Electronic Imaging in the Orthodontic office
Electronic
Imaging in the Orthodontic Office
By
Mark Leonard
en
Francais
On the market today there are more then two dozen digital
cameras, with prices ranging from $200 to $30,000. Only a select few are
suitable for use in an orthodontic office. Which is the best? After several
frustrating months of testing, questioning, and playing we narrowed our
choices down to three, the Fujix DS-220 ($2700), the Minolta RD-175 ($7200),
and the Kodak DCS-460 ($27,990).
Fujix: The Fujix is a nice camera for the
home, not the office. The image quality was not precise enough to see any
decalcification, or other preexisting problems that could later be blamed
on the appliances. There were to many attachments. Although the optional
LCD viewer is a nice feature because it allows you to see if your picture
needs to be retaken. The Fujix wasn’t as "user friendly" as some
of the other cameras tested, and it uses Type II PCMCIA cards to store
the pictures, which are expensive and hold only a few pictures.
Kodak:
Kodak makes 12 different digital cameras with more on the way. The
Kodak DCS-460 is the king of all the Kodaks. This camera is the closest
to a 35mm, but who wants to spend $30,000 on the camera alone? The image
quality was excellent with only a minor color difference between the digital
output and the actual subject. One major setback was: for intraorals or
facials, the internal camera settings, and the lens needed to be changed.
Kodak's ring flash was powerful enough to take the facial pictures. This
camera uses Type III PCMCIA card to store the pictures, which are less
expensive and hold more. If you have an extra $30,000 and want an excellent
camera the Kodak DCS-460 is a worthy investment, for those who are on a
budget an even better investment is the Minolta RD-175.
Minolta
RD-175: Right off the bat the RD-175 has something going for
it, the starting price is $5200. With the addition of the 50mm macro lens
which allows intraoral and facial pictures to be taken without changing
the lens, and Minoltas 4-tube ring flash the price jumps to $6000! Not
only do you get a great camera but also you get a great price allowing
you to purchase all the extras you need. The Minolta offers a 3 CCD chip
system which gives you better color representation, and the camera comes
with a 131MB Type III PCMCIA card which holds 114 pictures. The RD-175
is a point and shoot camera because everything is automatic and there are
no settings, or lenses to change, like most other cameras. If your office
currently uses a 35mm camera for its records there is no training. WSYWIG!
What you see in the viewfinder is what you get, and your staff only needs
to remember to recharge the batteries. Even though this camera is the preferred
choice it does have its limitations. The downloading time from camera to
computer is quite lengthy, and Minolta has it’s own proprietary software
with makes it difficult to run on some software programs.
After you have taken your pictures the fun really begins,
what to do with them. Using Adobe Photoshop 3.01 the images are downloaded
into the computer. The raw image is 5mb and to make it more manageable
the images are resized to 1.37mb. One by one the images are downloaded,
resized, copied and pasted into Dentofacial
ShowcaseTM v1.5. Within Showcase the images are
cropped, classified, patient information, and the x-rays are added.
When making the decision on which camera to purchase the
question of x-rays came into play. Some digital records systems require
that a separate flatbed scanner be purchased in order for patient x-rays
to be added. This can cost upwards of $1500 in addition to the other purchases
you make. When testing the RD-175 we took a picture of a cephalometric
x-ray while it was on a viewing box, and the results were astonishing!
The image was just as good as the scanner and $1500 was saved. Once the
records have been downloaded, including photos and x-rays, what do you
do with them? The first thing that needs to be done is a hard copy of the
images needs to be added to the patient’s charts.
When
setting up a digital records system the most important purchase is your
printer(s). $30,000 maybe spent on a camera but with the wrong printer
your images might look as if they came from a $200 camera. For printing
the record images a dye-sublimation printer is recommended. Dye-sub printers
can be quite expensive ranging from $1500 to $10,000, they have a high
operating cost, but the output is well worth it. After working out the
kinks the output is as close to a 35mm as you may get. The dye-sub we selected
is the Fargo Primera Pro. The Primera Pro is one of the best selling dye-sub
printers, and one of the most affordable with a starting price of $1895.
It has a DPI of 600X300 with 16.7 million colors, although it has a slow
print time of 9MPP!
After a hard copy of the records has been printed out the
patients usually has a consultation and begins treatment, which means letters.
One of the greatest advantages of having digital records is the simplicity
of adding photos to your letters. From Dentofacial
ShowcaseTM it is a simple step by step procedure starting
with Letter Links. Within Letter Links you simply select the letter you
have previously created, the "to" person, the "from"
person and the program open Microsoft WordTM, merges the patient
information, adds the pictures, and prints the documents. From start to
finish a letter usually takes 5 to 10 minutes.
For printing letters we use 1 of 2 printers, depending
on the letter, the Hewlett
Packard 5 or the 
Epson
Stylus Pro. The HP 5 ($2000) is a black and white laser printer, with
an additional 200 page paper tray, and a power envelope feeder. It has
600X600 DPI, 12PPM, and a 7000 page toner cartridge. The Stylus Pro is
a color ink jet printer with 720X720 DPI on special Epson paper, and it
has a slow print time of 10MPP. Epson has just released a new color printer
with a stunning 1440X720 DPI and a speed of 7PPM!
What
do you do with all your files that are taking up valuable hard drive space?
The files need to stored where they can easily be accessed for letters,
treatment review, and when someone finished treatment. The answer is a
CD-R (compact disk recordable) which allows you to permanently "burn"
your files on a CD. CD-R can be very tricky to setup and operate which
is why it is recommend that someone helps you. Pinnacle
Micro is a leader in the CD-R business but their customer support can
be trying, especially for someone unfamiliar with the process. We use the
5040 CD-R and we have had very few problems with it although the problems
encountered have not been solved due to Pinnacle Micro's slow response
time.
Digital cameras are the future of orthodontics
but it is a big investment. It is not something that can be decided overnight
and requires alot of research. I have a vast knowledge on this subject
and will help you in anyway that I can, please e-mail me with any questions
if I you would like my help.
You can E-mail Mark Leonard directly from here! zujc97a@prodigy.com
