0A TRIBUNE | March 2010 DENTAL Rubric DENTAL T Matters 7A Digital RIBUNE | MoNth 2010 www.dental-tribune.com Do you need 8-, 10- or 15-megapixels? TK to choose a digital camera How TK Missed the last edition of Dental Tribune? You can now read some of its content online! By Lorne Lavine, DMD By As a technology consultant, I TK work with many dentists who have a variety of questions regarding the DT TK addition of technology to their dental practices. Many of the questions are related to topics that I have previously written about in Dental Tribune: an overview of how to decide which technologies to purchase, how to choose dental software, digital radiography, etc. The topic that seems to receive the most attention, and the most confusion, is digital photography and digital images in general. The sheer number of choices perplexes most dentists. This two-part article will examine a number of issues that need to be answered when adding digital imaging to the dental practice. We’ll explore: • the pros and cons of both intraoral and extraoral cameras; • examine the criteria that dentists should use in picking a digital camera for their office; • look at the software choices that exist for storing and manipulating these images (part two); • delve into the myriad of options for digitizing existing non-digital images (in part two); • choices for storing these images; • printing images; • and other options for sharing these images with other people (such as the patient, insurance companies and other dental colleagues). Intraoral cameras Intraoral cameras have been used for dental applications since the early 1990s. One of the first products was the AcuCam, made by New Image Industries. At one point, New Image held over 40 percent of the market share for these systems. For many years, intraoral cameras were the cameras of choice. Although there was a bit of a learning curve, they were relatively easy to master and still have widespread acceptance today. Recent surveys have shown that intraoral cameras are found in about 50 percent of all dental offices, which seems to indicate that they may have reached their peak in this regard. Anyone that has used an intraoral camera is aware of the advantages that these systems offer. Most cameras are capable of magnifying images at 40–52x. This can be an invaluable tool in allowing the dentist to see pathology, such as open margins, fractures and caries, which wouldn’t easily be seen without this level of magnification. The ability to have images on a computer monitor screen that is visible to the patient is of great benefit. Most experts agree that one of the keys to improving patient acceptance to our treatment plans is the concept of “co-diagnosis.” In other words, allowing the patient to see the problems that we see will allow them to participate in the diagnosis of their dental problems, and they will then be more inclined to accept our recommendations for treating problems that they may have been previously unaware that they had. The cameras allow us to have a permanent record of a patient’s condition before we begin treatment. This can be quite beneficial for cosmetic cases where we can show patients before and after photos of their teeth. In addition, for legal reasons, it will often be valuable to have a record of a patient’s condition before treatment began, just in case the patient is unhappy with the results and is considering legal action. The cameras can be used to take photos of X-rays, which frees us from having to send in our original radiographs to the insurance companies. Moreover, adding photo documentation to an insurance claim will often speed up the approval of that claim. so that you can evaluate the different aspects of the cameras. • Ability to handle multiple views. According to many experts, there are six standard intraoral camera views that should be evaluated when choosing a camera. These are divided into intraoral and extraoral views. The intraoral views are the distal of the upper last molar, the buccal of the upper last molar and the lingual surfaces of the lower anterior teeth. As far as the extraoral shots are concerned, test the camera’s ability to take a full lower arch, a full-face photo and a photo of a bitewing radiograph that is being lit by an X-ray view box. Test all of these shots to see which camera can handle the majority of them with ease. • Portability. Many dentists have large offices and, to save costs, they will consider using a camera that can easily be moved from one operatory to another. Do not fool yourself into believing that if a camera system is on a large cart that you will be willing to wheel the cart from room to room — I tried it myself years ago and it just doesn’t work! Implants displaced into Some of the sinus the maxillary more popular models that allow for DMD,are manBy Dov M. Almog, this ufactured Cheng, DDS Doc (Iris.), Kenneth by Digital AcuCam Concept IV (DENTSPLY& Mohammad Rabah, DMD GENDEX) and the Claris i310D www.dental-tribune.com/artifrom Sota Optics. cles/content/scope/specialities/ • Ease of focus. Does the section/implantology/id/542 camera require manual focus or is it autofocus? Most cameras have an Washington cracks down adjustable focus, so you should on big tobacco evaluate how easy it is to change By Fred Michmershuizen, the focus. Online Editor The focus should be well labeled, www.dental-tribune.com/artiand should have a range of motion cles/content/id/480 that is less than 100 degrees so that you can the top 10 reasons focus Five of easily change the settingassociateships fail why with one hand. • Eugene W. Heller, DDS By Built-in freeze-frame. Many of the older models do not have this www.dental-tribune.com/ feature, and most people prefer articles/content/id/507/scope/ this element to be included with specialities/region/usa/section/ the system. practice_management • Capture button location. Some units use a foot guy on to capture ‘Aren’t you that pedal individual images, but other mod“Extreme Makeover”?’ els have the capture button right An interview with the face of on the handpieces. dentistry, Dr. modern cosmetic For many Dorfman William M. dentists, this is simply a By Robinof personal preference, matter Goodman, Group soEditor should try both types of you systems to see which feels most www.dental-tribune.com/ comfortable for you. articles/content/scope/speciali• Single lens system. Many ties/section/cosmetic_dentistry/earlier systems contained two wands, id/543 one for true intraoral photos (90 degree smile, new one for extraoral New lens) and life: Innovative photos (0 degree lens). Many of the technologies and techniques newertransform now use one wand can systems a smile for both types of photos. FAACD By Lorin Berland, DDS, Because you may & Sarah Kong, DDS want to use the camera to take photos of X-rays www.dental-tribune.com/ on a view box, the key factor is the articles/content/scope/specialiability of the camera’s built-in light ties/section/cosmetic_dentistry/ to id/544 be turned off when taking these types of photos. • Unique features. Most camera manufacturers will add special Here’s some other online features to their systems to difcontent that might be of ferentiate to you … interest themselves from their competitors. Some of the features Protective extraoral and that you will see include flexible cords, reinforced instrumentation extraoral light adjustments, printstrategies ing from a portable MA By Diane Millar, RDH, unit, light and color adjustments and image www.dental-tribune.com/articles/content/scope/specialities/ g DT page section/dental_hygiene/id/545 10A Special Operations Forces dental clinic brings smiles to Iraqi children By Jeffrey Ledesma, USA www.dental-tribune.com/ articles/content/id/535/scope/ politics/region/usa Ancient teeth question origin of men By Daniel Zimmermann, DTI www.dental-tribune.com/articles/content/scope/news/region/ asia_pacific/id/505 AD How to evaluate intraoral cameras When evaluating intraoral cameras, there are a number of factors to consider. I would highly recommend that anyone considering the purchase of an intraoral camera attend a dental meeting where many of the different vendors will be on hand