Smartphone Use for Tomographic Evaluation: Application in Endodontic Diagnosis

Abstract

Introduction: Portable equipment that allows quick exchanges of information, such as smartphones, is increasingly important in dentistry. Thus, they have become frequently used, with the potential to contribute to the tomographic evaluation. This study aimed to evaluate the accuracy of smartphone applications for diagnosing the root canal system (RCS) and measuring the root canal length.

Methods: Digital Imaging and Communications in Medicine files of 92 lower incisor teeth were evaluated by 2 trained and calibrated examiners using CS 3D Imaging software (Carestream Health, Rochester, NY) and 2 smartphone applications (DroidRender; Startm, Zhubei, Taiwan and Horos Mobile; iCat Solutions Ltd, Norwich, United Kingdom). The RCS was assessed according to Vertucci's classification, and the tooth length was measured using linear cusp-apex measurements. The diagnostic reference standard was obtained by the mode and the mean of the evaluations made by 3 experienced examiners using the CS 3D Imaging software. The diagnostic performance of RCS was evaluated using sensitivity (Se), specificity (Sp), and overall accuracy (Ac). Bland-Altman analysis was used to assess the agreement of linear measurements.

Results: The diagnostic tests showed similar performance between the smartphone applications (DroidRender: Se = 1.00, Sp = .95, and Ac = 0.97; Horos: Se = 0.95, Sp = .94, and Ac = 0.95) and the computer software (Se = 0.97-0.95, Sp = .93-0.96, and Ac = 0.95-0.96). The smartphone applications showed discrepancies greater than 1.0 mm for the dental lengths, which may signal relevant differences in some clinical situations.

Conclusions: Smartphone applications offered similar diagnostic performance in comparison with the computer software for the RCS evaluation.

Keywords: Anatomy; cone-beam computed tomography; endodontics; smartphone.