Artificial Intelligence for Tooth Detection in Cleft Lip and Palate Patients

Introduction: Cleft lip and palate patients often present with unique anatomical challenges, making dental anomaly detection and numbering particularly complex. The accurate identification of teeth in these patients is crucial for effective treatment planning and long-term management. Artificial intelligence (AI) has emerged as a promising tool for enhancing diagnostic precision, yet its application in this specific patient population remains underexplored. Objectives: This study aimed to evaluate the performance of an AI-based software in detecting and numbering teeth in cleft lip and palate patients. The research focused on assessing the system's sensitivity, precision, and specificity, while identifying potential limitations in specific anatomical regions and demographic groups. Methods: A total of 100 panoramic radiographs (52 males, 48 females) from patients aged 6 to 15 years were analyzed using AI software. Sensitivity, precision, and specificity were calculated, with ground truth annotations provided by four experienced orthodontists. The AI system's performance was compared across age and gender groups, with particular attention to areas prone to misidentification. Results: The AI system demonstrated high overall sensitivity (0.98 ± 0.03) and precision (0.96 ± 0.04). No statistically significant differences were found between age groups (p > 0.05), but challenges were observed in the maxillary left region, which exhibited higher false positive and false negative rates. These findings were consistent with the prevalence of unilateral left clefts in the study population. Conclusions: The AI system was effective in detecting and numbering teeth in cleft lip and palate patients, but further refinement is required for improved accuracy in the cleft region, particularly on the left side. Addressing these limitations could enhance the clinical utility of AI in managing complex craniofacial cases.