Although learning how to manipulate the camera in order to improve vision during treatment requires time, this pays off later.
Treatment Using Indirect Vision
In some areas of medicine, doctors have already used monitors for some time to perform surgery and other treatments. Some dentists have also gone through this transition, at least regarding certain procedures.
43 Treatment using direct vision
Following the course of the treatment directly in the patient's mouth is often quite cumbersome. Under these conditions, the dentist is often forced to adopt a very unhealthy posture that can result in early wear and tear of the spine.
44 Treatment using indirect vision
In many areas of medicine, treatment is already being carried out using image-generating procedures that use indirect vision. Today, certain methods are already available to dentists as well, enabling them to treat patients via a monitor. The use of an intraoral video camera is a prerequisite for this.
Presently, images on the monitors are two-dimensional, without recognizable depth and width. Therefore, certain procedures are more difficult to execute with indirect vision. Simple procedures suitable for learning the method include adjustments of occlusion, which is of a two-dimensional nature.
The advantages for the dentist are:
—A relaxed upright working position,
—Magnifying eyeglasses are not necessary,
—Enlargement on the monitor can be achieved by zooming,
—Regions that are difficult to access can be viewed.
It is expected that the indirect procedure will develop further in the future and gradually become routine in dentistry. The intraoral cameras of the future will probably be located in the head of the handpiece or the turbine.
Using Videos for Patient Education
Use of video for patient education is the simplest and most advantageous method. It has already become standard practice for a large number of dentists to show short videotapes in the treatment room. These films can be shown in the following ways:
—on the monitor connected to the intraoral camera
—on a standard VCR monitor, similar to a regular TV
—on a special monitor located on the ceiling of the treatment room
In order to reduce the noise level typical for a dental practice, the patient is given headphones. There are numerous opportunities to show the films, for example, during the diagnosis session, at preoperative or postoperative treatment sessions, or during treatment.
If patient education using video films takes place during treatment, the best place to install the monitor is just below the ceiling. By doing so, the patient can be informed during less demanding treatment. It patient education is to be integrated in the routine of the practice, suitable VCRs, monitors, headphones, and tapes must be available.
Cost-Benefit Considerations
Most dentists are worried about the expenses incurred by the intraoral camera, imaging system, or patient education by use of video technology. At first, the cost of purchasing the technical equipment and the tapes appears high, and integrating the equipment takes up a great deal of time. However, dentists should not be discouraged by this. Those who have already beeen using these concepts in their practices for some years confirm that the expense and effort involved pays off within a short period due to the patients' increasing acceptance of the proposed treatment plans.
The following three priorities emerge from the concepts introduced in this chapter:
1. Videos for patient education
2. Intraoral cameras
3. Imaging
Some systems are available that combine video technology and intraoral cameras; other complete systems combine all three concepts in one single system.
45 Video films during treatment
Some patients like to watch a video movie during a treatment. Video glasses and glasses with an integrated monitor help fulfill such a wish. Who would not like to pursue the course of his/her own treatment with a pair of such glasses? This is the concept of virtual reality in dentistry.
Characteristics of Intraoral Camera Systems
Clinical Research Associates (CRA) in Provo, Utah, identified the requirements that an intraoral camera should fulfill (1991). They are:
Manipulation: Only one hand should be needed to operate the camera.
Wide observation field: The camera should be able to view several teeth (a quadrant) simultaneously. This provides better orientation for the patient and makes it easier for the dentist to perform treatment with indirect vision. The ideal intraoral camera should be easy to adjust from close-up pictures of the teeth to pictures of the entire dentition.
Small camera hand-pieces: These should allow distal tooth surfaces and posterior teeth to be visualized.
High resolution: An intraoral camera should have high resolution without noticeable distortion.
Stills: It should be possible to take stills with an intraoral camera at high resolution. A still picture is helpful when analyzing and discussing a particular intraoral condition.
Accurate color reproduction: Poor color reproduction is confusing for both patient and dentist.
Automatic light regulation: Additional light sources to improve the light conditions for the intraoral camera should not be necessary.
Sterilization: An intraoral camera that can be sterilized would be desirable. However, sufficient disinfection is guaranteed by means of plastic foil wrapping.
Printing the pictures: A high resolution is necessary for documentation. The printer should be equipped with a large RAM (16 MB).
Rotation of pictures: It must be possible to rotate a picture by 180 and to change left—right orientation to execute a left-right switch.
Activation of the appliance: The intraoral camera should have a simple “on—off” switch and a short or no warming-up period.
Size of the unit: The smaller the better.
Further aspects: Multifunctional applications are advantageous, i.e., the camera can be networked to additional monitors and connected to other VCR equipment.
New developments are constantly taking place in intraoral cameras, which means that we will see new, improved features on a regular basis.
46 Components of an intraoral camera
An intraoral camera consists of a camera with interchangeable lenses (left) and a device capable of processing the video signals (right).
47 Intraoral camera
The lens of the intraoral camera should be very small, so that it