November 16, 2020
The rise in technology and material science has led to dental treatments be more effective than ever. In order to better the diagnosis and treatment plans, researchers have taken a step ahead by giving importance to documentation of cases with photographs. This led to the evolution of dental photography too.
The growing medico-legal concerns has made documentation of cases a mandatory procedure. This involves all the details of the patient's history, complain, treatments, follow-ups, all accompanied with the needed before and after treatment photographs. In order to better the quality of images of the dental photographs, there are various equipment used apart from the camera itself. One such category of items are contrasters.
A dental photograph involves taking photographs of the teeth in a particular region. In the process of taking the photographs for a particular region, many unwanted areas present behind the teeth may hinder the quality of the image. These include nostrils, lips and some soft tissues. Moreover, the human tooth at some areas has a translucent hue. These areas are important to visualise for better understanding the tooth's anatomy. The structure of the teeth can be thus enhanced by placing a black or grey colored screens behind the teeth of concern. This is achieved by placement of contrasters.
Contrasters are objects that are shaped for each particular segment from which the teeth can be photographed - front (anterior), back (palatal/lingual), inner lining of the cheeks (buccal), bite (occlusal). These objects have two parts. One is the main design of the screen and the other is the attached handle through which the contraster is held. It is available in sizes for both adults and children.
Dental contrasters used in intraoral photography are made of black anodized aluminium or metal plates. Additionally, they are coated with black silicone. These objects can be sterilized by putting inside an autoclave that functions at a temperature of 121°C. The initial contrasters were not compatible with the flash of the camera. The eventual photograph would bare the white color of the flash which degraded the quality of the image. The modern contrasters coated with silicone can handle the camera flash better. Moreover, digital softwares can now adjust the intensity of the black color and further enhance the image.
Dental contrasters made entirely of silicone rubber are better options when it comes to flexibility. These can be bent in the desired manner while taking the image of a particular segment of teeth. Alternatives to the dental contraster can be contraster papers that can be cut into desired shapes. However, these are disposable items. Currently, the most ideal choice for contraster color is black velvet which has a matte finish. Grey contrasters are used in order to balance the white exposure in dental photography but has limited use.
A contraster is usually used with a retractor and an intraoral mirror. The retractor pulls the cheeks and helps in better visualisations of the gums. The intraoral mirror ensures that all teeth in the arch or the desired teeth of a segment is easily seen. The contraster is placed at the region behind the teeth. The camera is focused on the intraoral mirror and the image is later captured.
The use of a contraster can be helpful in visualising many important conditions of the teeth. Any discoloration can be appreciated and be indicative of a carious lesion or staining. These images are so perfect to the minute details that even a decay on the edges of incisors can be seen. A proper bite photograph can also be used to determine how the upper and lower teeth meet each other and whether or not there is any malalignment of teeth. The health of the gums can also be assessed by seeing their texture, color and position in relation to the teeth. Post-operative treatments can help the dentist know whether the treatment carried out has been aesthetic and functionally acceptable for the patient.
Dental photographs with contrasters better the images quality and are often accepted for various scientific articles, journals, etc. Moreover, they help better analyze the patient's condition before and after the treatment. The use of contrasters with retractors and intraoral mirrors is thus a valuable tool in dental photography.