Caries and Restoration Detection Using Bitewing Film Based on Transfer Learning with CNNs.

Caries is a dental disease caused by bacterial infection. If the cause of the caries is detected early, the treatment will be relatively easy, which in turn prevents caries from spreading. The current common procedure of dentists is to first perform radiographic examination on the patient and mark the lesions manually. However, the work of judging lesions and markings requires professional experience and is very time-consuming and repetitive. Taking advantage of the rapid development of artificial intelligence imaging research and technical methods will help dentists make accurate markings and improve medical treatments. It can also shorten the judgment time of professionals. In addition to the use of Gaussian high-pass filter and Otsu's threshold image enhancement technology, this research solves the problem that the original cutting technology cannot extract certain single teeth, and it proposes a caries and lesions area analysis model based on convolutional neural networks (CNN), which can identify caries and restorations from the bitewing images. Moreover, it provides dentists with more accurate objective judgment data to achieve the purpose of automatic diagnosis and treatment planning as a technology for assisting precision medicine. A standardized database established following a defined set of steps is also proposed in this study. There are three main steps to generate the image of a single tooth from a bitewing image, which can increase the accuracy of the analysis model. The steps include (1) preprocessing of the dental image to obtain a high-quality binarization, (2) a dental image cropping procedure to obtain individually separated tooth samples, and (3) a dental image masking step which masks the fine broken teeth from the sample and enhances the quality of the training. Among the current four common neural networks, namely, AlexNet, GoogleNet, Vgg19, and ResNet50, experimental results show that the proposed AlexNet model in this study for restoration and caries judgments has an accuracy as high as 95.56% and 90.30%, respectively. These are promising results that lead to the possibility of developing an automatic judgment method of bitewing film.

Detection of Dental Apical Lesions Using CNNs on Periapical Radiograph.

Apical lesions, the general term for chronic infectious diseases, are very common dental diseases in modern life, and are caused by various factors. The current prevailing endodontic treatment makes use of X-ray photography taken from patients where the lesion area is marked manually, which is therefore time consuming. Additionally, for some images the significant details might not be recognizable due to the different shooting angles or doses. To make the diagnosis process shorter and efficient, repetitive tasks should be performed automatically to allow the dentists to focus more on the technical and medical diagnosis, such as treatment, tooth cleaning, or medical communication. To realize the automatic diagnosis, this article proposes and establishes a lesion area analysis model based on convolutional neural networks (CNN). For establishing a standardized database for clinical application, the Institutional Review Board (IRB) with application number 202002030B0 has been approved with the database established by dentists who provided the practical clinical data. In this study, the image data is preprocessed by a Gaussian high-pass filter. Then, an iterative thresholding is applied to slice the X-ray image into several individual tooth sample images. The collection of individual tooth images that comprises the image database are used as input into the CNN migration learning model for training. Seventy percent (70%) of the image database is used for training and validating the model while the remaining 30% is used for testing and estimating the accuracy of the model. The practical diagnosis accuracy of the proposed CNN model is 92.5%. The proposed model successfully facilitated the automatic diagnosis of the apical lesion.