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. 2024 Jun 20;13(12):3605.
doi: 10.3390/jcm13123605.

Reliability of the AI-Assisted Assessment of the Proximity of the Root Apices to Mandibular Canal

Wojciech Kazimierczak  1   2 , Natalia Kazimierczak  1 , Kamila Kędziora  2 , Marta Szcześniak  3 , Zbigniew Serafin  2
Affiliations

Reliability of the AI-Assisted Assessment of the Proximity of the Root Apices to Mandibular Canal

Wojciech Kazimierczak et al. J Clin Med. .

Abstract

Background: This study evaluates the diagnostic accuracy of an AI-assisted tool in assessing the proximity of the mandibular canal (MC) to the root apices (RAs) of mandibular teeth using computed tomography (CT). Methods: This study involved 57 patients aged 18-30 whose CT scans were analyzed by both AI and human experts. The primary aim was to measure the closest distance between the MC and RAs and to assess the AI tool's diagnostic performance. The results indicated significant variability in RA-MC distances, with third molars showing the smallest mean distances and first molars the greatest. Diagnostic accuracy metrics for the AI tool were assessed at three thresholds (0 mm, 0.5 mm, and 1 mm). Results: The AI demonstrated high specificity but generally low diagnostic accuracy, with the highest metrics at the 0.5 mm threshold with 40.91% sensitivity and 97.06% specificity. Conclusions: This study underscores the limited potential of tested AI programs in reducing iatrogenic damage to the inferior alveolar nerve (IAN) during dental procedures. Significant differences in RA-MC distances between evaluated teeth were found.

Keywords: artificial intelligence (AI); automatic detection; computed tomography; dental imaging; diagnostic test accuracy; mandibular canal; root apex.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Sample case of measurements of RA-MC distance of tooth 47 using MPRs. (A) Sagittal plane; (B) axial plane; (C) coronal plane; RA-MC distance marked with green color.
Figure 2
Figure 2
Bilateral direct RA-MC communication of third molars. (A) Axial plane; (B) coronal plane. The course of MC is marked in orange. RA-MC proximity detected by CephX.
Figure 3
Figure 3
Sample RA-MC proximity alert provided by CephX.
Figure 4
Figure 4
Three-dimensional model presenting teeth and MC segmentation results. RA-MC proximity detected by AI program.
Figure 5
Figure 5
Diagnostic accuracy metrics of AI program for RA-MC proximity.
Figure 6
Figure 6
Correlation between mean RA-MC distances and AI’s diagnosis on RA-MC proximity.
See this image and copyright information in PMC

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