Quality assessment of anterior composite restorations: clinical examination versus three digital photographic techniques

前牙复合树脂修复体质量评估:临床检查与三种数码摄影技术的比较

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Abstract

OBJECTIVE: The aim of this study was for the first time to evaluate of intraoral digital photography in assessing buccal surface of anterior composite restorations using a smartphone (iPhone 14 Pro), a smartphone with a lens (2IN1 Phone Macro Lens), and a digital camera with a macro lens (Canon Rebel XTi), compared to clinical examination, based on World Dental Federation (FDI) criteria. METHODS: A total of 185 anterior composite restorations were evaluated by calibrated restorative dentistry specialists. Restorations were scored according to the FDI criteria as intact, requiring repair, or needing replacement. Clinical examination was considered the gold standard. Photographs were taken under standardized conditions, and inter-observer and inter-method agreement were analyzed using Cohen’s Kappa and intraclass correlation coefficient (ICC). RESULTS: High inter-observer agreement was observed across all methods (Kappa = 0.928–1.0). Good to excellent agreement was found between clinical examination and digital photography methods for FDI final scores (Kappa = 0.775–0.973, p < 0.001). Photographs taken with the lens-equipped smartphone and macro camera showed higher agreement with clinical examination (Kappa = 0.973). CONCLUSION: Digital photography, particularly with a lens-equipped smartphone and macro camera, offers effectiveness comparable to clinical examination in evaluating anterior composite restorations. CLINICAL RELEVANCE: This study demonstrates that intraoral digital photography, particularly with a lens-equipped smartphone and macro camera, achieves diagnostic outcomes closely aligned with clinical examination using FDI criteria. While smartphones alone are practical, lens-assisted imaging enhances accuracy, supporting its use as a cost-effective alternative to professional macro cameras.

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