The Study of Specificity and Sensitivity of Teledentistry for Oral Lesion Diagnosis in Comparison to Clinical Examination: A Systematic Review and Meta-analysis
Keywords:
Teledentistry, Oral lesion, Diagnosis, Sensitivity, SpecificityAbstract
Background: Teledentistry, a branch of telemedicine utilizing information technology for dental diagnosis, treatment, and education, has gained popularity and development, particularly due to the COVID-19 pandemic. In resource-limited environments and rural areas lacking specialized expertise, the process of oral disease diagnosis is prolonged, potentially leading to the exacerbation of oral lesions or their progression to oral cancer. The implementation of teledentistry in oral medicine helps reduce barriers such as time, travel costs, and diagnostic waiting periods, facilitating earlier detection of oral cancer lesions and improving prognosis. Objective: To conduct a systematic review and meta-analysis to compile academic evidence and analyze the accuracy and efficiency of teledentistry systems in diagnosing oral lesions compared to clinical examinations. Methods: A systematic search was conducted in the PubMed database and Google Scholar. English or Thai articles published between 1990 and 2023 were included and subjected to meta-analysis. The data collected comprised sensitivity and specificity values of oral lesion examinations via teledentistry compared to clinical examinations. Results: Twelve studies met the inclusion criteria. The meta-analysis of sensitivity and specificity of teledentistry compared to clinical diagnosis of oral lesions from all 12 studies yielded a sensitivity of 94% (p < .001) and a specificity of 95% (p < .001). Subgroup analysis of five studies focusing on precancerous lesion diagnosis revealed a sensitivity of 96% (p < .001) and a specificity of 97% (p < .001). Subgroup analysis of eight studies providing final diagnoses showed a sensitivity of 93% (p < .001) and a specificity of 93% (p < .001). Conclusion: Teledentistry demonstrates high sensitivity and specificity in oral lesion examination compared to clinical examinations. However, definitive conclusions may be premature due to high heterogeneity in the data and insufficient studies.
References
Khan SA, Omar H. Teledentistry in practice: literature review. Telemed J E Health 2013;19(7):565-7.
Plaza-Ruíz SP, Barbosa-Liz DM, Agudelo-Suárez AA. Impact of COVID-19 on the knowledge and attitudes of dentists toward teledentistry. JDR Clin Trans Res 2021;6(3):268-78.
Estai M, Kanagasingam Y, Tennant M, Bunt S. A systematic review of the research evidence for the benefts of teledentistry. J Telemed Telecare 2018;24(3):147-56.
Kumar M, Nanavati R, Modi TG, Dobariya C. Oral cancer: etiology and risk factors: a review. Journal of Cancer Research and Therapeutics 2016;12(2):458-63.
Birur PN, Sunny SP, Jena S, Kandasarma U, Raghavan S, Ramaswamy B, et al. Mobile health application for remote oral cancer surveillance. J Am Dent Assoc 2015;146(12):886-94.
Haron N, Zain RB, Nabillah WM, Saleh A, Kallarakkal TG, Ramanathan A, et al. Mobile phone imaging in low resource settings for early detection of oral cancer and concordance with clinical oral examination. Telemed J E Health 2017;23(3):192-9.
Petruzzi M, De Benedittis M. WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;121(3):248-54.
Leao JC, Porter SR. Telediagnosis of oral disease. Braz Dent J 1999;10(1):47-53.
Younai FS, Messadi DV. E-mail-based oral medicine consultation. J Calif Dent Assoc 2000;28(2):144-51.
Uhrin E, Domokos Z, Czumbel LM, Kói T, Hegyi P, Hermann P, et al. Teledentistry: a future solution in the diagnosis of oral lesions: diagnostic meta-analysis and systematic review. Telemed J E Health 2023;29(11):1591-600.
Haron N, Zain RB, Ramanathan A, Abraham MT, Liew CS, Ng KG, et al. m-Health for early detection of oral cancer in low-and middle-income countries. Telemed J E Health 2020;26(3):278-85.
da Costa Flores AP, Roxo-Gonçalves M, Batista NVR, Gueiros LA, Linares M, Santos-Silva AR, et al. Diagnostic accuracy of a telediagnosis service of oral mucosal diseases: A multicentric survey. Oral Surg Oral Med Oral Pathol Oral Radiol 2022;134(1):65-72.
Nguyen J, Yang S, Melnikova A, Abouakl M, Lin K, Takesh T, et al. Novel approach to improving specialist access in underserved populations with suspicious oral lesions. Curr. Oncol 2023;30(1):1046-53.
Birur NP, Gurushanth K, Patrick S, Sunny SP, Raghavan SA, Gurudath S, et al. Role of community health worker in a mobile health program for early detection of oral cancer. Indian J Cancer 2019;56(2):107-13.
Fonseca BB, Perdoncini NN, da Silva VC, Gueiros LAM, Carrard VC, Lemos Jr CA, et al. Telediagnosis of oral lesions using smartphone photography. Oral Dis 2022;28(6):1573-9.
Keerthi G, Mukhia N, Sunny SP, Song B, Raghavan SA, Gurudath S, et al. Inter-observer agreement among specialists in the diagnosis of oral potentially malignant disorders and oral cancer using store-and-forward technology. Clin Oral Investig 2023;27(12):7575-81.
Gomes MS, Bonan PRF, Ferreira VYN, de Lucena Pereira L, Correia RJC, da Silva Teixeira HB, et al. Development of a mobile application for oral cancer screening. Technol Health Care 2017;25(2):187-95.
Tesfalul M, Littman-Quinn R, Antwi C, Ndlovu S, Motsepe D, Phuthego M, et al. Evaluating the potential impact of a mobile telemedicine system on coordination of specialty care for patients with complicated oral lesions in Botswana. J Am Med Inform Assoc 2016;23(e1):e142-5.
Ramesh RM, Patrick S, Lotha Z, Azole, Aier A, Birur N P. Prevalence and determinants of oral potentially malignant lesions using mobile health in a rural block, northeast India. Trop Doct 2022;52(1):53-60.
Birur N P, Song B, Sunny SP, Mendonca P, Mukhia N, Li S, et al. Field validation of deep learning based Point-of-Care device for early detection of oral malignant and potentially malignant disorders. Sci Rep 2022;12(1):14283.
Miller CS. Oral Medicine-the new dental specialty. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122(1):1-2.
Bez C, Sklavounou A, Carrozzo M. Oral medicine in Europe: past, present and future. Br Dent J 2017;223(9):726-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Department of Medical Services, Ministry of Public Health
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของกรมการแพทย์ กระทรวงสาธารณสุข
ข้อความและข้อคิดเห็นต่างๆ เป็นของผู้เขียนบทความ ไม่ใช่ความเห็นของกองบรรณาธิการหรือของวารสารกรมการแพทย์
