Intraoral Cameras

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• Intraoral Cameras
• Heiko Spallek, DMD, PhD
• Titus Schleyer, DMD, PhD
• Center for Dental Informatics
• School of Dental Medicine
• University of Pittsburgh
• email hspallek_at_dental.pitt.edu

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• Agenda
• Integration
• Image management
• Basics of digital imaging
• Camera features
• Switching to digital

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Integration Key for Success

• Display an intraoral image on the screen

1. remove the camera from the holder 2. switch
the camera on 3. start the image management
program on the computer 4. select "image capture"
1. remove the camera from the holder
OR
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Integration Key for Success

• Examples of integration problems

upgrading practice management system ?
incompatibilities bad ergonomic design ? turn
each time you want to use a computer poorly
integrated devices ? significant clutter (cables,
boxes, carts) Integration between hardware
and software is almost nonexistent.
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Integration Key for Success

• Examples of hardware integration
• intraoral cameras integrated into the delivery
  tray
• computer monitor mounts on dental chairs
• multifunction foot pedals (for instance for
  alternatively controlling handpiece speed and
  capturing intraoral images)

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Integration Key for Success

• Examples of hardware/software integration
• intraoral camera that automatically communicates
  with the digital imaging software when it is
  removed from its holder, and displays the image
  immediately without further intervention by the
  dentist

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Integration Key for Success

• Multiple bridged programs

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Integration Key for Success

• Single bridge between two programs

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Integration Key for Success

• Single program/ database

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Image Management

• Image Management Systems
• software application to store and retrieve all
  types of dental images
• - standalone or integrated into PMS

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Image Management Systems

• Image management systems should offer a
  comprehensive feature set
• management of multiple types of images from
  multiple sources
• flexible display
• annotation
• basic image manipulation
• flexible image retrieval
• multiple storage options
• integration with other dental software
• scalability

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Image Management

• Digital imaging workflow

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Image Management

• The Digital Imaging and Communications in
  Medicine (DICOM)
• standard governing the medical imaging domain
  without it, we suffer from
• - proprietary imaging systems
• - difficulty in exchanging digital images among
  colleagues
• - difficulty in importing patient images from
  removable media
• - lack of quality assurance for digital imaging

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Image Management

• DICOM facilitates
• - mixing of imaging devices and programs from
  different vendors
• - portability of images
• - image integrity and quality assurance in image
  exchange

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Basics of digital imaging

• Image Attributes and Their Clinical Relevance

Attribute Definition Clinical relevance
Resolution Sharpness and clarity Resolution must be high enough that picture does not appear grainy or fuzzy.
Color depth Number of distinct colors in the image Number of colors must be adequate to represent clinical colors with high fidelity.
File size Total size of the image on disk File size should be minimized to assure quick loading and transmission.
Compression Method with which file size is reduced Compression should not produce artifacts that reduce the quality of the image visibly.
Compatibility Ability to load and manipulate image in different programs Image format should be compatible with programs commonly used in dental practice.
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Basics of digital imaging
Resolution
The high-resolution image on the left appears
sharp, while the low-resolution image on the
right appears grainy.
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Basics of digital imaging
Resolution
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Basics of digital imaging
Color Depth
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Basics of digital imaging
File Formats
JPG (Joint Photographic Experts Group) - glossy
compression (user can define level of
compression) - purpose photographic (continuous
tone) images - bit depth 24 bit GIF (Graphics
Interchange Format) - lossless compression -
purpose best for images with areas of uniform
color such as illustrations - bit depth 8 bit
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Basics of digital imaging
File Formats In-class assignment

• Research all relevant details about the following
  file formats
• TIFF
• BMP
• PNG
• PICT
• Prepare a 2-minute presentation about your
  assigned format.

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Intraoral Cameras

• Intraoral cameras
• - primarily designed to record intraoral
  photographs
• - fit into small spaces ? record views not
  obtainable with other cameras
• - transmit the image to a base-unit or computer

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Intraoral Cameras

• Intraoral camera types
• analog
• - first on the market, but almost disappeared
• - connect to TV
• - better images than their digital counterparts
• digital
• - better designed to interact with computer
• - various image manipulation possible
• - many incompatibilities when connected to PMS
• hybrid
• - display images on standard TV monitors as well
  as computers
• - provide a backward-compatible solution

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Intraoral Cameras

• Digital Image Capture image sensors types
• - charge-couple device (CCD)
• - complementary metal oxide semiconductors (CMOS)
  
• newer type!

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Intraoral Cameras

• Physical Location and Integration 1
• single-operator offices
• - single, stationary intraoral camera

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Intraoral Cameras

• Physical Location and Integration 2

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Intraoral Cameras

• Physical Location and Integration 3

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Intraoral Cameras

• Ease of Operation
• Handpiece configuration
• - placement of the CCD sensor
• - location of the light source
• - location of the power source
• - image transmission

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Intraoral Cameras

• Ease of Operation
• Handpiece configuration
• Schick USB Cam
• - LEDs as light source
• - 60 g

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Intraoral Cameras

• Ease of Operation
• Handpiece configuration
• Dentrix Image
• Cam

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Intraoral Cameras

• Ease of Operation
• Handpiece configuration
• Dentrix Image
• Cam
• - bulky cable

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Intraoral Cameras

• Ease of Operation
• Handpiece configuration
• Schick USB Cam
• - light cable

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Intraoral Cameras

• Ease of Operation
• Lenses
• single lens
• - simpler design
• - tend to distort images
• set of interchangeable lenses
• - operator can pick the right lens

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Lens angles
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Intraoral Cameras

• Ease of Operation
• Focus
• Once an image is framed, it needs to be focused.
• fixed-focus cameras ? vary the distance to the
  object until it is in focus

SOPRO 575
Image Cam
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Intraoral Cameras

• Ease of Operation
• Image capture
• - continuously records images and displays them
  on the screen
• - capture button or foot pedal to freeze the
  current frame

Schick USB Cam
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Intraoral Cameras

• Ease of Operation
• Sterilization and disinfection
• - camera comes in direct contact with saliva,
  blood or oral tissues
• - protective plastic cover or disposal sheaths
• - some handpieces detachable intraoral parts
  which can be autoclaved

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Intraoral Cameras

• Image Quality and Properties
• - lens with large zoom
• - large viewing angle greater image area
• - large viewing angle increased distortion in
  periphery
• - small aperture larger DOF, but illumination!

distortion full-face shot
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Intraoral Cameras

• Cygnus Micro Plus
• - hybrid camera

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Intraoral Cameras

• Cygnus Micro Plus
• - hybrid camera

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Intraoral Cameras

• Cygnus Micro Plus
• - full face

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Intraoral Cameras

• Cygnus
• Micro Plus
• - front

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Intraoral Cameras

• Cygnus
• Micro Plus
• - molars

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Intraoral Cameras

• Cygnus
• Micro Plus
• - single tooth

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Intraoral Cameras

• Cygnus
• Micro Plus
• - closest

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Intraoral Cameras

• ViperCam USB 2.0
• - companion to the ViperSoft imaging software
• - digital
• - output Composite, S-video, USB 2.0
• - portable from docking station to docking
  station (must be connected to docking station)

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Intraoral Cameras

• ViperCam USB 2.0
• - full face

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Intraoral Cameras

• ViperCam USB 2.0
• - front

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Intraoral Cameras

• ViperCam USB 2.0
• - molars

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Intraoral Cameras

• ViperCam USB 2.0
• - single tooth

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Intraoral Cameras

• ViperCam USB 2.0
• - closest

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Intraoral Cameras

• Schick USB Cam
• - digital
• - output USB
• - portable entire camera is the handpiece, no
  other components

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Intraoral Cameras

• Schick USB Cam
• - full face

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Intraoral Cameras

• Schick USB Cam
• - front

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Intraoral Cameras

• Schick USB Cam
• - molars

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Intraoral Cameras

• Schick USB Cam
• - single tooth

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Intraoral Cameras

• Schick USB Cam
• - closest

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Switching from Traditional to Digital Imaging

• Switching from Traditional to Digital Imaging
• - significant undertaking careful consideration
  and planning
• - piecemeal approach or comprehensive and
  long-term strategy?
• - danger different devices from several vendors
  that are poorly integrated or incompatible

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Switching from Traditional to Digital Imaging

• Reasons for Implementing a Digital Imaging System
• - Immediacy
• - Quality control
• - Flexibility
• - Availability

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Switching from Traditional to Digital Imaging

• Strategy for Implementation
• - computerized environment is beneficial
• - paper-based practices will experience fewer
  benefits
• Plan
• - Needs assessment and planning
• - Scope
• - Infrastructure
• - Training