Comparative Evaluation of Patient and Orthodontist Preferences and Attitude in Mandibular Occlusal Photography: Novel Tongue Retractor vs. Conventional Technique

Abstract

Background: Intraoral photography is essential in orthodontics for diagnosis, treatment planning, and documentation. Capturing mandibular occlusal photographs is often challenging due to interference from the tongue, gag reflex, and patient discomfort. Conventional techniques require patients to retract the tongue, which may reduce image quality and increase discomfort. A novel 3D-printed tongue retractor has been designed as an adjunct to the occlusal photographic mirror to improve visibility and comfort. This study aimed to evaluate and compare the preferences and attitudes of patients and orthodontists toward intraoral photographic techniques using a novel tongue retractor versus conventional methods.

Materials and Methods: A prospective comparative questionnaire-based study was conducted with 48 participants (24 patients and 24 orthodontists/postgraduate students). Mandibular occlusal photographs were captured using both the conventional method and the novel tongue retractor-assisted method. Visual Analogue Scales (VAS) were used to assess discomfort, acceptability, and stress. Additionally, patients completed a 7-item questionnaire and orthodontists/postgraduate students completed an 8-item questionnaire regarding their preferences. Data were analyzed using descriptive statistics and unpaired t-tests, with p < 0.05 considered statistically significant.

Results: The novel tongue retractor significantly reduced mean scores for discomfort, time needed, nausea, gag reflex, and breathing impairment compared to the conventional method (p < 0.001). No significant difference was noted in TMJ discomfort or discomfort during mouth opening (p > 0.05). Patient preferences strongly favored the tongue retractor-assisted method for comfort, efficiency, and reduced gag reflex, while conventional techniques were preferred for specific photographic views. Orthodontists and postgraduate students reported significantly less discomfort, reduced gag reflex, and improved feasibility with the novel tongue retractor (p < 0.05), though some scenarios still favored conventional methods.

Conclusion: The novel tongue retractor improves patient comfort and operator ease in mandibular occlusal photography, making it a valuable adjunct to conventional techniques. While it cannot completely replace standard methods, its use enhances efficiency, reduces stress, and provides superior patient and operator experiences in routine orthodontic practice.