Artificial intelligence-based diagnostics of molar-incisor-hypomineralization (MIH) on intraoral photographs

Clin Oral Investig. 2022 Sep;26(9):5923-5930. doi: 10.1007/s00784-022-04552-4. Epub 2022 May 24.

Abstract

Objective: The aim of this study was to develop and validate a deep learning-based convolutional neural network (CNN) for the automated detection and categorization of teeth affected by molar-incisor-hypomineralization (MIH) on intraoral photographs.

Materials and methods: The data set consisted of 3241 intraoral images (767 teeth with no MIH/no intervention, 76 with no MIH/atypical restoration, 742 with no MIH/sealant, 815 with demarcated opacity/no intervention, 158 with demarcated opacity/atypical restoration, 181 with demarcated opacity/sealant, 290 with enamel breakdown/no intervention, 169 with enamel breakdown/atypical restoration, and 43 with enamel breakdown/sealant). These images were divided into a training (N = 2596) and a test sample (N = 649). All images were evaluated by an expert group, and each diagnosis served as a reference standard for cyclic training and evaluation of the CNN (ResNeXt-101-32 × 8d). Statistical analysis included the calculation of contingency tables, areas under the receiver operating characteristic curve (AUCs) and saliency maps.

Results: The developed CNN was able to categorize teeth with MIH correctly with an overall diagnostic accuracy of 95.2%. The overall SE and SP amounted to 78.6% and 97.3%, respectively, which indicate that the CNN performed better in healthy teeth compared to those with MIH. The AUC values ranging from 0.873 (enamel breakdown/sealant) to 0.994 (atypical restoration/no MIH).

Conclusion: It was possible to categorize the majority of clinical photographs automatically by using a trained deep learning-based CNN with an acceptably high diagnostic accuracy.

Clinical relevance: Artificial intelligence-based dental diagnostics may support dental diagnostics in the future regardless of the need to improve accuracy.

Keywords: Automated image analysis; Chalky teeth; Convolutional neural networks; Deep learning; Transfer learning.

MeSH terms

  • Artificial Intelligence
  • Dental Enamel Hypoplasia* / diagnostic imaging
  • Dental Materials
  • Humans
  • Incisor*
  • Molar / diagnostic imaging
  • Prevalence

Substances

  • Dental Materials