Aesthetic Dentistry. J. Schmidseder. Читать онлайн. Newlib. NEWLIB.NET

Автор: J. Schmidseder
Издательство: Ingram
Серия: Color Atlas of Dental Medicine
Жанр произведения: Медицина
Год издания: 0
isbn: 9783131607515
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areas of medicine—particularly in gastroenterology—endoscopes have been used for many years. The first intraoral video camera, the Fuji DentaCam, was developed from these endoscopes in 1987. Even though interest in the camera disappeared soon after its introduction, there were some dentists who realized the potential of intraoral miniature cameras. Since then, many manufacturers have made developments or improvements in intraoral cameras.

      Simultaneously, so-called imaging systems were being used in many areas of industry and medicine, with which digital pictures (of houses, cars, faces, etc.) were taken and later processed with the help of a computer. This imaging concept was also introduced into dentistry in the late 1980s and was used to change electronic images of anatomical, oral outlines to be used in treatment planning and in patient education. Although many users assumed that this imaging concept would be an extraordinarily successful method for improved patient education, it has not yet found the acceptance it deserves among users of intraoral cameras.

      Dental practices that are equipped with intraoral cameras use them, first and foremost, to show patients their own intraoral images. Video films, watched in the practice or at home, can also be used to promote patient education. These two ways of using video technology predominate in dentistry today.

      Diagnosis and Treatment Planning

      Each dentist uses different methods to modify patient behavior and acceptance of treatment plans. The intraoral camera allows the patient to directly observe the intraoral situation for the first time. Thus, the patient can participate directly in the decision-making process as far as the treatment plan is concerned. The dentist or staff can use an intraoral camera to explain any relevant details to the patient. In a dental office with well-trained staff, patient education is usually performed by the staff. This is cost-saving and, furthermore, the staff are often more thorough than the dentist in presenting the instructional aids.

      Intensive patient education with the use of intraoral images is recommended because these images show the necessity of a treatment or a particular, selected treatment method. The intraoral camera is a simple, easy-to-use medium for educational purposes. The areas of the mouth requiring therapeutic measures are shown on the screen situated in front of the patient. This relatively self-explanatory method usually leads to acceptance of the proposed therapy.

      A diagnostic session which also uses an intraoral camera takes only a little longer than a regular session. Patients taking advantage of such a diagnostic session alter their behaviour and develop, often spontaneously, an astonishing interest in the condition of their oral health. The advantages for the dentist He in having an increasingly active practice and the introduction of new clinical techniques.

      The intraoral camera is used primarily for patient education in the dental practice. The integration of an intraoral camera in the diagnostic session necessitates neither radical administrative changes nor other serious alterations.

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       40 Intraoral video appliances used chairside

      The intraoral video camera and the monitor should be installed close to the dental chair so that they can be used without significant time delays.

      

      Cosmetic Imaging

      Imaging methods are used to demonstrate to the patient possible modifications, for example, by means of aesthetic dentistry. Moreover, they open up new possibilities for the dentist in aesthetically-oriented therapy. After images of the oral structures have been made, they can be modified electronically. For example, a diastema can be closed, tooth color can be lightened, the visible gingiva can be increased or reduced, a chin remolded, class-III malocclusions altered, etc. These results can consequently be seen by both the dentist and the patient.

      If “before and after” pictures are shown, the computer-processed electronic image becomes particularly impressive for patients and often results in behavioral changes. However, use of intraoral images results in significantly greater changes in the routine of the practice than use of intraoral camera does. More time is required for a diagnostic session. Normally, a separate room must be available, and highly motivated and well-trained staff are needed who have sufficient time and creativity to demonstrate the different therapeutic options to the patient.

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       41 Mobile cart with integrated intraoral video player

      The advantage of a mobile cart is that it can be used in several treatment rooms.

      During Treatment

      The necessity of altering a treatment plan during therapy arises relatively frequently. Generally, many patients cannot accept this. The intraoral camera can substantially improve the patient's acceptance. If, whilst restoring a cavity, a full crown becomes necessary, the reason for the altered treatment plan can be explained to the patient on the spot with the help of the intraoral camera. The result is an improved dentist-patient relationship and increased acceptance.

      After Treatment

      Nowadays, it is especially important to gain patients' trust, so that they accept the chosen therapy. By using “before and after” pictures after treament has been completed to tactfully demonstrate differences to the patient, the dentist has a reliable way to build up trust and improve the dentist-patient relationship. The intraoral camera is also an outstanding tool for this task.

      The following section gives examples of situations in which it is necessary for the dentist to take pictures of oral conditions.

      Frequently, it is not the patient to be treated (child, spouse) or the patient alone who decides how the therapy will be carried out and paid for. Many intraoral camera systems now offer printouts of the oral conditions displayed on the monitor. These printouts can be given to the patient to be take home, thus facilitating the decision as to whether or not to execute the treatment plan.

      Prints of intraoral conditions, showing the necessity of a proposed treatment, are invaluable for dentists when they are negotiating with insurance companies. An excellent example of this is a patient with a root fracture, of which no radiographic image is submitted, but instead a picture of the current condition in the mouth. Insurance companies can be positively influenced by such pictures.

      The pictures generated by an intraoral camera are excellent for clinical research documentation, patient information, or for documentation of situations that do not (yet) require treatment, but need to be observed further. Some dentists also prepare patient portraits that are attached to the patient records.

      The storage of digital image data requires a large memory capacity. As well as the normal disks (Compaq), special ones are available, namely, Zip and Jaz drives, streamer, interchangeable hard disks, and rewriteable CD-ROMs in conjunction with a CD-ROM recorder.

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       42 Oral images on the monitor

      Every dentist is familiar with the problem of showing the patient defects on posterior teeth using two mirrors. Despite the dentist's efforts, the patient, in general, neither recognizes the problem correctly nor understands it. On the screen, the defective amalgam fillings can be demonstrated much more clearly and digitalized radiographs can be used to give added weight to the arguments previously put forward.

      There are certain situations in the daily routine of a dental pracatice in which the dentist