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Okawa R, Takagi M, Nakamoto T, Kakimoto N, Nakano K. Evaluation of dental manifestations in X-linked hypophosphatemia using orthopantomography. PLoS One 2024; 19:e0307896. [PMID: 39058679 PMCID: PMC11280221 DOI: 10.1371/journal.pone.0307896] [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: 04/25/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND X-linked hypophosphatemia (XLH) is the most common inherited form of rickets. The presence of sequence variations in the phosphate regulating endopeptidase homolog X-linked (PHEX) gene is associated with increased production of fibroblast growth factor 23 (FGF23). This results in renal phosphate wasting and impaired skeletal mineralization. Spontaneous dental abscesses, caused by endodontic infections resulting from hypomineralization of dentin, are a known dental complication of XLH. There is no objective method to evaluate the severity of dentin dysplasia. The purpose of this study was to develop a quantitative method to evaluate dentin dysplasia using orthopantomography that would allow the values in patients with XLH to be compared with the values in healthy participants of the same age. METHODS The severity of dentin dysplasia was analyzed by measuring the pulp cavity area of the tooth using orthopantomographic images. The teeth analyzed were mandibular second primary molars and mandibular first permanent molars with complete root formation. Teeth with dental caries, restorations, or root resorption were excluded. RESULTS This retrospective observational study included a total of 200 images of healthy participants (aged 2-15 years) divided into five age groups and 42 images of 17 patients with XLH. There was a significant tendency for the pulp cavity area to decrease with increasing age in primary and permanent teeth. The pulp chambers of patients with XLH were larger than those of healthy participants in primary and permanent teeth. CONCLUSION We have established a method of using orthopantomography for quantitative assessment of dentin dysplasia in XLH from the primary dentition to the permanent dentition. Evaluating the severity of dentin hypomineralization by this method is useful in the diagnosis of the dental manifestations of XLH. Early diagnosis of XLH enables oral management and leads to prevention of dental abscesses.
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Affiliation(s)
- Rena Okawa
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka Graduate School of Dentistry, Suita, Osaka, Japan
| | - Misato Takagi
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka Graduate School of Dentistry, Suita, Osaka, Japan
| | - Takashi Nakamoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiko Nakano
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka Graduate School of Dentistry, Suita, Osaka, Japan
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Ogawa R, Ogura I. Quantitative analysis of mandibular cortical morphology using artificial intelligence-based computer assisted diagnosis for panoramic radiography on underlying diseases and dental status in women over 20 years of age. J Dent Sci 2024; 19:937-944. [PMID: 38618087 PMCID: PMC11010619 DOI: 10.1016/j.jds.2023.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 07/27/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Recently, an artificial intelligence-based computer-assisted diagnosis (AI-CAD) for panoramic radiography was developed to scan the inferior margin of the mandible and automatically evaluate mandibular cortical morphology. The aim of this study was to analyze quantitatively the mandibular cortical morphology using the AI-CAD, especially focusing on underlying diseases and dental status in women over 20 years of age. Materials and methods 419 patients in women over 20 years of age who underwent panoramic radiography were included in this study. The mandibular cortical morphology was analyzed with an AI-CAD that evaluated the degree of deformation of the mandibular inferior cortex (MIC) and mandibular cortical index (MCI) automatically. Those were analyzed in relation to underlying diseases, such as diabetes, hypertension, dyslipidemia, rheumatism and osteoporosis, and dental status, such as the number of teeth present in the maxilla and mandible. Results The degree of deformation of MIC in women under 51 years of age (21-50 years; n = 229, 16.0 ± 12.7) was significantly lower than those of over 50 years of age (51-90 years; n = 190, 45.1 ± 23.0), and the MCI was a significant difference for the different age group. Regarding the degree of deformation of MIC and MCI in women over 50 years of age, osteoporosis and number of total teeth present in the maxilla and mandible were significant differences. Conclusion The results of this study indicated that the mandibular cortical morphology using the AI-CAD is significantly related to osteoporosis and dental status in women over 50 years of age.
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Affiliation(s)
- Ruri Ogawa
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Ichiro Ogura
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
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Hartoonian S, Hosseini M, Yousefi I, Mahdian M, Ghazizadeh Ahsaie M. Applications of artificial intelligence in dentomaxillofacial imaging-a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(23)01566-3. [PMID: 38637235 DOI: 10.1016/j.oooo.2023.12.790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/02/2023] [Accepted: 12/22/2023] [Indexed: 04/20/2024]
Abstract
BACKGROUND Artificial intelligence (AI) technology has been increasingly developed in oral and maxillofacial imaging. The aim of this systematic review was to assess the applications and performance of the developed algorithms in different dentomaxillofacial imaging modalities. STUDY DESIGN A systematic search of PubMed and Scopus databases was performed. The search strategy was set as a combination of the following keywords: "Artificial Intelligence," "Machine Learning," "Deep Learning," "Neural Networks," "Head and Neck Imaging," and "Maxillofacial Imaging." Full-text screening and data extraction were independently conducted by two independent reviewers; any mismatch was resolved by discussion. The risk of bias was assessed by one reviewer and validated by another. RESULTS The search returned a total of 3,392 articles. After careful evaluation of the titles, abstracts, and full texts, a total number of 194 articles were included. Most studies focused on AI applications for tooth and implant classification and identification, 3-dimensional cephalometric landmark detection, lesion detection (periapical, jaws, and bone), and osteoporosis detection. CONCLUSION Despite the AI models' limitations, they showed promising results. Further studies are needed to explore specific applications and real-world scenarios before confidently integrating these models into dental practice.
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Affiliation(s)
- Serlie Hartoonian
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Matine Hosseini
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Iman Yousefi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Mahdian
- Department of Prosthodontics and Digital Technology, Stony Brook University School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Katsumata A. Deep learning and artificial intelligence in dental diagnostic imaging. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:329-333. [PMID: 37811196 PMCID: PMC10551806 DOI: 10.1016/j.jdsr.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/04/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Abstract
The application of artificial intelligence (AI) based on deep learning in dental diagnostic imaging is increasing. Several popular deep learning tasks have been applied to dental diagnostic images. Classification tasks are used to classify images with and without positive abnormal findings or to evaluate the progress of a lesion based on imaging findings. Region (object) detection and segmentation tasks have been used for tooth identification in panoramic radiographs. This technique is useful for automatically creating a patient's dental chart. Deep learning methods can also be used for detecting and evaluating anatomical structures of interest from images. Furthermore, generative AI based on natural language processing can automatically create written reports from the findings of diagnostic imaging.
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Ogawa R, Ogura I. AI-based computer-aided diagnosis for panoramic radiographs: Quantitative analysis of mandibular cortical morphology in relation to age and gender. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:383-387. [PMID: 35772701 DOI: 10.1016/j.jormas.2022.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to investigate AI-based computer-aided diagnosis (AI-CAD) for panoramic radiographs, especially quantitative evaluation of mandibular cortical morphology in relation to age and gender. METHODS 321 patients with jaw lesions who underwent panoramic radiography were prospectively included. The mandibular cortical morphology was analyzed with an AI-CAD that evaluated the degree of deformation of mandibular inferior cortex and mandibular cortical index (MCI) automatically. Those were analyzed in relation to age and gender, such as younger (≦ 20 years), middle (21-60 years) and older group (≧ 61 years) in men and women. RESULTS The degree of deformation in older men (33.0 ± 18.5) was higher than those of middle (25.0 ± 15.3, p = 0.030) and younger (32.5 ± 16.9, p = 0.993), and those in older women (46.2 ± 22.5) was higher than those of middle (19.4 ± 16.5, p < 0.001) and younger (22.4 ± 14.5, p < 0.001). The MCI of women was a significant difference for aging (p < 0.001), although those of men was not significant difference for aging (p = 0.189). CONCLUSION The AI-CAD could be a useful tool for the quantitative analysis of mandibular cortical morphology.
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Affiliation(s)
- Ruri Ogawa
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Ichiro Ogura
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan; Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.
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Mima Y, Nakayama R, Hizukuri A, Murata K. Tooth detection for each tooth type by application of faster R-CNNs to divided analysis areas of dental panoramic X-ray images. Radiol Phys Technol 2022; 15:170-176. [PMID: 35507126 DOI: 10.1007/s12194-022-00659-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to propose a computerized method for detecting the tooth region for each tooth type as the initial stage in the development of a computer-aided diagnosis (CAD) scheme for dental panoramic X-ray images. Our database consists of 160 panoramic dental X-ray images obtained from 160 adult patients. To reduce false positives (FPs), the proposed method first extracts a rectangular area including all teeth from a dental panoramic X-ray image with a faster region using a convolutional neural network (Faster R-CNN). From the rectangular area including all teeth, six divided areas are then extracted with Faster R-CNN: top left, top center, top right, bottom left, bottom center, and bottom right. Faster R-CNNs for detecting tooth regions for each tooth type were trained individually for each of the divided areas that narrowed down the target tooth types. By applying these Faster R-CNNs to each divided area, the bounding boxes of each tooth were detected and classified into 32 tooth types. A k-fold cross-validation method with k = 4 was used for training and testing the proposed method. The detection rate for each tooth, number of FPs per image, mean intersection over union for each tooth, and classification accuracy for the 32 tooth types were 98.9%, 0.415, 0.748, and 91.7%, respectively, showing an improvement compared to the application of the Faster R-CNN once to the entire image (98.0%, 1.194, 0.736, and 88.8%).
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Affiliation(s)
- Yuichi Mima
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.
| | - Ryohei Nakayama
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Akiyoshi Hizukuri
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Kan Murata
- TAKARA TELESYSTEMS Corporation, 1-17-17 Nihonbashi, Chuo-ku, Osaka, 542-0073, Japan
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Sukegawa S, Fujimura A, Taguchi A, Yamamoto N, Kitamura A, Goto R, Nakano K, Takabatake K, Kawai H, Nagatsuka H, Furuki Y. Identification of osteoporosis using ensemble deep learning model with panoramic radiographs and clinical covariates. Sci Rep 2022; 12:6088. [PMID: 35413983 PMCID: PMC9005660 DOI: 10.1038/s41598-022-10150-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/25/2022] [Indexed: 11/18/2022] Open
Abstract
Osteoporosis is becoming a global health issue due to increased life expectancy. However, it is difficult to detect in its early stages owing to a lack of discernible symptoms. Hence, screening for osteoporosis with widely used dental panoramic radiographs would be very cost-effective and useful. In this study, we investigate the use of deep learning to classify osteoporosis from dental panoramic radiographs. In addition, the effect of adding clinical covariate data to the radiographic images on the identification performance was assessed. For objective labeling, a dataset containing 778 images was collected from patients who underwent both skeletal-bone-mineral density measurement and dental panoramic radiography at a single general hospital between 2014 and 2020. Osteoporosis was assessed from the dental panoramic radiographs using convolutional neural network (CNN) models, including EfficientNet-b0, -b3, and -b7 and ResNet-18, -50, and -152. An ensemble model was also constructed with clinical covariates added to each CNN. The ensemble model exhibited improved performance on all metrics for all CNNs, especially accuracy and AUC. The results show that deep learning using CNN can accurately classify osteoporosis from dental panoramic radiographs. Furthermore, it was shown that the accuracy can be improved using an ensemble model with patient covariates.
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Affiliation(s)
- Shintaro Sukegawa
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan. .,Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan.
| | - Ai Fujimura
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Hirooka Gobara, Shiojiri, Nagano, 399-0781, Japan
| | - Norio Yamamoto
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan
| | | | | | - Keisuke Nakano
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan
| | - Kiyofumi Takabatake
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan
| | - Hotaka Kawai
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan
| | - Hitoshi Nagatsuka
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan
| | - Yoshihiko Furuki
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
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Ogawa R, Ogura I. Change in the mandibular cortical morphology at pre- and postdental implant operations using artificial intelligence-based computer-aided diagnosis for panoramic radiography. JOURNAL OF ORAL AND MAXILLOFACIAL RADIOLOGY 2022. [DOI: 10.4103/jomr.jomr_23_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Putra RH, Doi C, Yoda N, Astuti ER, Sasaki K. Current applications and development of artificial intelligence for digital dental radiography. Dentomaxillofac Radiol 2022; 51:20210197. [PMID: 34233515 PMCID: PMC8693331 DOI: 10.1259/dmfr.20210197] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In the last few years, artificial intelligence (AI) research has been rapidly developing and emerging in the field of dental and maxillofacial radiology. Dental radiography, which is commonly used in daily practices, provides an incredibly rich resource for AI development and attracted many researchers to develop its application for various purposes. This study reviewed the applicability of AI for dental radiography from the current studies. Online searches on PubMed and IEEE Xplore databases, up to December 2020, and subsequent manual searches were performed. Then, we categorized the application of AI according to similarity of the following purposes: diagnosis of dental caries, periapical pathologies, and periodontal bone loss; cyst and tumor classification; cephalometric analysis; screening of osteoporosis; tooth recognition and forensic odontology; dental implant system recognition; and image quality enhancement. Current development of AI methodology in each aforementioned application were subsequently discussed. Although most of the reviewed studies demonstrated a great potential of AI application for dental radiography, further development is still needed before implementation in clinical routine due to several challenges and limitations, such as lack of datasets size justification and unstandardized reporting format. Considering the current limitations and challenges, future AI research in dental radiography should follow standardized reporting formats in order to align the research designs and enhance the impact of AI development globally.
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Affiliation(s)
| | - Chiaki Doi
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Sendai, Japan
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Sendai, Japan
| | - Eha Renwi Astuti
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo no 47, Surabaya, Indonesia
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Sendai, Japan
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Nishitani Y, Nakayama R, Hayashi D, Hizukuri A, Murata K. Segmentation of teeth in panoramic dental X-ray images using U-Net with a loss function weighted on the tooth edge. Radiol Phys Technol 2021; 14:64-69. [PMID: 33398671 DOI: 10.1007/s12194-020-00603-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Panoramic dental X-ray imaging is an established method for the diagnosis of dental problems. However, the resolution of panoramic dental X-ray images is relatively low. Thus, early lesions are often overlooked. As the first step in the development of a computer-aided diagnosis scheme for panoramic dental X-ray images, we propose a computerized method for the segmentation of teeth using U-Net with a loss function weighted on the tooth edge. Our database consisted of 162 panoramic dental X-ray images. The training dataset consisted of 102 images, while the remaining 60 images were used as the test dataset. The loss function obtained by the cross entropy (CE) in the entire image is usually used in training U-Net. To improve the segmentation accuracy of the tooth edge, a loss function weighted on the tooth edge is proposed by adding the CE in the tooth edge region to the CE for the entire image. The mean Jaccard index and Dice index for U-Net with the loss function combining the CEs for the entire image and tooth edge were 0.864 and 0.927, respectively, which were significantly larger than those for U-Net with the CE for the entire image (0.802 and 0.890, p < 0.001) and U-Net with the CE for the tooth edge (0.826 and 0.905, p < 0.001). U-Net with the new loss function exhibited a higher segmentation accuracy of the tooth in panoramic dental X-ray images than that obtained by U-Net with the conventional loss function.
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Affiliation(s)
- Yuya Nishitani
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Ryohei Nakayama
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.
| | - Daisei Hayashi
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Akiyoshi Hizukuri
- Graduate School of Science and Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Kan Murata
- TAKARA TELESYSTEMS Corporation, 1-17-17 Nihonbashi, Chuo-ku, Osaka, 542-0073, Japan
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Aliaga I, Vera V, Vera M, García E, Pedrera M, Pajares G. Automatic computation of mandibular indices in dental panoramic radiographs for early osteoporosis detection. Artif Intell Med 2020; 103:101816. [PMID: 32143810 DOI: 10.1016/j.artmed.2020.101816] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 11/29/2022]
Abstract
AIM A new automatic method for detecting specific points and lines (straight and curves) in dental panoramic radiographies (orthopantomographies) is proposed, where the human knowledge is mapped to the automatic system. The goal is to compute relevant mandibular indices (Mandibular Cortical Width, Panoramic Mandibular Index, Mandibular Ratio, Mandibular Cortical Index) in order to detect the thinning and deterioration of the mandibular bone. Data can be stored for posterior massive analysis. METHODS Panoramic radiographies are intrinsically complex, including: artificial structures, unclear limits in bony structures, jawbones with irregular curvatures and intensity levels, irregular shapes and borders of the mental foramen, irregular teeth alignments or missing dental pieces. An intelligent sequence of linked imaging segmentation processes is proposed to cope with the above situations towards the design of the automatic segmentation, making the following contributions: (i) Fuzzy K-means classification for identifying artificial structures; (ii) adjust a tangent line to the lower border of the lower jawbone (lower cortex), based on texture analysis, grey scale dilation, binarization and labelling; (iii) identification of the mental foramen region and its centre, based on multi-thresholding, binarization, morphological operations and labelling; (iv) tracing a perpendicular line to the tangent passing through the centre of the mental foramen region and two parallel lines to the tangent, passing through borders on the mental foramen intersected by the perpendicular; (v) following the perpendicular line, a sweep is made moving up the tangent for detecting accumulation of binary points after applying adaptive filtering; (vi) detection of the lower mandible alveolar crest line based on the identification of inter-teeth gaps by saliency and interest points feature description. RESULTS The performance of the proposed approach was quantitatively compared against the criteria of expert dentists, verifying also its validity with statistical studies based on the analysis of deterioration of bone structures with different levels of osteoporosis. All indices are computed inside two regions of interest, which tolerate flexibility in sizes and locations, making this process robust enough. CONCLUSIONS The proposed approach provides an automatic procedure able to process with efficiency and reliability panoramic X-Ray images for early osteoporosis detection.
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Affiliation(s)
- Ignacio Aliaga
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - Vicente Vera
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - María Vera
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - Enrique García
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - María Pedrera
- Hospital Clínico San Carlos, Complutense University, Madrid, Spain.
| | - Gonzalo Pajares
- Instituto del Conocimiento (Knowledge Institute). Complutense University, Madrid, Spain.
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Hayashi Y, Ito M, Imanishi Y, Watanabe K, Matsumoto K, Arai Y, Honda K. Use of experimental phantoms to determine the accuracy and reliability of mandibular cortical width measurements by panoramic radiography and cone-beam computed tomography. J Oral Sci 2020; 62:303-307. [DOI: 10.2334/josnusd.19-0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Yusuke Hayashi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Motohiro Ito
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Yusuke Imanishi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kenichiro Watanabe
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kunihito Matsumoto
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
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Tooth detection and classification on panoramic radiographs for automatic dental chart filing: improved classification by multi-sized input data. Oral Radiol 2020; 37:13-19. [PMID: 31893343 DOI: 10.1007/s11282-019-00418-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Dental state plays an important role in forensic radiology in case of large scale disasters. However, dental information stored in dental clinics are not standardized or electronically filed in general. The purpose of this study is to develop a computerized system to detect and classify teeth in dental panoramic radiographs for automatic structured filing of the dental charts. It can also be used as a preprocessing step for computerized image analysis of dental diseases. METHODS One hundred dental panoramic radiographs were employed for training and testing an object detection network using fourfold cross-validation method. The detected bounding boxes were then classified into four tooth types, including incisors, canines, premolars, and molars, and three tooth conditions, including nonmetal restored, partially restored, and completely restored, using classification network. Based on the visualization result, multisized image data were used for the double input layers of a convolutional neural network. The result was evaluated by the detection sensitivity, the number of false-positive detection, and classification accuracies. RESULTS The tooth detection sensitivity was 96.4% with 0.5 false positives per case. The classification accuracies for tooth types and tooth conditions were 93.2% and 98.0%. Using the double input layer network, 6 point increase in classification accuracy was achieved for the tooth types. CONCLUSIONS The proposed method can be useful in automatic filing of dental charts for forensic identification and preprocessing of dental disease prescreening purposes.
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Ogura I, Kobayashi E, Nakahara K, Haga-Tsujimura M, Igarashi K, Katsumata A. Computer programme to assess mandibular cortex morphology in cases of medication-related osteonecrosis of the jaw with osteoporosis or bone metastases. Imaging Sci Dent 2019; 49:281-286. [PMID: 31915613 PMCID: PMC6941839 DOI: 10.5624/isd.2019.49.4.281] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/25/2019] [Accepted: 08/11/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme. Materials and Methods Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used. Results The MCI of MRONJ patients with osteoporosis (class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases (class 1: 14, class 2: 5, class 3: 0) (P=0.000). Conclusion The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.
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Affiliation(s)
- Ichiro Ogura
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Kensuke Igarashi
- Department of Life Science Dentistry, The Nippon Dental University, Niigata, Japan
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
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Fukuda M, Inamoto K, Shibata N, Ariji Y, Yanashita Y, Kutsuna S, Nakata K, Katsumata A, Fujita H, Ariji E. Evaluation of an artificial intelligence system for detecting vertical root fracture on panoramic radiography. Oral Radiol 2019; 36:337-343. [PMID: 31535278 DOI: 10.1007/s11282-019-00409-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/31/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the use of a convolutional neural network (CNN) system for detecting vertical root fracture (VRF) on panoramic radiography. METHODS Three hundred panoramic images containing a total of 330 VRF teeth with clearly visible fracture lines were selected from our hospital imaging database. Confirmation of VRF lines was performed by two radiologists and one endodontist. Eighty percent (240 images) of the 300 images were assigned to a training set and 20% (60 images) to a test set. A CNN-based deep learning model for the detection of VRFs was built using DetectNet with DIGITS version 5.0. To defend test data selection bias and increase reliability, fivefold cross-validation was performed. Diagnostic performance was evaluated using recall, precision, and F measure. RESULTS Of the 330 VRFs, 267 were detected. Twenty teeth without fractures were falsely detected. Recall was 0.75, precision 0.93, and F measure 0.83. CONCLUSIONS The CNN learning model has shown promise as a tool to detect VRFs on panoramic images and to function as a CAD tool.
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Affiliation(s)
- Motoki Fukuda
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan.
| | - Kyoko Inamoto
- Department of Endodontics, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Naoki Shibata
- Department of Endodontics, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Yudai Yanashita
- Department of Electrical, Electronic and Computer Faculty of Engineering, Gifu University, Gifu, Japan
| | - Shota Kutsuna
- Department of Electrical, Electronic and Computer Faculty of Engineering, Gifu University, Gifu, Japan
| | - Kazuhiko Nakata
- Department of Endodontics, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | | | - Hiroshi Fujita
- Department of Electrical, Electronic and Computer Faculty of Engineering, Gifu University, Gifu, Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
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Hung K, Montalvao C, Tanaka R, Kawai T, Bornstein MM. The use and performance of artificial intelligence applications in dental and maxillofacial radiology: A systematic review. Dentomaxillofac Radiol 2019; 49:20190107. [PMID: 31386555 DOI: 10.1259/dmfr.20190107] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To investigate the current clinical applications and diagnostic performance of artificial intelligence (AI) in dental and maxillofacial radiology (DMFR). METHODS Studies using applications related to DMFR to develop or implement AI models were sought by searching five electronic databases and four selected core journals in the field of DMFR. The customized assessment criteria based on QUADAS-2 were adapted for quality analysis of the studies included. RESULTS The initial electronic search yielded 1862 titles, and 50 studies were eventually included. Most studies focused on AI applications for an automated localization of cephalometric landmarks, diagnosis of osteoporosis, classification/segmentation of maxillofacial cysts and/or tumors, and identification of periodontitis/periapical disease. The performance of AI models varies among different algorithms. CONCLUSION The AI models proposed in the studies included exhibited wide clinical applications in DMFR. Nevertheless, it is still necessary to further verify the reliability and applicability of the AI models prior to transferring these models into clinical practice.
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Affiliation(s)
- Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Carla Montalvao
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Ray Tanaka
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, Tokyo, Japan
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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A computer aided diagnosis system for measurement of mandibular cortical thickness on dental panoramic radiographs in prediction of women with low bone mineral density. J Med Syst 2019; 43:148. [DOI: 10.1007/s10916-019-1268-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/03/2019] [Indexed: 11/25/2022]
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Nakamoto T, Taguchi A, Verdonschot RG, Kakimoto N. Improvement of region of interest extraction and scanning method of computer-aided diagnosis system for osteoporosis using panoramic radiographs. Oral Radiol 2018; 35:143-151. [PMID: 30484188 DOI: 10.1007/s11282-018-0330-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/05/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Patients undergoing osteoporosis treatment benefit greatly from early detection. We previously developed a computer-aided diagnosis (CAD) system to identify osteoporosis using panoramic radiographs. However, the region of interest (ROI) was relatively small, and the method to select suitable ROIs was labor-intensive. This study aimed to expand the ROI and perform semi-automatized extraction of ROIs. The diagnostic performance and operating time were also assessed. METHODS We used panoramic radiographs and skeletal bone mineral density data of 200 postmenopausal women. Using the reference point that we defined by averaging 100 panoramic images as the lower mandibular border under the mental foramen, a 400 × 100-pixel ROI was automatically extracted and divided into four 100 × 100-pixel blocks. Valid blocks were analyzed using program 1, which examined each block separately, and program 2, which divided the blocks into smaller segments and performed scans/analyses across blocks. Diagnostic performance was evaluated using another set of 100 panoramic images. RESULTS Most ROIs (97.0%) were correctly extracted. The operation time decreased to 51.4% for program 1 and to 69.3% for program 2. The sensitivity, specificity, and accuracy for identifying osteoporosis were 84.0, 68.0, and 72.0% for program 1 and 92.0, 62.7, and 70.0% for program 2, respectively. Compared with the previous conventional system, program 2 recorded a slightly higher sensitivity, although it occasionally also elicited false positives. CONCLUSIONS Patients at risk for osteoporosis can be identified more rapidly using this new CAD system, which may contribute to earlier detection and intervention and improved medical care.
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Affiliation(s)
- Takashi Nakamoto
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Nagano, Japan
| | - Rinus Gerardus Verdonschot
- Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
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Computer-aided detection in musculoskeletal projection radiography: A systematic review. Radiography (Lond) 2018; 24:165-174. [DOI: 10.1016/j.radi.2017.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/31/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022]
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20
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Use of cone beam computed tomography in identifying postmenopausal women with osteoporosis. Arch Osteoporos 2017; 12:26. [PMID: 28265896 DOI: 10.1007/s11657-017-0314-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/06/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED The aim of this study is to correlate radiometric indices from cone beam computed tomography (CBCT) images and bone mineral density (BMD) in postmenopausal women. Quantitative CBCT indices can be used to screen for women with low BMD. PURPOSE Osteoporosis is a disease characterized by the deterioration of bone tissue and the consequent decrease in BMD and increase in bone fragility. Several studies have been performed to assess radiometric indices in panoramic images as low-BMD predictors. The aim of this study is to correlate radiometric indices from CBCT images and BMD in postmenopausal women. METHODS Sixty postmenopausal women with indications for dental implants and CBCT evaluation were selected. Dual-energy X-ray absorptiometry (DXA) was performed, and the patients were divided into normal, osteopenia, and osteoporosis groups, according to the World Health Organization (WHO) criteria. Cross-sectional images were used to evaluate the computed tomography mandibular index (CTMI), the computed tomography index (inferior) (CTI (I)) and computed tomography index (superior) (CTI (S)). Student's t test was used to compare the differences between the indices of the groups' intraclass correlation coefficient (ICC). RESULTS Statistical analysis showed a high degree of interobserver and intraobserver agreement for all measurements (ICC > 0.80). The mean values of CTMI, CTI (S), and CTI (I) were lower in the osteoporosis group than in osteopenia and normal patients (p < 0.05). In comparing normal patients and women with osteopenia, there was no statistically significant difference in the mean value of CTI (I) (p = 0.075). CONCLUSIONS Quantitative CBCT indices may help dentists to screen for women with low spinal and femoral bone mineral density so that they can refer postmenopausal women for bone densitometry.
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Panoramic radiographic features that predict the development of bisphosphonate-related osteonecrosis of the jaw. Oral Radiol 2017; 34:151-160. [DOI: 10.1007/s11282-017-0293-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/20/2017] [Indexed: 11/26/2022]
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Factors affecting observer agreement in morphological evaluation of mandibular cortical bone on panoramic radiographs. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0253-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Muramatsu C, Horiba K, Hayashi T, Fukui T, Hara T, Katsumata A, Fujita H. Quantitative assessment of mandibular cortical erosion on dental panoramic radiographs for screening osteoporosis. Int J Comput Assist Radiol Surg 2016; 11:2021-2032. [PMID: 27289239 DOI: 10.1007/s11548-016-1438-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Studies reported that the mandibular cortical width (MCW) measured on dental panoramic radiographs (DPRs) was significantly correlated with bone mineral density. However, MCW is not a perfect index by itself, and studies suggest the added utility of mandibular cortical index (MCI). In this study, we propose a method for computerized estimation of mandibular cortical degree (MCD), a new continuous measure of MCI, for osteoporotic risk assessment. METHODS The mandibular contour was automatically segmented using an active contour model. The regions of interest near mental foramen were extracted for MCW and MCD determination. The MCW was measured on the basis of residue-line detection results and pixel profiles. Image features including texture features based on gray-level co-occurrence matrices were determined. The MCD were estimated using support vector regression (SVR). The SVR was trained using previously collected 99 DPRs, including 26 osteoporotic cases, by a computed radiography system. The proposed scheme was tested using 99 DPRs obtained by a photon-counting system with data of bone mineral density at distal forearm. The number of osteoporotic, osteopenic, and control cases were 12, 18, and 69 cases, respectively. The subjective MCD by a dental radiologist was employed for training and evaluation. RESULTS The correlation coefficients with the subjective MCD were -0.549 for MCW alone, 0.609 for the MCD by the features without MCW, and 0.617 for the MCD by the features and MCW. The correlation coefficients with the BMD were 0.619, -0.608, and -0.670, respectively. The areas under the receiver operating characteristic curves for detecting osteoporotic cases were 0.830, 0.884, and 0.901, respectively, whereas those for detecting high-risk cases were 0.835, 0.833, and 0.880, respectively. CONCLUSIONS In conclusion, our scheme may have a potential to identify asymptomatic osteoporotic and osteopenic patients through dental examinations.
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Affiliation(s)
- Chisako Muramatsu
- Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan.
| | - Kazuki Horiba
- Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
| | - Tatsuro Hayashi
- Media Co., Ltd, 3-26-6 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tatsumasa Fukui
- Department of Oral Radiology, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Takeshi Hara
- Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Hiroshi Fujita
- Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
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Abstract
Osteoporosis is a major health problem affecting one in three women over the age of 50 and may not be detected until fractures occur. Since osteoporotic fractures are a health burden worldwide, identifying subjects with a high risk of osteoporosis and preventing osteoporosis-related mortality and morbidity are a very important health strategy. Women show an estrogen-related bone loss starting at menopause, predominantly occurring in trabecular bone. Diagnosis of osteoporosis is usually based on the bone mineral density measurement, but this is not a practical and economical technique for early detection. Therefore, investigators are interested in the possibility of detecting osteoporosis from the panoramic radiographs. Mandibular cortical bone undergoes resorptive activity in osteoporotic patients, leading to a decreased thickness and more porous inferior border. Therefore, studies have demonstrated the usefulness of cortical width and shape, determined from panoramic radiographs, in identifying elderly individuals with undetected osteoporosis, especially postmenopausal women. In conclusion, postmenopausal women with C3 category, Mental Index (MI) <3 mm, and panoramic mandibular index (PMI) <0.3 may be considered for further osteoporosis investigation.
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Affiliation(s)
- Ayse Gulsahi
- Department of Dentomaxillofacial Radiology, Baskent University, Ankara, Turkey
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25
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Graham J. Detecting low bone mineral density from dental radiographs: a mini-review. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2015; 12:178-82. [PMID: 26604946 PMCID: PMC4625777 DOI: 10.11138/ccmbm/2015.12.2.178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over a number of years researchers have reported associations between osteoporosis or low bone mineral density and signs that can be detected on dental radiographs, particularly in the width of the inferior mandibular cortex and the texture of the trabecular bone. As patients visit the dentist more regularly than they visit their doctor, there is the possibility that such signs could be used as a means of identifying individuals at risk of developing osteoporosis or suffering from consequent fracture. This paper reviews the historical background behind this research and the current status, including recent developments in automation of measurement using computer image analysis.
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Affiliation(s)
- James Graham
- Centre for Imaging Science, Institute of Population Health, Faculty of Medicine and Human Sciences, The University of Manchester, United Kingdom
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26
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Application of telemedicine to assess mandibular cortical width on panoramic images of dental patients in the Lao People’s Democratic Republic. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0198-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gonçalves VM, Delamaro ME, Nunes FDLDS. A systematic review on the evaluation and characteristics of computer-aided diagnosis systems. ACTA ACUST UNITED AC 2014. [DOI: 10.1590/1517-3151.0517] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Calciolari E, Donos N, Park JC, Petrie A, Mardas N. Panoramic measures for oral bone mass in detecting osteoporosis: a systematic review and meta-analysis. J Dent Res 2014; 94:17S-27S. [PMID: 25365969 DOI: 10.1177/0022034514554949] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Different quantitative and qualitative indices calculated on oral panoramic radiographs have been proposed as useful tools to screen for reduced skeletal bone mineral density (BMD). Our aim was to systematically review the literature on linear and qualitative panoramic measures and to assess the accuracy of these indices by performing a meta-analysis of their sensitivity and specificity. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was followed. Fifty studies were included in the qualitative appraisal and 19 were considered for meta-analysis. The methodological quality of the retrieved studies, assessed with the QUADAS-2 tool, was on average low. Three indices were reported by most of the studies: mandibular cortical width, panoramic mandibular index, and the Klemetti index. Mandibular cortical width presented with a better accuracy in excluding osteopenia/osteoporosis (specificity), since patients with a cortical width more than 4 mm had a normal BMD in 90% of the cases. Almost all studies used a cutoff of 0.3 for the panoramic mandibular index, resulting in an estimated sensitivity and specificity in detecting reduced BMD, respectively, of 0.723 (SE 0.160; 95% confidence interval [CI], 0.352-0.926) and 0.733 (SE 0.066; 95% CI, 0.587-0.841). The presence of any kind of mandibular cortical erosion gave an estimated sensitivity and specificity in detecting reduced BMD, respectively, of 0.789 (SE 0.031; 95% CI, 0.721-0.843) and 0.562 (SE 0.047; 95% CI, 0.47-0.651) and a sensitivity and specificity in detecting osteoporosis, respectively, of 0.806 (SE 0.105; 95% CI, 0.528-0.9200) and 0.643 (SE 0.109; 95% CI, 0.417-0.820). The mandibular cortical width, panoramic mandibular index, and Klemetti index are overall useful tools that potentially could be used by dentists to screen for low BMD. Their limitations are mainly related to the experience/agreement between different operators and the different image quality and magnification of the panoramic radiographs.
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Affiliation(s)
- E Calciolari
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - N Donos
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - J C Park
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom Department of Periodontology, College of Dentistry, Dankook University, Cheonan, South Korea
| | - A Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom
| | - N Mardas
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
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Kathirvelu D, Anburajan M. Prediction of low bone mass using a combinational approach of cortical and trabecular bone measures from dental panoramic radiographs. Proc Inst Mech Eng H 2014; 228:890-8. [PMID: 25179243 DOI: 10.1177/0954411914548700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to extract cortical and trabecular features of the mandible and to develop a novel combinational model of mandibular cortical thickness, trabecular bone area and age in order to predict low bone mineral density or osteoporosis from a dental panoramic radiograph. The study involved 64 south Indian women (age = 52.5 ± 12.7 years) categorised into two groups (normal and low bone mineral density) based on total femur bone mineral density. The dental panoramic radiographs were obtained by a digital scanner, and measurement of total bone mineral density at the right femur was performed by a dual-energy X-ray absorptiometry scanner. The mandibular cortical thickness and panoramic mandibular index were measured bilaterally, and the mean values were considered. The region of interest of 128 × 128 pixels around the mental foramen region was manually cropped and subjected to pre-processing, normalisation and average threshold-based segmentation to determine trabecular bone area. Multiple linear regression analyses of cortical and trabecular measures along with age were performed to develop a combinational model to classify subjects as normal and low bone mineral density. The proposed approach demonstrated strong correlation (r = 0.76; p < 0.01) against the total bone mineral density and resulted in accuracy, sensitivity and positive predictive values of 0.84, 0.92 and 0.85, respectively; the receiver operating characteristic outcomes disclosed that the area under the curve was 0.89.Our results suggest that the proposed combinational model could be useful to diagnose subjects with low bone mineral density.
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Affiliation(s)
- D Kathirvelu
- Department of Biomedical Engineering, SRM University, Kattankulathur, Tamil Nadu, India
| | - M Anburajan
- Department of Biomedical Engineering, SRM University, Kattankulathur, Tamil Nadu, India
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Katsumata A, Fujita H. Progress of computer-aided detection/diagnosis (CAD) in dentistry CAD in dentistry. JAPANESE DENTAL SCIENCE REVIEW 2014. [DOI: 10.1016/j.jdsr.2014.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Takahashi R, Muramatsu C, Hara T, Hayashi T, Katsumata A, Zhou X, Fujita H. [Improvements to an automated method for detecting carotid artery calcifications by adopting a positional feature and feature selection]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2014; 70:526-33. [PMID: 24953317 DOI: 10.6009/jjrt.2014_jsrt_70.6.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to improve an automated scheme for detecting carotid artery calcification (CAC) in dental panoramic radiographs (DPRs). Using 100 DPRs, the sensitivity of CAC detection employing our previous method was 90.0% with 5.0 false positives (FPs) per image. This study describes two enhancements. One is the adoption of a new feature for the position of CACs in addition to previous features. The other is feature selection employing the support vector machine using all combinations. Five of 12 features were selected. Using our proposed method, the average sensitivity for the same database proved to be 90.0%, with only 2.5 FPs per image. These results indicate the potential effectiveness of the new positional feature and feature selection.
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Affiliation(s)
- Ryo Takahashi
- Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Graduate School of Medicine
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Fukuoka D. [Computer-aided diagnosis on the field of head and neck: development and current trends]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2013; 69:1313-1319. [PMID: 24256657 DOI: 10.6009/jjrt.2013_jsrt_69.11.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Kavitha MS, Asano A, Taguchi A, Heo MS. The combination of a histogram-based clustering algorithm and support vector machine for the diagnosis of osteoporosis. Imaging Sci Dent 2013; 43:153-61. [PMID: 24083208 PMCID: PMC3784674 DOI: 10.5624/isd.2013.43.3.153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 04/28/2013] [Accepted: 05/07/2013] [Indexed: 12/04/2022] Open
Abstract
Purpose To prevent low bone mineral density (BMD), that is, osteoporosis, in postmenopausal women, it is essential to diagnose osteoporosis more precisely. This study presented an automatic approach utilizing a histogram-based automatic clustering (HAC) algorithm with a support vector machine (SVM) to analyse dental panoramic radiographs (DPRs) and thus improve diagnostic accuracy by identifying postmenopausal women with low BMD or osteoporosis. Materials and Methods We integrated our newly-proposed histogram-based automatic clustering (HAC) algorithm with our previously-designed computer-aided diagnosis system. The extracted moment-based features (mean, variance, skewness, and kurtosis) of the mandibular cortical width for the radial basis function (RBF) SVM classifier were employed. We also compared the diagnostic efficacy of the SVM model with the back propagation (BP) neural network model. In this study, DPRs and BMD measurements of 100 postmenopausal women patients (aged >50 years), with no previous record of osteoporosis, were randomly selected for inclusion. Results The accuracy, sensitivity, and specificity of the BMD measurements using our HAC-SVM model to identify women with low BMD were 93.0% (88.0%-98.0%), 95.8% (91.9%-99.7%) and 86.6% (79.9%-93.3%), respectively, at the lumbar spine; and 89.0% (82.9%-95.1%), 96.0% (92.2%-99.8%) and 84.0% (76.8%-91.2%), respectively, at the femoral neck. Conclusion Our experimental results predict that the proposed HAC-SVM model combination applied on DPRs could be useful to assist dentists in early diagnosis and help to reduce the morbidity and mortality associated with low BMD and osteoporosis.
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Affiliation(s)
- Muthu Subash Kavitha
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea. ; Graduate School of Engineering, Hiroshima University, Hiroshima, Japan
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Gráfová L, Kasparová M, Kakawand S, Procházka A, Dostálová T. Study of edge detection task in dental panoramic radiographs. Dentomaxillofac Radiol 2013; 42:20120391. [PMID: 23640989 DOI: 10.1259/dmfr.20120391] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study is (1) to introduce a new approach for edge detection in orthopantograms (OPGs) and an improved automatic parameter selector for common edge detectors, (2) to present a comparison between our novel approach with common edge detectors and (3) to provide faster outputs without compromising quality. A new approach for edge detection based on statistical measures was introduced: (1) a set of N edge detection results is calculated from a given input image and a selected type of edge detector, (2) N correspondence maps are constructed from N edge detection results, (3) probabilities and average probabilities are computed, (4) an overall correspondence is evaluated for each correspondence map and (5) the correspondence map providing the best overall correspondence is taken as the result of edge detection procedure. A comparison with common edge detectors (the Roberts, Prewitt, Sobel, Laplacian of the Gaussian and Canny methods) with various parameter settings (304 combinations for each test image) was carried out. The methods were assessed objectively [edge mismatch error (EME), modified Hausdorff distance (MHD) and principal component analysis] and subjectively by experts in dentistry and based on time demands. The suitability of the new approach for edge detection in OPGs was confirmed by experts. The current conventional methods in edge detection in OPGs are inadequate (none of the tested methods reach an EME value or MHD value below 0.1). Our proposed approach for edge detection shows promising potential for its implementation in clinical dentistry. It enhances the accuracy of OPG interpretation and advances diagnosis and treatment planning.
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Affiliation(s)
- L Gráfová
- Department of Computing and Control Engineering, Faculty of Chemical Engineering, Institute of Chemical Technology, 166 28 Prague 6, Czech Republic.
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