Assessment of the Diagnostic Accuracy of Artificial Intelligence Software in Identifying Common Periodontal and Restorative Dental Conditions (Marginal Bone Loss, Periapical Lesion, Crown, Restoration, Dental Caries) in Intraoral Periapical Radiographs.

The purpose of the study is to evaluate the diagnostic accuracy of artificial intelligence (AI) software in detecting a common set of periodontal and restorative conditions, including marginal bone loss, dental caries, periapical lesions, calculus, endodontic treatment, crowns, restorations, and open crown margins, using intraoral periapical radiographs. Additionally, the study will assess how this AI software influences the diagnostic accuracy of dentists with varying levels of experience in identifying these conditions. A total of three hundred digital IOPARs representing 1030 teeth were selected based on predetermined selection criteria. The parameters assessed included (a) calculus, (b) periapical radiolucency, (c) caries, (d) marginal bone loss, (e) type of restorative (filling) material, (f) type of crown retainer material, and (g) detection of open crown margins. Two oral radiologists performed the initial diagnosis of the selected radiographs and independently labeled all the predefined parameters for the provided IOPARs under standardized conditions. This data served as reference data. A pre-trained AI-based computer-aided detection ("CADe") software (Second Opinion, version 1.1) was used for the detection of the predefined features. The reports generated by the AI software were compared with the reference data to evaluate the diagnostic accuracy of the AI software. In the second phase of the study, thirty dental interns and thirty dental specialists were randomly selected. Each participant was randomly assigned five IOPARs and was asked to detect and diagnose the predefined conditions. Subsequently, all the participants were requested to reassess the IOPARs, this time with the assistance of the AI software. All the data was recorded using a self-designed Performa. The sensitivity of the AI software in detecting caries, periapical lesions, crowns, open crown margins, restoration, endodontic treatment, calculus, and marginal bone loss was 91.0%, 86.6%, 97.1%, 82.6%, 89.3%, 93.4%, 80.2%, and 91.1%, respectively. The specificity of the AI software in detected caries, periapical lesions, crowns, open crown margins, restoration, endodontic treatment, calculus, and marginal bone loss was 87%, 98.3%, 99.6%, 91.9%, 96.4%, 99.3%, 97.8%, and 93.1%, respectively. The differences between the AI software and radiologist diagnoses of caries, periapical lesions, crowns, open crown margins, restoration, endodontic treatment, calculus, and marginal bone loss were statistically significant (all values < 0.0001). The results showed that the diagnostic accuracy of operators (interns and specialists) with AI software revealed higher accuracy, sensitivity, and specificity in detecting caries, PA lesions, restoration, endodontic treatment, calculus, and marginal bone loss compared to that without using AI software. There were variations in the improvements in the diagnostic accuracy of interns and dental specialists. Within the limitations of the study, it can be concluded that the tested AI software has high accuracy in detecting the tested dental conditions in IOPARs. The use of AI software enhanced the diagnostic capabilities of dental operators. The present study used AI software to detect a clinically useful set of periodontal and restorative conditions, which can help dental operators in fast and accurate diagnosis and provide high-quality treatment to their patients.