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Martins HDD, de Lucena CP, da Silva QP, Dantas MVO, Costa MDDAS, de Lucena EHG, Bonan PRF. Telehealth in oral medicine: A cross-sectional evaluation based on a mobile application. Technol Health Care 2024; 32:1515-1522. [PMID: 37599549 DOI: 10.3233/thc-230584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND Teledentistry is considered a good tool in the diagnostic process. In oral medicine, there is a low number of trained professionals and dentists have difficulty in diagnosing and treating oral lesions. OBJECTIVE We aimed to perform a cross-sectional evaluation based on the mobile application for oral diagnosis using a mobile application in a Brazilian State. METHODS This is a retrospective, cross-sectional, observational study of the data of the "Telehealth in Stomatology in Paraíba" carried out between May 2021 and November 2022. RESULTS The app has a team of 16 consultants (Ph.D. professors, postgraduate students, residents, and dentists). In addition, there are 289 registered professionals, with a mean age of 33.7 years, predominantly female (70.2%), working in primary care (79.2%), and general practitioners (42.6%). Regarding the cases, the app has 194 cases, and reactive lesions are the most suggested hypotheses reported by dentists (24.5%) and consultants (22.3%). We had an overall concordance rate of 64.1%. CONCLUSION The application is easily accessible and has an assistance network that helps with early diagnosis. In addition, it has good coverage with users in more than 50% of the cities in the state. Thus, applications that provide specialized care to distant areas are important for better public health.
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Uhrin E, Domokos Z, Czumbel LM, Kói T, Hegyi P, Hermann P, Borbély J, Cavalcante BGN, Németh O. Teledentistry: A Future Solution in the Diagnosis of Oral Lesions: Diagnostic Meta-Analysis and Systematic Review. Telemed J E Health 2023; 29:1591-1600. [PMID: 36976779 PMCID: PMC10654653 DOI: 10.1089/tmj.2022.0426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 03/29/2023] Open
Abstract
Introduction: Teledentistry (TD) can offer a wide range of possibilities in the field of oral medicine. Oral potentially malignant disorders (OPMDs) are hard to detect, and even harder to diagnose correctly. With the help of TD, OPMDs can be detected and diagnosed by a remote specialist. Our aim was to investigate whether TD could provide a reliable diagnostic method compared with clinical oral examination (COE) in the diagnosis of OPMDs. Methods: A systematic search was conducted in three databases (Medline, EMBASE, CENTRAL) until November 2021. We included studies that compared telediagnosis and COE, both made by experts. Pooled specificity and sensitivity were calculated and visualized on a two-dimensional plot. Risk of bias was assessed using the QUADAS-2 tool, and the level of evidence is shown with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool. Results: Of the 7,608 studies, 13 were included in the qualitative and 9 in the quantitative synthesis. Using TD tools in the detection of oral lesions (OLs) showed high specificity (0.92 confidence interval [95% CI] = 0.59-0.99) and sensitivity (0.93 95% CI = 0.17-1.00). In the differential diagnosis of lesions, we found high sensitivity and specificity (0.942 95% CI = 0.826-0.982 and 0.982 95% CI = 0.913-0.997), respectively. We summarized the available data on time-effectiveness, screening person, referral decision, and technical settings. Conclusion: Detecting OLs with TD tools might lead to earlier diagnosis, treatment, and stricter follow-up of OPMD. TD may offer a great substitution for COE in the diagnosis of OLs, and thus, fewer referrals could be made to special care, resulting in a greater number of treated OPMDs.
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Affiliation(s)
- Eszter Uhrin
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Domokos
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - László Márk Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Prosthodontics and Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Prosthodontics and Semmelweis University, Budapest, Hungary
| | - Bianca Golzio Navarro Cavalcante
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Niknam F, Sharifian R, Bashiri A, Mardani M, Akbari R, Tuffaha H, Do L, Bastani P. Tele-dentistry, its trends, scope, and future framework in oral medicine; a scoping review during January 1999 to December 2021. Arch Public Health 2023; 81:104. [PMID: 37316914 DOI: 10.1186/s13690-023-01128-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Tele-dentistry has been increasingly used for different purposes of visit, consultation, triage, screening, and training in oral medicine. This study aims to determine the main facilitators, barriers, and participants` viewpoints of applying tele-dentistry in oral medicine and develop a framework indicating the input, process, output, and feedback. METHOD This was a scoping review conducted in 2022 applying Arksey and O'Malley (2005) approach. Four databases including ISI web of science, PubMed, Scopus, and ProQuest were searched from January 1999 to December 2021. Inclusion criteria consisted of all original and non-original articles (reviews, editorials, letters, comments, and book chapters), and dissertations in English with a full text electronic file. Excel2016 was used for descriptive quantitative analysis and MAXQDA version 10 was applied for qualitative thematic analysis. A thematic framework was developed customizing the results of the review in a virtual mini expert panel. RESULTS Descriptive results show that among 59 included articles, 27 (46%) have addressed the various applications of tele-dentistry during COVID-19 pandemic in the field of oral medicine. From geographical distribution perspective, most of the papers were published in Brazil (n = 13)/ 22.03%, India (n = 7)/11.86% and USA (n = 6)/10.17%. Thematic analysis shows that seven main themes of "information", "skill", "human resource", 'technical", "administrative', 'financial', and 'training and education' are explored as facilitators. 'Individual', 'environmental', 'organizational', 'regulation', 'clinical', and 'technical barriers' are also identified as main barriers of tele-dentistry in oral medicine. CONCLUSION According to the results for using tele-dentistry services in oral medicine, a diverse category of facilitators should be considered and at the same time, different barriers should be managed. Users` satisfaction and perceived usefulness of tele-dentistry as final outcomes can be increased considering the system`s feedback and applying facilitator incentives as well as decreasing the barriers.
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Affiliation(s)
- Fatemeh Niknam
- Department of Health Information Management, School of Health Management and Information Sciences, Student Research Committee, Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roxana Sharifian
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Bashiri
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Mardani
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Oral & Maxillofacial Medicine, School of Dentistry, Oral and Dental Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Akbari
- Department of Computer Engineering and Information Technology, Shiraz University of Technology, Shiraz, Iran
| | - Haitham Tuffaha
- Centre for the Business and Economics of Health, Faculty of Business Economics and Law, The University of Queensland, Brisbane, Australia
| | - Loc Do
- School of Dentistry, Faculty of Health and Behavioural Sciences, Oral Health Centre, The University of Queensland, Brisbane, Australia
| | - Peivand Bastani
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- School of Dentistry, Faculty of Health and Behavioural Sciences, Oral Health Centre, The University of Queensland, Brisbane, Australia.
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Haron N, Rajendran S, Kallarakkal TG, Zain RB, Ramanathan A, Abraham MT, Lau SH, Cheng LC, Chong SMY, Mohamed Azahar FA, Mohamad Zaini Z, Chan SW, Goh YC, Lim D, Khairi J, Abidin MZ, Abdul Rahman ZA, Liew CS, Fong SC, Yang YH, Ismail SM, Cheong SC. High referral accuracy for oral cancers and oral potentially malignant disorders using telemedicine. Oral Dis 2023; 29:380-389. [PMID: 33914993 DOI: 10.1111/odi.13892] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/02/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the accuracy of MeMoSA®, a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral. SUBJECTS AND METHODS A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA®. The identification of the presence of lesion/variant and referral decision made using MeMoSA® were compared to clinical oral examination, using kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions. RESULTS Kappa values comparing MeMoSA® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892, respectively. Sensitivity and specificity for referral decision were 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3%, respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA®. CONCLUSION Referral decisions made through MeMoSA® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.
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Affiliation(s)
| | | | - Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Rosnah Binti Zain
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Faculty of Dentistry, Saujana Putra Campus, MAHSA University, Selangor, Malaysia
| | - Anand Ramanathan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Mannil Thomas Abraham
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Shin Hin Lau
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Lai Choo Cheng
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Sherrie Mei Yee Chong
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Farah Aliya Mohamed Azahar
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia.,Oral Surgery Clinic, Hospital Serdang, Ministry of Health, Serdang, Malaysia
| | - Zuraiza Mohamad Zaini
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Siew Wui Chan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Daniel Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Juliana Khairi
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Marzuki Zainal Abidin
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia.,Oral Surgery Clinic, Hospital Serdang, Ministry of Health, Serdang, Malaysia
| | - Zainal Ariff Abdul Rahman
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, Kuala Lumpur, Malaysia.,Data Intensive Computing Centre, Research Management & Innovation Complex, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Data Science, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Sok Ching Cheong
- Cancer Research Malaysia, Selangor, Malaysia.,Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Muacevic A, Adler JR, Bains R, Singh A, Manar M, Kumar A. The Efficacy of Dental Caries Telediagnosis Using Smartphone: A Diagnostic Study in Geriatric Patients. Cureus 2023; 15:e33256. [PMID: 36741615 PMCID: PMC9891317 DOI: 10.7759/cureus.33256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/03/2023] Open
Abstract
Background and aim The major barrier to oral health care for geriatrics is access to dental care. Teledentistry is the field of dentistry that uses telecommunication with digital imaging for the exchange of valid information for diagnosis, treatment, and continuing dental education, enabling some means of approach to oral health care. This study aimed to assess the accuracy of diagnosing dental caries in the older age group by examining intraoral photographs taken by smartphone camera compared with standard clinical dental examination. Methods and material A calibrated dentist examined 18 patients aged 60-75 for six variables: sound tooth, decayed tooth, filled tooth with and without caries, missing tooth, and the presence of prosthesis. Intraoral photographs of each patient were taken using a smartphone. The photographs were then sent to six different examiners through WhatsApp. The accuracy of the diagnosis was measured by applying Cohen's kappa, sensitivity, and specificity. Fleiss' kappa was used to measure the agreement index using the software R (R Foundation for Statistical Computing, Vienna, Austria) version 4.2.1. Results The overall agreement between the tele-examiners and the control was measured, with the kappa scores ranging from 0.897 to 0.921, and the mean kappa score was 0.909. There was high specificity and sensitivity in the value observed. The agreement index, measured through Fleiss' kappa for six teeth conditions, reported the perfect agreement (0.867) among six examiners. Conclusions Under the limitations of the study, teledentistry using a mobile phone has acceptable accuracy for diagnosing caries in the older age group compared to a standard clinical dental examination.
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Fahim A, Saleem Z, Malik KA, Atta K, Mahmood R, Alam MK, Sethi A. Exploring challenges and mitigation strategies towards practicing Teledentistry. BMC Oral Health 2022; 22:658. [PMID: 36585644 PMCID: PMC9803256 DOI: 10.1186/s12903-022-02685-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, many dentists have opted for Teledentistry as a mechanism for patient consultation, oral lesion evaluation, diagnosis, and monitoring. The current study explores the challenges faced and potential solutions proposed by dentists practicing Teledentistry in a developing country like Pakistan. METHODS A qualitative case study was carried out from January to December 2021. A purposive maximum variation sample of 10 dentists was interviewed in two focus groups. The interview guide was developed using the technology-organization-environment framework. The data was transcribed verbatim using otter.ai. The analysis involved immersion in the data and open coding. The conceptually related codes were synthesized into themes and subthemes. FINDINGS The study found various Personnel, Technological and Organizational challenges, and potential solutions from those practicing Teledentistry. The challenges included operational cost, minimal financial returns, lack of awareness, hardware and software support, and other challenges related to the availability of specialization, accessibility, and institutional encouragement. They suggested Institutional Based Practice, staff training, hiring, development of government regulations, and supporting infrastructures such as designated space, central registry, internet, and using/building software to provide 3D images as solutions. CONCLUSION Teledentists face Personnel, Technological and Organizational challenges and related potential solutions from those practicing Teledentistry in Pakistan. Government should encourage Teledentistry to reduce long-term costs, encourage preventive services and enable rural access to dental care. They should also involve all stakeholders to develop regulations for practicing Teledentistry in Pakistan.
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Affiliation(s)
- Ayesha Fahim
- grid.440564.70000 0001 0415 4232University College of Dentistry, University of Lahore, Lahore, Pakistan
| | - Zakia Saleem
- grid.440564.70000 0001 0415 4232University College of Dentistry, University of Lahore, Lahore, Pakistan
| | - Khizar Ansar Malik
- grid.440564.70000 0001 0415 4232University College of Medicine, University of Lahore, Lahore, Pakistan
| | - Komal Atta
- grid.444767.20000 0004 0607 1811University Medical and Dental College, University of Faisalabad, Faisalabad, Pakistan
| | | | | | - Ahsan Sethi
- grid.412603.20000 0004 0634 1084QU Health, Qatar University, Doha, Qatar
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7
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Flores APDC, Roxo-Gonçalves M, Batista NVR, Gueiros LA, Linares M, Santos-Silva AR, Lopes MA, Flausino C, Meurer MI, Grando LJ, Molina-Bastos CG, Guattini VLDO, Carrard VC. Diagnostic accuracy of a telediagnosis service of oral mucosal diseases: A multicentric survey. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:65-72. [PMID: 35422409 DOI: 10.1016/j.oooo.2022.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The aim of this multicentric study was to assess the diagnostic accuracy of a telediagnosis service for oral mucosal disorders. STUDY DESIGN This study included 100 patients seen at the oral medicine outpatient clinic of 3 Brazilian Dental Schools (University of Campinas, Federal University of Pernambuco, and Federal University of Santa Catrina) from March 2019 to October 2019. In addition to the face-to-face assistance provided by graduate students and the final diagnosis validated by the professors of these institutions, a remote evaluation was requested for these patients through the EstomatoNet/TelessaúdeRS platform. RESULTS The sensitivity and specificity of telediagnosis were compared with those of the face-to-face approach and found to be 100% and 97.4%, respectively. The concordance between the examiners was 95%, and case management was relatively simple in approximately 60% of cases. CONCLUSIONS Based on the results, telediagnosis for oral diseases can be considered a reliable method, representing a promising alternative for the clinical support of health professionals, particularly in remote locations.
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Affiliation(s)
| | - Michelle Roxo-Gonçalves
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Luiz Alcino Gueiros
- Oral Medicine Unit, Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Brazil
| | - Matheus Linares
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Carolina Flausino
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Maria Inês Meurer
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Liliane Janete Grando
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | | | | | - Vinicius Coelho Carrard
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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8
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Cardozo I, Silva VCD, Perdoncini NN, Torres-Pereira CC. Telehealth in Oral Medicine: report of an experience from public health care in a southern Brazilian state. Braz Oral Res 2022; 36:e031. [PMID: 35293497 DOI: 10.1590/1807-3107bor-2022.vol36.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation "totally attended" their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.
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Affiliation(s)
- Ivy Cardozo
- Universidade Federal do Paraná - UFPR, Department of Stomatology, Curitiba, PR, Brazil
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9
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Fonseca BB, Perdoncini NN, da Silva VC, Gueiros LAM, Carrard VC, Lemos CA, Schussel JL, Amenábar JM, Torres-Pereira CC. Telediagnosis of oral lesions using smartphone photography. Oral Dis 2021; 28:1573-1579. [PMID: 34289201 DOI: 10.1111/odi.13972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/14/2021] [Accepted: 07/10/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The objective of this observational study was to evaluate telediagnosis of oral lesions using smartphone photography. MATERIALS AND METHODS Individuals with visible oral lesions composed a convenience sample. The lesions were photographed using a smartphone camera and emailed along with clinical information to three evaluators, who formulated up to two diagnostic hypotheses for each case. A total of 235 photographs from 113 clinical cases were obtained. The evaluators answered questions regarding referral decisions, requests for additional tests, diagnostic difficulties, and image quality. The diagnostic hypotheses were compared to the gold standard by means of percent agreement and kappa coefficient. Consensual face-to-face diagnoses of three specialists-when only a clinical diagnosis was necessary-or histopathological results-when a biopsy was necessary-were considered the gold standard. RESULTS The telediagnosis was similar to the gold standard in 76% of the cases, and kappa coefficients showed almost perfect agreement (k = 0.817-0.903). The evaluators considered that referrals could have been avoided on an average of 35,4% of the cases. CONCLUSION Diagnosis of oral lesions using images taken with a smartphone showed almost perfect agreement and diagnostic accuracy comparable to face-to-face diagnosis.
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Affiliation(s)
- Bruna Basso Fonseca
- Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Nicole Nichele Perdoncini
- Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Victor Cordeiro da Silva
- Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Luiz Alcino Monteiro Gueiros
- Department of Clinic and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Vinicius Coelho Carrard
- Oral Pathology Department, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Celso Augusto Lemos
- Department of Oral Medicine, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Juliana Lucena Schussel
- Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - José Miguel Amenábar
- Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
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10
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Amtha R, Gunardi I, Astoeti TE, Roeslan MO. Satisfaction Level of the Oral Medicine Patients Using Teledentistry During the COVID-19 Pandemic: A Factor Analysis. J Int Soc Prev Community Dent 2021; 11:414-420. [PMID: 34430503 PMCID: PMC8352063 DOI: 10.4103/jispcd.jispcd_72_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this article is to describe oral medicine patients' satisfaction level with teledentistry services during COVID-19 pandemic by a factor analysis. MATERIALS AND METHODS An observational cross-sectional study was conducted in the Oral Medicine Clinic in 31 patients who used teledentistry services at the beginning of the COVID-19 pandemic under informed consent. Questionnaire modification was validated with the Rasch model analysis and components that contribute to satisfaction were analyzed by the factor analysis. A total of satisfaction scores were then categorized into five levels (very dissatisfied; not satisfied; moderate; satisfied and very satisfied). RESULTS The questionnaire shows Cronbach's alpha of 0.83 and a reliability item of 0.95 with a separation of 4.49. The factor analysis shows two components that contribute to satisfaction, namely, components convenience and communication. One hundred percent of the subjects were in the satisfied and very satisfied categories. DISCUSSION The Rasch model can determine the validity and reliability of the questionnaire used more accurately. The components of convenience and communication are the main things that are considered when patients choose teledentistry services. CONCLUSION Oral medicine patients' satisfaction level with teledentistry services during the COVID-19 pandemic was 100% in the satisfied and very satisfied categories, with contributing factors being convenience and communication.
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Affiliation(s)
- Rahmi Amtha
- Department of Oral Medicine, Universitas Trisakti, Jakarta, Indonesia
| | - Indrayadi Gunardi
- Department of Oral Medicine, Universitas Trisakti, Jakarta, Indonesia
| | - Tri Erri Astoeti
- Department of Dental and Public Health, Universitas Trisakti, Jakarta, Indonesia
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Flores APDC, Lazaro SA, Molina-Bastos CG, Guattini VLDO, Umpierre RN, Gonçalves MR, Carrard VC. Teledentistry in the diagnosis of oral lesions: A systematic review of the literature. J Am Med Inform Assoc 2021; 27:1166-1172. [PMID: 32568392 DOI: 10.1093/jamia/ocaa069] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review is to summarize information on the use of teledentistry in the diagnosis of oral lesions. MATERIALS AND METHODS A systematic literature search conducted in August 2018 included articles published until December 2018 in 4 databases. Two reviewers evaluated the search results separately. If they were uncertain as to whether to include an article, a third reviewer made the final decision. Studies related to the diagnosis of oral lesions using teledentistry were included. The methodological quality of the studies was analyzed using the Quality Assessment of Studies of Diagnostic Accuracy. RESULTS Eleven articles were included in the study. The selected articles were published between 1999 and 2018, predominantly in developing countries. The professionals acting as patient examiners are dental students and dentists, as well as other health professionals. Most of the patients evaluated in the studies were from rural populations or locations distant from large centers. The tools used to obtain patient data were smartphones, videoconference, email, questionnaires, histopathological exams, and telemedicine applications and systems. Most studies concluded that there is a high level of agreement between teledentistry and clinical consultation and that the use of this resource for diagnostic purposes can reduce costs and the travel time to consult a specialist personally. Nine of the 11 studies were of good quality. CONCLUSIONS Teledentistry has the potential to improve the care quality related to diagnosis and management of oral lesions, shortening distances between patients who need specialized diagnoses and specialists.
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Affiliation(s)
| | - Samara Andreolla Lazaro
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Roberto Nunes Umpierre
- TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Residence in Family and Community Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marcelo Rodrigues Gonçalves
- TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Primary Health Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Vinicius Coelho Carrard
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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12
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Deshpande S, Patil D, Dhokar A, Bhanushali P, Katge F. Teledentistry: A Boon Amidst COVID-19 Lockdown-A Narrative Review. Int J Telemed Appl 2021; 2021:8859746. [PMID: 33628231 PMCID: PMC7894051 DOI: 10.1155/2021/8859746] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 12/19/2022] Open
Abstract
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease (COVID-19) has caused widespread public health concerns. Despite huge efforts to contain the disease spread, it is still on the rise because of the community spread pattern of this infection. In order to prevent the community spread, a nationwide lockdown was implemented, due to which many restrictions were imposed on movements of citizens within the country. Since the dental professionals were at the forefront of acquiring the infection, the majority of the dental clinics were shut for routine dental procedures. Only emergency treatment was provided to the patients. However, due to restrictions in movement, it was difficult for the patients to visit the clinics for routine check-ups. This was overcome by the advancements in technology which has a major impact on medicine. Due to increased usage of smartphones and related software applications, the clinical data exchange was facilitated between patients and clinicians which has been termed as "teledentistry." Teledentistry is a combination of telecommunications and dentistry, involving the exchange of clinical information and images for dental consultation and treatment planning. This technology served as a boon for the dentists to manage dental emergencies during the lockdown period. This narrative review discusses teledentistry and its applications in general and specialty dental practice amidst the COVID-19 lockdown.
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Affiliation(s)
- Shantanu Deshpande
- Department of Pediatric and Preventive Dentistry, TPCT's Terna Dental College, Navi Mumbai, India
| | - Devendra Patil
- Department of Pediatric and Preventive Dentistry, TPCT's Terna Dental College, Navi Mumbai, India
| | - Amol Dhokar
- Department of Oral Medicine, Diagnosis and Radiology, TPCT's Terna Dental College, Navi Mumbai, India
| | - Parin Bhanushali
- Department of Pediatric and Preventive Dentistry, TPCT's Terna Dental College, Navi Mumbai, India
| | - Farhin Katge
- Department of Pediatric and Preventive Dentistry, TPCT's Terna Dental College, Navi Mumbai, India
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13
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Perdoncini NN, Schussel JL, Amenábar JM, Torres-Pereira CC. Use of smartphone video calls in the diagnosis of oral lesions: Teleconsultations between a specialist and patients assisted by a general dentist. J Am Dent Assoc 2021; 152:127-135. [PMID: 33494867 DOI: 10.1016/j.adaj.2020.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/14/2020] [Accepted: 10/20/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Teleassistance in dentistry enables the support of dentists in areas without access to specialists. The aim of this study was to assess the feasibility and accuracy of synchronous teleconsultation in oral medicine. METHODS Patients referred for specialized care owing to oral lesions were evaluated in person by a general dentist who obtained photographs of the lesions with a smartphone. The images were sent via a mobile application to an oral medicine specialist, with whom a video call was initiated on the same instant messaging application. After interviewing the patient, the specialist formulated a diagnostic hypothesis and suggestions for case management. Then a second specialist, blinded to the first evaluation, assessed the oral lesion in person and defined a diagnosis, which was considered as the reference standard. Diagnoses from the remote and the face-to-face consultations were compared in percentage levels of agreement and κ coefficient. RESULTS Thirty-three patients, 25 through 83 years old, had 41 oral lesions. The average teleconsultation length was approximately 10 minutes. In 92.7% of the cases, there was concordance between the telediagnosis and the reference standard (κ = 0.922). CONCLUSIONS Synchronous teleconsultation can provide reliable remote diagnosis through the support to primary care health care professionals in management of oral lesions. PRACTICAL IMPLICATIONS Earlier diagnosis of malignancies, improvement of access for unassisted populations, and reduction of unnecessary referrals are possible practical implications of remote support of a specialist in the management and diagnosis of oral lesions.
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Guo S, Chen Y, Mallineni SK, Huang S, Liu B, Zhang S, Lu C. Feasibility of oral health evaluation by intraoral digital photography: a pilot study. J Int Med Res 2021; 49:300060520982841. [PMID: 33530811 PMCID: PMC7871079 DOI: 10.1177/0300060520982841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives This study investigated the accuracy and duration of intraoral digital photograph examination (IDPE) for evaluating oral health status and explored the feasibility of remote oral health assessment. Methods Thirty-one healthy college students underwent evaluations of oral health status via clinical examination (CE) combined with panoramic X-ray assessment at baseline, followed by IDPE 1 month later using photos taken at baseline. Methods for evaluation of gingival health included the Modified Gingival Index (MGI) and Plaque Index (PI). Examinations of caries status included the decayed, missing, and filled teeth and surfaces indexes (DMFT and DMFS indexes, respectively). The duration of each evaluation was also recorded. Results There were significant differences in MGI and PI between CE and IDPE. There were no significant differences in DMFT and DMFS indexes between CE and IDPE, and there were positive correlations between CE and IDPE for each of the two indexes (DMFT index: r=0.56; DMFS index: r=0.69). The IDPE duration was shorter than the CE duration. Conclusions The feasibility of caries status assessment via IDPE is promising. Digital oral health evaluation merits further clinical consideration. Trial registration Xiamen University Training Program of Innovation and Entrepreneurship for Undergraduates, project number: 2018X0583. Registered 1 April 2018; http://cxw.xmu.edu.cn/admin/Innovation/NewInnovationDetail?id=6ce0a415-6131-496b-891a-6a1ae44e556d
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Affiliation(s)
- ShuLing Guo
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Yong Chen
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Sreekanth Kumar Mallineni
- Department of Preventive Dental Science, College of Dentistry, Majmaah University, Majmaah, Saudi Arabia
| | - ShuYing Huang
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - BaiWang Liu
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - ShuYi Zhang
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Chang Lu
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
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16
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Almazrooa SA, Mansour GA, Alhamed SA, Ali SA, Akeel SK, Alhindi NA, Felemban OM, Mawardi HH, Binmadi NO. The application of teledentistry for Saudi patients' care: A national survey study. J Dent Sci 2021; 16:280-286. [PMID: 33384810 PMCID: PMC7770252 DOI: 10.1016/j.jds.2020.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/28/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/PURPOSE Teledentistry has emerged as a new communication tool in various dental disciplines around the world. The aim of this study was to investigate the applicability and reliability of teledentistry in the field of diagnostic dentistry and explore the perception of Saudi dentists of its benefits and concerns. MATERIALS AND METHODS An electronic survey with 40 questions was developed, validated and distributed electronically by email and social media channels to dentists from different specialty in Saudi Arabia. Collected data were analyzed for statistical significance. RESULTS A total of 148 dentists completed the survey. The current data demonstrated that 50% of study participants have had applied teledentistry in their clinical practice. Out of all, 90% have computers in their dental offices and 72% have been using electronic medical records in which radiographs and clinical images are uploaded. Most participants had smart phones (91%), in which they were used more commonly (74.3%) than conventional cameras (54.1%) to capture and share patients' clinical images over communication applications (74.3%) and less likely through emails (62.2%). Overall, 83% were confident that teledentistry can improve daily dental practice, specifically in the fields of oral radiology followed by endodontics and oral medicine. CONCLUSION Teledentistry is an emerging tool with potential to improve the delivery of diagnostic dental care for communities with limited or no access to dental specialists. As of today, teledentistry has not been truly implemented by the Saudi dental community. Development of national programs to educate the public and promote teledentistry among dental practitioners are warranted.
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Affiliation(s)
- Soulafa A. Almazrooa
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Ghada A. Mansour
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Sana A. Alhamed
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Sarah A. Ali
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Sara K. Akeel
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Nada A. Alhindi
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Osama M. Felemban
- Department of Pediatric Dentistry, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Hani H. Mawardi
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Nada O. Binmadi
- Department of Oral and Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
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Joda T, Yeung AWK, Hung K, Zitzmann NU, Bornstein MM. Disruptive Innovation in Dentistry: What It Is and What Could Be Next. J Dent Res 2020; 100:448-453. [PMID: 33322997 DOI: 10.1177/0022034520978774] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Dentistry is a technically oriented profession, and the health care sector is significantly influenced by the ubiquitous trend of digitalization. Some of these digital developments have the potential to result in disruptive changes for dental practice, while others may turn out to be just a pipedream. This Discovery! essay focuses on innovations built on artificial intelligence (AI) as the center-technology influencing 1) dental eHealth data management, 2) clinical and technical health care applications, and 3) services and operations. AI systems enable personalized dental medicine workflows by analyzing all eHealth data gathered from an individual patient. Besides dental-specific data, this also includes genomic, proteomic, and metabolomic information and therefore facilitates optimized and personalized treatment strategies and risk management. Based on the power of AI, the triangular frame of "data"/"health care"/"service" is supplemented by technological advancements in the field of social media, Internet of things, augmented and virtual reality, rapid prototyping, and intraoral optical scanning as well as teledentistry. Innovation continues to be critical to tackle dental problems until its routine implementation based on sound scientific evidence. Novel technologies must be viewed critically in relation to the cost-benefit ratio and the ethical implications of a misleading diagnosis or treatment produced by AI algorithms. Highly sensitive eHealth data must be handled responsibly to enable the immense benefits of these technologies to be realized for society. The focus on patient-centered research and the development of personalized dental medicine have the potential to improve individual and public health, as well as clarify the interconnectivity of disease in a more cost-effective way.
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Affiliation(s)
- T Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - A W K Yeung
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - K Hung
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - N U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - M M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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18
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Farooq I, Ali S, Moheet IA, AlHumaid J. COVID-19 outbreak, disruption of dental education, and the role of teledentistry. Pak J Med Sci 2020; 36:1726-1731. [PMID: 33235605 PMCID: PMC7674864 DOI: 10.12669/pjms.36.7.3125] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) has affected the whole world and has now been declared a Pandemic by the World Health Organization (WHO). Although the mortality rate of this virus is low, it is especially potent against people with underlying systemic conditions. Dentistry is a profession where the doctor, as well as the dental staff, works in close vicinity to the patient’s mouth. Dental education has two core components; didactic and clinical training (including patient care). Dental education has been interrupted in the past due to certain events (Arab Spring and SARS outbreak). Currently, the pandemic of COVID-19 has disrupted dental education globally as most of the dental schools and universities in the world have closed amidst the COVID-19 outbreak. Teledentistry is a subspecialty of telemedicine that helps in the provision of educational activities, advice, and diagnosis about treatment over a distance with the help of technology like video conferencing. The current overview summarizes the potential role of teledentistry in continuing the dental educational process in terms of delivery of didactic components, clinical training, and patient care. It can be concluded that with modern updated devices and tools, teledentistry can be an effective way to prevent disruption of dental education and it can be utilized in continuing the dental educational process in this critical time of the COVID-19 outbreak.
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Affiliation(s)
- Imran Farooq
- Imran Farooq, Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saqib Ali
- Saqib Ali, Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Imran Alam Moheet
- Imran Alam Moheet, Azra Naheed Dental College, Superior University, Lahore, Pakistan
| | - Jehan AlHumaid
- Jehan AlHumaid, Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Creation and Evaluation of an Endodontic Diagnosis Training Software. Int J Dent 2020; 2020:8123248. [PMID: 32802058 PMCID: PMC7415094 DOI: 10.1155/2020/8123248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The purpose of the study is to evaluate a user-friendly, comprehensive, fully integrated web- and mobile-based application that was specifically developed to guide learners and help them practice and train in pulpal and periapical diagnosis. METHODS The software was designed for assistance in the diagnosis of the pulpal and the periapical area. The software contained questions and tests, e.g., presence or absence of signs and symptoms, cold test, percussion, palpation, and radiographic examination that the user must answer to arrive at the final diagnosis. An electronic survey was prepared to evaluate the effectiveness, productivity, and accurateness of the software. The software and the electronic evaluation survey were sent by e-mail to dental students, endodontist, general dentists, and dental interns who study or work in four Saudi dental colleges. Data was analyzed using descriptive statistics. RESULT A total of 203 questionnaires were completed. Results showed that 29% of the participants were highly satisfied with the software; 40% gave a very good rating about the application satisfaction, while only 2% reported a poor degree of satisfaction with the software. Results also showed that students accurately selected the correct diagnosis but received relatively low diagnostic proficiency scores because they did not request diagnostic data in a pattern similar to experts. CONCLUSION In conclusion, the software is promising as an effective and efficient tool for teaching and assessing the diagnostic skills of learners.
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Inquimbert C, Hirata-Tsuchiya S, Yoshii S, Molinari N, Nogue E, Roy C, Morotomi T, Washio A, Cuisinier F, Tassery H, Levallois B, Kitamura C, Giraudeau N. Concordance study between regular face-to-face dental diagnosis and dental telediagnosis using fluorescence. J Telemed Telecare 2020; 27:509-517. [DOI: 10.1177/1357633x19894111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Teledentistry consultations are an effective way to increase access to care. Whether it be for a screening, referral or even an adapted treatment plan for a certain number of patients whose access to care is complicated, demonstrating the reliability of remote consultations is essential in allowing the technique to become generalised. Aim This study aimed to determine if teledentistry consultations using fluorescence are of the same quality as regular consultations in the diagnosis of caries. Methods Patients were seen in consultation in the dental care centre at the Montpellier University Hospital (France) and in the centre at Kyushu Dental University Hospital (Japan). The protocol was broken down into three parts: the regular consultation, the recording of videos with the Soprocare camera and the remote consultation. The regular consultation and the remote consultation were blinded and carried out by two different dentists. The recording of videos was carried out by a third dentist. The carious diagnosis was based on the International Caries Detection and Assessment System: a clinical rating system for the detection and assessment of caries. Results One hundred and ninety-five patients met the predefined inclusion criteria. Most patients had at least one surface at stage 3 or higher (73%) with a higher proportion amongst French patients (81% compared to 66%). However, they had good dental hygiene, given that dental hygiene was only deemed unsatisfactory for 10.8% (19% for French patients and 2% for Japanese patients). The odontogram (presence/absence of each tooth) seemed to be correctly identified during the remote consultation (reinterpretation). Out of the 195 patients, 168 (86.2%) were identified without error. Conclusions Teledentistry consultations can represent acceptable diagnostic performance with regard to the detection of dental caries. The Soprocare camera enables an early diagnosis of carious lesions with optimal efficiency. Several areas still need to be improved, however, so that the use of the camera during remote consultations is as coherent and effective as possible, especially with regard to the organisational aspects of remote consultations.
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Affiliation(s)
- Camille Inquimbert
- Department of Oral Public Health, Montpellier University Hospital, France
- Laboratory ‘Systemic Health Care’, University of Lyon, France
| | | | - Shinji Yoshii
- Division of Endodontics and Restorative Dentistry, Kyushu Dental University, Japan
| | - Nicolas Molinari
- Clinical Research and Epidemiology Unit, CHU Montpellier, France
- IMAG, University of Montpellier, France
| | - Erika Nogue
- Clinical Research and Epidemiology Unit, CHU Montpellier, France
| | - Clement Roy
- Department of Oral Public Health, Montpellier University Hospital, France
| | - Takahiko Morotomi
- Division of Endodontics and Restorative Dentistry, Kyushu Dental University, Japan
| | - Ayako Washio
- Division of Endodontics and Restorative Dentistry, Kyushu Dental University, Japan
| | | | | | | | - Chiaki Kitamura
- Division of Endodontics and Restorative Dentistry, Kyushu Dental University, Japan
| | - Nicolas Giraudeau
- Department of Oral Public Health, Montpellier University Hospital, France
- CEPEL, CNRS, University of Montpellier, France
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Vinayagamoorthy K, Acharya S, Kumar M, Pentapati KC, Acharya S. Efficacy of a remote screening model for oral potentially malignant disorders using a free messaging application: A diagnostic test for accuracy study. Aust J Rural Health 2019; 27:170-176. [PMID: 30942518 DOI: 10.1111/ajr.12496] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 10/16/2018] [Accepted: 12/02/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To assess the feasibility of using a remote sensing model as a free messaging application tool in the preventive screening of oral potentially malignant disorders in a rural area of India. DESIGN An observational cross-sectional study. SETTING Primary care setting in Udupi District, Karnataka, South India. PARTICIPANTS One-hundred and thirty-one individuals with a mean (SD) age of 37.34 (11.31) years, of whom 64.1% and 35.9% were men and women, respectively. INTERVENTIONS Clinical oral examination followed by photo capture of five areas of the patients' mouth. MAIN OUTCOME MEASURES Reliability measures for the use of a photo messaging service in diagnosing oral potentially malignant disorders, as compared to the clinical examination. RESULTS When lesions were categorised as normal and abnormal, the reliability (kappa) between the diagnoses, based on photo messaging and clinical oral examination, was 0.68 and 0.67 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.5% and 99.04%, respectively, whereas the specificity was 72% and 64%, respectively. When the agreement between photo messaging and clinical oral examination for an exact diagnostic match was assessed, the reliability (kappa) was 0.59 and 0.55 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.1% and 98.7%, respectively, whereas the specificity was 64% and 52% respectively. CONCLUSION There was a substantial agreement between the diagnosis based on clinical examination and WhatsApp image for both the examiners, when the lesions were dichotomised as normal and abnormal, but slightly reduced when assessed for the exact diagnostic match. Screening for oral potentially malignant disorders using photo messaging can serve as an effective adjunct and a potential cost-effective tool in a low-resource setting.
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Affiliation(s)
- Kalaiselvi Vinayagamoorthy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Mathangi Kumar
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Kalyana Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
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Binaisse P, Dehours E, Bodéré C, Chevalier V, Le Fur Bonnabesse A. Dental emergencies at sea: A study in the French maritime TeleMedical Assistance Service. J Telemed Telecare 2019; 26:285-293. [PMID: 30646814 DOI: 10.1177/1357633x18818736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of the study was to assess the frequency, features and management of dental emergencies at sea in France. METHODS A descriptive study was carried out by retrospectively examining medical records of patients who were assisted by the French maritime TeleMedical Assistance Service (TMAS) from 2012 to 2016. Data were ranked in different categories: socio-demographic data, diagnosis, prescription, and monitoring or treatment prescribed. RESULTS The TMAS recorded 9122 medical files for all medical emergencies. Among these medical records 135 concerned oral diseases. The main causes for dental emergencies are dental abscess (51.8%), tooth decay (33.3%), and dental fracture (8.9%). Even where teledentistry is validated for remote screening and oral lesion diagnosis, management of dental emergencies mostly requires a dental procedure. On board, without special equipment and/or specifically trained healthcare workers, this management often results in the prescription of medication. DISCUSSION The International Medical Guide for Ships published by the World Health Organization could be updated to suit the latest recommendations of dental emergency management. This could facilitate the addition of a medical act to dental management, resulting in more effective treatment. Furthermore, simple and specific equipment could be added to the medical supplies.
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Affiliation(s)
- Pierre Binaisse
- Dental Faculty of Brest, University of Western Brittany, Brest, France
| | - Emilie Dehours
- French maritime Tele-Medical Assistance Service - TMAS, Emergency Department, University Hospital, Toulouse, France
| | - Céline Bodéré
- LIEN EA 4685, University of Western Brittany, Brest, France.,Pain center, University Hospital, Brest, France
| | | | - Anaïs Le Fur Bonnabesse
- Dental Faculty of Brest, University of Western Brittany, Brest, France.,LIEN EA 4685, University of Western Brittany, Brest, France
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Carrard VC, Roxo Gonçalves M, Rodriguez Strey J, Pilz C, Martins M, Martins MD, Schmitz CA, Dal Moro RG, D'Ávila OP, Rados D, Harzheim E, Gonçalves MR. Telediagnosis of oral lesions in primary care: The EstomatoNet Program. Oral Dis 2018; 24:1012-1019. [PMID: 29505701 DOI: 10.1111/odi.12851] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/07/2018] [Accepted: 02/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The diagnosis of oral lesions is often challenging for primary healthcare providers, which explains the high number of referrals to specialist care. This favors increases in waiting lines and delays in diagnosis, contributing to high mortality rates from oral cancer. This study aimed to summarize the experience of the EstomatoNet, a telediagnosis program catering to primary care dentists and physicians from southern Brazil. STUDY DESIGN This exploratory study included all queries received by EstomatoNet from June 2015 to December 2016. Health providers (71 dentists and 18 physicians from primary care) submitted requests including clinical information and photographs of oral lesions by means of a cloud-based platform. Specialized oral medicine teleconsultants received the data, conveyed a diagnostic hypothesis, and conveyed management recommendations. RESULTS Actinic cheilitis (n = 41, 15.8%), squamous cell carcinoma (n = 22, 8.5%), and inflammatory hyperplasia (21, 8.1%) were the most frequent diagnoses. Teleconsultants recommended referral to specialists in 42.9% of the cases, total biopsy in 23.6%, and follow-up in 16.2%. After the EstomatoNet use, the intention to refer the patients to face-to-face consultation reduced from 96.9% to 35.1%. CONCLUSION Telediagnosis for oral lesions is feasible and has potential to improve the quality of primary health care by bridging the gap between primary and specialized health care.
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Affiliation(s)
- V C Carrard
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M Roxo Gonçalves
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J Rodriguez Strey
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - C Pilz
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mat Martins
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M D Martins
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - C A Schmitz
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - R G Dal Moro
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - O P D'Ávila
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Drv Rados
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - E Harzheim
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M R Gonçalves
- Telehealth, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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McFarland KK, Nayar P, Chandak A, Gupta N. Formative evaluation of a teledentistry training programme for oral health professionals. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:109-114. [PMID: 28294493 DOI: 10.1111/eje.12265] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The objective of this study was to conduct a formative evaluation of a teledentistry (TD) programme that was developed for a predominantly rural state in the Midwestern United States. MATERIALS AND METHODS Formative evaluation data were collected on programme activities from the TD programme records. In addition, the effectiveness of the TD training programme was evaluated using a self-administered paper-based survey administered to the participants, immediately following completion of the training activity. Ninety-three dental students, oral health and other health professionals participated in the TD training programme. RESULTS Overall, the trainees rated the TD training programme highly, with regard to the content, format and skills improvement. The evaluation also demonstrated a positive change in all trainees' attitudes following the training sessions, with most trainees acknowledging a positive impact of the training on their knowledge and competency. DISCUSSION AND CONCLUSIONS We identified challenges in the development of the TD programme and in expanding access to oral health care for rural communities. Challenges included reimbursement and a limited interest amongst established dental offices. Dental schools can play an important role in preparing both dental health professionals and other health professionals in the use of TD by providing training and oral health expertise. The use of TD by non-dental providers for consultation, referral and disease management has the potential to improve oral health outcomes, particularly for rural and underserved populations. Evaluation data provide critical feedback to programme planners and administrators.
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Affiliation(s)
| | - P Nayar
- Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Omaha, NE, USA
| | - A Chandak
- Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE, USA
| | - N Gupta
- Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE, USA
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25
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de Almeida Geraldino R, Rezende LVMDL, da-Silva CQ, Almeida JCF. Remote diagnosis of traumatic dental injuries using digital photographs captured via a mobile phone. Dent Traumatol 2017; 33:350-357. [PMID: 28453886 DOI: 10.1111/edt.12347] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Intra-oral photographs have been aided diagnosis of several pathologies in teledentistry. Mobile phone cameras may produce high-quality photographs, presenting itself as a viable tool for remote diagnosis of traumatic dental injuries. AIM To evaluate the levels of interexaminer agreement in cases of traumatic dental injuries when comparing diagnoses conducted in person and remotely. MATERIAL AND METHODS The sample included 40 patients with 73 traumatized teeth, and a total of 90 diagnoses, who had presented to two dental clinics, one private, and the other public, in Brazil's Federal District. The dental history and clinical examination data were registered in electronic forms, and digital photographs were captured with a mobile phone camera and uploaded to a cloud drive. Six remote examiners formulated their diagnoses based solely on photographic analysis. Thereafter, they were provided with additional clinical data and asked to provide a second round of diagnoses. These diagnoses were compared to those conducted in person, which were considered the gold standard. The data were analyzed with Gwet's AC1 interexaminers' measure to evaluate the agreement between the in-surgery and remote diagnoses. RESULTS The levels of interexaminer agreement between the in-surgery and remote diagnoses formulated exclusively with images were 0.83 or higher (95% confidence interval: 0.73-0.91), and 0.93 or higher (95% confidence interval: 0.88-0.97), when clinical information was available. CONCLUSION 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.
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Affiliation(s)
| | | | | | - Júlio César Franco Almeida
- Oral Health Unit - University Hospital, Health Sciences Faculty, University of Brasília, Brasília, Brazil
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Pentapati KC, Mishra P, Damania M, Narayanan S, Sachdeva G, Bhalla G. Reliability of intra-oral camera using teledentistry in screening of oral diseases - Pilot study. Saudi Dent J 2017; 29:74-77. [PMID: 28490846 PMCID: PMC5411894 DOI: 10.1016/j.sdentj.2017.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 03/01/2017] [Indexed: 11/19/2022] Open
Abstract
Objective Reliability of intra-oral camera using teledentistry in screening of oral diseases. Methodology A trained and calibrated examiner used intra-oral camera to capture videos of oral cavity along with clinical examination to evaluate caries, plaque, calculus, tooth wear and fluorosis, stains in children. Results The mean DT and DMFT were significantly higher with use of intra-oral camera than with clinical examination (p = 0.001 and 0.001) respectively. A positive strong significant correlation was seen between intra-oral camera and clinical examination with respect to DT, MT, FT and DMFT (r = 0.721, p < 0.001; r = 0.908, p < 0.001; r = 0.869, p < 0.001; r = 0.876, p < 0.001) respectively. Reliability of intra-oral camera when compared with clinical examination varied from substantial to almost perfect agreement various oral conditions. Disclosed immature plaque was not clear while mature plaque was clearly demonstrated. Conclusion/recommendations Intra-oral camera was shown to be a reliable tool to identify common oral diseases. Further studies involving applications like sealant retention, pre-malignant lesions, recurrent apthae, gingival recession and dental malocclusion and effectiveness in regular screening are needed.
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Busby B, Campbell S, Cole R, DeVries C, Dobbins K, Trimble MB, Wickline M. Photography in Telemedicine: Improving Diagnosis of Chronic Graft-Versus-Host Disease. Clin J Oncol Nurs 2017; 21:86-92. [PMID: 28107317 DOI: 10.1188/17.cjon.86-92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The long-term follow-up (LTFU) team at the Seattle Cancer Care Alliance uses telemedicine to diagnose and treat post-transplantation complications in hematopoietic cell transplantation (HCT) survivors. Photos are often requested via the telemedicine service to aid in diagnosis, but they are typically of poor quality, making them unusable. OBJECTIVES This project offered bachelor of science in nursing students, partnered with a comprehensive cancer center, the opportunity to participate in an evidence-based practice project to improve detection and management of chronic graft-versus-host disease (cGVHD) in patients after HCT. METHODS Students partnered with RNs to develop instructional tools using multiple evidence sources. A brochure and video were developed. FINDINGS Providing these instructional tools to those in the LTFU program improved patient outcomes for managing cGVHD through telemedicine. This partnership provided an opportunity for mutual learning and improved clinical practice.
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28
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Irving M, Stewart R, Spallek H, Blinkhorn A. Using teledentistry in clinical practice as an enabler to improve access to clinical care: A qualitative systematic review. J Telemed Telecare 2017; 24:129-146. [PMID: 28092220 DOI: 10.1177/1357633x16686776] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Access to dental care is important for overall health, but can remain problematic for those in rural or isolated locations. It can be difficult to encourage clinicians to choose or continue a rural health career. Teledentistry is showing some promise as a strategy to support rural, isolated and new health care workers. This study aims to explore the quantitative and qualitative framework associated with teledentistry in an effort to uncover the interaction of multiple influences on its delivery and sustainability. Methods A systematic search of the literature was undertaken and studies were included if they evaluated consultative teledentistry, reports on implementation of teledentistry in practice or attitudes to teledentistry. Studies were evaluated qualitatively. Results Thirty-nine studies were included focusing on the accuracy, effectiveness or description a teledentistry project in practice. Five main themes were identified in the qualitative analysis: (1) using information and communication technology (ICT), (2) regulatory and system improvements, (3) accuracy of teledentistry, (4) effectiveness, including increasing access to clinical services, efficiencies and acceptability, and (5) building and increasing clinical capacity of the dental workforce. Conclusion Teledentistry provides a viable option for remote screening, diagnosis, consultation, treatment planning and mentoring in the field of dentistry. Rapidly developing information and communication technologies have increasingly shown improving cost effectiveness, accuracy and efficient remote assistance for clinicians. There is high acceptability for teledentistry amongst clinicians and patients alike. Remuneration of advising clinicians is critical to sustainability.
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Affiliation(s)
- Michelle Irving
- 1 The Poche Centre for Indigenous Health, University of Sydney, New South Wales, Australia.,2 Faculty of Dentistry, University of Sydney, New South Wales, Australia
| | - Rosemary Stewart
- 1 The Poche Centre for Indigenous Health, University of Sydney, New South Wales, Australia
| | - Heiko Spallek
- 2 Faculty of Dentistry, University of Sydney, New South Wales, Australia
| | - Anthony Blinkhorn
- 2 Faculty of Dentistry, University of Sydney, New South Wales, Australia
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WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:248-54. [DOI: 10.1016/j.oooo.2015.11.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 11/04/2015] [Accepted: 11/08/2015] [Indexed: 11/19/2022]
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Poli Neto P, Tesser CD, Monteiro GH, Boso PFM, Lemos G. O uso do correio eletrônico na comunicação entre usuários e uma equipe de saúde da família: relato de experiência. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2015. [DOI: 10.5712/rbmfc10(37)1167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Este relato descreve o uso do correio eletrônico por uma equipe de saúde da família para comunicação com os pacientes e agendamento. Tal uso surgiu como consequência de um processo de facilitação do acesso presencial e não presencial. No período de 25 meses houve crescimento no número de mensagens e de remetentes. Das 1437 mensagens recebidas, 61,5% foram para agendar consultas, 27,8% solicitavam informações em saúde e 7,6% eram sobre serviços oferecidos. As mulheres enviaram 87% das mensagens (63,3% delas tinham 20-40 anos). Em 60% das vezes, o contato referia-se à demanda do remetente e mais de 30% à de familiares. A equipe respondeu a 83% das mensagens em até 8 horas úteis. Na percepção da equipe, o uso do correio eletrônico melhorou a comunicação e o acesso e foi bem aceito pelos usuários, não prejudicando grupos mais vulneráveis. Investigações mais aprofundadas serão necessárias para avaliar a contribuição dessa ferramenta na Atenção Primária à Saúde.
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Morosini IDAC, de Oliveira DC, Ferreira FDM, Fraiz FC, Torres-Pereira CC. Performance of Distant Diagnosis of Dental Caries by Teledentistry in Juvenile Offenders. Telemed J E Health 2014; 20:584-9. [DOI: 10.1089/tmj.2013.0202] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Diego Canavese de Oliveira
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Fernanda de Morais Ferreira
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
- Stomatology Department, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Fabian Calixto Fraiz
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
- Stomatology Department, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Cassius C. Torres-Pereira
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
- Stomatology Department, Federal University of Paraná, Curitiba, Paraná, Brazil
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Abstract
UNLABELLED Teledentistry has the potential to address the oral care needs of those who have limited access to care. More research is needed to establish the evidence base to support teledentistry practice. BACKGROUND AND PURPOSE Enormous potential exists to improve oral health services throughout the world by using information and communication technologies, such as teledentistry to expand access to primary, secondary and tertiary care. Comparison of teledentistry procedures with standard clinical procedures can demonstrate the relative effectiveness and cost of each approach. However, due to insufficient evidence, it is unclear how these strategies compare for improving and maintaining oral health, quality of life, and reducing health care costs. This review discusses the merits of teledentistry for the delivery of oral care. METHODS This article summarizes the available literature related to the efficacy and effectiveness of teledentistry and presents possible barriers to its broader adoption. CONCLUSIONS Teledentistry seems to be a promising path for providing oral health services where there is a shortage of oral health care providers.
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Affiliation(s)
- Susan J Daniel
- Gene W. Hirschfeld School of Dental Hygiene, College of Health Sciences, Old Dominion University, Norfolk, VA, USA.
| | - Sajeesh Kumar
- Department of Health Informatics & Information Management, College of Allied Health, University of Tennessee Health Science Center, Memphis, TN, USA
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Choi JW. Clinical usefulness of teleradiology in general dental practice. Imaging Sci Dent 2013; 43:99-104. [PMID: 23807933 PMCID: PMC3691380 DOI: 10.5624/isd.2013.43.2.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 11/27/2012] [Accepted: 12/05/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was performed to investigate the clinical usefulness of teleradiology in general dental practice. Materials and Methods Two hundred and seventy five cases were submitted for inquiry to the case presentation board of the website of The Korean Academy of Oral and Maxillofacial Radiology for a 5 year periods. The diagnosis results of those cases were analyzed according to the disease classification, the correlation with the patient's chief complaint, the necessity of additional examinations or treatments, the image modalities, and the number of dentists inquiring. Results Differential diagnoses of normal anatomic structures were the most frequently submitted cases, covering 15.6% of all cases. Among 275 cases, 164 cases required no additional treatments or examinations. Panoramic radiographs were the most frequently submitted images, accounting for 248 inquiries. The 275 cases were submitted by 96 dentists. Fifty-two dentists wrote one inquiry, and 44 inquired 2 or more times. The average inquiry number of the latter group was 5.0 cases. Conclusion A teleradiology system in general dental practice could be helpful in the differential diagnosis of common lesions and reduce unnecessary costs.
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Affiliation(s)
- Jin-Woo Choi
- Department of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan, Korea
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35
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Abstract
We conducted a systematic review of teledentistry applications. We searched the MEDLINE/PubMed, Embase and Cochrane Library databases for relevant articles published from 1992 to 2012. The reference lists of all retrieved articles were hand-searched. Studies were included after assessing the eligibility of the full-text article. A total of 878 studies were identified, of which 59 fulfilled the inclusion criteria of the review. The articles covered several dental specialties, mostly oral surgery, oral medicine and oral pathology. The most common type of teledentistry application was education (n = 21), followed by diagnosis (n = 16), consultation (n = 3) and treatment (n = 2). Teledentistry studies were reported in a total of 15 countries. The largest number of studies were conducted in the US (n = 22) and there were no studies from developing countries. Most of the reports referred to pilot projects and short-term outcomes, and most of the studies were descriptive. The review indicates that although teledentistry is an area of expansion, there are still some barriers to its increased use.
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Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, University of Melbourne, Australia
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36
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Abstract
Teledentistry can be defined as the remote provision of dental care, advice, or treatment through the medium of information technology, rather than through direct personal contact with any patient(s) involved. Within dental practice, teledentistry is used extensively in disciplines like preventive dentistry, orthodontics, endodontics, oral surgery, periodontal conditions, detection of early dental caries, patient education, oral medicine, and diagnosis. Some of the key modes and methods used in teledentistry are electronic health records, electronic referral systems, digitizing images, teleconsultations, and telediagnosis. All the applications used in teledentistry aim to bring about efficiency, provide access to underserved population, improve quality of care, and reduce oral disease burden.
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Affiliation(s)
- Saad Ahmed Khan
- Conservative Department, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
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37
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Torres-Pereira CC, Morosini IDAC, Possebon RS, Giovanini AF, Bortoluzzi MC, Leão JC, Piazzetta CM. Teledentistry: distant diagnosis of oral disease using e-mails. Telemed J E Health 2013; 19:117-21. [PMID: 23356381 DOI: 10.1089/tmj.2012.0087] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the applicability of telediagnosis in oral medicine, through the transmission of clinical digital images by e-mail. SUBJECTS AND METHODS The sample included 60 consecutive patients who sought oral medicine services at the Federal University of Paraná, in the state of Paraná, located in southern Brazil. The clinical history and oral lesion images were recorded using clinical electronic charts and a digital camera, respectively, and sent by e-mail to two oral medicine consultants. The consultants provided a maximum of two clinical hypotheses for each case, which were compared with biopsy results that served as the gold standard. RESULTS In 31 of the 60 cases (51.7%), both consultants made the correct diagnosis; in 17 cases (28.3%), only one consultant made the correct diagnosis; and in 12 cases (20%), neither consultant made the correct diagnosis. Therefore, in 80% of cases, at least one consultant provided the correct diagnosis. The agreement between the first consultant and the gold standard was substantial (κ=0.669), and the agreement between the second consultant and the gold standard was fair (κ=0.574). CONCLUSIONS The use of information technology can increase the accuracy of consultations in oral medicine. As expected, the participation of two remote experts increased the possibility of correct diagnosis.
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Affiliation(s)
- Cassius C Torres-Pereira
- Stromatology Department and Post-Graduate Program in Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
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Blomstrand L, Sand LP, Gullbrandsson L, Eklund B, Kildal M, Hirsch JM. Telemedicine—A Complement to Traditional Referrals in Oral Medicine. Telemed J E Health 2012; 18:549-53. [DOI: 10.1089/tmj.2011.0207] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Lena Blomstrand
- Department of Surgical Sciences, Oral & Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Lars P. Sand
- Department of Surgical Sciences, Oral & Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | | | - Benny Eklund
- Chancellery of Uppsala County Council, Uppsala, Sweden
| | - Morten Kildal
- Department of Plastic Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Jan-Michael Hirsch
- Department of Surgical Sciences, Oral & Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
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Zadik Y, Orbach H, Panzok A, Smith Y, Czerninski R. Evaluation of oral mucosal diseases: inter- and intra-observer analyses. J Oral Pathol Med 2011; 41:68-72. [DOI: 10.1111/j.1600-0714.2011.01070.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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40
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Jampani ND, Nutalapati R, Dontula BSK, Boyapati R. Applications of teledentistry: A literature review and update. J Int Soc Prev Community Dent 2011; 1:37-44. [PMID: 24478952 PMCID: PMC3894070 DOI: 10.4103/2231-0762.97695] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Teledentistry is a combination of telecommunications and dentistry involving the exchange of clinical information and images over remote distances for dental consultation and treatment planning. Teledentistry has the ability to improve access to oral healthcare, improve the delivery of oral healthcare, and lower its costs. It also has the potential to eliminate the disparities in oral health care between rural and urban communities. This article reviews the origin, rationale, scope, basis, and requirements for teledentistry, along with the current evidence that exists in the literature. This article also reviews the ethical and legal issues related to the practice of teledentistry and the future of this alternative and innovative method of delivering dental care.
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Affiliation(s)
- N. D. Jampani
- Department of Periodontics, Government Dental College & Hospital, Vijayawada, India
| | - R. Nutalapati
- Department of Periodontics, Sree Sai Dental College & Research Institute, Srikakulam, Andhra Pradesh, India
| | - B. S. K. Dontula
- Department of Conservative Dentistry & Endodontics, Aditya Dental College, Beed, Maharashtra, India
| | - R. Boyapati
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Walker TWM, O'Connor N, Byrne S, McCann PJ, Kerin MJ. Electronic follow-up of facial lacerations in the emergency department. J Telemed Telecare 2011; 17:133-6. [DOI: 10.1258/jtt.2010.100307] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It is often difficult for emergency department staff to follow up the primary closure of simple facial lacerations. This is important to allow closure of the feedback loop. Consecutive patients who were sutured by a single operator using the same technique were asked to send a photograph of the laceration six months and 12 months afterwards. The patients had Internet access and a digital camera, or a mobile phone with a camera. They were given a leaflet with the details of the email address or mobile number to send the picture to. A reminder telephone call was made to each patient at six months and 12 months, and the email address or mobile number to send the picture to was given again. In each telephone call patients were asked to grade the healing on a 5-point scale from 1 = very happy to 5 = very unhappy. At 13 months all patients were re-contacted and reminded again. Fifty patients were included in the study (33 males). The cause of injury was sport in 17 patients, assault in 18 and accidents in 15. At six months, 23 patients stated that they were happy and 27 were very happy with the scar. The mean score was 1.5. At 12 and 13 months, four patients were happy and 46 very happy. The mean score was 1.1. Twenty-four patients said they would use a computer/camera to send in the follow-up image, and 26 patients had a mobile phone with a camera and said they would use that. Despite the reminders, no patients sent a photograph. The results provide no evidence to support the use of photographs sent by email or text message for the follow-up of facial lacerations sutured in the emergency department.
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Affiliation(s)
- Tom W M Walker
- Department of Oral and Maxillofacial Surgery, University College Hospital, Galway, Ireland
| | - Norma O'Connor
- Department of Oral and Maxillofacial Surgery, Mid Western Regional Hospital, Limerick, Ireland
| | | | - Patrick J McCann
- Department of Oral and Maxillofacial Surgery, University College Hospital, Galway, Ireland
| | - Michael J Kerin
- Department of Surgery, National University of Ireland, Galway, Ireland
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Barnes JJ, Patel S, Mannocci F. Why do general dental practitioners refer to a specific specialist endodontist in practice? Int Endod J 2010; 44:21-32. [DOI: 10.1111/j.1365-2591.2010.01791.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lienert N, Zitzmann NU, Filippi A, Weiger R, Krastl G. Teledental consultations related to trauma in a Swiss telemedical center: a retrospective survey. Dent Traumatol 2010; 26:223-7. [DOI: 10.1111/j.1600-9657.2010.00873.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Duka M, Mihailović B, Miladinović M, Janković A, Vujicić B. [Evaluation of telemedicine systems for impacted third molars diagnosis]. VOJNOSANIT PREGL 2010; 66:985-91. [PMID: 20095519 DOI: 10.2298/vsp0912985d] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
UNLABELLED BACKGROUND/AIM. In the last twenty years significant advances have been made in the fields of information and telecommunication technology in health care applications, with a positive impact on the health care practice. The need for remote diagnosis and planning of interventions is of special importance in military health care, and health management of immobile persons, and those with special needs. In cases such as these, availability of specialist health care is mainly limited by geographic and financial factors. The aim of this study was to investigate practical usability of telemedicine approaches in everyday management of oral surgery patients in terms of reliability of established diagnosis and indications for oral surgery treatment of the third molars. METHODS Our experimental randomized study enrolled 432 randomly selected patients of both genders, aged 20 to 87 years, undergoing panoramic radiography for some reason in the Centre for Dental Radiography in Belgrade. In addition to radiography, photographs of the face and mouth cavity were taken. These images were uploaded to the web server specially dedicated to the study purposes, and then transmitted to teledentists, i.e. oral surgeons, who made remote diagnoses. Diagnostic agreement was determined by way of the Cohen's kappa coefficient, and diagnostic sensitivity (SE), specificity (SP), and effectiveness (EFF) were also established. Statistical significance was determined and comparisons performed by using the z-test, and testing of non-parametric characteristics by using the McNemar's chi2 test for p = 0.05 significance cut-off. RESULTS The results obtained by analyzed images and diagnostic assessment of the clinical diagnosis (kappa = 0.99, SE = 99%, SP = 99%, EFF = 99%, for 95% CI) indicate an almost complete diagnostic agreement. The differences in diagnosis were not statistically significant. CONCLUSION Diagnostic assessment of the clinical diagnosis of impacted or semi-impacted third molars assisted by the telemedicine approach was equal to the real-time assessment of clinical diagnosis. Telemedicine, and teledentistry as its branch, represent the present and even more the future of this field of health care.
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Affiliation(s)
- Milos Duka
- Vojnomedicinska akademija, Klinika za maksilofacijalnu i oralnu hirurgiju i implantologiju, Beograd, Srbija
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