Deep Learning for Predicting the Difficulty Level of Removing the Impacted Mandibular Third Molar.

ABSTRACT

BACKGROUND: Preoperative assessment of the impacted mandibular third molar (LM3) in a panoramic radiograph is important in surgical planning. The aim of this study was to develop and evaluate a computer-aided visualisation-based deep learning (DL) system using a panoramic radiograph to predict the difficulty level of surgical removal of an impacted LM3. METHODS: The study included 1367 LM3 images from 784 patients who presented from 2021-2023 to the University Dental Hospital; images were collected retrospectively. The difficulty level of surgically removing impacted LM3s was assessed via our newly developed DL system, which seamlessly integrated 3 distinct DL models. ResNet101V2 handled binary classification for identifying impacted LM3s in panoramic radiographs, RetinaNet detected the precise location of the impacted LM3, and Vision Transformer performed multiclass image classification to evaluate the difficulty levels of removing the detected impacted LM3. RESULTS: The ResNet101V2 model achieved a classification accuracy of 0.8671. The RetinaNet model demonstrated exceptional detection performance, with a mean average precision of 0.9928. Additionally, the Vision Transformer model delivered an average accuracy of 0.7899 in predicting removal difficulty levels. CONCLUSIONS: The development of a 3-phase computer-aided visualisation-based DL system has yielded a very good performance in using panoramic radiographs to predict the difficulty level of surgically removing an impacted LM3.