Big differences are pistons, injector spray angle, turbo compressor wheel, and tuning (2 injection events on the 04 vs 3 events on the 04.5, and the 04 generally runs more timing and lower rail pressure).
The 04.5 puts more soot into the oil, even on ones that have been modified (hardware and tuning) to run more like a 04.
The Cam is the same from 03-07, at least as far as I can tell. There have been lots of talk about a cam change, but all the cam builders I have spoken with state they are all the same. The part number is also the same.
I like the fact that the 04.5 engine was beefed up for the higher EGT, as far as the oil change interval, I changed mine every 3K regardless, but they were free through the dealer were I bought it.
The pistons used in 04.5 are far weaker and more susceptible to melting than the 04. Even thou the 04.5 has higher EGT's it runs cooler cylinder temperatures and lower pressures than the 04, one of the reasons the 04 can get better fuel economy.
If you were to tune a 04.5 like an 04 and run them both the same the 04.5 would be at a greater chance for piston damage due to heat than the 04, even thou in stock for the 04.5 runs higher EGT's and has more power.
Really nothing was changed for the higher EGT's, other the reduced cylinder temps via retarded timing.
The valves were changed in 06 due to some failures from the high EGTs in 04.5-05.
The 04 and 04.5 use the same turbine housing, wheel, and center section which means both handle EGT's the same.