Can Smartphones Be Used for Routine Dental Clinical Application? A Validation Study for Using Smartphone-Generated 3D Facial Images.

Objectives: To compare the accuracy of smartphone-generated three-dimensional (3D) facial images to that of direct anthropometry (DA) and 3dMD with the aim of assessing the validity and reliability of smartphone-generated 3D facial images for routine clinical applications.Materials and methods: Twenty-five anthropometric soft-tissue facial landmarks were labelled manually on 22 orthognathic surgery patients (11 males and 11 females; mean age 26.2 +/- 5.3 years). For each labelled face, two imaging operations were performed using two different surface imaging systems: 3dMDface and Bellus3D Face-App. Next, 42 inter-landmark facial measurements amongst the identified facial landmarks were measured directly on each labelled face and also digitally on 3D facial images. The measurements obtained from smartphone-generated 3D facial images (SGI) were statistically compared with those from DA and 3dMD.Results: SGI had slightly higher measurement values than DA and 3dMD, but there was no statistically significant difference between the mean values of inter-landmark measures across the three methods. Clinically acceptable differences (<= 3 mm or <= 5(degrees)) were observed for 67 % and 74 % of measurements with good agreement between DA and SGI, and 3dMD and SGI, respectively. An overall small systematic bias of +/- 0.2 mm was observed be-tween the three methods. Furthermore, the mean absolute difference between DA and SGI methods was highest for linear (1.41 +/- 0.33 mm) as well as angular measurements (3.07 +/- 0.73).Conclusions: SGI demonstrated fair trueness compared to DA and 3dMD. The central region and flat areas of the face in SGI are more accurate. Despite this, SGI have limited clinical application, and the panfacial accuracy of the SGI would be more desirable from a clinical application standpoint.Clinical significance: The usage of SGI in clinical practice for region-specific macro-proportional facial assessment involving central and flat regions of the face or for patient education purposes, which does not require accuracy within 3 mm and 5(degrees) can be considered.