patient does not require occlusal views of the posterior teeth, Only certain scientific societies or academies [publish guidelines regarding photographic doc ‘umentation, Forexample, inits2007 guidelines, ‘the Accademia Italiana di Conservativa listed a specific set of photographs forall presentations: © Pretreatment: frontal lateral, and cechusal © Specific area to be treated, with and without rubberdam Sequential steps of tooth preparation © Operative stages of reconstruction, according to ‘the typeof technique «© Completed and polished restoration with rubber dam, highlighting the comect integration of ‘the restorations with the marginal tissues Ieis clear that there are no well-defined crite- 1a for either the number ortype of photographs necessary for a presentation, so this situation remains vague and subject to interpretation, ‘However, recommendations exist for standard ized, repeatable documentation for each of the ‘most common dental disciplines. The suggested photographic documentation is not identical to that needed to comply with specific academies or scientific societies, but it may prove useful Photographic Documentation {in creating personal photographic files, com- plete with the practitioner's own clinical cases. ‘Among the dental disciplines, prosthetic den- tistryis likely the one that requires the greatest ‘number of images. In fact, correct documen- tation of full-mouth rehabilitation requires all extraoral and intraoral shots previously de- scribed, Furthermore, it may also be necessary ‘to document details considered significant dur ng the operative stages of treatment; these im: ages will only difer from the pretreatment se- ries in the greater magnification ratio required, Orthodontic Documentation ‘The orthodontic image series is undoubtedly the simplest to accomplish, and itis for this reason thatorthodontistsprobably document theirclinical ‘cases the most often. ‘There are 1g photographs required for correct ‘orthodontic documentation: Extraoral views Frontal face, smiling and with ips elaxed « Right profile, smiling and with lipsrelaxed Leftprofile, smiling and with lips vlaxed Three-quarter profile, smiling Intraoral views (Fig 333) fe Rightandleftoverjet fe Fullarches in occlusion «Right quadrants in occlusion, f Left quadrants in exclusion © Complete maxilary dentition, occlusal view © Complete mandibular dentition, occlusal view anPhotography in Dentistry ORTHODONTIC wa 0 PBR oe a See arr derto, ochsa vew Fan [ee Fanad ER aaron i ocuson ororttoumic documento. Fane Fi Bethesn anol ocduion Fans Gita noes foroadoe docmeration a EGR Rovonsinoctson Fgh opie mandibular dentition, cclusal view. Ears inconpo _____ Photographic Documentation 3BPhotographiy in DentistryPeriodontal Documentation Photography of periodontal patients can be diverse. Presenters at medical conferences of- ten demonstrate therapeutic steps with pho- tographs of the tissues rather than the teeth because the tissues reveal more information about the patient's periodontal status. For example, mucogingival therapy is often documented with buccal views of the posterior quadrants in which the aiming point is moved. toward the mulcogingival line because this is the anatomical landmark of significance in as- sessing the final result. These images have not been included in chapter 22, but the positions of the patient, assistant, and practitioner are {dentical; only the aiming point varies. The fol lowing views should be recorded before and af- ‘er treatment Extraoral views ‘e Frontal face, smiling and with lips relaxed ‘© Right profile, smiling ana with lips relaxed Left profile, smiling and with lips relaxed e Right lateral smile Leftlateral smile fe Slight, average, and maximum smiles Photographic Documentation Intraoral views (Fig 132) « Fullarches in occlusion Anterior sextants in occlusion ‘e Right quadrants in occlusion «Left quadrants in occlusion ‘© Complete maxillary dentition, occlusal view Complete mandibular dentition, occlusal © Maxillary right posterior sextant, palatal «© Maxillary anterior sextant, palatal view © Maxillary left posterior sextant, palatal © Mandibular left posterior sextant, lingual © Mandibular anterior sextant, lingual view © Mandibular right posterior sextant, lingual This set of images is also appropriate for doc- ‘umentation of oral hygiene status by the hy- gienist, a5Photography in Dentistry —_ PERIODONTAL EF repr sue pla viee {Fathom sere, alow ‘aha roster setat pelt Te Famersetonsinacson At sarsnnomalotosn TR P2hersexnsnecson arbor gn poze sean rgulon ‘eebioraneor seat, haul ew ‘Meridor poser seat, ingle. Figs Figtyad 316Figs Fig Photographic Documentation 37Photographiy in Dentistry 38Prosthetic Documentation 4s previously mentioned, correct documentation of prosthetic rehabilitation requires the complete set of extraoral and intraoral images. Ie is important to record any teatment previously completed by other dentists or specialists when documenting planned permanent prostheses, ‘This includes implant placement, endodontic therapy, periodontal therapy, and orthodontic ‘teatment. Furthermore, good documentation requires a complete set of photographs because information regarding every aspect of the tooth surface s necessary. Im addition to pre- and posttreatment images, photographs against a background that provides significant contrast are recommended te highlight ‘thenuances of surface color and texture, especially in anterior regions with high esthetic value. A black background best distinguishes the details both ofthe teth and the soft tissue, The following complete set of images is recommended: Extraoral views Frontal face, smiling and with lips relaxed o Right profil, smiling and with lips relaxed © Left profile, smiling and with lips relaxed > Right lateral smile » Left ateral smile e Slight, average, and maximum smiles Intraoral views (Fig 333) Right and let overjet Fullarches in occlusion Anterior sextants in occlusion Right quadrants in occlusion ‘Left quadrants in occlusion Complete maxillary dentition, occlusal view ‘© Complete mandibular dentition, occlusal view Maxillary right posterior sextant, occlusal view Maxillary right posterior sextant, palatal view ‘Maxillary anterior sextant, facial view © Maxillary anterior sextant, incisal view ‘Maaillary anterior sextant, palatal view Maxillary left posterior sextant, occlusal view ‘Maxillary left posterior sextant, palatal view ‘Mandibular left posterior sextant, occlusal view ‘Mandibular left posterior sextant, lingual view ‘Mandibular anterior sextant, facial view Photographic Documentation © Mandibular anterior sextant, incisal view ‘Mandibular anterior sextant, lingual view Mandibular tight postetior sextant, occlusal ‘© Mandibular right posterior sextant, lingual Conservative Dentistry Documentation Thislist of required images very similarto those listed for prosthetic patients. Because both direct and indirect restorations, such as inlays, may be laced, it is always necessary to document the patient's condition before and after treatment, ‘The required photos are: Extraoral views ‘ Frontal face, smiling and with lips relaxed ® Right profile, smiling and with lips relaxed Left profile, smiling and with lips relaxed Right lateral smile Loft lateral smile e Slight, average, and maximum smiles Intraoral views ‘e Right and left overjet Full arches in occlusion o Anterior sextants in occlusion Right quadrants in occiusion Left quadrants in occlusion ‘Complete maxillary dentition, occlusal view «Complete mandibular dentition, occlusal view ‘© Manillary right posterior sextant, occlusal view ‘© Maxillary right posterior sextant, palatal view © Maxillary anterior sextant, facial view © Maxillary anterior sextant, incisal view © Maxillary anterior sextant, palatal view ‘Maxillary left poseror sextant, occlusal view © Maxillary left posterior sextant, palatal view ‘Mandibular left posterior sextant, occlusal view Mandibular left posterior sextant, lingual © Mandibular anterior sextant, facial view ‘Mandibular anterior sextant, incisal view ‘© Mandibular anterior sextant, lingual view Mandibular tightposteriorsextant, occlusal view Mandibular right posterior sextant, Ungual view 39Photography in Dentistry —_ PROSTHETIC 30 Fgnab Finan Righter Fas ety otros flew Fig wae ‘Minibar anterior etn fcial view Fg 3d tecaceet emanation ccs pie molarydertn,cccusl ew. ae Fans Fes a normal ocsion 133 ie maureen, sav Fash ‘along posterior sextan, cls view. gua! asi ater secant view Fang ‘eit left postr sextant, ous view Font ribulr oh posterior sextant, ous rear amet sean navi Fi ‘anil pester serar, cls vw. Fan______ Photographic DocumentationPhotography in Dentistry PROSTHETIC Fg trite poster sean, palta vow Fans ‘esi omer sean plata vw waaay iy et peste sean, palatal ow OR Psi sears inceuson Fas ‘Rote sesamin normal oc. Fans ER Reno sotonsinccsion Fons ‘antbaright posterior sent, ngul vw 133 ear omer sextant, gua ew Figs ‘Manabe posterior erat, nga view. Fign-an Figo m2— ________ Photographic Documentation Figra30 Figo BBPhotography in Dentistry — Photographing with rubber dam m documenting the operative phases of conser- ‘ative dental treatment, itis necessary to pho- tograph with correctly applied rubber dam, itis much easier to take photographs, with or ‘without mirror, with rubber dam in place, be cause itis nt necessary to use cheek retractors, nor is there any possibility of Interference from. the tongue. The operative field is dry, and the rubber dam material provides a uniform back: ‘ground, However, certain precautions must be taken, First, the clamp used must be intact, preferably new, without any signs of wear or, ‘worse stil, adhesive residues. ‘As noted in chapter 8, the rubber dam clamp can create reflections, which interfere with the functioning of the exposure meter, making the through-the-lens (TTL) function unusable. ‘To circumvent this problem, the clamp can be ‘made opaque with alrborne-particle abrasion, or the flash can be set on manual mode. ‘The use of blue- or green-colored dam sheets fs recommended because they do not create vi sual distractions in the photographs. Its also important to ensure that the dam is reflected into the gingival sulcus to completely isolate the operative field {rom oral fluids; moreover, the dam must be taut, without any creases, Following application procedures, a thin adhesive film may remain, which can create ‘a very unpleasant effect if not completely re ‘moved, It is advisable to remove any such resi- ‘dues before polymerization, because afterwards {twill be dificult to remove the adhesive. tcan. ‘beremoved witha small amount of cotton wool with rubbing alcohol; great caze should be take en not to contaminate the prepared tooth sur- faces, Alcohol is a solvent for some adhesives, Be and contact could prove harmful tothe quality fof the adhesion ofthe restoration. ‘The number and type of photographs to cor- rectly describe operative procedures is a sub- ject of debate, The author suggests showing teach operative phase, as ifevery shot isa single frame in the lm of the entire procedure; how- ever, for efficiency, it is a good idea to select only the most relevant steps (Fig 134). The fol- lowing photographic sequence is suggested for a Class: composite restoration: pretreatment, prior to application of rubber dam Pretreatment, after application of rubber dam » Removal of previous restoration ‘Tooth preparation pplication of etchant to the enamel sur- faces » Application of etchant to the dentinal sur- faces » Application of the adhesive «© Application of flowable composite resin ‘© Dentinal buildup with composite resin » Enamel buildup with composite resin, » Occlusal fissure staining e Posttreatment, after rubber dam removal and occlusal fishing and polishing “Tis list of proposed shots represents standard documentation, which is more than adequate for detailed medicolegal purposes, but might prove insufficient in the scope of a conservative dental treatment plan. In summary, the deci sion of how many and which photographs to take to document the treatment of a patient is always dependent on the final aim of the prac titioner. |ener, ri tooppaton of ‘bercam. 7 Fiona wea Pretectment oft application of era Fig ac Removal of previous restoration. Fig ed ‘oath preparation. Figre4e Sein ofecan thee i Bln etchant othe dein Fon ‘Aledo ofthe oesive. Marlton of powalecenposte Fig Banta buildup wit composite ie tate tap wt compose resin. a (eta fissure sting, Final Frente uber dam removal ord ous figing and paehing Photographic Documentation BSPhotography in Dentistry Communication with the Dental Laboratory Technician, Correct communication and a good relationship ‘with the dental laboratory technician is an es sential and complex aspect of modern dentistry, It is not advisable to discount this elationship, because the success of prosthetic therapy is dependent on teamwork. Communication be- ‘ween the dentist and the laboratory technician {sof fandamental importance when attempting to imitate what nature has created as faithfully as possible ‘To accurately reproduce the natural harmony of teeth and their supporting tissues, itis imper ative to provide the technician with the greatest amount of data possible, not only of a strictly dental nature (hue, chtoma, value, wanslu- cency, and characteristics concerning the sur. face structure), but also those aspects relating to facial expression, harmony, and faclal type, ‘The dental techniclan must be able to faithfully reconstruct, With the aid of photographs, the ‘context in which the teeth are situated and to ‘estore dental harmony in every dimension, ‘Because images have a communicative power that is extremely useful, itis advisable to pro vide the technician with several photographs uring the course of treatment, ideally, the patient should visit the laboratory, so that the technician can personally examine the various aspects of tooth color, but often this is not pos- sible because ofthe distance involved, 36 Alternatively, a video can be sent to the tech- nician, not for a correct interpretation of colo, Dut to’ highlight facial expressions, lip move- ‘ments, and the exposure of teeth and gingiva. A video provides a more realistic and dynamic source of three-dimensional information re- garding functioning; itis not static like a photo- ‘graph, although these remain indispensable. It fs desirable that the dentist and the technician ‘should work together toward the selection of the color, adopting a shared procedure, Moreover, the ambient illumination during shade selec- ton should be neutral, without any chromatic dominants present. Currently, new equipment for the acquisition of color data is being introduced, using ground- breaking instruments such as reflection spectro- photometers. The Spectrashade (Medical High ‘Technologies) is one such instrument; it has been specifically designed for the dental field and accurately measures the hue, chroma, and value of teeth and full-coverage restorations. AS discussed in chapter 3, the two methodologies, photography and spectrophotometry, should be considered complementary; the spectrophotom: eter takes precise measurements for shade selec- tion, while photography is used to obtain and ‘uansmit information about a tooth’s general shape and surface characteristics (Fig 13). Itis especially advantageous to take photographs, ‘with color references, at the beginning of the ‘dental appointment to avoid altering the exact ‘perception of color from tooth dehydration dur- ‘ng dental procedures,fees Photographic Documentation os ‘The porn Bava rao F ah aay Eterm restoraon 4 Foust Fant Fast andy sh SSrditdmenod of Staaaidmethodof Aer tar stu of photographs, the labora Sate secon ‘rome! shageselecon, tet cet apes! Frconstvcton of the toth sac Fonsi Fas st ‘nedstrbucon ofeolorordotal The specroshade Spetroshade store performs comple {Bhrmapeg camecredbyine Mean bravo te dial color mapping. Specoshadespectroptomeer 3B?Recommended Reading ‘AHMAD Digital dental photography. Part: An overview Br Dent) 2008 206:403-47 |AHIIAD Digital dental photography. Part 2 Purposes and uses, Br Det 2009:206'459-¢6, ‘AKIMAD |. Digital dental photography Pat: Principles iptal photgropy Dent 2009206'S0-523 ‘AHMAD |, Digital dental photography. Par ¢ Choosing a camer. Br Den 2009;206 95-5. AHMAD. Digital dental photography. Ports: ghtng. Dent 20082071338. AHMAD |, Digital dental photography, Par6: Came settings. Br Dent 200920763-63, ‘ANIMAD |, Digital dental photography. Part: Extro-aal set-ups. Br Det 2003:207703-70, AHMAD |, Digital dental photograpy. Part intron set-ups. Br Den 009320705152 ‘ENGEL Digital photography nthe dental practice An overview (I). nt Comput Dent 00031282 BENGELW. Mastering Digital Dental Photography. Chicago: Quintessence, 2006. NZ, Digital photography: Exposures, eng images, and presentation, int) Comput Den 2003 299-281 ‘BOWERS Cit, JOHANSEN A. Photographic evidence protocol: Te use oft imaging methods to rectangular Astorton ond creat lifesize reproductions of bite mark edenc.jFresieSc 20024778185, (CHRISTENSEN Gl Important clinical uses for digital photography. JA Der Assoc 005:9677-7, \CHUS) Cina steps to predictable color management in aestheticrestortve dent. Dent ln NorthAm 2007S473-485 (CHU), DEVIGUSA, RADE P, MELESZKO A), The Fundamentals of Color Shade Matching ond Communication in Esthetic Dentistry eda. Chicago Quincessence, 20, (CHUMAN TA, HUIMMEL SK, BOKMEVER 7). Evaluation of working distances at a3 reproduction rato for sven popular _35-rm dental camera ystems. |Prsthadort938:791-93. (CLARK EB, The Clark tooth color system. Parts and I, Dent Mag Oral Top exon 245-28 ELTERA, CANIKLIOGLU 8, DEGERS, OZEN). The elobilty ogi cameras for color sleton. in Postado 20058: 438-440. 329Photography in Dentistry [REEHECL. Photography in dentistry: Equipment ond tehnique. Dent lin North An 988273-75 CcoLDSTEIN M8. Digital photography: Make your iftine. Dent Tay 2009285) CoLDSTEIN Mo, Distl photography and your laboratory Den Tod 2008 7(8)0 922% GOLDSTEIN Me, YOUNG, BERGMANN R gta photography. Compend Corn uc De 200324 6054-268270-m2 CORDON aMANDERP Techniques fr dental photography. Det) 98762307-86. GRIF 30 Exclencein photography: Helghtening dentist crams communication. Det Tay 20092872447 HAAK R SCHIRRAC. Dental photography in support of patient documentation and communication. Quintessence int 2000,31849-65. HUFFKD. Photography: An integral component of oa cance screening. Dent Today 2003328(9)709, HUTCHINSON |, WILLIAMS P iat cameras. Br} Orthod 9926326-30 {AR FD: RUSSELLIND, MOSS BW. The ws fatal Imaging for colour matching and communication in restorative dentistry. r Dent 20057993448. KATAOKAS, NISHIMURAY, Nature's Morphology. Cicag Quintessence, 2002, {L0P OR Technica. ysis of clinical digital photographs.) Calf Dent Assoc 20093799206. LoMBARDIRE. The principe of visuel perception and their clinical application to denture esthetics.) Poster Dent 19732935882 _MAGIIEPBELSER U, Bonded Porcelain Restorations inthe Anterior Denton: A Biomimetic Approach. cricagc (Quintessence, 2002 [MASSIRON 0, PASCETTAR, ROMEO. Prcsion in Dental Esthetics: lnical Procedures, Chcogo: Quintessence, 2005 MCLAREN EA, CULPL. WHITES. The evolution of digital dentistry and the digital dental team. Det Today 200827(0) 7246-17 [MCLAREN A, TERRY.DA. Photography in dentistry. Calif Den Asc 200129735-742. _MIVASAKI A Photography ensures beter lab communications, beter restorations. Dent Tay 200170! 36-58 _MUIAP The Fur Dimensional Toth Clo Sytem. chicegoQuitessen 38 [MUNSELLAM, The Mune Bookof olor. Bato: uns 3 APPEL ELip retractor for occlusal photography. | lin Orted 99630538,Recommended Reading PERETZ 8, KAFFE|, AMIR. Digtl images obtained witha digital camera are not essocated with loss fetal Information preliminary study. Br Dent] 2005206), POLAN MA Digital imaging: t's easier than you think. Dent Today 200120(4)208-nosi-05 PRAPAYASATOKS, JANHOM A, VEROCHANA K, PRAMOJANEE 5, Digital camera resolution and proximal cries detection, Deneamaxilofc Radiol 200635 53-2597. RUIZ). Asstematc approach to dent-fcial smile evelution using digal photography and enew photographic view. Dene Today 200625) 82-85 ‘SCHROPP Shade matching asisted by ital photography and computer softwar.) Pasthodont 200958 235-2. SHARLAND {AR Aa update on gta photagrapy forthe general dental practioner Dent Updote20085:38-4oo,s00-404 'SHARLAND MR. Digital imaging forthe general dental pracitoner1. Geting started Dent Update 200433265 ssb.por2 HARLAND MR, BURKE. MCHUGH S, WALASLEYAD. Us of dental photography by general dentelpactiioners in ‘Great Britain, Dent Update 2004;31999-202 SHOREY R, MOORE KE. Clinical digital photography today: nepal to effiient dental communications. Caf Cent Assee 2009:5.05-17 ‘SHOREYR MOORE K clinical gia photography: Implementation of clinical photography for everyoy race) Calif Dent assoc 2009.37179-83. “SNOWSR, Assessing and achieving accuracy ndgital dental photography.) Calf Dent Assac20093785-3. SNOWSR, Dental photography systems: Requited features for equipment election. Compend Contin Educ Det 200s.a6 900-ODTHH. SNOWSR Repeatale lgnment—Part: Consistent madl transfer record accuracy. Pct rced eset Den 2003587 8. ‘NOWSR.Repeatabealignment—Part I: Consistent photographic algnment accuracy. Prat Paced Aesthet Dent DOORS SSS? SPROUL RC Color matching in dentist |. The thee dimensional nature of coor.) Prosthet Cen ri:a6-424 SPROULLRC Color matching in dentist: Practical appliations of the organization of colt Prosthet Den wr.29s96-56 ‘STUMPELL 3D. Simplifying the correction of the digital imagen shade communication.) Prosthet Dent 04,98208-203 SIFTER, QUROZ L, HALLSA. An introduction to ctncal dental photography. Quintessence it 98718 859-355. TERRY DA, SNOW SR, MCLAREN EA. Contemporary dental photography: Selection and application. Compend Contin Educ Dent 2008 29:32-436.438.440-442.Photographiyin Dentistry [UBASSY 6. Shape and Color: The Key to Successful Ceramic Restorations Beli: Quintessence, 993. WAKOH , KUROYANAGIK. Digital imoging madlites fr dental practice. Bl Toyo Dent Cll2or42.- WANDER PA The applications of photography in general practic. 6 Dent) 1987762795-201 WANDER ®, GORDOW P.Seting up: Euipment, ightng and acessories Br Det /1g67162:268-280. WANDER , GORDON P.Specific applications of dental photography. 6rDent987762385-405. WEISGOLDAS. depends on when you take th picture Int) Pridontis Restorative Cer 20092524 \WINTERR. Visualizing the natural dettion.jthet Dent 335100517 2YMANP ETIENNE JW. Recording and communicating shade with digital photography: Concepts and considerations. rac Proced Aesthet Dent 200234 49513.Image Credits {All the photographs in Part 1 were taken by the author, Dr Pasquale Lofacono, and published ‘with kind permission, with the exception of Figs 17a and 17>, courtesy of Dr Mauzo Cabiddu, and Fig2-19, with kind permission of Dr Domenico Massiroa ‘The photos in Part 2 were taken by the author, DrLuca Pascolett, except forthe chapter 10 opener image (p 222) and Figs 10-1 010-7 and 0-9; the chapter n opener image (p 236) and Figs 114 to11-6, n-aab, 113b, 2-14), and 11-17; the images related tothe positions and accessories in chapter 12; and that in chapter x3n page 310 were taken by the photographer Alberto Quoco and kindly conceded.