How To Achieve Pre & Post Operative Images That Match?

When you share your clinical cases with your dentist friends, students or patients; it is important that the series of images of that case should look identical and uniform in composition in order to get the changes noticed easily by your audience .

The advantages of  a well composed image is far more than a poorly composed image. Further more if images of a single subject, taken at different times, shot from different angles & settings looks different; leaving your audience in a state of confusion, where they find it uninteresting & very difficult to relate to. There is loss of detail and co relating between the before and after images becomes a nightmare. When the images are uniformly composed, well lit in similar (or same) settings, relating to the images and the situation becomes much more authentic and understandable. The audience finds it very easy to understand and accept the changes or what ever the  dentist is trying to show. Pre operative / Operative and post operative images must always look same in composition It is not a child’s play however to get the composition uniformly correct all the times because the dentist / dental assistant (anyone who is taking images) has to face long intervals in between the shots. These intervals can be in hours/ days, weeks, months or even years!!! So it is always best that before starting the shoot the dentist takes a look at the earlier images first and goes through the METADATA (EXIF) (file information after right clicking on the image) What is more important is that the images need to be shot with the same equipment that were used at the start of the case and use the same settings as far as possible.

The dentist needs to maintain the patient position and camera position constant for all the shoots (be it intra or extra oral) The following details should be kept in mind to get a uniformly composed image: 1) Constant & Uniform background (E.g. appropriate use of contrastors) Types of contrastors & mirrors in Magic Box intraoral photography kit by dental photography school 2) Relative positions of the dentist and the patient should be maintained constant. 3) Good uniform retraction (Retraction has to be outward and laterally) Cheek  Retractors by Dental Photography School 4) Avoiding saliva/blood/ GCF at all times. (Use a good high vac suction)

5) MAGNIFICATION (biggest factor) (In our course we teach 4 magnifications which a dentist typically uses to do all the dental photography. it is a major topic and has to be discussed separately) MAGNIFICATION RATIO is the property of a MACRO lens only. Shown above in yellow font encircled in the red ellipse is the magnification ratio. We can change the magnification ratio by rotating the lens. Various magnification ratios are available for use in dental photography like 1:1, 1:1.5, 1:2 etc. To keep images standardized it is important that we keep magnification ratio of the pre operative and post operative images same always. 6) Uniform cropping (cropping done in the camera maker software is the best because it helps you with a GRID which will guide a dentist to crop accurately) 7) Preferably keep the main tooth/area in the center (This is because this allows for maximum cropping in case there is a mistake with respect to composition) 8) Always notice the other teeth / landmarks (For instance if its an anterior shot at 1:1 magnification then how many teeth are seen?

If the before image shows 2 centrals and 2 laterals on both sides then this frame has to be accurately repeated and the post operative image should also show 2 centrals and half laterals on the sides. It can also happen that 2 centrals ARE visible and the dentist might think that the purpose is solved because the work was only in the centrals (e.g diastema closure,) but the post operative picture instead of showing 2 laterals is showing 1 full lateral of one side!!!In the latter case the composition is unacceptable and a lot of data with respect to the work is lost and not recorded.) 9) Another important and hugely neglected part about composition is that a dentist should never loose a sense of orientation (angulation) which frequently happens and is evident in the shots. Parallelism has to be maintained between the guiding lines and the viewfinder. If this is lost then we will be able to see a “CANTING” in the images which is visually very disturbing. Always keep your frame in such a way that the ridge OR the teeth are parallel (or perpendicular) to the viewfinder (either lengthwise or breadth wise) 10) Lastly whenever a Shade guide is to be used the incisal edge of the guide tooth has to align with the incisal edge of the natural tooth. Always wet the surface of the teeth slightly before shade matching. Insist on taking 2 shots for shade matching (one at picture style NEUTRAL and the other at picture style MONOCHROMATIC which is for appreciating the VALUE of the tooth) For more interesting articles on dental photography log on to www.dentalphotographyschool.in All images and write up in the blog are intellectual property of Dr. Mayur Davda / Dental photography School. Any unauthorized use or copy is subject to legal action and violation of law.