Can smartphone cameras be a viable alternative to digital single-lens reflex (DSLR) cameras for dental shade assessment?

A COMMENTARY ON: Alhumoud T, Zankawi A, Li KY, Yu O, Pow E, Lam W. Performance of smartphone cameras for measuring and analyzing dental shade: A systematic review. J Dent. 2026; 166:106506. https://doi.org/10.1016/j.jdent.2026.106506 .

DESIGN

A systematic review evaluating the performance of digital single-lens reflex (DSLR) and smartphone-acquired photographs for dental shade assessment. The review followed PRISMA 2020 guidelines, was registered in PROSPERO (CRD42024580518), and searched five electronic databases: PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL).

STUDY SELECTION: Eligible studies comprised both in vivo and in vitro experimental designs evaluating dental shade assessment using smartphone cameras compared with DSLR cameras. Primary outcomes included colour difference (ΔE) relative to a reference standard (accuracy) and/or between devices (agreement). Studies evaluating three-dimensional imaging modalities, such as intraoral scanners, as well as teeth affected by bleaching, restoration discoloration, or carious lesions within the shade assessment area, were excluded. Only English-language full-text articles were eligible, while conference papers, case reports, and review articles were excluded.

DATA ANALYSIS: Risk of bias was assessed using a modified QUADAS-2 tool, and the certainty of evidence was evaluated using the GRADE framework. Due to extreme heterogeneity in study designs, imaging protocols, camera systems, and outcome assessment methods, meta-analysis was not considered appropriate. Findings were therefore synthesised narratively and presented using descriptive forest plots.

RESULTS

Eight studies were included, comprising three in vivo, three in vitro, and two mixed-design studies. Findings regarding colour difference (ΔE) were highly inconsistent, with some studies favouring DSLR cameras and others favouring smartphones for dental shade assessment. Considerable clinical, methodological, and statistical heterogeneity (I2 = 100%) was observed across camera models, lighting conditions, calibration protocols, and reference standards. Overall, the evidence did not demonstrate a consistent superiority of either device, and the certainty of the evidence was judged to be very low.

CONCLUSIONS

The available evidence comparing smartphone and DSLR photography for dental shade assessment is heterogeneous and inconclusive. Neither device has demonstrated consistent superiority, suggesting that standardised image acquisition, calibration, and image-processing protocols may be more important than the choice of camera system. Future research should adopt standardized methodologies and workflows to support evidence-based recommendations for device selection in dental shade matching.