Deep learning-based segmentation of dental implants on cone-beam computed tomography images: A validation study.

OBJECTIVES: To train and validate a cloud-based convolutional neural network (CNN) model for automated segmentation (AS) of dental implant and attached prosthetic crown on cone-beam computed tomography (CBCT) images. METHODS: A total dataset of 280 maxillomandibular jawbone CBCT scans was acquired from patients who underwent implant placement with or without coronal restoration. The dataset was randomly divided into three subsets: training set (n = 225), validation set (n = 25) and testing set (n = 30). A CNN model was developed and trained using expert-based semi-automated segmentation (SS) of the implant and attached prosthetic crown as the ground truth. The performance of AS was assessed by comparing with SS and manually corrected automated segmentation referred to as refined-automated segmentation (R-AS). Evaluation metrics included timing, voxel-wise comparison based on confusion matrix and 3D surface differences. RESULTS: The average time required for AS was 60 times faster (<30 s) than the SS approach. The CNN model was highly effective in segmenting dental implants both with and without coronal restoration, achieving a high dice similarity coefficient score of 0.92±0.02 and 0.91±0.03, respectively. Moreover, the root mean square deviation values were also found to be low (implant only: 0.08±0.09 mm, implant+restoration: 0.11±0.07 mm) when compared with R-AS, implying high AI segmentation accuracy. CONCLUSIONS: The proposed cloud-based deep learning tool demonstrated high performance and time-efficient segmentation of implants on CBCT images. CLINICAL SIGNIFICANCE: AI-based segmentation of implants and prosthetic crowns can minimize the negative impact of artifacts and enhance the generalizability of creating dental virtual models. Furthermore, incorporating the suggested tool into existing CNN models specialized for segmenting anatomical structures can improve pre-surgical planning for implants and post-operative assessment of peri­implant bone levels.

Development and validation of a novel artificial intelligence driven tool for accurate mandibular canal segmentation on CBCT.

OBJECTIVES: The objective of this study is the development and validation of a novel artificial intelligence driven tool for fast and accurate mandibular canal segmentation on cone beam computed tomography (CBCT). METHODS: A total of 235 CBCT scans from dentate subjects needing oral surgery were used in this study, allowing for development, training and validation of a deep learning algorithm for automated mandibular canal (MC) segmentation on CBCT. Shape, diameter and direction of the MC were adjusted on all CBCT slices using a voxel-wise approach. Validation was then performed on a random set of 30 CBCTs - previously unseen by the algorithm - where voxel-level annotations allowed for assessment of all MC segmentations. RESULTS: Primary results show successful implementation of the AI algorithm for segmentation of the MC with a mean IoU of 0.636 (± 0.081), a median IoU of 0.639 (± 0.081), a mean Dice Similarity Coefficient of 0.774 (± 0.062). Precision, recall and accuracy had mean values of 0.782 (± 0.121), 0.792 (± 0.108) and 0.99 (± 7.64×10-05) respectively. The total time for automated AI segmentation was 21.26 s (±2.79), which is 107 times faster than accurate manual segmentation. CONCLUSIONS: This study demonstrates a novel, fast and accurate AI-driven module for MC segmentation on CBCT. CLINICAL SIGNIFICANCE: Given the importance of adequate pre-operative mandibular canal assessment, Artificial Intelligence could help relieve practitioners from the delicate and time-consuming task of manually tracing and segmenting this structure, helping prevent per- and post-operative neurovascular complications.