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Deep Learning-Based Periapical Lesion Detection on Panoramic Radiographs.

Viktor Szabó1, Kaan Orhan1,2,3, Csaba Dobó-Nagy1

  • 1Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 47 Szentkiralyi Str., 1088 Budapest, Hungary.

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Summary

The Diagnocat AI system shows high accuracy in detecting periapical lesions (PL) on panoramic radiographs (PRs), serving as a valuable diagnostic support tool. While generally effective, its performance varies for specific teeth like canines.

Keywords:
artificial intelligencedeep learningdental digital radiographypanoramic radiographyperiapical diseases

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Area of Science:

  • Dentistry
  • Radiology
  • Artificial Intelligence

Background:

  • Periapical lesions (PL) are common findings on panoramic radiographs (PRs).
  • Accurate detection of PL is crucial for timely diagnosis and treatment planning.
  • Artificial intelligence (AI) systems offer potential for improving radiographic interpretation.

Purpose of the Study:

  • To evaluate the accuracy of the AI-based Diagnocat system (DC) in detecting periapical lesions (PL) on panoramic radiographs (PRs).
  • To assess the performance metrics including sensitivity, specificity, and diagnostic accuracy of the AI tool.
  • To investigate the influence of factors like palatoglossal air space (PGAS) and specific tooth types on AI detection accuracy.

Main Methods:

  • A dataset of 616 teeth from 357 PRs was analyzed, comprising 308 teeth with and 308 without visible PL.
  • Teeth were categorized into groups based on radiographic signs: caries, coronal restoration, and root canal filling.
  • The Diagnocat system's convolutional neural network (CNN) performance was evaluated using sensitivity, specificity, predictive values, and diagnostic accuracy.

Main Results:

  • The Diagnocat system achieved an overall sensitivity of 0.78, specificity of 1.00, and diagnostic accuracy of 0.89.
  • Group 2 (teeth with coronal restoration) demonstrated the highest performance with sensitivity, specificity, and accuracy of 0.84, 1.00, and 0.95, respectively.
  • The palatoglossal air space (PGAS) did not significantly affect PL detection (p=1). Lower detection accuracy was noted for central incisors, wisdom teeth, and canines.

Conclusions:

  • The CNN-based Diagnocat system demonstrates significant potential as a decision-support tool for diagnosing periapical lesions on panoramic radiographs.
  • The AI system can aid clinicians in radiographic assessments, improving diagnostic efficiency.
  • Further refinement may be needed to enhance detection accuracy for specific tooth types, such as canines.