Artificial Intelligence and Deep Learning in Dental Radiology

Ash Yousefi
5 min readMay 7, 2020

Healthcare in general is a very natural customer for artificial intelligence applications. IBM Watson can read a half million medical research papers in 15 seconds and, with deep learning, can recommend diagnoses and the most promising treatment options.

AI has an ability to analyze vast numbers of diagnostic images such as X-rays, CT scans and MRIs, systems like this can point doctors and radiologists to the most probable areas of concern, increasing both the speed and probability of detection. And now with the FDA creating regulatory pathways to encourage developers of medical decision support software, analysts predict that the use of artificial intelligence in healthcare will grow tenfold in the next five years.

The introduction of cone beam computed tomography (CBCT) in the late 90s transformed the way the profession as a whole analyzes the oral and maxillofacial images. Dental providers, who previously were limited to panoramic images, now had the ability to visualize the hard tissues of the head and neck in all the desired planes as well as in 3D reconstructions. In addition, CBCT scans may reveal occult pathology and incidental findings of varying clinical significance located in structures outside a dentist’s conventional area of expertise.

Dental and Maxillofacial Radiology is a specialty that is closely related to technology and therefore constantly subject to change. The “next big thing” in DMF radiology is not a new type of scanner or storage device or image delivery system, but technologies to improve or accelerate image data interpretation or to facilitate tasks with less or no input from a dentist: this is what most people refer to as “artificial intelligence” (AI) in radiology. The recent hype about AI in dmf radiology is mainly due to the success of the tools based on Deep Learning (DL) for analyzing CBCT images. In less than a decade, computers and algorithms based upon DL have gained the power to equal or exceed humans in an increasing number of simple tasks, such as detection of lesions or caries. According to Google AI research group, a new study shows that physicians and algorithms working together are more effective than either alone. It’s one of the first studies to examine how AI can improve physicians’ diagnostic accuracy.

AI in general and AI in dentistry or medicine, in particular, started gaining its foothold with the advent of data computing as well as cloud computing ability to collect large amount of data records. With the vast amount of data, for example in field of radiology, a specific algorithm can be created which further helps to diagnose and suggest probable treatment options. AI is slowly nudging its head in the field of dental radiology with emphasis on diagnostic records in digital three‑dimensional (3D) scans and cone beam computed tomography. Much information can be gathered and computed to create AI for rapid diagnosis and enhanced treatment planning.

AI in Clinical Dentistry
Correct diagnosis is the key to successful clinical practice outcomes. In this regard, adequately trained neural networks can be an effective tool for diagnosis. This limits the time spent for analysis and provides hints to possible pathological processes, even if those where not primarily indicated.

Smart dent artificial intelligence analyzes the acquired CBCT and panoramic images in DICOM format (a standard format in medical imaging) enabling a smooth data transfer. Smartdent allows for analysis of CBCT and panoramic images obtained with any CBCT and digital panoramic units without using the installed, unit specific, conventional software (viewer). This increases diagnostic freedom and decreases the addiction to forced software by the manufacturers.

Workflow
A neural network, while processing DICOM files of CT and panoramic images, finds and segments the main anatomical regions (jaws, teeth, periapical lesions). Smartdent identifies various conditions and disorders by assessing 80 signs (normal appearance, filling, crown, treated root canal, implant, sign of periapical lesion, etc.) and selects dedicated images to support an individualized therapeutic planning. The dentist needs only a browser and all the applications will be run in the cloud. CT images and reports are stored in the dentist’s account. The dentist thus receives a data storage system platform powered by the cloud in which data may be arranged by patient name, medical condition, creation and modification dates. CT and panoramic images may be transferred from dentist to dentist in a secure way. Apart from a panoramic image, the patient report contains the dental chart with annotation in color on the teeth with findings requiring the attention marked in red. Other interactive report formats may be generated and obtained from Smartdent platform.

Performance:

In a recent clinical test, the results of a man vs. Smartdent challenge four dentists compete with the Smartdent AI technology for anomaly detection for the panoramic images and the Smartdent algorithm outperformed the dentists in precision and sensitivity.

With the continued adoption of CBCT, interpreting cone beam images is another area in which AI can boost productivity. At this point, analyzing cone beam data requires a specific level of training and expertise. This analysis can be time consuming, involving analyzing hundreds of image slices. With AI, the entire process of interpretation can be automated to assess the image as a whole to detect dental pathologies more quickly and accurately. Clearly, the stage is set for the rapid proliferation of truly effective applications of AI in dentistry over the next year or two. In 10 to 15 years, the use of AI-based technologies in the practice will be as commonplace and pervasive as practice management and imaging systems are today.

Conclusion:
Artificial intelligence (AI) is a breakthrough in the field of technology, which is rapidly progressing. Ever since its inception, dentistry has witnessed some of its exceptional achievements. Dentists should get acquainted with this technology as the future of dentistry will surely include implementation of its many applications. Smartdent diagnostic solutions enlists the computer- generated knowledge of experts for automated dental radiography analysis. Automation can help save time and improve the completeness of electronic dental records. While AI cannot replace the role of the dentist or radiologist, accurate and fast processing of panoramic and CT images by the artificial intelligence of a neural network offers exciting diagnostic opportunities for the future and will certainly be an integral part in point of care dental radiology.

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Ash Yousefi

I was part of UC Berkeley entrepreneurship center with 8 years of experience in developing digital products with focus on supply chain innovation.