Accuracy of Artificial Intelligence-Based Photographic Detection of Gingivitis

Abstract

Objectives: Gingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs.

Methods: Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement.

Results: A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50.

Conclusions: Artificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients' plaque control.

Keywords: Artificial intelligence; Community dentistry; Deep learning; Gingivitis; Neural networks, computer; Periodontal diseases.

Fig. 1

Illustration of architecture of DeepLabv3+ neural networks in this study.

Fig. 2

STARD-2015 flow diagram of this study.

Fig. 3

Selected detection results of the validation set using the adopted segmentation model. A, Input intraoral photograph. B, Ground truth (health status) labelled by calibrated dentist. C, Detection results: green = healthy, red = diseased, yellow = questionable.