Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Deep learning to assess bone quality from panoramic radiographs: the feasibility of clinical application through comparison with an implant surgeon and cone-beam computed tomography

  • Jae-Hong Lee (Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University) ;
  • Jeong-Ho Yun (Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University) ;
  • Yeon-Tae Kim (Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry)
  • Received : 2023.06.01
  • Accepted : 2023.10.05
  • Published : 2024.10.30
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Abstract

Purpose: Bone quality is one of the most important clinical factors for the primary stability and successful osseointegration of dental implants. This preliminary pilot study aimed to evaluate the clinical applicability of deep learning (DL) for assessing bone quality using panoramic (PA) radiographs compared with an implant surgeon's subjective tactile sense and cone-beam computed tomography (CBCT) values. Methods: In total, PA images of 2,270 edentulous sites for implant placement were selected, and the corresponding CBCT relative gray value measurements and bone quality classification were performed using 3-dimensional dental image analysis software. Based on the pre-trained and fine-tuned ResNet-50 architecture, the bone quality classification of PA images was classified into 4 levels, from D1 to D4, and Spearman correlation analyses were performed with the implant surgeon's tactile sense and CBCT values. Results: The classification accuracy of DL was evaluated using a test dataset comprising 454 cropped PA images, and it achieved an area under the receiving characteristic curve of 0.762 (95% confidence interval [CI], 0.714-0.810). Spearman correlation analysis of bone quality showed significant positive correlations with the CBCT classification (r=0.702; 95% CI, 0.651-0.747; P<0.001) and the surgeon's tactile sense (r=0.658; 95% CI, 0.600-0.708, P<0.001) versus the DL classification. Conclusions: DL classification using PA images showed a significant and consistent correlation with CBCT classification and the surgeon's tactile sense in classifying the bone quality at the implant placement site. Further research based on high-quality quantitative datasets is essential to increase the reliability and validity of this method for actual clinical applications.

Keywords

Acknowledgement

This study was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2019R1A2C1083978) and research funds for newly appointed professors of Jeonbuk National University in 2023.

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