Smartphone-based Teleradiology in Dentistry: A Cross-platform Diagnostic Accuracy and Feasibility Assessment

Background and aim: Given the increasing demand for diagnostic services in remote and underserved areas, smartphone-based teleradiology platforms have now been proposed as an alternative for the transmission of dental imaging.So, the present study was conducted to evaluate the diagnostic efficacy, interpretation efficiency, and user satisfaction of dental radiographic images on WhatsApp, Telegram, and Email when compared to conventional desktop Digital Imaging and Communications in Medicine (DICOM) viewing.Materials and methods: This was a cross-sectional diagnostic accuracy study involving 60 anonymized intraoral and panoramic radiographs, which were evaluated by three experienced oral radiologists in four viewing modalities (desktop DICOM, WhatsApp, Telegram, and Email).Sensitivity, specificity, Cohen's kappa, and interpretation time were documented.Perceived subjective image clarity and diagnostic confidence were assessed with the use of Likert scales.A structured questionnaire was completed to evaluate feasibility and user preference.Results: The level of consistency with desktop interpretation was the best in the case of Telegram ( = 0.86), followed by Email ( = 0.81) and WhatsApp ( = 0.74).Sensitivity and specificity were highest for Telegram (92.5 and 94.0%, respectively).Desktop (42.5 7.8 s) had the fastest time for interpretation, followed by Telegram (45.2 8.5 s).The longest interpretation time (53.6 10.2 s) and lowest image clarity scores (3.9 0.5) were observed in WhatsApp.Telegram was considered the most suitable platform for the teleradiology applications. Conclusion:Telegram is a high-fidelity, efficient, and satisfactory platform for remote interpretation of dental radiographs with diagnostic accuracy comparable to a conventional desktop DICOM system.Although used extensively, the quality of diagnosis on WhatsApp is likely to be affected by image compression.Clinical significance: Telegram-based teleradiology on mobile provides a practical option for enhancing dental diagnostics in resource-poor areas.