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In Practice TECHNOLOGY CLINICAL BRIEF | TECH PROFILE detail for the dental case presentation. T he next component to consider is Using Visual Technology for a good quality macro lens coupled to a dedicated flash. A ring flash or side- by-side flash is best for close-up dental Case Presentation shots, while moving the flash away from the lens is desired for portrait photog- The most direct path to treatment acceptance is hastened using visual technology. raphy. The author uses the Nikkor 105- By Alvin W. Neff, DDS mm lens (Nikon Inc) with a removable ring-flash coupled with theN ikon D-90 (Figure 3). There are several resources available for more information on these ase presentations result in scheduled appointments for a 3” monitor. The Canon EOS 50D has a systems, such as National Camera that use visual tech- needed treatment. There is nothing 22.3 mm x 14.9 mm sensor that captures Company, Clini Pix, Dental Learning nology can become more revealing than a close-up view 15.1 megapixels. The Nikon D90 has a Center, Norman Camera, PhotoMed, the integral com- of your own teeth or a full-face view of 15.8 x 23.6 mm sensor that captures 12.3 and Lester Dine. ponent of success your own smile. Using this new format effective megapixels. An ISO setting of I t is recommended to shoot dental for the modern day of case presentation, patients will be- 200 and a large image file (fine) should photographs in the aperture priority practice. Our pa- come engaged in a co-diagnosis type be used. These cameras are user-friend- mode so that the shutter speed will tients must be able to clearly see their of conversation and they will begin to ly and can capture more than enough be adjusted by the camera. The focal Cexisting conditions, understand treat- ask for treatment. Clinicians can avoid ment recommendations, and visualize most sales tactics and rehearsed scripts the anticipated results before they can once the patient sees their case presen- accept and approve treatment. tation with their own eyes. They see the Historically, dentists have used com- existing condition of their teeth and the plicated dental terminology, x-rays, and image of the anticipated result. This study models to communicate a pro- creates immediate desire and answers posed treatment plan. Patients were many of their concerns that had been expected to accept recommendations getting in the way of case acceptance. without being able to visualize the an- ticipated results. Patients often left the Digital Camera Systems dental office confused about treatment T he evolution of digital photography recommendations and uncertain about has been rapid; it is now the main- the final outcome. stream for even the most discriminat- T he most important aspect of case ing professional photographer. The presentation is the ability to clearly author remembers using a 3.0 mega- FIG. 1 communicate the treatment goals to pixel camera as recently as 2002 for the patient in a manner that will help computer imaging. He was always less them make a decision toward treat- than impressed with the resolution and ment acceptance. The most direct path relied on 35-mm slides for lectures and to treatment acceptance is hastened us- marketing use. Many manufacturers ing visual technology. The use of digital now offer cameras that can capture photography, upgraded display moni- 12.0 to 14.0 megapixels of information tors, and computer imaging can create in the blink of an eye. This article will dramatic case presentations that will discuss a few basic features that should be considered as this technology relates to case presentation. ALVIN W. NEFF, DDS Private Practice in Restor- T he first and foremost would be to in- ative Dentistry vest in a “through the lens” (TTL) cam- Rogers, Arkansas era body. Examples of these include the N ikon D-90 (Nikon Inc, www.nikonusa. Senior Clinical Instructor FIG. 2 com) and the Canon EOS 50D (Canon Aesthetic Advantage New York, New York I nc, www.usa.canon.com) (Figure 1 and TTL CAMERA BODIES (1. & 2.) The Nikon D-90 and Canon EOS 50D TTL Figure 2). Both of these cameras feature cameras. 78 INSIDE DENTISTRY | April 2010 | insidedentistry.net I n Practice T ECHNOLOGY length also can be set using the lens ra- Computer Imaging Software tios so that all photographs will have The final piece of this technology puz- the same basic dimensions. Using the zle is arguably the most important of appropriate f-stop will provide an ade- all. The author has seen the evolution quate depth of field (the closer the shot, of computer imaging since 1986. His the higher the f-stop). The following first imaging system, purchased in 1987, are some basic camera settings: used a professional-grade video cam- era, umbrella shielded lighting, and a • S etting for portrait: 1:12/f-stop, 13/flash digitizer pad. The system required la- on high power away from the lens borious drawing motions and complex • S etting for close-up: 1:2.5/f-stop, 32/1/4 software tools to achieve a less than power ring flash to lens natural-looking image. Each image took more than 40 minutes to com- “There is nothing plete and could not be easily delegated to staff members. The author found FIG. 3 more revealing these limitations too difficult to image very many patients per week. This new- than a close found technology was effective for case up view of your acceptance, but it required too much non-clinical time to be cost-effective. own teeth or T he second generation of compu ter a full-face imaging software came along in the early 1990s (ie, Image FX; DICOM, view of your PracticeWorks, www.practiceworks.com; own smile.” Viper Soft®, Integra Medical Systems, www.vipersoft.com; and Dentrix Image®, Dentrix Dental Systems, www.dentrix. Upgraded Monitors com). These systems had much more Plasma technology was popular for a user-friendly software that could be few years but has lost its appeal be- used by a trained staff member. They FIG. 4 cause of burn in. LCD screens have introduced the concept of a smile li- now become the gold standard for brary to quickly overlay a completed LENSES AND MONITORS (3.) Nikkor 105-mm lens with removable ring- high-quality resolution. The greatest smile onto the preoperative photograph. flash coupled with the Nikon D-90 camera body. (4.) A viewing distance “wow” effect can be achieved using the This was a major step forward: a more of 3 to 6 feet will be best suited by a 26” to 32” inch monitor. newer widescreen format technology. realistic image could be delivered in T he 16:10 aspect ratio can accommo- about 20 minutes. are a few that this author is aware have a hand in the design of the imag- date up to 2,560 x 1,600 pixels. The T his technology was effective in the au- of. Incorporating imaging into your ing, which is a tremendous advantage author uses a 32” Samsung monitor. It thor’s practice for several years but, in his practice to promote the possibilities when imaging is done within the office. makes sense to invest in a high-grade opinion, it sometimes lacked anatomi- to your patients of what they can look Additionally, not all imaging services monitor for dramatic case presentation. cal correctness. The author felt that the like provides many advantages to the provide frontal 1:2 and lateral 1:2 smile T he monitor cable is also a key com- weakest link was the early digital cam- development of the cosmetically di- views. Often they are limited to just ponent in high-quality resolution. The eras that only captured 2.0 megapixels; rected practice. The obvious advantage the full-face view. These additional older style VGA (HD 15) cables cannot the digital camera technology currently is case acceptance of more esthetic/ views are significant in communica- support resolutions above 1,024 x 768. available has obviated this issue. functional cases. Providing a means for tion with the patient and can impact Either an HDMI or DVI cable must be T he Envision A Smile software (www. staff growth and esteem also is impor- case acceptance. run to send native resolution up to the envisonasmile.com) is now the author’s tant. Delegating this art form to a staff full potential of an upgraded monitor. personal choice for its ease of use and member allows them to expand their Conclusion The next component to ensure maxi- anatomically correct images. This knowledge, abilities, and productivity T he author’s observation of computer mum resolution is the video card inside software company has innovative tech- within the practice. As they become imaging technology over the last 22 the computer. Many of the traditional niques to image both frontal and lateral better and more fulfilled, so does the years has led to his conclusion that it is video cards will not support the 16:10 views. These images also can be done quality and productivity of the practice. prudent to offer this visual type of case aspect ratio and do not have DVI out- in about 15 minutes using a versatile Cosmetic imaging can also be done presentation for increased case accep- puts for a digital signal. If the computer smile library. The author now provides through imaging services. Envision A tance. It is surprising that this art form is does not have an upgraded video card artistic consultation only for the image Smile, Smile Vision (smilevision.net), not used more often by dentists perform- with DVI outputs, an upgraded moni- during the process to be sure that the S milePix (www.smilepix.com), and ing cosmetic and restorative procedures.

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