ORTHODONTIC

PHOTOGRAPHY
By:
Dr.Hiba Abdullah
1ST PG
DEPT.OF ORTHODONTICS
 CONTENTS

• INTRODUCTION

• HISTORY OF PHOTOGRAPHY IN ORTHODONTICS

• IMPORTANCE OF PHOTOGRAPHY IN ORTHODONTICS

• ALL ABOUT DIGITAL PHOTOGRAPHY

• CAMERA

• LENS

• DIGITAL PHOTOGRAPHY (CLINICAL SCENARIO)

• PHOTOGRAPHY LIGHTINGS

• ORTHODONTIC PEARLS

• CONCLUSION
 INTRODUCTION
• It is often stated that Photography is the magic by which light is transformed in
colour, space and time
• The three facets of the visual experience:
• colour : a three dimensional entity consisting of hue, value, chroma
• space : defines the depth, transparency, size, shape/form and texture
• time: indicates movement, flicker, fluctuation and glitter
 • Today, photography is omnipresent in every sphere of human activity right from
research work to entertainment and from documentation to creating stunning
pictorial work of art.

• With reference to medicine and dentistry, photography plays a vital role, not only
in academics but also in clinical practice.

• In clinical practice, it serves many important purposes. First and foremost it

allows one to document patient’s condition pre, post and during treatment. By
taking pictures we are creating a visual record that will be helpful in clinical
presentations and will tell fascinating story of progress in treatment.

• Photography, in this sense, is a very strong means of communication, a vehicle

for expressing ideas.

• Photographic documentation of treated cases is a must for passing masters degree

in many branches of dentistry. It also helps in clinical settings as a prominent
marketing tool. In scientific conventions, those people are in limelight who have
clinical photographic records. For want of it others are just the audience.
Clinical photography in Dentistry , Matrishva B Vyas
HISTORY OF PHOTOGRAPHY
IN ORTHODONTICS
The history of dentistry and photography began in
1840

First dental school was opened

world's first
photographic
gallery was
opened
Dr. Edward Angle (Father of Orthodontics) was first known
orthodontist to photograph his patients as part of his
diagnostic workup
■ Digital photography has been generally available since 1981.

■ In 1991 ‘Autotrader’ were the first mass market publication to move

completely to digital recording of images.

■ Kodak began to struggle financially in the late 1990s, as a result of the

decline in sales of photographic film and its slowness in transitioning to
digital photography, they filed for bankruptcy protection in 2012.

■ Digital imaging, one of the innovative , popular fields in the computer world,
is attracting more and more interest among orthodontists.

■ It is now possible, with a reasonable investment, to digitally acquire, archive,

and easily retrieve clinical images of our patients.
 1980’s
• The most important invention in dentistry - DIGITAL PHOTOGRAPHY

• Digital photography combines the best of all the three of the previous photographic
concepts:

• the quality of 35mm film

• the speed of instant photography
• the computerized integration of video

■ Special diagnostic software allow the orthodontist to customize the presentation of text,
graphics, and photographs.
 Why go digital in orthodontics?
Clinical orthodontic photography is a vital skill set that every practicing
orthodontist should master to be successful at the documentation of case
records, patient education, peer presentations, marketing, and at acquiring
additional certifications.

As a clinician, it is mandatory for orthodontists to learn using a camera and to

master clinical photography skills for the following reasons:

• Documentation of records for medicolegal reasons

• To compare pretreatment and posttreatment results
• To document findings that may be unique and to share those findings with
peers
• For obtaining data to make presentations and teaching students
• To use data in clinical practice for patient information and motivation
• Mandatory requirements of certification examinations

Nayak A. Clinical photography: A to Z. APOS Trends Orthod

2017;7:19-28.
Advantages of photography in orthodontics:

• Images can be easily stored

• Can be instantly forwarded or transmitted to patients, labs, colleagues etc

• Cost effective

• From a diagnostic point of view

• Academic research

• Publications

• Patient education

• Presurgical planning, and post operative analysis

 Why take orthodontic
photographic records?

Current ‘the best practice’ is a full set of extra and intra-oral

photographs, both at the start and completion of orthodontic treatment
and ideally, some mid-treatment photographs showing key-stages in
treatment.

Jonathan Sandler and Alison Murray

Journal of Orthodontics, Vol. 28, No. 3, 197-202, September 2001
 How does digital camera works
• The term camera is shortened from
camera obscura, literally "dark
room" in Latin.

• The camera is basically a box , with

small aperture or opening where the
lens is attached at one end and the
film at the other.

• The inside of the camera must be

completely dark , so that the rays of
light reach the film only through the
aperture
 PRINCIPLE
• The camera works in much the same way
as your eye.
• The lens in the eye focuses the image on to
the nerve cells in the retina and this image is
sent to the brain by the optic nerve.
• This is the principle employed in the
camera. The lens sharply focuses the image
on to the film.
• To keep the image sharp even when the
distance varies, the lens has to be moved
either farther or closer to the film. This what
we commonly call ‘focussing’.
• The diaphragm of the camera is a variable aperture which controls the
amount of light allowed onto the film, much in the same way that the iris of
the human eye contracts in bright sunlight but opens when the room is dark.
• The light reflects from a subject, enters the camera through the lens, which
focuses the rays of light into an image on the film.
• Light rays from the top of the subject form the lower part of the image and
those from the bottom form the upper part. Thus the image on the film is
upside down.
 LENS
• Lens is a piece of transparent material that has
at least one curved surface.

• Its job is to take the beams of light bouncing off

of an object and redirect them so they come
together to form a real image -- an image that
looks just like the scene in front of the lens.

• The best way to understand the behaviour of

light through a curved lens is to relate it to a
prism. A prism is thicker at one end, and light
passing through it is bent (refracted) toward the
thickest portion.

• A lens can be thought of as two rounded prisms

joined together. Light passing through the lens is
always bent toward the thickest part of the
prisms.
• A lens produces its focusing effect because light travels more slowly in the
lens than in the surrounding air.
• Therefore, refraction (an abrupt bending of a light beam) occurs both where
the beam enters the lens and where it emerges from the lens into the air.
• Because of the curvature of the lens surfaces, different rays of an incident light
beam are refracted through different angles.
 FOCAL POINT
• An entire beam of parallel rays can be caused to converge on a single
point. This point is called the focal point, or principal focus, of the
lens.

• Refraction of the rays of light emitted by an object causes the rays to

form a visual image of the object.

• This image may be either – real--photographable or visible on a screen

or – virtual--visible only upon looking into the lens, as in a
microscope.
 FOCAL LENGTH
• The focal length of a lens is the distance from the center of the
lens to the point at which the image of a distant object is formed.

• A long-focus lens forms a larger image of a distant object, while

a short-focus lens forms a small image.

• The closer that you move an object to the lens, the larger it will
appear on the film or photograph The image may be much larger
or smaller than the object, depending on – the distance between
the lens and the object and – the focal length of the lens .

• There is a limit to how close you can move an object in order to

enlarge an image size.

• If you move too close to an object, with a lens which is not

suited to that distance, then the image will get distorted.
CLINICAL REQUIREMENTS FOR PHOTOGRAPHIC
RECORDS

• The Digital Camera

• The Lens
• The Flash
• The Retractors
• The Dental Photography Mirrors
 types of cameras
• PROSUMER CAMERAS

• A prosumer camera is a mix of a consumer and professional camera, as its name implies. A
prosumer camera is still fairly basic in terms of functionality.

Advantages:
• Image preview facility

• Problems –
- small and lightweight

– point flash(built-in) : shadows on most images - lower cost

– Not powerful enough to allow the photos to be taken on very small aperture (f32)

– Live display on LCD is inaccurate and are very power hungry

– Focusing system is problematic

– Macro settings also sometimes gives disappointing results

DSLR CAMERA
digital single-lens reflex camera

Advantages:

- highest image quality

upgradeable

various lighting options

Disadvantages:

heavy

expensive
• An DSLR allows manual focus and can accommodate a variety of
lenses

• Virtually any digital SLR can produce excellent photographs.

• Satisfactory depth of field + good illumination = high quality intra-

oral photos
 The lens needed for dental photography is a Macro lens with a focal length
of 85-105mm

• Mirrorless interchangeable-lens camera (MILC),

frequently simply mirrorless camera, also called
DSLM (digital single lens mirrorless), and
sometimes also called EVF(electronic viewfinder)

• The word "mirrorless" indicates that the camera does

not have an optical mirror or an optical viewfinder
like a conventional DSLR, but an electronic
viewfinder which displays what the camera image
sensor sees.[1]
 Camera Exposure
• Determines how light or dark an
image will appear when it's been
captured by your camera

• Determined by just three camera

settings:
• Aperture

• ISO Exposure triangle

• Shutter speed
 Shutter speed
• The shutter speed controls the length of the exposure time. Shutters have speeds ranging from
1/8000 s to a few seconds.

• Length of time during which the shutter is open

• Expressed as a fraction of a second (.. 1/60 , 1/125 , 1/200, .. , 1/500..)

• A shutter speed shown as ‘120’ is 1/120, which means that the shutter is open only for a fraction
of a second. Each speed will allow half as much of light to strike the sensor as the preceding
one and double as the succeeding one.

• 1/4000 is a faster shutter speed

• Faster shutter speed freeze the action

• Good photography requires a balance between shutter speed and aperture

Shutter Speed Typical Examples
1 - 30+ seconds Specialty night and low-light photos on a
tripod
To add a silky look to flowing water, Landscape
2 - 1/2 second
photos on a tripod for enhanced depth of field

To add motion blur to the background of a

1/2 to 1/30 second
moving subject Carefully taken hand-held photos
with stabilization

1/50 - 1/100 second Typical hand-held photos without zoom

To freeze everyday sports/action subject

1/250 - 1/500 second movement
Hand-held photos with substantial
zoom (telephoto lens)
1/1000 - 1/4000 second To freeze extremely fast, up close subject
motion
 Aperture setting

• The opening that controls the amount

of light entering the lens.

• Aperture size is measured in “f-

numbers”.

• Every time the f-stop value halves, the

light-collecting area quadruples.
 Depth of field
• A camera's aperture setting is
what determines a photo's depth
of field

• The range of distance over which

objects appear in sharp focus.

• Wide Aperture f/2.0 - low f- Narrow Aperture

stop number shallow depth of f/16 - high f-stop number
field large depth of field
 ISO SPEED
• The ISO speed determines how sensitive
the camera is to incoming light

• A lower ISO speed is almost always

desirable, since higher ISO speeds
dramatically increase image noise.
 Recommended camera settings
• Digital cameras automatically calculate exposures

• To take the best possible shot, however, you may need to control the settings
manually
• Shutter speed 1/125

• ISO 100

• Mode M

• Aperture for Extra-oral f-8 to f-11

• Aperture for intra oral f-32

• Aperture for mirror view f-19 to f-16

Digital dental photograph;British Dental Journal 207, 63 - 69 (2009)

 IMAGE FORMATS

• JPG/JPEG (joint photographic experts group) : most common file format used
in digital photography

• RAW : actual data taken directly from a digital camera’s image sensor
unprocessed image, purest image file possible need specific software, large file
size

• TIF(tagged image file format): larger size, good quality photographs, can be
compressed and uncompressed
 Standard lens
• a camera lens giving a field of view similar to that of the naked eye.
 Wide angle lens
Wide-angle lens refers to a lens whose focal length is substantially
smaller than the focal length of a normal lens.
 Telephoto lens
Telephoto lenses are especially handy when you can’t get
physically close to your subject
 Macro lens
A macro lens is one which allows you to take sharp, detailed, close-
up photos of small subject
 Fisheye lens
A fisheye lens is an ultra wide-angle lens that produces strong visual
distortion intended to create a wide panoramic image
 Flash Systems
The flash systems that should be utilized will fall into two categories:
1. Ring system
2. Point system

Ring system flashes: are placed around the lens in either a sectored
format or a more traditional single flash component that surrounds the
lens.
 Photography lighting
• There was one huge road block to taking dental pictures. There was no
clear way to get light from the camera’s flash inside the dark cavern
that is the mouth

• Universal flash system for general macro

photography

• A circular flash that attached to the end of the

camera’s lens

• Ability to pinpoint light directly into patient’s

mouth

• Providing full illumination from external anterior

to posterior intra-oral quadrant pictures
Ring flash system

• the ring flash offers the advantage of evenly

illuminating difficult areas within the oral
environment and properly rendering their color.

• One potential drawback of the ring flash

system is removing all shadows. This drawback
is not as evident with intraoral photography
because complete illumination of the subject
matter is nearly impossible, as the cheeks, lips,
and tongue tend to block some light.
 Point flash
• Unlike ring systems that distribute light in a circular pattern, point systems are
meant to bring light in from the side.

• Single strobe-light source mounted on one side of the camera lens

• Flash can be moved around the lens to provide directional lighting from
different angles
• Placed at 12, 9 , and 3 o’clock position
for frontal, right lateral and left lateral
views respectively

• Requires considerable experience and

additional setup time before each
exposure
 The Dental Photography Mirrors
• Many photographic mirrors
designed specifically for intraoral
photography are available. These
mirrors are fabricated with
chromium, rhodium, or titanium.
Any of the aforementioned mirrors
will suffice in capturing quality
intraoral images; however titanium
– coated mirrors tend to produce
slightly brighter images.
 Long-handle Mirrors
• It is preferred to use “long- handle” mirrors (see Image) as they allow
better control and handling by the clinician during the occlusal shots.

• Different sizes for different patients depending on age and mouth-opening

size but generally, the “Medium” sized mirrors would be fit for use with
most patients.

• With all mirror shots, it is possible to

reduce the problem of fogging by
warming the mirror in hot water just
prior to use in the mouth.
 Photographic contrasters
• Black photographic contrasters should also
be utilized in the documentation of
aesthetic cases .
• Black photographic contrasters allow the
focus to fall on an individual segment of
the smile while blocking distracting
images of the tongue, lips, or back of the
mouth.
• Contrasters are particularly useful when
communicating incisal translucency to
your dental laboratory technician.
 Retractors
• In order to properly frame images,
retractors are a must.
• At a minimum, two sets of
retractors in various sizes should be
considered.
• One set should allow the patient or
assistant to hold the retractors
• the other set should be auto -
expanding .

The recommended cheek retractors to

be used for best results in clinical
photography are the double- ended
retractors
• Lip and cheek retractors are made of clear or opaque plastic

• Clear plastic retractors allow the tissue to be seen through the retractor and
the different size double end allows versatility.

• Plastic retractors can also be reshaped with an acrylic bur to any size the
photographer finds useful. Sometimes metal retractors can be used in
combination with facial mirrors.
NUMBER OF PHOTOGRAPHS
• Different clinicians take different numbers of clinical photographs, depending
on who you talk to!

• There is no “standard” set that is universally-approved as a rule of thumb.

• However, it can generally be accepted - based on many authorities’ opinions in

this field - that a complete “Clinical Photographic Set” for any orthodontic
patient at any stage of treatment, that would enable the clinician to obtain
maximum benefit and information, should include a minimum of nine
photographs; four extra-oral & five intraoral photographs.
 EXTRA ORAL PHOTOGRAPH

1. Face-Frontal (lips relaxed).

2. Face-Frontal (Smiling).

3. Profile (Right side preferably - Lips relaxed).

4. (45 °) Profile (also known as 3/4 Profile - Smiling).

 INTRA ORAL PHOTOGRAPHS
• There are five essential intra-oral photographs:

Right buccal
Maxillary occlusal Mandibular occlusal

Left buccal Frontal

• Extra-oral clinical photographs are the easiest photographs to take.

• They only require proper positioning of the patient and clinician, in

addition of course to the digital camera setup itself.

• Intra-oral photos require in addition to the camera setup - the proper

cheek retractors, dental photography mirrors, as well as a well
trained assistant if possible.
 EXTRA-ORAL PHOTOGRAPHS

1. Frontal
• The background used in taking the photos should be either a solid-white
background (or a back-lit light-box), or a solid-dark color such as Dark Blue.

• Taking extra-oral photos with the patient sitting on the dental chair or with
multiple distracting objects in the background should be avoided.

• The clinician’s positioning for these photos would be standing a few feet
away from the patient, and at the same eye level if possible. Younger and
shorter patients can stand on a special stand to get them to reach a suitable
height if needed.
• Frontal at rest: Frontal view with
the teeth in maximal intercuspation

• Frontal with teeth in maximal

intercuspation and the lips closed
even if it strains the patient :
provides documentation of lip strain
in patients with lip incompetence,
visualization of philtrum-
commissure height.

• Frontal dynamic (smile):

Demonstrates incisor show and
gingival display

• A close-up image of the posed

smile: more detailed analysis of the
smile relationships.
Method for taking a frontal photo of the patients
ž The following general guidelines should also be noted:

• The patient should stand with their head in the Natural Head
Position, with eyes looking straight into the camera lens.

• The patient should hold their teeth and jaw in a relaxed (Rest)
position, with the lips in contact (if possible) and in a relaxed
position.

• Make sure the patient’s head is not tilted or their face rotated to
either side; the shot should be taken at 90° to the facial mid-line
from the front.

• Ensuring the patient’s inter-pupillary line is levelled is also very

important
 2. Oblique (three-quarter, 45-degree)

• Patient in natural head position looking 45 degrees to the camera.

ž Three views are useful

a. Oblique at rest.

b. Oblique on smile.

c. Oblique close-up smile.

Oblique at rest • This view can be useful for examination of the
midface and is particularly informative of
midface deformities, including nasal deformity.

• This view also reveals anatomic characteristics

that are difficult to quantify but are important
aesthetic factors, such as the chin-neck area,
the prominence of the gonial angle, and the
length and definition of the border of the
mandible

• This view also permits focus on lip fullness and

vermilion display.

• For a patient with obvious facial asymmetry,

oblique views of both sides are recommended
 OBLIQUE ON SMILE.
• From the Profile photo position, the patient
is asked to turn their heads slightly to their
right (about 3/4 of the way - hence the
name), while keeping their body still in the
“Profile Shot” position i.e. Facing
forward

• They are then instructed to look straight and

then smile.

• It is essential that the patient’s teeth show

clearly when smiling, otherwise the
photograph would be of minimum benefit.
• The oblique view of the smile reveals characteristics of the smile not
obtainable through other means and it aids the visualization of both incisor
flare and occlusal plane orientation.

• A particular point for observation is the anteroposterior cant of the occlusal

plane.

• In the most desirable orientation, the occlusal plane is consonant with the
curvature of the lower lip on smile (the smile arc).

• Deviations from this orientation that should be noted as potential problems

include a downward cant of the posterior maxilla, an upward cant of the
anterior maxilla, or variations of both.
Oblique close-up smile

This view allows a more precise

evaluation of the lip relationships
to the teeth and jaws than is
possible using the full oblique
view.
3. Profile (Lips Relaxed)
• The patient is asked to bodily turn to their
left, thus having their right profile side facing
the clinician.

• The head should be in the Natural Head

Position, with their eyes fixed horizontally
(preferably at a specific point at eye-level, or
at the reflection of their own pupils in a
mirror).

• The wrong head posture can result in

confusion regarding the patient’s actual
skeletal pattern.
• Ideally, the whole of the right side of the face should be clearly
visible with no obstructions such as hair, hats or scarfs.

• The inferior border be slightly above the scapula, at the base of

the neck.

• This position permits visualization of the contours of the chin

and neck area.

• The superior border should be only slightly above the top of the
head, and the right border slightly ahead of the nasal tip.
• Some clinicians prefer that the left border stop just behind the ear,
whereas others prefer a full head shot.

• Under any circumstance, the hair should be pulled behind the ear
to permit visualization of the entire face
PROFILE SMILE

• The profile smile image allows one to

see the angulations of the maxillary
incisors, an important aesthetic factor
that patients see clearly and
orthodontists tend to miss because the
inclination noted on cephalometric
radiographs may not represent what one
sees on direct examination.
An optional submental view
• Such a view may be taken to document
mandibular asymmetry.

• In patients with asymmetries, submental

views can be particularly revealing.
 INTRA ORAL PHOTOGRAPHS
• It is essential during orthodontic photography for high quality
results, that the person doing the photography holds the
retractor on the side of interest during buccal shots and holds
the mirror during the occlusal shots.

• The reason for this is that the person holding the camera is the
only one who knows exactly when the photograph will be
taken.

• This allows the true relationship of the first molars and

sometimes the second molars to be recorded without prolonged
discomfort for the patients
• The mirror position during the occlusal shots can also be
adjusted at the last moment, or the patient can be asked to
open momentarily that little bit wider to secure a high quality
photograph.

• The occlusal photograph should be taken using a front surface

mirror to permit a 90-degree view of the occlusal surface.
 The frontal centered dental photograph
• The first photo to be usually taken of the
set.

• The dental mid-lines are not as reliable

for this purpose as they can be shifted to
one side or the other depending on the
malocclusion present.

• The full extension of the sulci is

paramount for full visualization and
clarity

• It shows teeth and surrounding soft tissue

and excluding retractors and lips.
• With the patient sitting comfortably in the dental chair and raised to elbow-
level of the clinician, the assistant stands behind the patient and uses the first
larger set of retractors from the wide ends to retract the patient’s lips
sideways and away from the teeth and gingiva, & slightly towards the
clinician.

• This is important to allow maximum visualization of all teeth and alveolar

ridges, and also to minimize discomfort for the patient from retractor edges
impinging on the gingiva.

• The photo should be taken 90° to the facial mid-line & central incisors
 The right buccal dental photograph
• Usually the second shot in the series.

• The assistant flips the right retractor to the

narrower side, while the left retractor remains in
place as for the previous frontal shot.

• The patient is asked to turn their head slightly to

their left so their right side will be facing the
clinician.

• The clinician holds the right retractor and stretches it to the extent that the last present molar is
visible if possible, while the assistant maintains hold of the left retractor, without undue
stretching.

• Again, the shot is taken 90° to the canine premolar area for best visualization of the buccal
segment relationship, as this is very important in orthodontic assessment.

• A useful tip would be for the clinician to fully stretch the right retractor just before taking
the shot to minimize any discomfort for the patient, and achieve maximum visibility of the
last present molar, if possible.
 The left buccal dental photograph

• ž The assistant now switches the

retractor with the narrow end on the
photo side (patient’s left) and the wide
end on the other (patient’s right).

• Again, the shot is taken at 90° to the

canine- premolar area, to ensure this
the clinician should move their body
slightly to the right while holding the
retractor on the photo side, while the
patient turns their head slightly to their
right.
 Upper Occlusal - Mirror

• The assistant now switches to the

smaller retractor set and withthe
patient’s mouth held open, the
retractors are inserted in a “V”
shape to retract the upper lips
sideways and away from the teeth.

• The patient is instructed to lower

their head slightly so that the shot
can be taken 90° to the plane of
the mirror for best visibility.
• The clinician inserts the mirror
with its wider end inwards to
capture maximum width of the
arch posteriorly, and pulls it
slightly downwards so that the
whole upper arch is visible to the
last present molar.

• Use the mid-palatal raphe as a

guide to get the shot levelled.

• Minimum retractor show in the

image is recommended, and no
fingers should be visible at any
time.
 Lower Occlusal - Mirror
• The assistant would now lower the
smaller retractors into a Reverse
“V” shape to retract the lower lips
sideways and away form the teeth.

• The clinician would now lift the

mirror upwards so he/she may
visualize the reflection of the lower
arch, while the patient is be asked to
“lift their chin up” slightly.

• Ideally, the shot should be taken 90°

to the plane of the mirror, with the
last molar present visible.
• An important issue here would be the tongue position of the
patient while taking the photo.

• It is best to ask the patient to “roll back” their tongue behind

the mirror so that it won’t interfere with the visibility of
any teeth, particularly in the posterior area.
Ideal” Shot :
Less-than-Ideal” Shot :
Tongue Rolled Tongue Visible But
Back, Midline Not Obstructing View.
Centered.
 ORTHODONTIC PEARLS

• The direction of pull of the retractors is always sideways and slightly forward,
away from the gingival tissues.

• This maximizes the field of view and minimizes patient discomfort.

• Wetting the retractors just before insertion eases the process of positioning them
properly with minimum patient discomfort.

• When taking occlusal “Mirror” shots, slightly warming the mirror in warm
water prior to insertion helps prevent “Fogging” of the mirrors which would
prevent a clear image.
• In certain cases, profuse salivary flow and “frothing” can affect the quality of
the image being taken, thus a saliva ejector can be used to eliminate saliva
prior to taking each photograph.

• During occlusal “mirror” shots, instruct the patient to “open wide” just prior
to pressing the camera button.

• This helps in obtaining the maximum mouth opening at the right moment,
and minimizes the patient’s fatigue during the procedure.

• It is recommended that all photographic records be taken before impression-

taking, to eliminate the possibility of impression material being stuck
between the teeth or the face during photographic record-taking
• To reflect buccal interdigitation accurately, as much cheek retraction as
possible is needed, or one can use a mirror to gain a more direct view.

• A 45-degree view from the front makes a Class II malocclusion appear to

be Class I.

• Because occlusal relationships are captured more accurately on casts,

mirror views of the lateral occlusion are usually not absolutely necessary.
TECHNICAL ERRORS
• Camera. The correct equipment is required for high quality clinical
photographs, which include a camera (either conventional or digital)
with a macro-facility (ability to produce 1 : 1 images) and, ideally, a
ring flash,
• Retractors. Two sizes of double-ended retractor are prerequisite to
obtaining a set of high quality intra-oral photographs
Shadow
• Problems involving shadowing are almost inevitable
• Rotating the camera through 180 to ensure the flash throws the shadow
behind the patients outline
• Errors with profile shots include a misrepresentation of the soft tissue
morphology or skeletal pattern and this may be due to patient posturing
or alternatively excessive tilting of the head forwards or backwards
 CONCLUSION
• Clinical photography has been greatly improved with the advent of digital
cameras, especially digital SLRs. To obtain high-quality, consistent
photographs, the orthodontist must select a DSLR that meets clinical
requirements.
• It provides a diagnostic information that is easily recognized and
understood by both professionals and laypersons
• In order to get the full diagnostic value out of digital photography, a
systematic method and regimentation of clinical images must be adopted
 REFERENCES
• Orthodontics current principles and techniques- Graber - 6th edition.

• Nayak A. Clinical photography: A to Z. APOS Trends Orthod 2017;7:19-28.

• Comparison of 10 digital SLR cameras for orthodontic photography; Journal of

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