Estimation of Alveolar Bone Loss in Periodontitis Using Machine Learning

• Main Authors: Nektarios Tsoromokos (Author), Sarah Parinussa (Author), Frank Claessen (Author), David Anssari Moin (Author), Bruno G. Loos (Author)
• Format: Book
• Published: Elsevier, 2022-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0020-6539; 10.1016/j.identj.2022.02.009
• Keywords: Alveolar bone loss; Machine learning; Convolutional neural network; Periapical radiographs; Periodontitis; Dentistry; RK1-715
• Source: International Dental Journal, Vol 72, Iss 5, Pp 621-627 (2022)

Aim: The objective of this research was to perform a pilot study to develop an automatic analysis of periapical radiographs from patients with and without periodontitis for the percentage alveolar bone loss (ABL) on the approximal surfaces of teeth using a supervised machine learning model, that is, convolutional neural networks (CNN). Material and methods: A total of 1546 approximal sites from 54 participants on mandibular periapical radiographs were manually annotated (MA) for a training set (n = 1308 sites), a validation set (n = 98 sites), and a test set (n = 140 sites). The training and validation sets were used for the development of a CNN algorithm. The algorithm recognised the cemento-enamel junction, the most apical extent of the alveolar crest, the apex, and the surrounding alveolar bone. Results: For the total of 140 images in the test set, the CNN scored a mean of 23.1 ± 11.8 %ABL, whilst the corresponding value for MA was 27.8 ± 13.8 %ABL. The intraclass correlation (ICC) was 0.601 (P < .001), indicating moderate reliability. Further subanalyses for various tooth types and various bone loss patterns showed that ICCs remained significant, although the algorithm performed with excellent reliability for %ABL on nonmolar teeth (incisors, canines, premolars; ICC = 0.763). Conclusions: A CNN trained algorithm on radiographic images showed a diagnostic performance with moderate to good reliability to detect and quantify %ABL in periapical radiographs.