THE ACCURACY OF SMARTPHONE IMAGES FOR ORAL HEALTH SCREENING AMONG CHILDREN COMPARED TO CLINICAL EXAMINATION: A PILOT STUDY The aim of this study was to determine the accuracy of smartphone images for oral health screening among children compared to clinical examination. Children aged 7–12 years old were visually examined by Examiner 1 (E1) for caries status using the International Caries Detection and Assessment System (ICDAS), and carious lesions were classified as enamel or dentin caries, dental plaque assessment using the Debris Index (DI), and gingival health using the Modified Gingival Index (MGI). Following the clinical examination (CE), an iPhone 13 (Apple Corp.) was used to take five images of their teeth for caries detection and one frontal view image of anterior teeth coated with plaque disclosing gel for smartphone image examination (SIE) using the same clinical parameters. The smartphone image examination was conducted independently by Examiner 2 (E2) without any knowledge of the results from the visual clinical examination. The sensitivity of smartphone images to detect enamel and dentin caries was similar at 74% and 72%, respectively, which reflects its ability to correctly identify participants with dental caries. The specificity and positive predictive value (PPV) for dentin caries were both 100%, while the negative predictive value (NPV) was approximately 98%. The positive predictive value and negative predictive value of enamel caries detection were 76.9% and 77.4%, respectively. The inter-rater reliability between the two examinations was calculated using ICC, and the scores for DMFT, DI, and MGI were 0.842, 0.964, and 0.832, respectively. The Wilcoxon signed rank test was used to compare the mean DMFT, DI, and MGI between the visual and image-based examinations with p-values of 0.121, 0.965, and 0.445, respectively (not statistically significant). The findings in this pilot study showed that the mobile teledentistry approach using smartphone images has demonstrated its ability to identify caries, plaque, and gingival status in children with acceptable diagnostic accuracy when compared to visual clinical examination. Smartphone cameras can serve as a reliable and practical alternative in screening for enamel and dentin carious lesions, dental plaque, and gingival status when compared to the visual clinical examination.

Retention phase is fundamental in orthodontic treatment. Around 70% of patients are subjected to relapse postorthodontic treatment. The risk of relapse can be minimized by prescribing a retainer suitable to a patient’s pre-treatment clinical condition and based on retention characteristics of retainers. When removable retainers are prescribed, responsibility of maintaining tooth stability lies on patients. Recent idea has been proposed that removable retainer should be worn indefinitely in order to maintain the treatment result. Therefore, the understanding of retention characteristics of removable retainers is important for promoting patient compliance and satisfaction. This article focuses on reviewing the use of removable retainers in relation to preferences among clinicians, patient acceptability, effectiveness, compliance, as well as retention regimes. An electronic search was conducted in the PubMed/MEDLINE, ScienceDirect and Scopus database. The search was performed up to June 2020 using a variety of keywords including orthodontic retainers, Hawley, vacuum formed and retention. Among the 248 publications that were initially searched, total of 56 publications were finally included. Twenty-seven were observational (6 prospective; 16 cross-sectional, 4 retrospective, and 1 case series), fourteen experimental, fourteen review articles, and one opinion piece. Although quite a number of reviews on removable retainers were available, several significant papers have been published recently. Furthermore, a guideline on retention regime is warranted.