Toward Digital Periodontal Health: Recent Advances and Future Perspectives

Periodontal diseases, ranging from gingivitis to periodontitis, are prevalent oral diseases affecting over 50% of the global population. These diseases arise from infections and inflammation of the gums and supporting bones, significantly impacting oral health. The established link between periodontal diseases and systemic diseases, such as cardiovascular diseases, underscores their importance as a public health concern. Consequently, the early detection and prevention of periodontal diseases have become critical objectives in healthcare, particularly through the integration of advanced artificial intelligence (AI) technologies. This paper aims to bridge the gap between clinical practices and cutting-edge technologies by providing a comprehensive review of current research. We examine the identification of causative factors, disease progression, and the role of AI in enhancing early detection and treatment. Our goal is to underscore the importance of early intervention in improving patient outcomes and to stimulate further interest among researchers, bioengineers, and AI specialists in the ongoing exploration of AI applications in periodontal disease diagnosis.

Detecting dental caries on oral photographs using artificial intelligence: A systematic review

OBJECTIVES

This systematic review aimed at evaluating the performance of artificial intelligence (AI) models in detecting dental caries on oral photographs.

METHODS

Methodological characteristics and performance metrics of clinical studies reporting on deep learning and other machine learning algorithms were assessed. The risk of bias was evaluated using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) tool. A systematic search was conducted in EMBASE, Medline, and Scopus.

RESULTS

Out of 3410 identified records, 19 studies were included with six and seven studies having low risk of biases and applicability concerns for all the domains, respectively. Metrics varied widely and were assessed on multiple levels. F1-scores for classification and detection tasks were 68.3%-94.3% and 42.8%-95.4%, respectively. Irrespective of the task, F1-scores were 68.3%-95.4% for professional cameras, 78.8%-87.6%, for intraoral cameras, and 42.8%-80% for smartphone cameras. Limited studies allowed assessing AI performance for lesions of different severity.

CONCLUSION

Automatic detection of dental caries using AI may provide objective verification of clinicians' diagnoses and facilitate patient-clinician communication and teledentistry. Future studies should consider more robust study designs, employ comparable and standardized metrics, and focus on the severity of caries lesions.

An augmentation aided concise CNN based architecture for COVID-19 diagnosis in real time

Over 6.5 million people around the world have lost their lives due to the highly contagious COVID 19 virus. The virus increases the danger of fatal health effects by damaging the lungs severely. The only method to reduce mortality and contain the spread of this disease is by promptly detecting it. Recently, deep learning has become one of the most prominent approaches to CAD, helping surgeons make more informed decisions. But deep learning models are computation hungry and devices with TPUs and GPUs are needed to run these models. The current focus of machine learning research is on developing models that can be deployed on mobile and edge devices. To this end, this research aims to develop a concise convolutional neural network-based computer-aided diagnostic system for detecting the COVID 19 virus in X-ray images, which may be deployed on devices with limited processing resources, such as mobile phones and tablets. The proposed architecture aspires to use the image enhancement in first phase and data augmentation in the second phase for image pre-processing, additionally hyperparameters are also optimized to obtain the optimal parameter settings in the third phase that provide the best results. The experimental analysis has provided empirical evidence of the impact of image enhancement, data augmentation, and hyperparameter tuning on the proposed convolutional neural network model, which increased accuracy from 94 to 98%. Results from the evaluation show that the suggested method gives an accuracy of 98%, which is better than popular transfer learning models like Xception, Resnet50, and Inception.

A blockchain-based federated learning mechanism for privacy preservation of healthcare IoT data

The Corona virus outbreak sped up the process of digitalizing healthcare. The ubiquity of IoT devices in healthcare has thrust the Healthcare Internet of Things (HIoT) to the forefront as a viable answer to the shortage of healthcare professionals. However, the medical field's ability to utilize this technology may be constrained by rules governing the sharing of data and privacy issues. Furthermore, endangering human life is what happens when a medical machine learning system is tricked or hacked. As a result, robust protections against cyberattacks are essential in the medical sector. This research uses two technologies, namely federated learning and blockchain, to solve these problems. The ultimate goal is to construct a trusted federated learning system on the blockchain that can predict people who are at risk for developing diabetes. The study's findings were deemed satisfactory as it achieved a multilayer perceptron accuracy of 97.11% and an average federated learning accuracy of 93.95%.

Machine learning techniques for periodontitis and dental caries detection: A narrative review

OBJECTIVES

In recent years, periodontitis, and dental caries have become common in humans and need to be diagnosed in the early stage to prevent severe complications and tooth loss. These dental issues are diagnosed by visual inspection, measuring pocket probing depth, and radiographs findings from experienced dentists. Though a glut of machine learning (ML) algorithms has been proposed for the automated detection of periodontitis, and dental caries, determining which ML techniques are suitable for clinical practice remains under debate. This review aims to identify the research challenges by analyzing the limitations of current methods and how to address these to obtain robust systems suitable for clinical use or point-of-care testing.

METHODS

An extensive search of the literature published from 2015 to 2022 written in English, related to the subject of study was sought by searching the electronic databases: PubMed, Institute of Electrical and Electronics Engineers (IEEE) Xplore, and ScienceDirect.

RESULTS

The initial electronic search yielded 1743 titles, and 55 studies were eventually included based on the selection criteria adopted in this review. Studies selected were on ML applications for the automatic detection of periodontitis and dental caries and related dental issues: Apical lessons, Periodontal bone loss, and Vertical root fracture.

CONCLUSION

While most of the ML-based studies use radiograph images for the detection of periodontitis and dental caries, few pieces of the literature revealed that good diagnostic accuracy could be achieved by training the ML model even with mobile photos representing the images of dental issues. Nowadays smartphones are used in every sector for different applications. Training the ML model with as many images of dental issues captured by the smartphone can achieve good accuracy, reduce the cost of clinical diagnosis, and provide user interaction.

TranSDFNet: Transformer-Based Truncated Signed Distance Fields for the Shape Design of Removable Partial Denture Clasps

The ever-growing aging population has led to an increasing need for removable partial dentures (RPDs) since they are typically the least expensive treatment options for partial edentulism. However, the digital design of RPDs remains challenging for dental technicians due to the variety of partially edentulous scenarios and complex combinations of denture components. To accelerate the design of RPDs, we propose a U-shape network incorporated with Transformer blocks to automatically generate RPD clasps, one of the most frequently used RPD components. Unlike existing dental restoration design algorithms, we introduce the voxel-based truncated signed distance field (TSDF) as an intermediate representation, which reduces the sensitivity of the network to resolution and contributes to more smooth reconstruction. Besides, a selective insertion scheme is proposed for solving the memory issue caused by Transformer blocks and enables the algorithm to work well in scenarios with insufficient data. We further design two weighted loss functions to filter out the noisy signals generated from the zero-gradient areas in TSDF. Ablation and comparison studies demonstrate that our algorithm outperforms state-of-the-art reconstruction methods by a large margin and can serve as an intelligent auxiliary in denture design.

Image generation technology for functional occlusal pits and fissures based on a conditional generative adversarial network

The occlusal surfaces of natural teeth have complex features of functional pits and fissures. These morphological features directly affect the occlusal state of the upper and lower teeth. An image generation technology for functional occlusal pits and fissures is proposed to address the lack of local detailed crown surface features in existing dental restoration methods. First, tooth depth image datasets were constructed using an orthogonal projection method. Second, the optimization and improvement of the model parameters were guided by introducing the jaw position spatial constraint, the L1 loss and the perceptual loss functions. Finally, two image quality evaluation metrics were applied to evaluate the quality of the generated images, and deform the dental crown by using the generated occlusal pits and fissures as constraints to compare with expert data. The results showed that the images generated using the network constructed in this study had high quality, and the detailed pit and fissure features on the crown were effectively restored, with a standard deviation of 0.1802mm compared to the expert-designed tooth crown models.

Teeth Lesion Detection Using Deep Learning and the Internet of Things Post-COVID-19

With a view of the post-COVID-19 world and probable future pandemics, this paper presents an Internet of Things (IoT)-based automated healthcare diagnosis model that employs a mixed approach using data augmentation, transfer learning, and deep learning techniques and does not require physical interaction between the patient and physician. Through a user-friendly graphic user interface and availability of suitable computing power on smart devices, the embedded artificial intelligence allows the proposed model to be effectively used by a layperson without the need for a dental expert by indicating any issues with the teeth and subsequent treatment options. The proposed method involves multiple processes, including data acquisition using IoT devices, data preprocessing, deep learning-based feature extraction, and classification through an unsupervised neural network. The dataset contains multiple periapical X-rays of five different types of lesions obtained through an IoT device mounted within the mouth guard. A pretrained AlexNet, a fast GPU implementation of a convolutional neural network (CNN), is fine-tuned using data augmentation and transfer learning and employed to extract the suitable feature set. The data augmentation avoids overtraining, whereas accuracy is improved by transfer learning. Later, support vector machine (SVM) and the K-nearest neighbors (KNN) classifiers are trained for lesion classification. It was found that the proposed automated model based on the AlexNet extraction mechanism followed by the SVM classifier achieved an accuracy of 98%, showing the effectiveness of the presented approach.

A Comprehensive Review of Recent Advances in Artificial Intelligence for Dentistry E-Health

Artificial intelligence has made substantial progress in medicine. Automated dental imaging interpretation is one of the most prolific areas of research using AI. X-ray and infrared imaging systems have enabled dental clinicians to identify dental diseases since the 1950s. However, the manual process of dental disease assessment is tedious and error-prone when diagnosed by inexperienced dentists. Thus, researchers have employed different advanced computer vision techniques, and machine- and deep-learning models for dental disease diagnoses using X-ray and near-infrared imagery. Despite the notable development of AI in dentistry, certain factors affect the performance of the proposed approaches, including limited data availability, imbalanced classes, and lack of transparency and interpretability. Hence, it is of utmost importance for the research community to formulate suitable approaches, considering the existing challenges and leveraging findings from the existing studies. Based on an extensive literature review, this survey provides a brief overview of X-ray and near-infrared imaging systems. Additionally, a comprehensive insight into challenges faced by researchers in the dental domain has been brought forth in this survey. The article further offers an amalgamative assessment of both performances and methods evaluated on public benchmarks and concludes with ethical considerations and future research avenues.

Deep learning: survey of environmental and camera impacts on internet of things images

Internet of Things (IoT) images are captivating growing attention because of their wide range of applications which requires visual analysis to drive automation. However, IoT images are predominantly captured from outdoor environments and thus are inherently impacted by the camera and environmental parameters which can adversely affect corresponding applications. Deep Learning (DL) has been widely adopted in the field of image processing and computer vision and can reduce the impact of these parameters on IoT images. Albeit, there are many DL-based techniques available in the current literature for analyzing and reducing the environmental and camera impacts on IoT images. However, to the best of our knowledge, no survey paper presents state-of-the-art DL-based approaches for this purpose. Motivated by this, for the first time, we present a Systematic Literature Review (SLR) of existing DL techniques available for analyzing and reducing environmental and camera lens impacts on IoT images. As part of this SLR, firstly, we reiterate and highlight the significance of IoT images in their respective applications. Secondly, we describe the DL techniques employed for assessing the environmental and camera lens distortion impacts on IoT images. Thirdly, we illustrate how DL can be effective in reducing the impact of environmental and camera lens distortion in IoT images. Finally, along with the critical reflection on the advantages and limitations of the techniques, we also present ways to address the research challenges of existing techniques and identify some further researches to advance the relevant research areas.

Multi-task deep learning for medical image computing and analysis: A review

The renaissance of deep learning has provided promising solutions to various tasks. While conventional deep learning models are constructed for a single specific task, multi-task deep learning (MTDL) that is capable to simultaneously accomplish at least two tasks has attracted research attention. MTDL is a joint learning paradigm that harnesses the inherent correlation of multiple related tasks to achieve reciprocal benefits in improving performance, enhancing generalizability, and reducing the overall computational cost. This review focuses on the advanced applications of MTDL for medical image computing and analysis. We first summarize four popular MTDL network architectures (i.e., cascaded, parallel, interacted, and hybrid). Then, we review the representative MTDL-based networks for eight application areas, including the brain, eye, chest, cardiac, abdomen, musculoskeletal, pathology, and other human body regions. While MTDL-based medical image processing has been flourishing and demonstrating outstanding performance in many tasks, in the meanwhile, there are performance gaps in some tasks, and accordingly we perceive the open challenges and the perspective trends. For instance, in the 2018 Ischemic Stroke Lesion Segmentation challenge, the reported top dice score of 0.51 and top recall of 0.55 achieved by the cascaded MTDL model indicate further research efforts in high demand to escalate the performance of current models.

Machine Learning in Dentistry: A Scoping Review

Machine learning (ML) is being increasingly employed in dental research and application. We aimed to systematically compile studies using ML in dentistry and assess their methodological quality, including the risk of bias and reporting standards. We evaluated studies employing ML in dentistry published from 1 January 2015 to 31 May 2021 on MEDLINE, IEEE Xplore, and arXiv. We assessed publication trends and the distribution of ML tasks (classification, object detection, semantic segmentation, instance segmentation, and generation) in different clinical fields. We appraised the risk of bias and adherence to reporting standards, using the QUADAS-2 and TRIPOD checklists, respectively. Out of 183 identified studies, 168 were included, focusing on various ML tasks and employing a broad range of ML models, input data, data sources, strategies to generate reference tests, and performance metrics. Classification tasks were most common. Forty-two different metrics were used to evaluate model performances, with accuracy, sensitivity, precision, and intersection-over-union being the most common. We observed considerable risk of bias and moderate adherence to reporting standards which hampers replication of results. A minimum (core) set of outcome and outcome metrics is necessary to facilitate comparisons across studies.

Deep Learning Models for Classification of Dental Diseases Using Orthopantomography X-ray OPG Images

The teeth are the most challenging material to work with in the human body. Existing methods for detecting teeth problems are characterised by low efficiency, the complexity of the experiential operation, and a higher level of user intervention. Older oral disease detection approaches were manual, time-consuming, and required a dentist to examine and evaluate the disease. To address these concerns, we propose a novel approach for detecting and classifying the four most common teeth problems: cavities, root canals, dental crowns, and broken-down root canals, based on the deep learning model. In this study, we apply the YOLOv3 deep learning model to develop an automated tool capable of diagnosing and classifying dental abnormalities, such as dental panoramic X-ray images (OPG). Due to the lack of dental disease datasets, we created the Dental X-rays dataset to detect and classify these diseases. The size of datasets used after augmentation was 1200 images. The dataset comprises dental panoramic images with dental disorders such as cavities, root canals, BDR, dental crowns, and so on. The dataset was divided into 70% training and 30% testing images. The trained model YOLOv3 was evaluated on test images after training. The experiments demonstrated that the proposed model achieved 99.33% accuracy and performed better than the existing state-of-the-art models in terms of accuracy and universality if we used our datasets on other models.

A machine learning and blockchain based secure and cost-effective framework for minor medical consultations

With the ever-increasing awareness among people regarding their health, visiting a doctor has become quite common. However, with the onset of the COVID-19 pandemic, home-based consultations are gaining popularity. Nevertheless, the worries over privacy and the lack of willingness to assist patients by the medical professionals in the online consultation process have made current models ineffective. In this paper, we present an advanced protected blockchain-based consultation model for minor medical conditions. Our model not only ensures users’ privacy but by incorporating a calculation model, it also offers an opportunity for consulting end-users to voluntarily take part in the consultation process. Our work proposes a smart contract based on machine learning to be implemented for the prediction of a score of a professional who consults based on various prioritized parameters. This is done by using word2vec and TF-IDF weighting to classify the question and cosine similarity scores for detailed orientation analysis. Based on this score, the patient is charged, and simultaneously, the responder is awarded ether. An incentivized method leads to more accessible healthcare while reducing the cost itself.

Deep learning in periodontology and oral implantology: A scoping review

Deep learning (DL) has been employed for a wide range of tasks in dentistry. We aimed to systematically review studies employing DL for periodontal and implantological purposes. A systematic electronic search was conducted on four databases (Medline via PubMed, Google Scholar, Scopus, and Embase) and a repository (ArXiv) for publications after 2010, without any limitation on language. In the present review, we included studies that reported deep learning models' performance on periodontal or oral implantological tasks. Given the heterogeneities in the included studies, no meta-analysis was performed. The risk of bias was assessed using the QUADAS-2 tool. We included 47 studies: focusing on imaging data (n = 20) and non-imaging data in periodontology (n = 12), or dental implantology (n = 15). The detection of periodontitis and gingivitis or periodontal bone loss, the classification of dental implant systems, or the prediction of treatment outcomes in periodontology and implantology were major use cases. The performance of the models was generally high. However, it varied given the employed methods (which includes various types of convolutional neural networks (CNN) and multi-layered perceptron (MLP)), the variety in specific modeling tasks, as well as the chosen and reported outcomes, outcome measures and outcome level. Only a few studies (n = 7) showed a low risk of bias across all assessed domains. A growing number of studies evaluated DL for periodontal or implantological objectives. Heterogeneity in study design, poor reporting and a high risk of bias severely limit the comparability of studies and the robustness of the overall evidence.

A Dual Discriminator Adversarial Learning Approach for Dental Occlusal Surface Reconstruction

Objective. Restoring the correct masticatory function of partially edentulous patient is a challenging task primarily due to the complex tooth morphology between individuals. Although some deep learning-based approaches have been proposed for dental restorations, most of them do not consider the influence of dental biological characteristics for the occlusal surface reconstruction. Description. In this article, we propose a novel dual discriminator adversarial learning network to address these challenges. In particular, this network architecture integrates two models: a dilated convolutional-based generative model and a dual global-local discriminative model. While the generative model adopts dilated convolution layers to generate a feature representation that preserves clear tissue structure, the dual discriminative model makes use of two discriminators to jointly distinguish whether the input is real or fake. While the global discriminator focuses on the missing teeth and adjacent teeth to assess whether it is coherent as a whole, the local discriminator aims only at the defective teeth to ensure the local consistency of the generated dental crown. Results. Experiments on 1000 real-world patient dental samples demonstrate the effectiveness of our method. For quantitative comparison, the image quality metrics are used to measure the similarity of the generated occlusal surface, and the root mean square between the generated result and the target crown calculated by our method is 0.114 mm. In qualitative analysis, the proposed approach can generate more reasonable dental biological morphology. Conclusion. The results demonstrate that our method significantly outperforms the state-of-the-art methods in occlusal surface reconstruction. Importantly, the designed occlusal surface has enough anatomical morphology of natural teeth and superior clinical application value.

Towards accurate prediction of patient length of stay at emergency department: a GAN-driven deep learning framework

Recently, the hospital systems face a high influx of patients generated by several events, such as seasonal flows or health crises related to epidemics (e.g., COVID'19). Despite the extent of the care demands, hospital establishments, particularly emergency departments (EDs), must admit patients for medical treatments. However, the high patient influx often increases patients' length of stay (LOS) and leads to overcrowding problems within the EDs. To mitigate this issue, hospital managers need to predict the patient's LOS, which is an essential indicator for assessing ED overcrowding and the use of the medical resources (allocation, planning, utilization rates). Thus, accurately predicting LOS is necessary to improve ED management. This paper proposes a deep learning-driven approach for predicting the patient LOS in ED using a generative adversarial network (GAN) model. The GAN-driven approach flexibly learns relevant information from linear and nonlinear processes without prior assumptions on data distribution and significantly enhances the prediction accuracy. Furthermore, we classified the predicted patients' LOS according to time spent at the pediatric emergency department (PED) to further help decision-making and prevent overcrowding. The experiments were conducted on actual data obtained from the PED in Lille regional hospital center, France. The GAN model results were compared with other deep learning models, including deep belief networks, convolutional neural network, stacked auto-encoder, and four machine learning models, namely support vector regression, random forests, adaboost, and decision tree. Results testify that deep learning models are suitable for predicting patient LOS and highlight GAN's superior performance than the other models.

Applications of artificial intelligence in dentistry: A comprehensive review

OBJECTIVE

To perform a comprehensive review of the use of artificial intelligence (AI) and machine learning (ML) in dentistry, providing the community with a broad insight on the different advances that these technologies and tools have produced, paying special attention to the area of esthetic dentistry and color research.

MATERIALS AND METHODS

The comprehensive review was conducted in MEDLINE/PubMed, Web of Science, and Scopus databases, for papers published in English language in the last 20 years.

RESULTS

Out of 3871 eligible papers, 120 were included for final appraisal. Study methodologies included deep learning (DL; n = 76), fuzzy logic (FL; n = 12), and other ML techniques (n = 32), which were mainly applied to disease identification, image segmentation, image correction, and biomimetic color analysis and modeling.

CONCLUSIONS

The insight provided by the present work has reported outstanding results in the design of high-performance decision support systems for the aforementioned areas. The future of digital dentistry goes through the design of integrated approaches providing personalized treatments to patients. In addition, esthetic dentistry can benefit from those advances by developing models allowing a complete characterization of tooth color, enhancing the accuracy of dental restorations.

CLINICAL SIGNIFICANCE

The use of AI and ML has an increasing impact on the dental profession and is complementing the development of digital technologies and tools, with a wide application in treatment planning and esthetic dentistry procedures.

DCPR-GAN: Dental Crown Prosthesis Restoration Using Two-stage Generative Adversarial Networks

Restoring the correct masticatory function of broken teeth is the basis of dental crown prosthesis rehabilitation. However, it is a challenging task primarily due to the complex and personalized morphology of the occlusal surface. In this article, we address this problem by designing a new two-stage generative adversarial network (GAN) to reconstruct a dental crown surface in the data-driven perspective. Specifically, in the first stage, a conditional GAN (CGAN) is designed to learn the inherent relationship between the defective tooth and the target crown, which can solve the problem of the occlusal relationship restoration. In the second stage, an improved CGAN is further devised by considering an occlusal groove parsing network (GroNet) and an occlusal fingerprint constraint to enforce the generator to enrich the functional characteristics of the occlusal surface. Experimental results demonstrate that the proposed framework significantly outperforms the state-of-the-art deep learning methods in functional occlusal surface reconstruction using a real-world patient database. Moreover, the standard deviation (SD) and root mean square (RMS) between the generated occlusal surface and the target crown calculated by our method are both less than 0.161mm. Importantly, the designed dental crown has enough anatomical morphology and higher clinical applicability.

Tufts Dental Database: A Multimodal Panoramic X-ray Dataset for Benchmarking Diagnostic Systems

The application of Artificial Intelligence in dental healthcare has a very promising role due to the abundance of imagery and non-imagery-based clinical data. Expert analysis of dental radiographs can provide crucial information for clinical diagnosis and treatment. In recent years, Convolutional Neural Networks have achieved the highest accuracy in various benchmarks, including analyzing dental X-ray images to improve clinical care quality. The Tufts Dental Database, a new X-ray panoramic radiography image dataset, has been presented in this paper. This dataset consists of 1000 panoramic dental radiography images with expert labeling of abnormalities and teeth. The classification of radiography images was performed based on five different levels: anatomical location, peripheral characteristics, radiodensity, effects on the surrounding structure, and the abnormality category. This first-of-its-kind multimodal dataset also includes the radiologist's expertise captured in the form of eye-tracking and think-aloud protocol. The contributions of this work are 1) publicly available dataset that can help researchers to incorporate human expertise into AI and achieve more robust and accurate abnormality detection; 2) a benchmark performance analysis for various state-of-the-art systems for dental radiograph image enhancement and image segmentation using deep learning; 3) an in-depth review of various panoramic dental image datasets, along with segmentation and detection systems. The release of this dataset aims to propel the development of AI-powered automated abnormality detection and classification in dental panoramic radiographs, enhance tooth segmentation algorithms, and the ability to distill the radiologist's expertise into AI.

A smart home dental care system: integration of deep learning, image sensors, and mobile controller

In this study, a home dental care system consisting of an oral image acquisition device and deep learning models for maxillary and mandibular teeth images is proposed. The presented method not only classifies tooth diseases, but also determines whether a professional dental treatment (NPDT) is required. Additionally, a specially designed oral image acquisition device was developed to perform image acquisition of maxillary and mandibular teeth. Two evaluation metrics, namely, tooth disease and NPDT classifications, were examined using 610 compounded and 5251 tooth images annotated by an experienced dentist with a Doctor of Dental Surgery and another dentist with a Doctor of Dental Medicine. In the tooth disease and NPDT classifications, the proposed system showed accuracies greater than 96% and 89%, respectively. Based on these results, we believe that the proposed system will allow users to effectively manage their dental health by detecting tooth diseases by providing information on the need for dental treatment.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12652-021-03366-8.

Caries and Restoration Detection Using Bitewing Film Based on Transfer Learning with CNNs

Caries is a dental disease caused by bacterial infection. If the cause of the caries is detected early, the treatment will be relatively easy, which in turn prevents caries from spreading. The current common procedure of dentists is to first perform radiographic examination on the patient and mark the lesions manually. However, the work of judging lesions and markings requires professional experience and is very time-consuming and repetitive. Taking advantage of the rapid development of artificial intelligence imaging research and technical methods will help dentists make accurate markings and improve medical treatments. It can also shorten the judgment time of professionals. In addition to the use of Gaussian high-pass filter and Otsu’s threshold image enhancement technology, this research solves the problem that the original cutting technology cannot extract certain single teeth, and it proposes a caries and lesions area analysis model based on convolutional neural networks (CNN), which can identify caries and restorations from the bitewing images. Moreover, it provides dentists with more accurate objective judgment data to achieve the purpose of automatic diagnosis and treatment planning as a technology for assisting precision medicine. A standardized database established following a defined set of steps is also proposed in this study. There are three main steps to generate the image of a single tooth from a bitewing image, which can increase the accuracy of the analysis model. The steps include (1) preprocessing of the dental image to obtain a high-quality binarization, (2) a dental image cropping procedure to obtain individually separated tooth samples, and (3) a dental image masking step which masks the fine broken teeth from the sample and enhances the quality of the training. Among the current four common neural networks, namely, AlexNet, GoogleNet, Vgg19, and ResNet50, experimental results show that the proposed AlexNet model in this study for restoration and caries judgments has an accuracy as high as 95.56% and 90.30%, respectively. These are promising results that lead to the possibility of developing an automatic judgment method of bitewing film.

Classification of caries in third molars on panoramic radiographs using deep learning

The objective of this study is to assess the classification accuracy of dental caries on panoramic radiographs using deep-learning algorithms. A convolutional neural network (CNN) was trained on a reference data set consisted of 400 cropped panoramic images in the classification of carious lesions in mandibular and maxillary third molars, based on the CNN MobileNet V2. For this pilot study, the trained MobileNet V2 was applied on a test set consisting of 100 cropped PR(s). The classification accuracy and the area-under-the-curve (AUC) were calculated. The proposed method achieved an accuracy of 0.87, a sensitivity of 0.86, a specificity of 0.88 and an AUC of 0.90 for the classification of carious lesions of third molars on PR(s). A high accuracy was achieved in caries classification in third molars based on the MobileNet V2 algorithm as presented. This is beneficial for the further development of a deep-learning based automated third molar removal assessment in future.

Mosaic Privacy-Preserving Mechanisms for Healthcare Analytics

The Internet of Things (IoT) has propelled the evolution of medical sensing technologies to greater heights. Thus, traditional health systems have been transformed into new data-rich environments. This provides an unprecedented opportunity to develop new analytical methods and tools towards a new paradigm of smart and interconnected health systems. Nevertheless, there are risks pertinent to increasing levels of system connectivity and data accessibility. Cyber-attacks become more prevalent and complex, leading to greater likelihood of data breaches. These events bring sudden disruptions to routine operations and cause the loss of billions of dollars. Adversaries often attempt to leverage models to learn a target's sensitive attributes or extrapolate its inclusion within a database. As healthcare systems are critical to improving the wellbeing of our society, there is an urgent need to protect the privacy of patients and minimize the risk of model inversion attacks. This paper presents a new approach, named Mosaic Gradient Perturbation (MGP), to preserve privacy in the framework of predictive modeling, which meets the requirement of differential privacy while mitigating the risk of model inversion. MGP is flexible in fine-tuning the trade-offs between model performance and attack accuracy while being highly scalable for large-scale computing. Experimental results show that the proposed MGP method improves upon traditional gradient perturbation to mitigate the risk of model inversion while offering greater preservation of model accuracy. The MGP technique shows strong potential to circumvent paramount costs due to privacy breaches while maintaining the quality of existing decision-support systems, thereby ushering in a privacy-preserving smart health system.

Comparative study of machine learning methods for COVID-19 transmission forecasting

Within the recent pandemic, scientists and clinicians are engaged in seeking new technology to stop or slow down the COVID-19 pandemic. The benefit of machine learning, as an essential aspect of artificial intelligence, on past epidemics offers a new line to tackle the novel Coronavirus outbreak. Accurate short-term forecasting of COVID-19 spread plays an essential role in improving the management of the overcrowding problem in hospitals and enables appropriate optimization of the available resources (i.e., materials and staff).This paper presents a comparative study of machine learning methods for COVID-19 transmission forecasting. We investigated the performances of deep learning methods, including the hybrid convolutional neural networks-Long short-term memory (LSTM-CNN), the hybrid gated recurrent unit-convolutional neural networks (GAN-GRU), GAN, CNN, LSTM, and Restricted Boltzmann Machine (RBM), as well as baseline machine learning methods, namely logistic regression (LR) and support vector regression (SVR). The employment of hybrid models (i.e., LSTM-CNN and GAN-GRU) is expected to eventually improve the forecasting accuracy of COVID-19 future trends. The performance of the investigated deep learning and machine learning models was tested using confirmed and recovered COVID-19 cases time-series data from seven impacted countries: Brazil, France, India, Mexico, Russia, Saudi Arabia, and the US. The results reveal that hybrid deep learning models can efficiently forecast COVID-19 cases. Also, results confirmed the superior performance of deep learning models compared to the two considered baseline machine learning models. Furthermore, results showed that LSTM-CNN achieved improved performances with an averaged mean absolute percentage error of 3.718%, among others.

Machine Learning and Intelligent Diagnostics in Dental and Orofacial Pain Management: A Systematic Review

Purpose

The study explored the clinical influence, effectiveness, limitations, and human comparison outcomes of machine learning in diagnosing (1) dental diseases, (2) periodontal diseases, (3) trauma and neuralgias, (4) cysts and tumors, (5) glandular disorders, and (6) bone and temporomandibular joint as possible causes of dental and orofacial pain.

Method

Scopus, PubMed, and Web of Science (all databases) were searched by 2 reviewers until 29^th October 2020. Articles were screened and narratively synthesized according to PRISMA-DTA guidelines based on predefined eligibility criteria. Articles that made direct reference test comparisons to human clinicians were evaluated using the MI-CLAIM checklist. The risk of bias was assessed by JBI-DTA critical appraisal, and certainty of the evidence was evaluated using the GRADE approach. Information regarding the quantification method of dental pain and disease, the conditional characteristics of both training and test data cohort in the machine learning, diagnostic outcomes, and diagnostic test comparisons with clinicians, where applicable, were extracted.

Results

34 eligible articles were found for data synthesis, of which 8 articles made direct reference comparisons to human clinicians. 7 papers scored over 13 (out of the evaluated 15 points) in the MI-CLAIM approach with all papers scoring 5+ (out of 7) in JBI-DTA appraisals. GRADE approach revealed serious risks of bias and inconsistencies with most studies containing more positive cases than their true prevalence in order to facilitate machine learning. Patient-perceived symptoms and clinical history were generally found to be less reliable than radiographs or histology for training accurate machine learning models. A low agreement level between clinicians training the models was suggested to have a negative impact on the prediction accuracy. Reference comparisons found nonspecialized clinicians with less than 3 years of experience to be disadvantaged against trained models.

Conclusion

Machine learning in dental and orofacial healthcare has shown respectable results in diagnosing diseases with symptomatic pain and with improved future iterations and can be used as a diagnostic aid in the clinics. The current review did not internally analyze the machine learning models and their respective algorithms, nor consider the confounding variables and factors responsible for shaping the orofacial disorders responsible for eliciting pain.