In this study, an integrated deep learning framework was developed for classifying the periodontitis stages of each individual tooth using dental panoramic radiographs. Based on actual patient panoramic radiographs data, the bone loss by periodontitis and cementoenamel junction boundaries were detected, while the tooth number and tooth length were identified using data from AIHub, an open database platform. The two factors were integrated to classify and to evaluate the periodontitis staging on dental panoramic radiography. Periodontitis is classified into four stages based on the criteria of the radiographic bone level, as suggested at the relevant international conference in 2017. For the integrated deep learning framework developed in this study, the classification performance was evaluated by comparing the results of dental specialists, which indicated that the integrated framework had an accuracy of 0.929, with a recall and precision of 0.807 and 0.724, respectively, in average across all four stages. The novel framework was thus shown to exhibit a relatively high level of performance, and the findings in this study are expected to assist dental specialists with detecting the periodontitis stage and subsequent effective treatment. A systematic application will be developed in the future, to provide ancillary data for diagnosis and basic data for the treatment and prevention of periodontal disease.
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