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van Loon DFR, van Es EM, Eygendaal D, Veeger DHEJ, Colaris JW. Automatic identification of radius and ulna bone landmarks on 3D virtual models. Comput Biol Med 2024; 179:108891. [PMID: 39047505 DOI: 10.1016/j.compbiomed.2024.108891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 07/12/2024] [Accepted: 07/12/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND For bone morphology and biomechanics analysis, landmarks are essential to define position, orientation, and shape. These landmarks define bone and joint coordinate systems and are widely used in these research fields. Currently, no method is known for automatically identifying landmarks on virtual 3D bone models of the radius and ulna. This paper proposes a knowledge-based method for locating landmarks and calculating a coordinate system for the radius, ulna, and combined forearm bones, which is essential for measuring forearm function. This method does not rely on pre-labeled data. VALIDATION The algorithm is validated by comparing the landmarks placed by the algorithm with the mean position of landmarks placed by a group of experts on cadaveric specimens regarding distance and orientation. RESULTS The median Euclidean distance differences between all the automated and reference landmarks range from 0.4 to 1.8 millimeters. The median angular differences of the coordinate system of the radius and ulna range from -1.4 to 0.6 degrees. The forearm coordinate system's median errors range from -0.2 to 2.0 degrees. The median error in calculating the rotational position of the radius relative to the ulna is 1.8 degrees. CONCLUSION The automatic method's applicability depends on the use context and desired accuracy. However, the current method is a validated first step in the automatic analysis of the three-dimensional forearm anatomy.
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Affiliation(s)
- Derek F R van Loon
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands.
| | - Eline M van Es
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Denise Eygendaal
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - DirkJan H E J Veeger
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Joost W Colaris
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
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Hendrickx J, Gracea RS, Vanheers M, Winderickx N, Preda F, Shujaat S, Jacobs R. Can artificial intelligence-driven cephalometric analysis replace manual tracing? A systematic review and meta-analysis. Eur J Orthod 2024; 46:cjae029. [PMID: 38895901 PMCID: PMC11185929 DOI: 10.1093/ejo/cjae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to investigate the accuracy and efficiency of artificial intelligence (AI)-driven automated landmark detection for cephalometric analysis on two-dimensional (2D) lateral cephalograms and three-dimensional (3D) cone-beam computed tomographic (CBCT) images. SEARCH METHODS An electronic search was conducted in the following databases: PubMed, Web of Science, Embase, and grey literature with search timeline extending up to January 2024. SELECTION CRITERIA Studies that employed AI for 2D or 3D cephalometric landmark detection were included. DATA COLLECTION AND ANALYSIS The selection of studies, data extraction, and quality assessment of the included studies were performed independently by two reviewers. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A meta-analysis was conducted to evaluate the accuracy of the 2D landmarks identification based on both mean radial error and standard error. RESULTS Following the removal of duplicates, title and abstract screening, and full-text reading, 34 publications were selected. Amongst these, 27 studies evaluated the accuracy of AI-driven automated landmarking on 2D lateral cephalograms, while 7 studies involved 3D-CBCT images. A meta-analysis, based on the success detection rate of landmark placement on 2D images, revealed that the error was below the clinically acceptable threshold of 2 mm (1.39 mm; 95% confidence interval: 0.85-1.92 mm). For 3D images, meta-analysis could not be conducted due to significant heterogeneity amongst the study designs. However, qualitative synthesis indicated that the mean error of landmark detection on 3D images ranged from 1.0 to 5.8 mm. Both automated 2D and 3D landmarking proved to be time-efficient, taking less than 1 min. Most studies exhibited a high risk of bias in data selection (n = 27) and reference standard (n = 29). CONCLUSION The performance of AI-driven cephalometric landmark detection on both 2D cephalograms and 3D-CBCT images showed potential in terms of accuracy and time efficiency. However, the generalizability and robustness of these AI systems could benefit from further improvement. REGISTRATION PROSPERO: CRD42022328800.
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Affiliation(s)
- Julie Hendrickx
- Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Rellyca Sola Gracea
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Michiel Vanheers
- Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Nicolas Winderickx
- Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Flavia Preda
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 14611, Kingdom of Saudi Arabia
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, 141 04 Stockholm, Sweden
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Yang Y, Zhang M, An Y, Huang Q, Shi Y, Jin L, Zeng A, Long X, Yu N, Wang X. Automated 3D Perioral Landmark Detection Using High-Resolution Network: Artificial Intelligence-based Anthropometric Analysis. Aesthet Surg J 2024; 44:NP606-NP612. [PMID: 38662744 DOI: 10.1093/asj/sjae103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Three-dimensional facial stereophotogrammetry, a convenient, noninvasive and highly reliable evaluation tool, has in recent years shown great potential in plastic surgery for preoperative planning and evaluating treatment efficacy. However, it requires manual identification of facial landmarks by trained evaluators to obtain anthropometric data, which takes much time and effort. Automatic 3D facial landmark localization has the potential to facilitate fast data acquisition and eliminate evaluator error. OBJECTIVES The aim of this work was to describe a novel deep-learning method based on dimension transformation and key-point detection for automated 3D perioral landmark annotation. METHODS After transforming a 3D facial model into 2D images, High-Resolution Network is implemented for key-point detection. The 2D coordinates of key points are then mapped back to the 3D model using mathematical methods to obtain the 3D landmark coordinates. This program was trained with 120 facial models and validated in 50 facial models. RESULTS Our approach achieved a satisfactory mean [standard deviation] accuracy of 1.30 [0.68] mm error in landmark detection with a mean processing time of 5.2 [0.21] seconds per model. Subsequent analysis based on these landmarks showed mean errors of 0.87 [1.02] mm for linear measurements and 5.62° [6.61°] for angular measurements. CONCLUSIONS This automated 3D perioral landmarking method could serve as an effective tool that enables fast and accurate anthropometric analysis of lip morphology for plastic surgery and aesthetic procedures.
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Polizzi A, Leonardi R. Automatic cephalometric landmark identification with artificial intelligence: An umbrella review of systematic reviews. J Dent 2024; 146:105056. [PMID: 38729291 DOI: 10.1016/j.jdent.2024.105056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/25/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES The transition from manual to automatic cephalometric landmark identification has not yet reached a consensus for clinical application in orthodontic diagnosis. The present umbrella review aimed to assess artificial intelligence (AI) performance in automatic 2D and 3D cephalometric landmark identification. DATA A combination of free text words and MeSH keywords pooled by boolean operators: Automa* AND cephalo* AND ("artificial intelligence" OR "machine learning" OR "deep learning" OR "learning"). SOURCES A search strategy without a timeframe setting was conducted on PubMed, Scopus, Web of Science, Cochrane Library and LILACS. STUDY SELECTION The study protocol followed the PRISMA guidelines and the PICO question was formulated according to the aim of the article. The database search led to the selection of 15 articles that were assessed for eligibility in full-text. Finally, 11 systematic reviews met the inclusion criteria and were analyzed according to the risk of bias in systematic reviews (ROBIS) tool. CONCLUSIONS AI was not able to identify the various cephalometric landmarks with the same accuracy. Since most of the included studies' conclusions were based on a wrong 2 mm cut-off difference between the AI automatic landmark location and that allocated by human operators, future research should focus on refining the most powerful architectures to improve the clinical relevance of AI-driven automatic cephalometric analysis. CLINICAL SIGNIFICANCE Despite a progressively improved performance, AI has exceeded the recommended magnitude of error for most cephalometric landmarks. Moreover, AI automatic landmarking on 3D CBCT appeared to be less accurate compared to that on 2D X-rays. To date, AI-driven cephalometric landmarking still requires the final supervision of an experienced orthodontist.
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Affiliation(s)
- Alessandro Polizzi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
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Kazimierczak W, Gawin G, Janiszewska-Olszowska J, Dyszkiewicz-Konwińska M, Nowicki P, Kazimierczak N, Serafin Z, Orhan K. Comparison of Three Commercially Available, AI-Driven Cephalometric Analysis Tools in Orthodontics. J Clin Med 2024; 13:3733. [PMID: 38999299 PMCID: PMC11242750 DOI: 10.3390/jcm13133733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Cephalometric analysis (CA) is an indispensable diagnostic tool in orthodontics for treatment planning and outcome assessment. Manual CA is time-consuming and prone to variability. Methods: This study aims to compare the accuracy and repeatability of CA results among three commercial AI-driven programs: CephX, WebCeph, and AudaxCeph. This study involved a retrospective analysis of lateral cephalograms from a single orthodontic center. Automated CA was performed using the AI programs, focusing on common parameters defined by Downs, Ricketts, and Steiner. Repeatability was tested through 50 randomly reanalyzed cases by each software. Statistical analyses included intraclass correlation coefficients (ICC3) for agreement and the Friedman test for concordance. Results: One hundred twenty-four cephalograms were analyzed. High agreement between the AI systems was noted for most parameters (ICC3 > 0.9). Notable differences were found in the measurements of angle convexity and the occlusal plane, where discrepancies suggested different methodologies among the programs. Some analyses presented high variability in the results, indicating errors. Repeatability analysis revealed perfect agreement within each program. Conclusions: AI-driven cephalometric analysis tools demonstrate a high potential for reliable and efficient orthodontic assessments, with substantial agreement in repeated analyses. Despite this, the observed discrepancies and high variability in part of analyses underscore the need for standardization across AI platforms and the critical evaluation of automated results by clinicians, particularly in parameters with significant treatment implications.
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Affiliation(s)
- Wojciech Kazimierczak
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Grzegorz Gawin
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | | | | | - Paweł Nowicki
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Natalia Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - Kaan Orhan
- Department of DentoMaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara 06500, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara 06500, Turkey
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
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Sahlsten J, Järnstedt J, Jaskari J, Naukkarinen H, Mahasantipiya P, Charuakkra A, Vasankari K, Hietanen A, Sundqvist O, Lehtinen A, Kaski K. Deep learning for 3D cephalometric landmarking with heterogeneous multi-center CBCT dataset. PLoS One 2024; 19:e0305947. [PMID: 38917161 PMCID: PMC11198780 DOI: 10.1371/journal.pone.0305947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
Cephalometric analysis is critically important and common procedure prior to orthodontic treatment and orthognathic surgery. Recently, deep learning approaches have been proposed for automatic 3D cephalometric analysis based on landmarking from CBCT scans. However, these approaches have relied on uniform datasets from a single center or imaging device but without considering patient ethnicity. In addition, previous works have considered a limited number of clinically relevant cephalometric landmarks and the approaches were computationally infeasible, both impairing integration into clinical workflow. Here our aim is to analyze the clinical applicability of a light-weight deep learning neural network for fast localization of 46 clinically significant cephalometric landmarks with multi-center, multi-ethnic, and multi-device data consisting of 309 CBCT scans from Finnish and Thai patients. The localization performance of our approach resulted in the mean distance of 1.99 ± 1.55 mm for the Finnish cohort and 1.96 ± 1.25 mm for the Thai cohort. This performance turned out to be clinically significant i.e., ≤ 2 mm with 61.7% and 64.3% of the landmarks with Finnish and Thai cohorts, respectively. Furthermore, the estimated landmarks were used to measure cephalometric characteristics successfully i.e., with ≤ 2 mm or ≤ 2° error, on 85.9% of the Finnish and 74.4% of the Thai cases. Between the two patient cohorts, 33 of the landmarks and all cephalometric characteristics had no statistically significant difference (p < 0.05) measured by the Mann-Whitney U test with Benjamini-Hochberg correction. Moreover, our method is found to be computationally light, i.e., providing the predictions with the mean duration of 0.77 s and 2.27 s with single machine GPU and CPU computing, respectively. Our findings advocate for the inclusion of this method into clinical settings based on its technical feasibility and robustness across varied clinical datasets.
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Affiliation(s)
- Jaakko Sahlsten
- Department of Computer Science, Aalto University School of Science, Espoo, Finland
| | - Jorma Järnstedt
- Department of Radiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Joel Jaskari
- Department of Computer Science, Aalto University School of Science, Espoo, Finland
| | | | - Phattaranant Mahasantipiya
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
- Division of Oral and Maxillofacial Radiology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Arnon Charuakkra
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
- Division of Oral and Maxillofacial Radiology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Krista Vasankari
- Department of Oral Diseases, Tampere University Hospital, Tampere, Finland
| | | | | | - Antti Lehtinen
- Department of Radiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Kimmo Kaski
- Department of Computer Science, Aalto University School of Science, Espoo, Finland
- The Alan Turing Institute, British Library, London, United Kingdom
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Grammens J, Van Haver A, Lumban-Gaol I, Danckaers F, Verdonk P, Sijbers J. Automated Landmark Annotation for Morphometric Analysis of Distal Femur and Proximal Tibia. J Imaging 2024; 10:90. [PMID: 38667988 PMCID: PMC11051533 DOI: 10.3390/jimaging10040090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/30/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Manual anatomical landmarking for morphometric knee bone characterization in orthopedics is highly time-consuming and shows high operator variability. Therefore, automation could be a substantial improvement for diagnostics and personalized treatments relying on landmark-based methods. Applications include implant sizing and planning, meniscal allograft sizing, and morphological risk factor assessment. For twenty MRI-based 3D bone and cartilage models, anatomical landmarks were manually applied by three experts, and morphometric measurements for 3D characterization of the distal femur and proximal tibia were calculated from all observations. One expert performed the landmark annotations three times. Intra- and inter-observer variations were assessed for landmark position and measurements. The mean of the three expert annotations served as the ground truth. Next, automated landmark annotation was performed by elastic deformation of a template shape, followed by landmark optimization at extreme positions (highest/lowest/most medial/lateral point). The results of our automated annotation method were compared with ground truth, and percentages of landmarks and measurements adhering to different tolerances were calculated. Reliability was evaluated by the intraclass correlation coefficient (ICC). For the manual annotations, the inter-observer absolute difference was 1.53 ± 1.22 mm (mean ± SD) for the landmark positions and 0.56 ± 0.55 mm (mean ± SD) for the morphometric measurements. Automated versus manual landmark extraction differed by an average of 2.05 mm. The automated measurements demonstrated an absolute difference of 0.78 ± 0.60 mm (mean ± SD) from their manual counterparts. Overall, 92% of the automated landmarks were within 4 mm of the expert mean position, and 95% of all morphometric measurements were within 2 mm of the expert mean measurements. The ICC (manual versus automated) for automated morphometric measurements was between 0.926 and 1. Manual annotations required on average 18 min of operator interaction time, while automated annotations only needed 7 min of operator-independent computing time. Considering the time consumption and variability among observers, there is a clear need for a more efficient, standardized, and operator-independent algorithm. Our automated method demonstrated excellent accuracy and reliability for landmark positioning and morphometric measurements. Above all, this automated method will lead to a faster, scalable, and operator-independent morphometric analysis of the knee.
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Affiliation(s)
- Jonas Grammens
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Wilrijk, 2610 Antwerp, Belgium
- imec-VisionLab, Department of Physics, University of Antwerp, Wilrijk, 2610 Antwerp, Belgium; (F.D.)
| | | | - Imelda Lumban-Gaol
- Nicolaas Institute of Constructive Orthopaedic Research and Education Foundation for Arthroplasty and Sports Medicine, Medistra Hospital, Jakarta 12950, Indonesia;
| | - Femke Danckaers
- imec-VisionLab, Department of Physics, University of Antwerp, Wilrijk, 2610 Antwerp, Belgium; (F.D.)
| | - Peter Verdonk
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Wilrijk, 2610 Antwerp, Belgium
- OrthoCA (Orthopaedic Center Antwerp), Deurne, 2100 Antwerp, Belgium
- Department of Orthopaedics, University Hospitals Antwerp, Edegem, 2650 Antwerp, Belgium
| | - Jan Sijbers
- imec-VisionLab, Department of Physics, University of Antwerp, Wilrijk, 2610 Antwerp, Belgium; (F.D.)
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Berends B, Bielevelt F, Schreurs R, Vinayahalingam S, Maal T, de Jong G. Fully automated landmarking and facial segmentation on 3D photographs. Sci Rep 2024; 14:6463. [PMID: 38499700 PMCID: PMC10948387 DOI: 10.1038/s41598-024-56956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/13/2024] [Indexed: 03/20/2024] Open
Abstract
Three-dimensional facial stereophotogrammetry provides a detailed representation of craniofacial soft tissue without the use of ionizing radiation. While manual annotation of landmarks serves as the current gold standard for cephalometric analysis, it is a time-consuming process and is prone to human error. The aim in this study was to develop and evaluate an automated cephalometric annotation method using a deep learning-based approach. Ten landmarks were manually annotated on 2897 3D facial photographs. The automated landmarking workflow involved two successive DiffusionNet models. The dataset was randomly divided into a training and test dataset. The precision of the workflow was evaluated by calculating the Euclidean distances between the automated and manual landmarks and compared to the intra-observer and inter-observer variability of manual annotation and a semi-automated landmarking method. The workflow was successful in 98.6% of all test cases. The deep learning-based landmarking method achieved precise and consistent landmark annotation. The mean precision of 1.69 ± 1.15 mm was comparable to the inter-observer variability (1.31 ± 0.91 mm) of manual annotation. Automated landmark annotation on 3D photographs was achieved with the DiffusionNet-based approach. The proposed method allows quantitative analysis of large datasets and may be used in diagnosis, follow-up, and virtual surgical planning.
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Affiliation(s)
- Bo Berends
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Freek Bielevelt
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Ruud Schreurs
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (UMC), AMC, Academic Center for Dentistry Amsterdam (ACTA), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Thomas Maal
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Guido de Jong
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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Kazimierczak N, Kazimierczak W, Serafin Z, Nowicki P, Nożewski J, Janiszewska-Olszowska J. AI in Orthodontics: Revolutionizing Diagnostics and Treatment Planning-A Comprehensive Review. J Clin Med 2024; 13:344. [PMID: 38256478 PMCID: PMC10816993 DOI: 10.3390/jcm13020344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
The advent of artificial intelligence (AI) in medicine has transformed various medical specialties, including orthodontics. AI has shown promising results in enhancing the accuracy of diagnoses, treatment planning, and predicting treatment outcomes. Its usage in orthodontic practices worldwide has increased with the availability of various AI applications and tools. This review explores the principles of AI, its applications in orthodontics, and its implementation in clinical practice. A comprehensive literature review was conducted, focusing on AI applications in dental diagnostics, cephalometric evaluation, skeletal age determination, temporomandibular joint (TMJ) evaluation, decision making, and patient telemonitoring. Due to study heterogeneity, no meta-analysis was possible. AI has demonstrated high efficacy in all these areas, but variations in performance and the need for manual supervision suggest caution in clinical settings. The complexity and unpredictability of AI algorithms call for cautious implementation and regular manual validation. Continuous AI learning, proper governance, and addressing privacy and ethical concerns are crucial for successful integration into orthodontic practice.
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Affiliation(s)
- Natalia Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Wojciech Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - Paweł Nowicki
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Jakub Nożewski
- Department of Emeregncy Medicine, University Hospital No 2 in Bydgoszcz, Ujejskiego 75, 85-168 Bydgoszcz, Poland
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Wong KF, Lam XY, Jiang Y, Yeung AWK, Lin Y. Artificial intelligence in orthodontics and orthognathic surgery: a bibliometric analysis of the 100 most-cited articles. Head Face Med 2023; 19:38. [PMID: 37612673 PMCID: PMC10463886 DOI: 10.1186/s13005-023-00383-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The application of artificial intelligence (AI) in orthodontics and orthognathic surgery has gained significant attention in recent years. However, there is a lack of bibliometric reports that analyze the academic literature in this field to identify publishing and citation trends. By conducting an analysis of the top 100 most-cited articles on AI in orthodontics and orthognathic surgery, we aim to unveil popular research topics, key authors, institutions, countries, and journals in this area. METHODS A comprehensive search was conducted in the Web of Science (WOS) electronic database to identify the top 100 most-cited articles on AI in orthodontics and orthognathic surgery. Publication and citation data were obtained and further analyzed and visualized using R Biblioshiny. The key domains of the 100 articles were also identified. RESULTS The top 100 most-cited articles were published between 2005 and 2022, contributed by 458 authors, with an average citation count of 22.09. South Korea emerged as the leading contributor with the highest number of publications (28) and citations (595), followed by China (16, 373), and the United States (7, 248). Notably, six South Korean authors ranked among the top 10 contributors, and three South Korean institutions were listed as the most productive. International collaborations were predominantly observed between the United States, China, and South Korea. The main domains of the articles focused on automated imaging assessment (42%), aiding diagnosis and treatment planning (34%), and the assessment of growth and development (10%). Besides, a positive correlation was observed between the testing sample size and citation counts (P = 0.010), as well as between the time of publication and citation counts (P < 0.001). CONCLUSIONS The utilization of AI in orthodontics and orthognathic surgery has shown remarkable progress, particularly in the domains of imaging analysis, diagnosis and treatment planning, and growth and development assessment. This bibliometric analysis provides valuable insights into the top-cited articles and the trends of AI research in this field.
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Affiliation(s)
- Ka Fai Wong
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Prince Philip Dental Hospital, No.34 Hospital Road, Hong Kong SAR, China
| | - Xiang Yao Lam
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Prince Philip Dental Hospital, No.34 Hospital Road, Hong Kong SAR, China
| | - Yuhao Jiang
- Department of Restorative Dentistry, Faculty of Dentistry, the National University of Malaysia, Kuala Lumpur, Malaysia
| | - Andy Wai Kan Yeung
- Division of Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Prince Philip Dental Hospital, No.34 Hospital Road, Hong Kong SAR, China.
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