Using Intraoral Cameras
While some dentists use only one treatment room, others use several simultaneously. Ideally, one monitor should be available in each room. Some systems allow the camera to be connected to the monitor or printer in each treatment room. Portable complete systems, easily transferred, can also be used.
Many dentists start off with a simple portable system and then later progress to installing a monitor in each treatment room.
The four most important applications of the intraoral camera include:
—Showing the present condition of the teeth
—Describing the condition of the teeth after treatment, using an imaging system
—Explaining different treatment methods by means of a video
—Documentation
Summary
Different recording techniques are now available, which enable dentists to provide patients with information in a manner which was previously not possible. This obviously contributes considerably to improving patient education. The best known concept in dentistry is the educational use of videotapes and intraoral cameras. The integration of both techniques in a practice should be recommended to every dentist. This increases patients' acceptance of different treatment alternatives that are now offered by modern dentistry.
Imaging systems allow dentists and patients to visualize and judge the planned treatment and its aesthetic impact even before beginning therapy. Imaging systems are less common than intraoral cameras, but they can be of great value when properly applied. The use of video technology can also be expected to spread in the future in indirect dentistry, i.e., the dentist performs the treatment with the aid of a camera and a monitor.
48 Integrated video system with flexible camera
To reduce the disadvantages of a mobile cart (preparation time, installation), and to make use of the advantages of integrated systems, some manufacturers now make the expensive camera the only mobile part of the system. This enables the camera to be used in several rooms with integrated systems.
Recommended Cameras
Several brandname appliances reflect how fast technology is evolving. They all have the required characteristics outlined on p. 32. The following appliances represent the spectrum of developments in intraoral cameras that are currently available. Three of them (Acucam, Reveal, and Cygnascope) have a relatively wide depth of focus and only one lens. This enables the camera to be used in all four of the important areas of application of the intraoral camera.
However, the technological advances in this area are so rapid that it is recommended that all available appliances on the market are checked for the desired characteristics.
Acucam
This camera system has been the market leader for several years. It has been improved continuously. Acucam can be installed as a mobile unit, but it is also available as a multifunctional appliance, so that this camera can be connected to the monitor installed in each treatment room.
49 Comparison of eleven currently available intraoral cameras
Clinical Research Associates in Provo (Utah, USA) performed currently the most extensive comparative study on intraoral camera systems.
7 excellent
5 good
3 acceptable
1 inadequate
(Adapted from: CRA Newsletter, May 1996)
Reveal
This intraoral camera system is relatively new on the market. The manufacturer mainly produces endoscopes for various uses in medicine. Reveal was one of the first companies to make sterilizable, lightweight camera systems that could be combined with an easy-to-use, multifunctional concept. It is also available as a mobile standard unit.
Cygnascope
This is the smallest intraoral camera system available on the market. It can be carried by hand from one treatment room to another. In addition, the camera is currently the smallest available.
Insight
This company is one of the pioneers in the field of digital graphic representation, which has helped this camera concept to increase its versatility and broaden its area of application. It is very useful for both patient education as well as for documentation.
Bleaching
Beautiful white teeth were already important to the Romans. They polished their teeth using urea (carbamide), especially urea from Portugal because this was known to give the teeth a brillant white appearance. During the Middle Ages, tooth bleaching was a barbaric treatment. The barbers not only extracted teeth, they also bleached teeth with aqua fortis, a mixture containing nitric acid. This treatment was initiated by first filing the patient's teeth—today one would call the process “recontouring”—with an iron grater. At the beginning of the 20th century, teeth were bleached with high concentrations of hydrogen peroxide (H2O2). The micro abrasion technique, i.e., the use of a weak hydrochloric acid solution, was used to remove stains. These treatment methods were first published in 1895 in the American Journal of Dental Science (Westlake 1895). At the beginning of the 20th century, “Colorado brown stains,” a form of fluorosis, were also removed with diluted hydrochloric acid (micro abrasion) and hydrogen peroxide (bleaching).
50 Various causes of teeth discoloration before and after bleaching
Many teeth have discolored surfaces. As one ages, teeth become darker and change to a brown-orange color. In addition, external effects of tooth discoloring are observed, such as those from smoking and some beverages (coffee, tea, red wine, etc.). However, discolorations are also due to genetic conditions or caused by the use of certain medicines (tetracycline).
History of Bleaching
Bleaching in the Practice
At the end of the 19th century, dentists began to bleach vital teeth. Westlake (1895) used a mixture of peroxide and ether. Abbot used Superoxol, a stabilized mixture consisting of 30% H2O2 to bleach teeth discolored by fluorosis (Abbot 1918; Prinz 1924). Ames earned his fame with a mixture consisting of 30% H2O2 and ether that he used with a source of heat (Ames 1937). Indeed, a treatment lasted approximately 30 minutes and the sessions were repeated up to 25 times.
Zack and Cohen (1965) were the first to conduct a scientific evaluation on how the effect of the source of heat affected the pulp. They found no pulp damage. The results were later confirmed by Nyborg and Brännström (1970).
Since 1972 Arens has also tried to bleach tetracycline discolorations with 35% Superoxol kept at a temperature of 10 °C below the pain threshold.
Home Bleaching
The orthodontist Klusmier from Fort Smith, Arkansas, had, like so many other orthodontists, patients with problematic gingivitis. He examined the effect of Gly-Oxid (Marion), which his young patients used during the night in a removable appliance. This treatment resulted in a close-to-healthy gingiva. After some patients had used this gingivitis therapy for some time, Klusmier discovered that the teeth had become brighter and that lighter tetracycline discolorations had disappeared. He presented his observations between 1970 and 1975 at different “table clinic” meetings.