We developed an automatic method for staging periodontitis on dental panoramic radiographs using the deep learning hybrid method. A novel hybrid framework was proposed to automatically detect and classify the periodontal bone loss of each individual tooth. The framework is a hybrid of deep learning architecture for detection and conventional CAD processing for classification. Deep learning was used to detect the radiographic bone level (or the CEJ level) as a simple structure for the whole jaw on panoramic radiographs. Next, the percentage rate analysis of the radiographic bone loss combined the tooth long-axis with the periodontal bone and CEJ levels. Using the percentage rate, we could automatically classify the periodontal bone loss. This classification was used for periodontitis staging according to the new criteria proposed at the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The Pearson correlation coefficient of the automatic method with the diagnoses by radiologists was 0.73 overall for the whole jaw (p < 0.01), and the intraclass correlation value 0.91 overall for the whole jaw (p < 0.01). The novel hybrid framework that combined deep learning architecture and the conventional CAD approach demonstrated high accuracy and excellent reliability in the automatic diagnosis of periodontal bone loss and staging of periodontitis.
Purpose: The aim of this study was to evaluate the clinical efficacy of a Tanner-Whitehouse 3 (TW3)-based fully automated bone age assessment system on hand-wrist radiographs of Korean children and adolescents. Materials and Methods: Hand-wrist radiographs of 80 subjects (40 boys and 40 girls, 7-15 years of age) were collected. The clinical efficacy was evaluated by comparing the bone ages that were determined using the system with those from the reference standard produced by 2 oral and maxillofacial radiologists. Comparisons were conducted using the paired t-test and simple regression analysis. Results: The bone ages estimated with this bone age assessment system were not significantly different from those obtained with the reference standard (P>0.05) and satisfied the equivalence criterion of 0.6 years within the 95% confidence interval (-0.07 to 0.22), demonstrating excellent performance of the system. Similarly, in the comparisons of gender subgroups, no significant difference in bone age between the values produced by the system and the reference standard was observed (P>0.05 for both boys and girls). The determination coefficients obtained via regression analysis were 0.962, 0.945, and 0.952 for boys, girls, and overall, respectively (P = 0.000); hence, the radiologist-determined bone ages and the system-determined bone ages were strongly correlated. Conclusion: This TW3-based system can be effectively used for bone age assessment based on hand-wrist radiographs of Korean children and adolescents.
Steatocystoma multiplex is a rare benign subcutaneous disease characterized by multiple dermal cyst-like lesions derived from the pilosebaceous glands. Its pathogenesis remains unclear, but it is predominantly referred to as a hamartomatous malformation of the pilosebaceous duct junction. 1 Steatocystoma multiplex is most commonly diagnosed in adolescence or early adulthood; 2 however, it has been reported as early as birth 3 and in patients as old as 78 years old. 4 The condition appears to lack any sex or race predilection. 5 Although usually asymptomatic, it can cause patients social stress related to their appearance if the lesions are numerous or large, especially on the face and neck. Some cases are sporadic; however, an autosomal dominant inherited type associated with mutations of the gene coding for keratin 17 (KRT17) has also been described. 6 Steatocystoma multiplex was first mentioned in a case report published by Jamieson in 1873 involving numerous cutaneous cysts scattered throughout the body. 7 This condition has mainly been reported on the trunk and the proximal extremities, though it has been described as occurring on the oral mucosa 8 as well. Few previous studies have reported lesions of the head and neck area concurrent with other characteristics resembling ectodermal dysplasia, especially with regard to their radiographic imaging features. This report aimed to describe a case of steatocystoma multiplex on the cervical area concurrent with several dental anomalies, with a focus on its clinical, radiological, and histopathological characteristics, as well as the possibility that this condition was inherited.
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