A Secondary Analysis of Panoramic Radiographs Reveals Hotspots in the Maxillofacial Region Associated with Diabetes.

Diabetes mellitus is the putative cause of a number of pathologies occurring in the bony and soft tissues of the maxillo-facial region and is known to exacerbate other oral diseases such as periodontitis.We present the first use of clinical panoramic radiographs for a secondary analysis of disease, with a focus on identifying hotspots in the maxillofacial region that are associated with diabetes. We developed a curated data set using Consensus Landmark Points (CLPs) and used that data to develop an analysis pipeline. This pipeline entailed automatic data cleansing, registration, and intensity normalization. The pipeline was used to process 7280 uncurated images that were subsequently analyzed using pixel-wise methods for a case/control study of patients with a history of diabetes. We detected statistically significant clusters of pixels that demarcated anatomical hotspots specific to the diabetic patients.