1000055 JOO Journal of OrthodonticsShahrul

Cutting Edge

Journal of Orthodontics

Mirrorless cameras in orthodontic 1­–5

https://doi.org/10.1177/14653125211000055
DOI: 10.1177/14653125211000055
© The Author(s) 2021
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Al Imran Shahrul

Abstract
Mirrorless cameras have seen rapid advancements in recent years. Orthodontists may benefit from these technological
advancements in their daily orthodontic practice. This article will explore the advantages and disadvantages of mirrorless
cameras, and assess how these camera compare to the tried-and-tested digital single-lens reflex (DSLR) camera.

Keywords
mirrorless cameras, photography, orthodontics

Date received: 19 January 2021; revised: 19 January 2021; accepted: 15 February 2021

Introduction of mirrorless cameras for taking clinical orthodontic photos

(DSW Team, 2020).
The use of photography in orthodontic practice goes back
more than 100 years to Edward Angle, who is recognised as
the first orthodontist to routinely utilise photography for Mirrorless cameras
diagnosis (Galante, 2009). A full set of high-standard ortho-
A DSLR camera is constructed with a complex system of
dontic clinical photographs is an invaluable record for an
mirrors that reflect the light upward as it passes through the
orthodontist (Ahmad, 2009a). There are many benefits of
lens, using a pentaprism, then out through the viewfinder
orthodontic clinical photographs (Sandler and Murray,
(Figure 1). The mirrors also reflect light downward to the
2010a). These include: recording a baseline in clinical
dedicated autofocus sensor. In a mirrorless camera, the
records; aids for communication with general dental practi-
complex mirror, pentaprism and dedicated autofocus sen-
tioners; aids for communication with patients and parents;
sor are removed, and the light passing through the lens trav-
photographs as teaching tools; determining whether to
els directly onto the image sensor (Figure 2).
intercept treatment that is not progressing normally; maxi-
The image sensor in a mirrorless camera then converts
misation of the learning experience for trainees; adherence
the light into an image and displays it in an electronic view-
to medico-legal requirements; and usefulness in communi-
finder or on the back liquid-crystal display (LCD) (Canon,
cation with the courts.
2020b). The image sensor must function as an autofocus
Taking high-quality orthodontic photographs requires
sensor, as well. Thus, the performance of a mirrorless cam-
photography skills and the proper equipment, such as a
era is highly dependent on the image sensor. Mirrorless
digital single-lens reflex (DSLR) (Ahmad, 2009c; Bister
cameras were previously considered to be inferior to DSLR
et al., 2006; Sandler and Murray, 2010b). For more than
cameras due to their smaller sensor size, slower autofocus
two decades, DSLR cameras have been recognised as the
speed and reduced accuracy, but this is no longer the case.
best cameras for taking orthodontic clinical photographs
(Sandler and Murray, 2001). In the last few years, however,
camera technology has seen rapid developments, especially Centre for Paediatric Dentistry and Orthodontic Studies, Faculty of
in the mirrorless camera category (Zoltie, 2018). It is the Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
author’s opinion that mirrorless cameras have surpassed or
Corresponding author:
now equal DSLR cameras in both their technology and Al Imran Shahrul, Centre for Paediatric Dentistry and Orthodontic
functionality. This article will explain how it is that mirror- Studies, Faculty of Dentistry, Universiti Teknologi MARA, Jalan Hospital,
less cameras differ from the current gold standard— Sungai Buloh, Selangor 47000, Malaysia.
DSLR—and will explore the advantages and disadvantages Email: dralimranshahrul@gmail.com
2 Journal of Orthodontics 

Figure 1.  Photograph of a digital single-lens reflex (DSLR) Figure 3.  Photograph demonstrating the Eye AF feature.
camera.

Figure 2.  Photograph of a mirrorless camera. RP mirrorless camera is significantly lighter than the Canon
EOS 7D Mark II DSLR, even though the DSLR has a
smaller sensor size. The reduced weight is particularly ben-
eficial when taking occlusal and buccal intraoral shots, for
which it is recommended that the camera be held with one
hand while the other hand holds the retractor or mirror
(McKeown et al., 2005).

Focusing
Mirrorless cameras have significant benefits for ortho-
dontists who wish to use autofocus. One major benefit is
Eye AF (Alpha Universe, 2016), a feature that enables
the camera to autofocus specifically at the eye and track
Camera manufacturers have introduced advanced photo its movement (Figure 3). For extra-oral photography,
system type-C (APS-C), full-frame and a medium-format this feature allows precise autofocus on the patient’s
sensor sizes that are equivalent to that of DSLRs (Zoltie, eye, resulting in a reduced occurrence of out-of-focus
2018). The larger sensor sizes equate to a better photo qual- extra-oral photos.
ity. Autofocus performance has also been drastically One other major advantage of mirrorless cameras is the
improved by advancements in phase- and contrast-detect number of autofocus points. The Canon EOS RP, for
autofocuses. Both these autofocus features result in an example, has 4779 autofocus points (Canon, 2020a),
autofocus system in a mirrorless camera that is as fast and whereas the Canon DSLR EOS 7D Mark II has only 65.
precise as its DSLR counterpart (Captain, 2020). Furthermore, the focus point in mirrorless cameras covers
The DSLR and mirrorless cameras discussed in this arti- almost the entire picture frame. This is crucial when ­trying
cle are from Canon. Other camera manufacturers, such as to focus on a tooth at the margin of the picture frame. In
Sony, Nikon and Fujifilm, also produce mirrorless cameras contrast, for DSLR cameras, the focus points are clustered
with the same features. The author has been using the in the middle of the frame; as a result, it is sometimes
Canon EOS RP mirrorless camera (Figure 2) to take clini- necessary for the orthodontist to focus and recompose
cal photographs on a daily basis since its release in March when taking a photo.
2019; hence, it is fitting that this Canon camera was chosen To obtain a standardised clinical photo, the orthodon-
for this article (Canon, 2020a). tist is advised to use the manual focus (McKeown et al.,
2005; Sandler and Murray, 2010b). The orthodontist
achieves focus by moving the camera closer to or farther
Advantages of mirrorless cameras away from the subject until the subject is in focus. One
excellent feature of mirrorless cameras is ‘focus peaking’,
Size and weight
which highlights the part of the photo that is currently in
By removing the mirrors and autofocus sensor, camera focus (Figure 4). Based on the author’s experience, this
manufacturers can produce a camera that is significantly feature is extremely valuable in achieving a consistent,
lighter and smaller than a DSLR camera. The Canon EOS perfectly sharp manual-focus image.
Shahrul 3

Figure 4.  Photograph showing the focus peaking feature. Image stabilisation
The subject in focus is highlighted in red. Image stabilisation is activated when the image sensor
detects any camera movement. The camera processor then
analyses the information and counteracts the movement by
moving either part of the lens or the image (Nicholson,
2020). Image stabilisation in DSLR cameras is limited to
the lens, whereas the latest mirrorless cameras (Canon EOS
R5 and R6) are capable of stabilising both the image sensor
and the lens. This is beneficial because it compensates
admirably for any camera shake, which may occur espe-
cially when holding the camera with one hand while taking
intra-oral photos.

Disadvantages
Small form factor
Having a lighter and a smaller camera does come with sev-
Figure 5.  Photograph demonstrating the electronic level eral disadvantages. First, a mirrorless camera may feel
display and photo grid. front-heavy or imbalanced due to the difference in weight
between the camera body and lens. The second disadvan-
tage is the smaller grip of a mirrorless camera, which the
orthodontist may feel less comfortable holding (Zoltie,
2018), as it may cause straining of the wrist and fingers.

Battery life
Mirrorless cameras have a poor battery life compared to
DSLR cameras (Captain, 2020; DSW Team, 2020) for sev-
eral reasons. First, mirrorless cameras perform a greater
number of functions than DSLR cameras, as described
above, and the electronic viewfinder and image sensor
deplete the battery power at a faster rate than in DSLR cam-
eras. Second, due to the smaller form of mirrorless designs,
these cameras can only accommodate smaller batteries,
Electronic viewfinder and back liquid-crystal despite the greater power demand. Based on the author’s
display experiences, using a Canon EOS RP mirrorless camera, the
battery life may last for one day or more of orthodontic
Mirrorless cameras display the image on the electronic clinical sessions. This can vary, however, depending on the
viewfinder or the back LCD, allowing for more informa- number of patients and number of photos taken.
tion to be displayed than is possible in a traditional DSLR
viewfinder (Ringsmuth, 2018; Suzuki, 2017). The elec- Cost
tronic level display feature provides valuable information
and allows the orthodontist to ensure that the camera is Mirrorless cameras and their lenses are more expensive
level to the floor. Additional guides can also be added, such than DSLR cameras and lenses (Captain, 2020). The
as the photo grid (Figure 5), which may aid in the framing increased cost is due both to the extra features as well as the
of intra-oral or extra-oral photos. fact that because it is a new system, there are fewer sold on
Another advantage of the mirrorless camera is that the the second-hand market. In contrast, because they have
orthodontist is able to preview the image directly in the been available for more than two decades, many DSLR
electronic viewfinder. This means that the orthodontist cameras can be purchased second-hand.
does not need to take their eye away from the electronic
viewfinder to check the quality of the image taken. If the
orthodontist would like to take the picture again, after pre-
Discussion
viewing the previous picture, they can do so straightaway Mirrorless cameras are seen as the future of photography
without needing to recompose. (Durand, 2018). Major camera manufacturers, such as
4 Journal of Orthodontics 

Figure 6.  Photograph of a macro lens, ring flash and a Figure 7.  Photograph of an adapter which allows the
mirrorless camera. attachment of a DSLR lens to a mirrorless camera.

To the author’s knowledge, there is no study compar-

ing the image quality between mirrorless cameras and
DSLR cameras when taking orthodontic photos. The
author finds that the image quality produce by a mirror-
less camera is on par with that of a DSLR camera (Figure
Canon and Nikon, who have traditionally produced
8). However, the ease of use of a mirrorless camera,
DSLR cameras, have now shifted their focus to mirror-
because of the new features explained above, increases
less cameras (Mansurov, 2020). Camera manufacturers
the likelihood of obtaining a quality photo. According to
are producing mirrorless cameras with high megapixel
the author’s experience, the learning curve of getting to
counts equivalent to those of their DSLR counterparts.
grips with using all of the new features is not as steep as it
Currently, clinical photographs are viewed not only in
was when first started using a DSLR camera. The switch
print but on a monitor as well. By viewing them on a
from using a DSLR camera to a mirrorless camera is
monitor, the orthodontist can digitally magnify the pho-
seamless and can be accomplished without any training as
tos, and with a high megapixel count, the image is able
the menus and buttons are similar to those of DSLR coun-
to preserve high detail even under magnification
terparts. There is no denying the cost involved in switch-
(Ahmad, 2009b). A greater number of megapixels are
ing to a mirrorless camera from a DSLR camera. The cost,
also beneficial when presenting on a large projector.
however, is offset by the time saved and the increased
The author would like to emphasise that producing high-
number of quality photos that can be taken when using a
quality clinical photos requires more than a state-of-the-art mirrorless camera.
mirrorless camera. A macro lens and flash are also necessary
to achieve the highest-quality clinical photos (Figure 6)
(Sandler and Murray, 2010b; Wander, 2016). If one already Conclusion
owns a DSLR camera with a macro lens and flash, the mirror- Mirrorless cameras have new features that are advanta-
less system is compatible with DSLR lenses and flashes geous for an orthodontist when taking clinical orthodontic
(Figure 7). Other photography equipment has also been photos. They are, for instance, small and lightweight; fur-
recently developed, which may assist photographers in taking nished with focusing aids, such as eye AF and focus peak-
clinical photos. One such development is the Canon Speedlite ing; in possession of a large number of autofocus points,
470EX-AI, a flash that employs auto-intelligent technology covering almost the entire frame; fitted out with an elec-
to determine the best position of the flash head and moves tronic viewfinder; and enhanced by improved image stabi-
automatically to achieve the proper exposure (Canon, 2020c). lisation. Before adopting mirrorless cameras in their daily
This feature is ideal for taking extra-oral photos, in which practice, orthodontists should consider their disadvantages,
shadows are a great problem (Ahmad, 2009d). such as poor battery life, small form and high cost.
Shahrul 5

Figure 8.  Example of an extraoral and intraoral photograph taken with a mirrorless camera.

Declaration of conflicting interests Captain S (2020) DSLR vs. mirrorless cameras: Which is better for you?
Tom’s Guide. Available at: https://www.tomsguide.com/face-off/dslr-
The author declared no potential conflicts of interest with respect vs-mirrorless-cameras (accessed 8 December 2020).
to the research, authorship, and/or publication of this article. DSW Team (2020) DSLR vs mirrorless cameras in 2020. Digital Camera
World. Available at: https://www.digitalcameraworld.com/features/
Funding dslr-vs-mirrorless-cameras-how-do-they-compare#section-focusing
(accessed 8 December 2020).
The author received no financial support for the research, author-
Durand F (2018) The DSLR Will Likely Die: Are Mirrorless the Future
ship, and/or publication of this article.
of Big Standalone Cameras? Available at: https://petapixel.
com/2018/11/07/the-dslr-will-likely-die-are-mirrorless-the-future-of-
ORCID iD big-standalone-cameras/ (accessed 8 December 2020).
Al Imran Shahrul https://orcid.org/0000-0003-1673-7878 Galante DL (2009) History and current use of clinical photography in ortho-
dontics. Journal of the California Dental Association 37: 173–174.
Mansurov N (2020) 2020-2021: Big Leaps for Nikon and Canon
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