Larry Emmott, DDS
Cosmetic imaging, or using a computer to digitally alter a patient`s smile to demonstrate esthetic treatment results, has been re-born with amazing new systems, cameras, printers, and software.
Cosmetic imaging was introduced to dentistry in the mid-1980s. After a brief flurry of excitement, it faded away. It faded because it was hard to do, took too much time, and was expensive. All of that has changed. Like most technology-driven items, imaging has become easier, better, and a lot less expensive. What has caused this change is:
> the introduction of better software with specific tools designed for dental use;
> the introduction of good digital cameras and other inexpensive capture systems;
> photo-quality ink jet printers; and
> the growing use of computers in all areas of the dental office.
Software: Two imaging software programs have been driving the revolution, ImageFX and Vipersoft. Several others have just entered the market, including Dicom and Imagine-It. Imaging software combines several image management features including image capture, storage, retrieval, editing, printing, and manipulation. Some advanced features include video, radiograph integration, and electronic image transmission.
Here`s the basic process. First an image is captured. That means a digital smile picture is taken. This can be done with a digital camera, it can be captured from a video image, or it can be scanned from a conventional photograph.
Once the digital image is captured, it is stored in an electronic photo album. The photo album or database will have a search function to locate each patient`s photos. These are usually some sort of alphabetical search and a thumbnail image to choose from.
Cosmetic tools: The next step is to alter the image to demonstrate treatment. These cosmetic manipulation tools set imaging software apart from basic image management such as Tigerview. New programs have better tools, which are easier to use than most of the original systems. The tools are really just common photo manipulation tools (such as are used in Photoshop), but they are customized for easy dental applications. For example, there are tools for easy whitening or to move, rotate, reshape, or replace teeth.
There are two basic ways to make cosmetic image changes. The first is to reshape individual teeth. This works well for simple changes such as closing a diastema or lengthening individual teeth. It also works well for whitening.
For more complex cases, replacement tools allow you to replace selected teeth with ideal teeth chosen from a smile library. The library try-in method also can be used to replace three or four teeth instead of the whole arch. However there are some areas of concern with this method. First, the quality of the smiles in the library is critical. Also the patient picture you take must be properly aligned if the substitute teeth are to look normal. Another factor is the ease of substitution. How easy is it to align the size and position of the try-in teeth with the original smile? But the most significant issue with this method is delivery of the treatment. You must be able to actually deliver the treatment you are proposing.
Whichever method you use, it is a good idea to include a disclaimer on all printed images. For example, the disclaimer could read, "This is a simulation only; actual results will vary."
ImageFX vs. Vipersoft: I have had the chance to use both programs in my office. They are both good, however, in my opinion, they have different strengths.
For pure cosmetic manipulation, I prefer ImageFX. The tools are easier to use, the library, which was developed by Bill Dickerson, is better and the smile replacement system is easier to use. It also has nicer display options.
On the other hand Vipersoft has some advanced features ImageFX does not. Vipersoft has a better slide show, more graphics options, and a unique digital movie capture feature called DIME.
The future is coming and it will be amazing!
Dr. Larry Emmott is a practicing general dentist in Phoenix, Ariz. He also is an entertaining, award-winning professional speaker. He has addressed hundreds of professional groups. He is a featured speaker at the Las Vegas Institute, is a member of AADPA. He will be a speaker at Cosmetic Dentistry 2000. He has written many articles for national magazines on dentistry, computer use, and management. He produces a monthly newsletter on management and computer use in the dental office. He has developed and maintains an Internet Web site at www.drlarryemmott.com; his e-mail address is [email protected].
