Lamas-Lara Victor F, Mattos-Vela Manuel A, Evaristo-Chiyong Teresa A, Guerrero Maria Eugenia, Jiménez-Yano Juan F, Gómez-Meza Dora N
Department of Dentistry, Policlinico Chincha, Essalud, Lima, Peru.
SAETA Research Group, Universidad Nacional Mayor de San Marcos, Lima, Peru.
Front Oral Health. 2025 May 15;6:1470706. doi: 10.3389/froh.2025.1470706. eCollection 2025.
With the arrival of the COVID-19 pandemic, the role of teledentistry increased its need for implementation. In this sense, the study aimed to validate a smartphone-based remote photographic method for diagnosing dental caries in adults attending a polyclinic in Lima, Peru.
A cross-sectional, descriptive research was conducted; 87 patients were selected, and 2020 teeth were evaluated. Each participant underwent a clinical diagnosis of dental caries by two trained and calibrated dentists, considering the diagnostic criteria of the WHO; during the same visit, after the clinical examination, a family member of the patient was instructed to take a photographic record with a cell phone, through a video. Five photographs of the dental arches were recorded, where the centering of images, resolution, and visualization of all the teeth were evaluated. The photographic evaluation was performed by two independent evaluators blinded to the visual evaluation performed, following the same criteria as the clinical visual evaluation. For the data analysis, Cohen's kappa index was determined for interexaminer reliability; sensitivity, specificity, and positive and negative predictive values were obtained.
Overall, high sensitivity: 90.19% [Interquartile 95% (CI): 88.23-92.16]; and specificity: 95.15% (95% CI: 93.83-96.47). The interexaminer agreement was almost perfect, with a kappa of 0.935 and 0.974 for clinical and photographic evaluation, respectively.
It is concluded that the photographic method using a smartphone has demonstrated a satisfactory level of caries detection in adults.
随着新冠疫情的到来，远程牙科的作用使其实施需求增加。从这个意义上说，本研究旨在验证一种基于智能手机的远程摄影方法，用于诊断秘鲁利马一家综合诊所成年患者的龋齿。
进行了一项横断面描述性研究；选取了87名患者，对2020颗牙齿进行评估。两名经过培训和校准的牙医根据世界卫生组织的诊断标准，对每位参与者进行龋齿的临床诊断；在同一次就诊中，临床检查后，指导患者的一名家庭成员通过视频用手机拍摄记录。记录了五张牙弓照片，评估图像的居中情况、分辨率以及所有牙齿的可视性。由两名对视觉评估不知情的独立评估者按照与临床视觉评估相同的标准进行摄影评估。对于数据分析，确定了检查者间可靠性的科恩kappa指数；获得了敏感性、特异性以及阳性和阴性预测值。
总体而言，敏感性较高：90.19%[四分位间距95%（CI）：88.23 - 92.16]；特异性为：95.15%（95% CI：93.83 - 96.47）。检查者间一致性几乎完美，临床评估和摄影评估的kappa值分别为0.935和0.974。
得出结论，使用智能手机的摄影方法在成人龋齿检测中已显示出令人满意的水平。
