Accuracy of dental images for the diagnosis of dental caries and enamel defects in children and adolescents: A systematic review.

Aim: The aim of this review was to determine if photographic examination and subsequent image analysis provides comparable accuracy to visual inspection for the diagnosis of common dental conditions in children and adolescents.

Methods: We searched the PubMed database for studies that compared diagnostic accuracy of the two inspection techniques. Studies were screened for inclusion and were assessed for quality and risk of bias using the quality assessment of diagnostic accuracy studies tools. Findings were reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA).

Findings: Sixteen studies met the inclusion criteria. Nine of the included studies evaluated dental caries and eight evaluated enamel defects (one study evaluated both conditions).

Conclusions: Three studies found image analysis to be superior. For the remaining six studies the diagnostic accuracy was comparable. For enamel defects, three studies found image analysis to be superior, two found visual inspection to be superior and three studies reported comparable diagnostic accuracy. Most studies have found at least comparable results between photographic and visual inspection techniques. However, the wide variation in equipment and personnel used for the collection and interpretation of photographic images made it impossible to generalise the results. It remains unclear exactly how effective store-and-forward teledentistry is for the diagnosis of common dental conditions in children.