Use of smartphones and tablets in radiographic evaluation: accuracy of caries detection on bitewing radiographs.

The objective of this study was to compare the accuracy of smartphone and tablet displays for the detection of incipient caries on bitewing radiographs. Forty-six digital bitewing radiographs with a total of 1656 unrestored, readable surfaces were evaluated. The included surfaces extended from the distal surface of each canine to the last posterior contact in each arch. The evaluation excluded nonreadable proximal surfaces. The gold standard for the presence or absence of incipient caries was the consensus of 2 expert oral and maxillofacial radiologists with 15 and 30 years of experience. The radiographs were then independently reevaluated by 2 other professionals with a master's degree in dentistry with an emphasis on oral radiology with more than 5 years of experience (observers 1 and 2). Observers 1 and 2 performed the reevaluations using a notebook computer (Pavilion dm1) with a calibrated LCD monitor as well as 2 smartphones (iPhone 6s and Galaxy Gran2 Duos) and 2 tablet computers (iPad and Galaxy Tab). The presence or absence of incipient dental caries was classified according to the following scale: 1, definitely present; 2, probably present; 3, uncertain; 4, probably absent; and 5, definitely absent. Receiver operating characteristic (ROC) curves were used to determine the accuracy of the diagnoses established by operators 1 and 2. The areas under the ROC curves (Az ) were compared with the binomial exact test at a significance level of 5%. The mean Az values for the Pavilion dm1 (0.948), iPhone 6s (0.944), Galaxy Gran2 Duos (0.916), iPad (0.949), and Galaxy Tab (0.950) did not present statistically significant differences (P > 0.05). The results suggest that all of the displays used in this study have statistically similar accuracy and can be used to detect incipient caries on bitewing radiographs.