Editorial Feature

AI Tool to Perform Dental Diagnostics in the Near Future

Artificial intelligence is becoming increasingly popular in healthcare and dentistry. Traditional methods have evolved into digital techniques in recent times with the advent of new software that can be employed with a variety of medical instruments.

AI Tool to Perform Dental Diagnostics in the Near Future

​​​​​​​Image Credit: astarot/Shutterstock.com

Artificial intelligence (AI) is gaining traction in public healthcare as more people attempt to diagnose patients using technology that helps them work quickly and effectively, lowering expenses and minimizing medical mistakes.

When AI is applied to the massive amounts of data generated by healthcare facilities, it can provide tremendous benefits and a wide range of contributions, such as predictive, more targeted, and more precise symptom identification, automated use of analysis results, implementation of treatment plans or customized protocols, and enablement of care team coordination.

AI in dentistry can be used for a variety of purposes, ranging from dental emergencies to prosthesis planning. Machines can learn from their mistakes, adapt to different inputs, and perform jobs in a human-like manner, thanks to artificial intelligence.

AI will be able to measure the success of various treatment options linked with specific symptoms and anatomical conditions and enhance the quality of standardization procedures by utilizing enormous volumes of data, like diagnostic results, treatments, and outcomes.

The major goal of this pilot study was to assess the accuracy of a screening tool based on machine learning and artificial intelligence. The secondary goal was to evaluate the tool’s effectiveness in diagnosing various dental disorders and conditions.

Methodology

In this study, 120 panoramic X-rays (OPGs) were chosen at random from the Sapienza University of Rome’s Department of Oral and Maxillofacial Sciences. The OPGs may be jpeg (JPEG) or dicom (DICOM) (DICOM or DCM). Apox was used to create the OPGs, which capture a panoramic X-ray and convert it into clinical insights.

After 1 minute, the software examines the OPGs uploaded and delivered the following results, as shown in Figure 1.

The figure shows an example of analyzed OPG and the outcomes given by the software.

Figure 1. The figure shows an example of analyzed OPG and the outcomes given by the software. Image Credit: De Angelis, et al. 2022

The value of true negative (TN) was assigned when the same analyzed elements were not in the right position; the value of false negative (FN) was delegated when the software did not identify the presence of the analyzed element, and the value of false positive (FP) was delegated when the software showed the presence of one of the elements under analysis that did not even exist (Figures 2–5).

This selected view of Figure 1 shows the correct detection in the right position of an implant. The assigned value was TP.

Figure 2. This selected view of Figure 1 shows the correct detection in the right position of an implant. The assigned value was TP. Image Credit: De Angelis, et al. 2022

This selected view of Figure 1 shows the correct detection in the right position of an absent tooth in position 3.7. The assigned value was TN.

Figure 3. This selected view of Figure 1 shows the correct detection in the right position of an absent tooth in position 3.7. The assigned value was TN. Image Credit: De Angelis, et al. 2022

This selected view of Figure 1 shows the incorrect detection in the right position of the tooth 2.7. The assigned value was FP.

Figure 4. This selected view of Figure 1 shows the incorrect detection in the right position of the tooth 2.7. The assigned value was FP. Image Credit: De Angelis, et al. 2022

This selected view of Figure 1 shows the missing detection of the tooth filling in position 2.6. The assigned value was FN.

Figure 5. This selected view of Figure 1 shows the missing detection of the tooth filling in position 2.6. The assigned value was FN. Image Credit: De Angelis, et al. 2022

As seen in Figure 6, all values were given in an Excel table.

An example of data collected from an OPG using an Excel table.

Figure 6. An example of data collected from an OPG using an Excel table. Image Credit: De Angelis, et al. 2022

The categorical variables were presented as relative and absolute frequencies in a descriptive analysis. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), negative likelihood ratio (LR–), and positive likelihood ratio (LR+) were used to estimate diagnostic performance.

Results and Discussion

The Cohen’s kappa coefficient was 1.0, indicating that the data collectors were in complete agreement. Table 1 shows the calculated true positive (TP), true negative (TN), false positive (FP), false negative (FN) values for each category (teeth, implants, crowns, fillings, residual roots, and root canal procedures).

Table 1. TP, TN, FP, and FN values calculated for each group (teeth, implants, crowns, fillings, residual roots and root canal treatments). Source: De Angelis, et al. 2022

  Freq. Percent. Cum.
TP 182 9.48 9.48
TN 1684 87.71 97.19
FP 16 0.83 98.02
FN 38 1.98 100.00
Total 1920 100.00  

 

Figure 7 shows the area under the Receiver operating characteristic (ROC) curve as 0.94 (AUC) after controlling for the variable group as a covariate.

The area under the ROC curve (AUC).

Figure 7. The area under the ROC curve (AUC). Image Credit: De Angelis, et al. 2022

Table 2 shows the AUCs evaluated for the ROC curves of each group variable and Figure 8 depicts the ROC curves for all variables.

Table 2. The AUCs calculated for the ROC curves of each group variable. Source: De Angelis, et al. 2022

Group Obs ROC Std. Err. [95% Conf. Interval]
0 1920 0.9253 0.0070 0.91162        0.93901
1 1919 0.9164 0.0184 0.88027        0.95259
2 1920 0.9600 0.0067 0.94694        0.97308
3 1920 0.8030 0.0520 0.70106        0.90500
4 1919 0.8332 0.0118 0.81005        0.85643
5 1920 0.9089 0.0128 0.88379        0.93407

 

ROC curves of all variables.​​​​​​​

Figure 8. ROC curves of all variables. Image Credit: De Angelis, et al. 2022

Researchers have been looking for an appropriate and standardized way to diagnose the most prevalent dental diseases by employing two-dimensional (2D) X-rays and considering three-dimensional (3D) images derived from the CT cone beam in recent times.

A review of current literature on artificial intelligence systems in dental and maxillofacial radiology disclosed only in vitro studies, skull studies, and anatomical model studies.

The current study’s objectives were to evaluate the evaluation metrics of a screening tool based on artificial intelligence machine learning and analyze the tool’s precision for diagnosing various dental pathologies or conditions.

Researchers investigated the effectiveness of AI software (Promaton) to evaluate the ability to identify the number of teeth, roots, implants, and fillings by assessing the margin of error. They discovered that while the results are promising, a few errors still exist have to be avoided.

Dentistry is entering a new phase of medicine based on robot-assisted AI. Since AI has not yet been properly implemented in dental research, it appears to be a promising challenge.

With AI, researchers expect to obtain easier treatment protocols with minimal mistakes and boost the efficacy of the healthcare system in the future. Dentists will need to become acquainted with electronic systems, as well as the ability to engage with digital robots and humans.

Conclusion

Artificial intelligence has tremendous potential in dentistry. Artificial intelligence in dentistry is considered very beneficial for analyzing dental X-rays for earlier detection. All of this will result in a one-of-a-kind treatment plan for every patient, from planning to treatment and follow-up.

This software will be able to learn instantaneously and thus enhance its effectiveness over time. As a result, AI assists clinicians in improving the quality of their diagnosis and treatment, saving time, and generating revenue.

To properly utilize the benefits of AI, it is necessary to dose the use of these tools with intellectual ability, objectivity, and practical wisdom, as well as a suitable learning curve.

Journal Reference:

De Angelis, F., Pranno, N., Franchina, A., Di Carlo, S., Brauner, E., Ferri, A., Pellegrino, G., Grecchi, E., Goker, F., Stefanelli, L. V. (2022) Artificial Intelligence: A New Diagnostic Software in Dentistry: A Preliminary Performance Diagnostic Study. International Journal of Environmental Research and Public Health, 19(3), p. 1728. Available Online: https://www.mdpi.com/1660-4601/19/3/1728/htm.

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Megan Craig

Written by

Megan Craig

Megan graduated from The University of Manchester with a B.Sc. in Genetics, and decided to pursue an M.Sc. in Science and Health Communication due to her passion for combining science with content creation. As part of her studies, Megan partnered with Jodrell Bank Discovery Centre as a Digital Marketing Assistant, producing content and updating sections of their website. In her spare time, she loves to travel, exploring each location's culture and history - including the local cuisine. Her other interests include embroidery, reading fiction, and practicing her Japanese language skills.

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