The precision of the remote diagnoses was comparable to the diagnoses conducted in person. The levels of interexaminer agreement were higher when clinical data were included with the images. Mobile phones may be an effective tool for capturing images that assist in the remote diagnosis of traumatic dental injuries.
The general objective of this study was to evaluate the use of resources of the Teledentistry (TD) in the management of Traumatic Dental Injuries (TDI). In order to comply with this objective, two studies with specific objectives were designed: 1) Evaluation of prevalence and exploration of perception and attitudes of pediatric dentists from Brazil's Distrito Federal towards the use of teledentistry in the management of TDI. 2) Comparison of agreement level among inter-examiners in the TDI diagnosis when performed presently or remotely, through the use of digital photographs, captured with a mobile phone camera. In the first study, an online questionnaire (http://pt.surveymonkey.com) was answered by 37.16% of the pediatric dentists in Distrito Federal (n = 97). Descriptive analyses and the Pearson correlation test were performed. In the second study, 40 patients with 89 traumatized teeth were examined (n = 89). Present and remote diagnosis, aided by images and images associated to clinical data, were performed by 7 examiners and the inter-examiners agreement was assessed with the Gwet's AC1 measure. In the first study, it was identified that 80.41% of participants had already used one of the TD tools in their clinical practice, and 76.29% for the diagnosis and treatment related to TDI. The results evidence the use of TD tools, with the possibility to remotely orientate laypersons and professionals as to appropriately take care of TDI. In the second study, the mean agreement obtained between the Present Diagnosis and the Distant Diagnosis was considered "Very Good" for cases in which only images were used (0.83 or superior) and for cases in which clinical data was associated to images (0.93 or superior). Most of the pediatric dentists from Brazil's Distrito Federal have already used TD tools in the management of TDI and have a positive perception and attitude towards them. Digital photographs, captured with a mobile phone camera, are effective tools for the distant diagnosis in cases of TDI. The distant diagnosis through images is equivalent to the present clinical diagnosis in most TDI cases.
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