An Artificial Intelligence model for implant segmentation on periapical radiographs.

OBJECTIVE: To segment dental implants on PA radiographs using a Deep Learning (DL) algorithm. To compare the performance of the algorithm relative to ground truth determined by the human annotator. Methodology: Three hundred PA radiographs were retrieved from the radiographic database and consequently annotated to label implants as well as teeth on the LabelMe annotation software. The dataset was augmented to increase the number of images in the training data and a total of 1294 images were used to train, validate and test the DL algorithm. An untrained U-net was downloaded and trained on the annotated dataset to allow detection of implants using polygons on PA radiographs. RESULTS: A total of one hundred and thirty unseen images were run through the trained U-net to determine its ability to segment implants on PA radiographs. The performance metrics are as follows: accuracy of 93.8%, precision of 90%, recall of 83%, F-1 score of 86%, Intersection over Union of 86.4% and loss = 21%. CONCLUSIONS: The trained DL algorithm segmented implants on PA radiographs with high performance similar to that of the humans who labelled the images forming the ground truth.

Generative artificial intelligence: synthetic datasets in dentistry.

INTRODUCTION: Artificial Intelligence (AI) algorithms, particularly Deep Learning (DL) models are known to be data intensive. This has increased the demand for digital data in all domains of healthcare, including dentistry. The main hindrance in the progress of AI is access to diverse datasets which train DL models ensuring optimal performance, comparable to subject experts. However, administration of these traditionally acquired datasets is challenging due to privacy regulations and the extensive manual annotation required by subject experts. Biases such as ethical, socioeconomic and class imbalances are also incorporated during the curation of these datasets, limiting their overall generalizability. These challenges prevent their accrual at a larger scale for training DL models. METHODS: Generative AI techniques can be useful in the production of Synthetic Datasets (SDs) that can overcome issues affecting traditionally acquired datasets. Variational autoencoders, generative adversarial networks and diffusion models have been used to generate SDs. The following text is a review of these generative AI techniques and their operations. It discusses the chances of SDs and challenges with potential solutions which will improve the understanding of healthcare professionals working in AI research. CONCLUSION: Synthetic data customized to the need of researchers can be produced to train robust AI models. These models, having been trained on such a diverse dataset will be applicable for dissemination across countries. However, there is a need for the limitations associated with SDs to be better understood, and attempts made to overcome those concerns prior to their widespread use.

The Dilemma Of Management Of Cystic Lesions; An Uncertain Way Forward: A Case Report.

Periapical diseases ranges from mild granulomatous lesions to large cystic ones, with the treatments corresponding to their respective pre-operative diagnoses. However, the determination of cause of periapical radiolucency is impossible on pre-operative clinical and radiographic examinations. We present a case highlighting the difficulties encountered in treating a periapical cyst using the current evidence in literature. It demonstrates the uncertainty involved in treating such lesions, owing to the impossible nature of determining the histopathological nature of the cyst, i.e., being either true cysts or pocket cysts. This case includes orthograde re-treatment; decompression of the cystic lesion, followed by peri-apical surgery of two teeth over a course of three years; and the uncertain outcomes encountered after each phase of the treatment.

Implementation of transfer learning for the segmentation of human mesenchymal stem cells-A validation study.

INTRODUCTION: Stem cell therapy has been gaining interest in the regeneration rather than repair of lost human tissues. However, the manual analysis of stem cells prior to implantation is a cumbersome task that can be automated to improve the efficiency and accuracy of this process. OBJECTIVE: To develop a Deep Learning (DL) algorithm for segmentation of human mesenchymal stem cells (MSCs) on micrographic images and to validate its performance relative to the ground truth laid down via annotation. METHODOLOGY: Pre-trained DeepLab algorithms were trained on annotated images of human MSCs obtained from the open-source EVICAN dataset. This dataset comprises of partially annotated images; a limitation that is overcome by blurring backgrounds of these images which consequently blurs the unannotated cells. Two algorithms were trained on the two different kinds of images from this dataset; with blurred and normal backgrounds, respectively. Algorithm 1 was trained on 139 images with blurred backgrounds and algorithm 2 was trained on 37 images from the same dataset with normal backgrounds to replicate real-life scenarios. RESULTS: The performance metrics of algorithm 1 included accuracy of 99.22%, dice co-efficient of 99.66% and Intersection over Union (IoU) score of 0.84. Algorithm 2 was 96.34% accurate with dice co-efficient and IoU scores of 98.39% and 0.48, respectively. CONCLUSION: Both algorithms showed adequate performance in the segmentation of human MSCs with performance metrics close to the ground truth. However, algorithm 2 has better clinical applicability, even with smaller dataset and relatively lower performance metrics.

An artificial intelligence model for instance segmentation and tooth numbering on orthopantomograms.

AIM: To develop a deep learning (DL) artificial intelligence (AI) model for instance segmentation and tooth numbering on orthopantomograms (OPGs). MATERIALS AND METHODS: Forty OPGs were manually annotated to lay down the ground truth for training two convolutional neural networks (CNNs): U-net and Faster RCNN. These algorithms were concurrently trained and validated on a dataset of 1280 teeth (40 OPGs) each. The U-net algorithm was trained on OPGs specifically annotated with polygons to label all 32 teeth via instance segmentation, allowing each tooth to be denoted as a separate entity from the surrounding structures. Simultaneously, teeth were also numbered according to the Fédération Dentaire Internationale (FDI) numbering system, using bounding boxes to train Faster RCNN. Consequently, both trained CNNs were combined to develop an AI model capable of segmenting and numbering all teeth on an OPG. RESULTS: The performance of the U-net algorithm was determined using various performance metrics including precision = 88.8%, accuracy = 88.2%, recall = 87.3%, F-1 score = 88%, dice index = 92.3%, and Intersection over Union (IoU) = 86.3%. The performance metrics of the Faster RCNN algorithm were determined using overlap accuracy = 30.2 bounding boxes (out of a possible of 32 boxes) and classifier accuracy of labels = 93.8%. CONCLUSIONS: The instance segmentation and tooth numbering results of our trained AI model were close to the ground truth, indicating a promising future for their incorporation into clinical dental practice. The ability of an AI model to automatically identify teeth on OPGs will aid dentists with diagnosis and treatment planning, thus increasing efficiency.

Multi-model Deep Learning approach for segmentation of teeth and periapical lesions on Pantomographs.

INTRODUCTION: The fields of medicine and dentistry are beginning to integrate Artificial Intelligence (AI) in diagnostics. This may reduce subjectivity and improve the accuracy of diagnoses and treatment planning. Current evidence on pathosis detection on Pantomographs(PGs) indicates the presence or absence of disease in the entire radiographic image, with little evidence of the relation of periapical pathosis to the causative tooth. OBJECTIVE: To develop a Deep Learning (DL) AI model for the segmentation of periapical pathosis and its relation to teeth on PGs. METHOD: 250 PGs were manually annotated by subject experts to lay down the ground truth for training AI algorithms on the segmentation of periapical pathosis. Two approaches were used for lesion detection: Multi-models 1 and 2, using U-net and Mask RCNN algorithms, respectively. The resulting segmented lesions generated on the testing data set were superimposed with results of teeth segmentation and numbering algorithms trained separately to relate lesions to causative teeth. Hence, both multi-model approaches related periapical pathosis to the causative teeth on PGs. RESULTS: The performance metrics of lesion segmentation carried out by U-net are as follows: Accuracy = 98.1%, precision = 84.5%, re-call = 80.3%, F-1 score = 82.2%, dice index = 75.2%, and Intersection over Union = 67.6%. Mask RCNN carried out lesion segmentation with an accuracy of 46.7%, precision of 80.6%, recall of 55%, and F-1 score of 63.1%. CONCLUSION: In this study, the multi-model approach successfully related periapical pathosis to the causative tooth on PGs. However, U-net outperformed Mask RCNN in the tasks performed, suggesting that U-net will remain the standard for medical image segmentation tasks. Further training of the models on other findings and an increased number of images will lead to the automation of the detection of common radiographic findings in the dental diagnostic workflow.

Application of deep learning in teeth identification tasks on panoramic radiographs.

OBJECTIVES: To investigate the current developments of Artificial Intelligence (AI) in teeth identification on Panoramic Radiographs (PR). Our aim was to evaluate and compare the performances of Deep Learning (DL) models that have been employed in the execution of this task. METHODS: The systematic review was registered on PROSPERO. All recent studies that utilized DL models for identifying teeth on PRs were included in this review. An extensive search of the medical electronic databases including PubMed NLM, EBSCO Dentistry & Oral Sciences Source, and Wiley Cochrane Library was conducted. This was followed by a hand search of the IEEE Xplore database. The diagnostic performance of DL models in teeth identification tasks on PR was the primary outcome assessed in this review. The risk of bias assessment of the included studies was evaluated via the modified QUADAS-2 tool. Owing to the heterogeneity of the reported performance metrics, a meta-analysis was not possible.. RESULTS: The search yielded a total of 282 articles, out of which 13 relevant ones were included in this review. These studies utilized a diverse range of DL models for teeth identification tasks on PRs and reported their performances using a variety of metrics. CONCLUSION: The results of teeth identification tasks carried out by DL models are encouraging; however, there is a need for the shortcomings that have been identified in our preliminary review, to be addressed by future researchers.

Understanding deep learning - challenges and prospects.

The developments in Artificial Intelligence have been on the rise since its advent. The advancements in this field have been the innovative research area across a wide range of industries, making its incorporation in dentistry inevitable. Artificial Intelligence techniques are making serious progress in the diagnostic and treatment planning aspects of dental clinical practice. This will ultimately help in the elimination of subjectivity and human error that are often part of radiographic interpretations, and will improve the overall efficiency of the process. The various types of Artificial Intelligence algorithms that exist today make the understanding of their application quite complex. The current narrative review was planned to make comprehension of Artificial Intelligence algorithms relatively straightforward. The focus was planned to be kept on the current developments and prospects of Artificial Intelligence in dentistry, especially Deep Learning and Convolutional Neural Networks in diagnostic imaging. The narrative review may facilitate the interpretation of seemingly perplexing research published widely in dental journals.