Tablet-computers and Smartphones can Reliably Detect Radiographic Tooth Fractures

Objectives: Traumatic events in the maxillofacial region can benefit from having the ability to acquire and visualize radiographs onsite .This is now possible with mobile x-ray units and mobile screens, including tablet computers and often times smart phones. However, the diagnostic accuracy of these mobile screens has not been very well studied. The objective of this study was to evaluate the reliability of identification of anterior tooth fractures in panoramic and posteroanterior (PA) radiographs on a medical grade monitor and on 2 smartphones (iPhone 5 and Nexus 5x) and 2 tablet computers (iPad 5 and Nexus 7).
Methods: Thirty anterior human teeth were used in this study. The teeth were randomly distributed between maxillary and mandibular arches, and a variety of commonly occurring traumatic fractures were simulated. Panoramic and PA radiographs were acquired. The presence of fractures was evaluated by two pediatric dental residents on all displays. All images were viewed twice, with an interval of at least two weeks between sessions.
Results: Statistical analysis using multivariate analysis showed no significant difference between the display qualities of a smartphone or tablet computer in diagnosing fractures when compared to a standard medical grade monitor which served as the gold standard. Kappa analysis showed good Intra-and inter-examiner reliability for diagnosing fractures on all displays.
Conclusions: Smartphones and tablet computers can reliably show anterior tooth fractures in PA and panoramic radiographs.