Value of an Intraoral Camera in Evaluating Restorations and Plaque in a Simulated Environment: Observational Experiences of Dentists in Pediatric Contexts to Establish a Proof of Concept.

Access to the posterior maxillary and mandibular teeth is a significant challenge while evaluating plaque, gingiva, teeth, restorations, and crown margins. It is tougher when there are also limitations of mouth opening, small mouths, or when patients are not cooperative. The evolution of small intraoral cameras appears to be a promising solution - intraoral cameras fit into the mouth and deliver live, high-resolution video feeds of the intraoral areas. There are not many well-designed studies that have tested the value addition of an intraoral camera in pediatric patient scenarios. The objective of this study is to evaluate the value addition of an intraoral camera compared to conventional evaluation using a mouth mirror and explorer in its ability to evaluate the posterior maxillary and mandibular teeth to study common pediatric dental scenarios, namely, evaluation of plaque, margins of restorations, margins of a stainless-steel crown, and permanent tooth eruption. Pediatric typodonts were utilized to simulate a representation of common intraoral scenarios in the pediatric patient. Reviewers first examined typodonts with a mouth mirror and explorer and then with an intraoral camera to determine the visibility and clarity of the simulated scenarios. This process was then repeated two weeks later for evaluation of intra-rater reliability. For all the parameters evaluated using the conventional method, all four evaluators marked "not visible" as the most chosen option. For examination with the intraoral camera, all evaluators marked "clearly visible" as the most chosen option. All the raters agreed that the intraoral camera added a significant advantage in clinical examinations, especially in hard-to-visualize areas. The results also show a high intra-rater reliability. The results of this proof-of-concept study show that the intraoral camera adds significant value to the visualization of posterior maxillary and mandibular arches for evaluation of cavity preparations, restorations, tooth eruption, and identifying plaque in pediatric typodonts.