ObjectivesIn this study, a clinical decision support system was developed to help general practitioners assess the need for orthodontic treatment in patients with permanent dentition.MethodsWe chose a Bayesian network (BN) as the underlying model for assessing the need for orthodontic treatment. One thousand permanent dentition patient data sets chosen from a hospital record system were prepared in which one data element represented one participant with information for all variables and their stated need for orthodontic treatment. To evaluate the system, we compared the assessment results based on the judgements of two orthodontists to those recommended by the decision support system.ResultsIn a BN decision support model, each variable is modelled as a node, and the causal relationship between two variables may be represented as a directed arc. For each node, a conditional probability table is supplied that represents the probabilities of each value of this node, given the conditions of its parents. There was a high degree of agreement between the two orthodontists (kappa value = 0.894) in their diagnoses and their judgements regarding the need for orthodontic treatment. Also, there was a high degree of agreement between the decision support system and orthodontists A (kappa value = 1.00) and B (kappa value = 0.894).ConclusionsThe study was the first testing phase in which the results generated by the proposed system were compared with those suggested by expert orthodontists. The system delivered promising results; it showed a high degree of accuracy in classifying patients into groups needing and not needing orthodontic treatment.
Purpose: Periodontal disease causes tooth loss and is associated with cardiovascular diseases, diabetes, and rheumatoid arthritis. The present study proposes using a deep learning-based object detection method to identify periodontally compromised teeth on digital panoramic radiographs. A faster regional convolutional neural network (faster R-CNN) which is a state-of-the-art deep detection network, was adapted from the natural image domain using a small annotated clinical data-set. Materials and Methods: In total, 100 digital panoramic radiographs of periodontally compromised patients were retrospectively collected from our hospital's information system and augmented. The periodontally compromised teeth found in each image were annotated by experts in periodontology to obtain the ground truth. The Keras library, which is written in Python, was used to train and test the model on a single NVidia 1080Ti GPU. The faster R-CNN model used a pretrained ResNet architecture. Results: The average precision rate of 0.81 demonstrated that there was a significant region of overlap between the predicted regions and the ground truth. The average recall rate of 0.80 showed that the periodontally compromised teeth regions generated by the detection method excluded healthiest teeth areas. In addition, the model achieved a sensitivity of 0.84, a specificity of 0.88 and an F-measure of 0.81. Conclusion: The faster R-CNN trained on a limited amount of labeled imaging data performed satisfactorily in detecting periodontally compromised teeth. The application of a faster R-CNN to assist in the detection of periodontally compromised teeth may reduce diagnostic effort by saving assessment time and allowing automated screening documentation.
Work-related musculoskeletal disorders (WMSDs) have become increasingly common among dentists and initiate a series of events that could result in a career ending. This study aims to construct a system for predicting and preventing WMSD among dentists. We used Bayesian network (BN) that describes the mutual relationships among multiple variables contributing to WMSDs. The data-sets were prepared from direct measurements of dentist's movements and a questionnaire survey. We applied BN learning algorithms to the training data-sets to develop WMSD prediction model using 10-fold cross-validation. To evaluate the system performance, 16 dentists were randomly assigned into a 2 × 2 crossover trial scheduled to each of two sequences of dental working: receiving feedback or no feedback including the probability of WMSD and related risk factors from the system. The group that received feedback decreased significantly (t-test, p < 0.05) the extensions of neck and upper back in the y-axis as well as the WMSD probability on the post-test. In conclusion, the system for predicting and preventing WMSD aids the correction of neck and upper back extensions and reduction in WMSD probability, which may potentially contribute to reduce the risk of WMSD among dentists.
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