Validity and Reliability of Intraoral Camera with Fluorescent Aids for Oral Potentially Malignant Disorders Screening in Teledentistry

Abstract

There is limited documentation of using fluorescence images in oral potentially malignant disorders (OPMDs) and oral cancer screening through the field of teledentistry. This study aims to develop and evaluate the validity and reliability of the intraoral camera with the combination method of autofluorescence and LED white light used for OPMDs and oral cancer screening in teledentistry. The intraoral camera with fluorescent aids, which uses a combined method of both autofluorescence and LED white light, was developed before the device was evaluated for validity and reliability as a OPMDs screening tool for teledentistry. All lesions of thirty-four OPMD patients underwent biopsy for definitive diagnosis and were examined by an oral medicine specialist. Both images under autofluorescent and LED white light mode captured from the device were sent online and interpreted for the initial diagnosis and dysplastic features in addition to being compared to the direct clinical examination and histopathological findings. The combination method was also compared with autofluorescence method alone. The device provided good image quality, which was enough for initial diagnosis. Using the combination method, sensitivity, specificity, PPV, and NPV of the device via teledentistry were 87.5%, 84.6%, 63.6%, and 95.7%, respectively, which were higher than autofluorescence method alone in every parameter. The concordance of dysplastic lesion was 85.29% and 79.41% for category of lesion. The validity and reliability results of the combination method for the screening of dysplasia in OPMDs were higher than autofluorescent method alone. The intraoral camera with fluorescent aids for the OPMDs screening can be utilized for screening via teledentistry.

Facilitating dental disease screening program in prisoners using an intraoral camera in teledentistry

“…In the present teledentistry program, the IOC was used due to its low cost, being convenient to transport, and easy to maintain. The IOC has been used for patient-dentist communication [ 5 , 22 ], oral examination [ 17 , 18 ], screening oral cancer lesions [ 23 ], and identifying dental diseases and soft tissue conditions [ 21 , 24 ]. Previous studies have found that the IOC is a valid and reliable tool for screening oral diseases, such as dental caries [ 21 ] and oral cancer [ 23 ], compared with a direct oral examination.…”

“…The IOC has been used for patient-dentist communication [ 5 , 22 ], oral examination [ 17 , 18 ], screening oral cancer lesions [ 23 ], and identifying dental diseases and soft tissue conditions [ 21 , 24 ]. Previous studies have found that the IOC is a valid and reliable tool for screening oral diseases, such as dental caries [ 21 ] and oral cancer [ 23 ], compared with a direct oral examination. We found that the IOC used in the present teledentistry demonstrated acceptable diagnostic accuracy in determining the prisoners’ dental treatment needs compared with a direct oral examination.…”

Tele-dentistry, its trends, scope, and future framework in oral medicine; a scoping review during January 1999 to December 2021

“…Communication skills [5] Human error [8,24] Clinical skill [5,25] Ex: Clinical reasoning [5], Differential diagnosis construction [5] Environmental Inappropriate environmental conditions [1,11,12,23,40,41] Documentation skill [5] Technical Integration problems [3] Participants digital skill [11] Internet bandwidth problems [1,23,24] Human resource Use of experienced clinicians [5,36] Problems in data storing [3,23,24] Using two remote clinicians and consultant [42] Security and confidentiality problems [10,26,40] Using a trained assistant to record videos and photos [43] Photo quality problems [20,24] Technical Cloud-based platform [44] Problems in real time interpretation [35,45] Photography with smartphone [26,38,40,46,47] Accessibility problems [7] Photography with intra oral camera [19,39,48] Regulation legal and ethical issues [41] Photography by intra oral camera with fluorescent aids…”