Extraoral Photography Research Articles

Changes in smile parameters after surgical-orthodontic treatment for skeletal Class III malocclusion

Background/purposeMany patients pursue attractive smiles, and surgical-orthodontic treatment is a common method. We aimed to analyze the changes in smile parameters after surgical-orthodontic treatment in patients with skeletal Class III pattern and identify factors influencing postoperative outcomes. Materials and methodsThis retrospective study comprised 34 patients with skeletal Class III malocclusion and pure mandible prognathism who received surgical-orthodontic treatment. Hard and soft tissue parameters were assessed through lateral cephalometry, and smile esthetics were evaluated through extraoral photography. Postoperative changes in smile parameters and between-parameter correlations were analyzed. Random forest and decision tree deep learning models were used to identify factors influencing postoperative changes. ResultsSubstantial postoperative changes were observed in the buccal corridor, upper lip height, and smile index. Significant between-sex differences were noted in the upper midline and right chelion. Strong, positive correlations were found between upper lip height and upper lip ratio and between lower lip height and lower lip ratio. By contrast, strong negative correlations were observed between lower teeth exposure and smile index and between interlabial gap and smile index. The highest degrees of postoperative changes were noted in asymmetry-associated smile parameters: lower lip area, interlabial gap, smile index, buccal corridor, and arc ratio. ConclusionConsiderable changes were noted in skeletal, dental, and soft tissue parameters after surgical-orthodontic treatment. However, the changes in smile esthetics were less prominent from the frontal view. As for chin asymmetry, the most to least prominent changes were in the lower lip area, interlabial gap, smile index, buccal corridor, and arc ratio, respectively.

Management of the Pediatric Patient with Suspected Diagnosis of Obstructive Sleep Apnea Syndrome.

The aim of this paper is to describe the multidisciplinary management pathway for pediatric patients with suspected obstructive sleep apnea syndrome (OSAS) conducted by the Pediatric and Orthodontic Department of the Dental Clinic of Padua. All pediatric subjects undergo a comprehensive medical history, including the completion of the Pediatric Sleep Questionnaire (PSQ), and a physical examination. Patients with suspected OSAS are placed on a waiting list for home respiratory polygraphy testing. The respiratory polygraphy examination is conducted over two consecutive nights and interpreted by a neurologist. Additionally, patients diagnosed with OSAS undergo a case study involving intraoral and extraoral photography, as well as radiographic evaluation. Between September 2021 and May 2023, a total of 134 subjects (including 76 males), with an average age of 9.2 years, were identified as diagnostic suspects. Among these, 38 patients (28.3%) tested positive based on respiratory polygraphic results. Depending on the severity and etiopathogenetic characteristics of the disease, the positive cases were referred to various specialists. In the daily clinical practice of dentistry, particularly in orthodontics and pedodontics, the establishment of a defined management pathway for pediatric patients with OSAS is crucial. The collaboration of a multidisciplinary team with a shared objective of achieving accurate diagnosis and implementing targeted treatment in a timely manner is essential. Regular re-evaluation of patients through clinical and instrumental examinations is recommended.

The “Beveled One-and-a-Half-Barrel” Fibula Transplant with Virtual Surgical Planning and CT-Guided Implant Surgery for Prosthetic Rehabilitation in Posterior Mandible Defects: A Pictorial Essay

In this study, we present a new case of segmental oro-mandibular reconstruction with fibula transplant, first described as “beveled one-and-a-half-barrel” shape, highlighting tips and tricks for not jeopardizing its vascularity and our technical considerations for adequate dental rehabilitation. A report of all reconstructive stages and secondary implant-rehabilitation phases, outlining the reliability of this new technique together with a comparative analysis of advantages and disadvantages of different reconstructive techniques for alveolar bone reconstruction, was made. This technique was applied in our hospital for a 49-year-old Caucasian woman with an aggressive recurrent ameloblastoma of the left mandible. Post-operative computed tomography with clinical intra- and extraoral photography are presented. We believe that this pictorial essay presented in our paper could be useful as a goal-oriented step-by-step highly detailed surgical guide to achieve a reliable and good shaped bone hardware for further dental rehabilitation in case of segmental posterolateral mandibular reconstruction.

Significance of error in extraoral photography in orthodontic diagnosis and treatment planning- An appraisal

Significance of error in extraoral photography in orthodontic diagnosis and treatment planning- An appraisal

Using Concept Videos to Teach Predoctoral Dental Students About Intraoral and Extraoral Photography.

IntroductionClinical photography in dentistry has become a vital part of dental education and clinical practice. Dental students seek demonstrations that help them visualize and understand new concepts and clinical procedures. Few multimedia resources are available that provide instruction regarding clinical photography for dental students. The concept videos serve as adjunctive teaching tools for predoctoral dental students in taking clinical photographs.MethodsI created the three concept videos on intraoral and extraoral photography by recording narrated PowerPoint slideshows. After sessions on basic photography concepts and digital camera operation, I used concept videos to show how to take comprehensive quality dental photographs in a step-by-step manner and to demonstrate positions of an operator and a patient. I collected feedback using an electronic survey sent to all 33 third-year dental students who participated.ResultsEleven students completed the survey; all students responded favorably to this method of instruction. Individual comments were also positive on helpfulness, conciseness, and applicability.DiscussionThese concept videos were shown to be a helpful resource for dental students in enhancing their knowledge and skills in obtaining dental photographs. Multimedia resources that helped provide students with practical tips and suggestions could supplement clinical chair-side teaching with faculty and further advance their knowledge and skills. Future studies could include more interactive platforms for better student utilization of the resource, and also compare students' performance before and after watching the videos.

Using Standard Digital Extra-Oral Photography in Patient With Cleft Lip and Palate

Using Standard Digital Extra-Oral Photography in Patient With Cleft Lip and Palate

Inadequate record keeping by dental practitioners.

When a dental practitioner is brought before a disciplinary body, a common finding is that dental records were poorly kept and inadequate to establish issues of consent for treatment or the nature of the treatment undertaken. Often this finding may be incidental to the actual issue that brought the practitioner before a regulatory body or the Courts. The aim of this study was to examine recent cases reported in the State of Victoria involving dental practitioners, specifically seeking those cases where the record keeping was found to be inadequate as an incidental finding. Published rulings of formal complaints and notification cases brought before disciplinary hearings in the State of Victoria for the period January 2000 to June 2014 were analysed with regards to orders made in respect to record keeping. Complaints and notifications specific to dental record keeping accounted for less than 2% of formal complaints. And yet up to 75% of cases have made a finding of unprofessional conduct against a dental practitioner on the basis of inadequate record keeping, most often in combination with other breaches of conduct. Adherence to the traditional format of handwriting or typing entries into patient records may contribute to the problem of poor record keeping in a clinical dental setting. Newer technologies such as digital intraoral and extraoral photography and audio-recording of patient interactions may offer a solution to the problems of record keeping.

Orthodontic extraoral photography: Comparative subjective analysis of five digital single lens reflex cameras

Objectives: To compare 5 digital single lens reflex cameras (DSLRs) for extraoral photography in the orthodontic office, to recognize the best camera and the best mode for each camera. Materials and Methods: 5 DSLRs namely Canon 500D, Canon 550D, Nikon D3100, Nikon D40 and Nikon D5000 were compared. Images were clicked in auto mode, program mode, manual mode, macro mode and aperture priority mode. Same settings were used for all cameras. Thirteen orthodontists were asked to rank the images for quality. Data was collected and statistically analyzed using Kruskall Wallis analysis of variance. Results: Canon 500D ranked the highest ( P P Conclusion: Images by Canon 500D and Canon 550D were perceived better than Nikon for the chosen settings, establishing ease of use for these cameras. This study gives a basic idea regarding technical specifications that can be used for a particular camera for extraoral photography.

Clinical photographs: The Gold Standard, an update

ObjectiveThis survey is an update of a survey that was originally carried out in 1999 and published in 2001. Over the last 10 years the prevalence of digital photography in orthodontics has increased beyond measure and the study was to document any effects of this change. Materials and methodsThe opinions of 69 orthodontists from many European countries, as to what would be considered good practice with regards to intra and extra-oral photography with modern digital camera equipment, were sought. A written survey was distributed to the participants and collected by hand a few minutes later, once completed. A comparison was then made between current practice and what was considered best practice at the turn of the millennium. ResultsThe main change was the widespread move from conventional to digital photography throughout Europe. This has resulted in a reduction in the cost of photographing each and every case on multiple occasions throughout treatment. ConclusionThe move to digital photography offers many advantages to orthodontists. High quality photographic documentation is almost routinely taken throughout treatment with little direct cost to the clinician.

Comparison of 10 digital SLR cameras for orthodontic photography

Digital photography is now widely used to document orthodontic patients. High quality intra-oral photography depends on a satisfactory 'depth of field' focus and good illumination. Automatic 'through the lens' (TTL) metering is ideal to achieve both the above aims. Ten current digital single lens reflex (SLR) cameras were tested for use in intra- and extra-oral photography as used in orthodontics. The manufacturers' recommended macro-lens and macro-flash were used with each camera. Handling characteristics, colour-reproducibility, quality of the viewfinder and flash recharge time were investigated. No camera took acceptable images in factory default setting or 'automatic' mode: this mode was not present for some cameras (Nikon, Fujifilm); led to overexposure (Olympus) or poor depth of field (Canon, Konica-Minolta, Pentax), particularly for intra-oral views. Once adjusted, only Olympus cameras were able to take intra- and extra-oral photographs without the need to change settings, and were therefore the easiest to use. All other cameras needed adjustments of aperture (Canon, Konica-Minolta, Pentax), or aperture and flash (Fujifilm, Nikon), making the latter the most complex to use. However, all cameras produced high quality intra- and extra-oral images, once appropriately adjusted. The resolution of the images is more than satisfactory for all cameras. There were significant differences relating to the quality of colour reproduction, size and brightness of the viewfinders. The Nikon D100 and Fujifilm S 3 Pro consistently scored best for colour fidelity. Pentax and Konica-Minolta had the largest and brightest viewfinders.

Photography in dentistry

Photography offers precious support in all areas of medicine and dentistry. Usage of photography in dentistry is an integral part of numerous diagnostic and therapeutic procedures and an important document of progression and outcome of subscribed therapy. Various types of cameras are available for intraoral and extraoral photography. Market offers different kinds of photographic equipment to dental practitioners such as cameras with films (Single Lens Reflex) SLR, digital SLR (DSLR) and compact digital cameras. However, majority of analyses emphasize advantages and relevancy of digital cameras, especially in taking macro photographs in dentistry. Introduction of digital cameras in dental practice is an important step toward the future. The aim of this study was to point out the importance of photography in dentistry, demonstrate basic technology of contemporary cameras and to analyze advantages and disadvantages of available cameras.

Relationship between static natural head position and head position measured during walking

The aim of this project was to determine whether there is a statistically significant difference between the means of static and dynamic (measured during walking) measurements of head posture. The sample consisted of 50 subjects, 25 women and 25 men, 20 to 25 years of age. None had a history of orthodontic treatment, head or neck injury, or nasal breathing problems, and none wore eyeglasses to correct vision. Static measurement of head position was recorded by using the self-balance position. Dynamic measurements of head position were made with an inclinometer device with the subject walking in a relaxed manner for 5 minutes. The data, measured in degrees, were stored in a pocket data logger. Recorded static and dynamic head posture data were transferred to a computer for analysis. The means of the measurements were statistically compared with the t test (alpha = .05). The mean walking head position was tipped forward relative to the mean static head position. The mean value of static position minus walking head position measurements was +4.60 degrees . The differences between the 2 recordings were statistically significant (P < .001). Static and walking head position measurements are not interchangeable. Therefore, it might be advisable to use the mean dynamic measurement of head position to represent natural head position for positioning when taking case records such as lateral and posteroanterior cephalograms, clinical extraoral photography, or 3-dimensional imaging.

A long-term retrospective outcome assessment of facial growth, secondary surgical need, and maxillary lateral incisor status in a surgical-orthodontic protocol for complete clefts.

In 1965, the cleft palate team at Children's Memorial Hospital embarked on a new surgical-orthodontic protocol in the habilitation of newborn complete cleft lip and palate cases. It brought the orthodontic effort into focus at birth and in planned sequence to correspond with the surgical procedures of lip closure, maxillary alveolar stabilization by means of an autogenous graft of the authors' design, and complete palate closure, all within the first year of life. The purpose of this investigation is threefold: first, to review the authors' previous publications and assess growth, secondary surgical need, and lateral incisor status of teeth adjacent to the cleft in a series of patients who have all followed a precise, early surgical/orthodontic protocol; second, to compare these cases with other collaborative studies wherein this protocol was not used; and third, to report on an additional 82 cases with regard to secondary surgical need and the status of teeth adjacent to the cleft. Methods of assessment have included cephalometric radiography, periapical and occlusal dental radiography, computer-assisted tomography, plaster cast analysis, and intraoral and extraoral photography. The authors have demonstrated, along with other collaborative studies, that there is growth as good as other similar samples wherein there was no primary osteoplasty. In addition, the authors found their incidence of orthognathic surgery to be 18.29 percent; pharyngoplasty, 3.65 percent; and oronasal fistulas requiring surgical closure, 29.27 percent. In the case of unilateral complete clefts, 53.13 percent of those lateral incisors present adjacent to the cleft area were usable, and in bilateral cases, 57.77 percent were usable. The authors remain convinced after more than 35 years of following this successful protocol that early maxillary orthopedics and their technique of primary osteoplasty in planned sequence with lip and palate closure can produce a more favorable alignment of maxillary growth potential and, with comprehensive orthodontic treatment, can lead to teeth in a better overall occlusion than if these procedures had not been undertaken.

A Long-Term Retrospective Outcome Assessment of Facial Growth, Secondary Surgical Need, and Maxillary Lateral Incisor Status in a Surgical-Orthodontic Protocol for Complete Clefts

In 1965, the cleft palate team at Children's Memorial Hospital embarked on a new surgical-orthodontic protocol in the habilitation of newborn complete cleft lip and palate cases. It brought the orthodontic effort into focus at birth and in planned sequence to correspond with the surgical procedures of lip closure, maxillary alveolar stabilization by means of an autogenous graft of the authors’ design, and complete palate closure, all within the first year of life. The purpose of this investigation is threefold: first, to review the authors’ previous publications and assess growth, secondary surgical need, and lateral incisor status of teeth adjacent to the cleft in a series of patients who have all followed a precise, early surgical/orthodontic protocol; second, to compare these cases with other collaborative studies wherein this protocol was not used; and third, to report on an additional 82 cases with regard to secondary surgical need and the status of teeth adjacent to the cleft. Methods of assessment have included cephalometric radiography, periapical and occlusal dental radiography, computer-assisted tomography, plaster cast analysis, and intraoral and extraoral photography. The authors have demonstrated, along with other collaborative studies, that there is growth as good as other similar samples wherein there was no primary osteoplasty. In addition, the authors found their incidence of orthognathic surgery to be 18.29 percent; pharyngoplasty, 3.65 percent; and oronasal fistulas requiring surgical closure, 29.27 percent. In the case of unilateral complete clefts, 53.13 percent of those lateral incisors present adjacent to the cleft area were usable, and in bilateral cases, 57.77 percent were usable. The authors remain convinced after more than 35 years of following this successful protocol that early maxillary orthopedics and their technique of primary osteoplasty in planned sequence with lip and palate closure can produce a more favorable alignment of maxillary growth potential and, with comprehensive orthodontic treatment, can lead to teeth in a better overall occlusion than if these procedures had not been undertaken. (Plast. Reconstr. Surg. 111: 1, 2003.)

Recent developments in clinical photography.

A system comprising a clinical camera, specialized retractors, and a new occlusal mirror are described to maximize the quality of both intra-oral and extra-oral photography in the multi-user situation.