ask a question Discussing the Latest in Implant Dentistry
Utilizing Intraoral Photography in your Office
Taking intraoral photographs is easy. Dr.Robert Horowitz is a periodontist with a special interest in intraoral photography. He has lectured across the U.S. on this and related subjects. He maintains a private practice specializing in periodontics and implant dentistry with offices in Scarsdale, New York and New York City. He is a Clinical Assistant Professor in Implant Dentistry at New York University. Dr. Horowitz has offered to provide our subscribers with pearls on intraoral photography. This will be the first article in a series that will cover both camera equipment and software utilized to enhance patient education and presentations.
Osseonews (ON): Dr. Horowitz what kinds of cameras would you recommend to the novice just getting strated with intraoral photography?
Dr. Horowitz: One excellent camera for the beginner is the Canon G5. This is an all-in-one type camera. It is very easy to learn and even an auxiliary can be trained to use it. To get closer than full-face images, Canon makes a conversion lens adapter and a closeup lens. When you need close-up images, the assembly fits on the front of the camera over the existing lens.
ON: What would you recommend for illumination?
Dr. Horowitz: One simple solution is to use the flash built into the camera body. While the built-in flash works very well for full-face and portrait shots, it has limitations for intraoral photography. The disadvantage with that is that it sometimes creates shadowing in some areas due to the add-on macro adapter. Another excellent option is the use of a ring flash which snaps on to the lens. One very good system is the Canon MR14 EX. This is a ring flash with two outstanding features. Firstly, the flash gives very even, high-powered illumination. This will get sufficient light to take an image of the posterior parts of the mouth or a full-arch. Sufficient light from the flash enables the operator to get a great depth of field, transferring all of the information in the field of view to the patient or audience with no out of focus areas. If the practitioner is interested in accentuating contour in anterior restorations, the flash can be made to operate as if it were a 2-point flash. Another system is the Canon MT24 EX which is a two-point flash, outstanding for anterior cosmetic images.
ON: As a rule of thumb, what would you recommend for f stops?
Dr. Horowitz: For most intraoral photographs taken on the G5, f8, the narrowest aperture, would be the best setting. The smaller the aperture (which, unfortunately for confusion’s sake, corresponds to the largest f-stop) will enable the image to be taken resulting in the greatest depth of field.
ON: Which film speed would you recommend?
Dr. Horowitz: An effective film speed of 50 is the equivalent of the slowest film speed that this camera will utilize. Using a slow ISO film speed will give the operator less noise and a more accurate image. For intraoral photography with this camera, this speed will work well in all situations.
ON: What would you recommend for shutter speed?
Dr. Horowitz: Set your shutter speed at 1/125. This will work well in all situations and enables the flash to fire at the proper time.
September 27, 2005 in Dental Implant Interviews, Digital Dentistry | Permalink | Comments (0)
Dental Implant Restorations: Internal Thread Complications
One complication encountered in dental implant restoration occurs when the internal threads of the dental implant become stripped or bent.
This may make it difficult, if not impossible, to torque down the abutment screw. Has anybody had any success in managing this complication?
September 26, 2005 in Dental Implant Complications, Dental Implant Materials, Techniques and Procedures | Permalink | Comments (8)
Dental Implants: Unpredictable Problems
While practicing implant dentistry, no matter how careful we are in performing procedures, unpredictable events and problems occur.
A real life example: While performing a procedure, the assitant knocks the driver out of my hand and the patient thinks they swallowed the driver. Actually, the patient is sure they swallowed the driver. What would you do? Would you send the patient for a chest XRay? Would you wait for something else? Would it be appropriate to have the patient check their stool?
Another interesting simple problem, and yet difficult to deal with, is when a cover screw strips so you can not remove it with the appropriate driver. On occasion, I have had to use an ultrasonic tip to loosen a cover screw. I have also had to create a slot and use a regular screw driver.
Do you have an interesting problem to share? Let´s talk about some of these unpredictable situations that rear their ugly head and post some solutions (including how I can deal with the patient who may have swallowed the driver). Furthermore, what are some of the steps people may take to avoid these these small complications?
September 23, 2005 in Dental Implant Complications | Permalink | Comments (9)
Non-Ideal Positions and Angulations
There are times when dental implants are not placed in ideal positions with ideal angulations. Suppose you intend to restore an edentulous mandible with a dental implant supported fixed partial denture.
You have taken accurate records, mounted your diagnostic casts, waxed-up the case, made your surgical stent, etc. The patient is wearing a maxillary complete denture. Your treatment plan is based on the placement of 5 regular platform dental implants in the classic A-B-C-D-E positions. The patient has a narrow, atrophic mandible which you split and grafted. Unfortunately there is sufficient bone width for the placement of narrow platform implants. The implants in A and E positions are angulated 15 degrees to the distal to accommodate the anterior loop of the mental foramen nerve. The implant in C position is angulated to the lingual to avoid perforation of the buccal cortical plate.
What would be your technique for restoring this case with a fixed partial denture? How would you make your dental implant level impressions? What design would you use for the abutments? What design would you use for the metal framework? Feel free to leave your comments below.
September 20, 2005 in Dental Implant Complications, Surgical Placement of Dental Implants | Permalink | Comments (5)
Passive Fit
One of the most challenging areas in implant dentistry is to achieve passive insertion of a screw-retained metal framework for a bar-retained overdenture or a fixed partial denture.
This frequently involves sectioning the initial framework, connecting
the segments with acrylic and picking up the united framework in an
impression to return to the lab for soldering or welding.
We invite
subscribers to share their clinical tips and pearls on this issue. We
invite dental laboratory technicians as well. Does anybody have a
tried-and-true technique that they would like to share?
September 13, 2005 in Dental Implant Materials, Techniques and Procedures | Permalink | Comments (10)
Mini Dental Implants
Dr. Todd Shatkin provided OsseoNews.com with an exclusive interview about Mini Dental Implants. Read the first interview by clicking here. Read the second interview by clicking here Feel free to post your thoughts on this interview, by adding your comments below. For additional discussions on mini dental implants, please visit our mini implants section.
September 10, 2005 in Mini Dental Implants | Permalink | Comments (77)
The Changing Role of GP's in Implant Dentistry
Are we now experiencing a major paradigm shift in implant dentistry, with the expanding role of the general dentist in the dental implant treatment process? Read an article on this topic by clicking here. Feel free to post your thoughts on this important topic, by adding your comments below.
September 9, 2005 in Future Trends | Permalink | Comments (28)
CT-based Planning for Dental Implants
Some of our subscribers believe that the real major paradigm shift in implant dentistry, is towards CT-based Planning for Dental Implants. Read some comments on this topic by clicking here. Feel free to post your thoughts on this issue, by adding your comments below.
September 8, 2005 in CT Scanning | Permalink | Comments (14)
Hydraulic Sinus Condensing
Our latest interview concludes that: "Hydraulic sinus condensing is a predictable and minimally invasive alternative for prosthetic rehabilitation of maxillary anterior and posterior regions in the presence of anatomical restrictions to implant placement." Any comments about Hydraulic Sinus Condensing? Further case studies? Suggestions? Please give us your comments below. You can also read the interview by clicking here.
September 2, 2005 in Surgical Placement of Dental Implants, Techniques and Procedures | Permalink | Comments (4)
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