Novel Techniques for Automated Dental Identification

Automated dental identification is one of the best candidates for postmortem identification. With the large number of victims encountered in mass disasters, automating the process of postmortem identification is receiving an increased attention. This dissertation introduces new approaches for different stages of Automated Dental Identification system: These stages include segmentations, classification, labeling, and matching:;We modified the seam carving technique to adapt the problem of segmenting dental image records into individual teeth. We propose a two-stage teeth segmentation approach for segmenting the dental images. In the first stage, the teeth images are preprocessed by a two-step thresholding technique, which starts with an iterative thresholding followed by an adaptive thresholding to binarize the teeth images. In the second stage, we adapt the seam carving technique on the binary images, using both horizontal and vertical seams, to separate each individual tooth. We have obtained an optimality rate of 54.02% for the bitewing type images, which is superior to all existing fully automated dental segmentation algorithms in the literature, and a failure rate of 1.05%. For the periapical type images, we have obtained a high optimality rate of 58.13% and a low failure rate of 0.74 which also surpasses the performance of existing techniques. An important problem in automated dental identification is automatic classification of teeth into four classes (molars, premolars, canines, and incisors). A dental chart is a key to avoiding illogical comparisons that inefficiently consume the limited computational resources, and may mislead decision-making. We tackle this composite problem using a two-stage approach. The first stage, utilizes low computational-cost, appearance-based features, using Orthogonal Locality Preserving Projections (OLPP) for assigning an initial class. The second stage applies a string matching technique, based on teeth neighborhood rules, to validate initial teeth-classes and hence to assign each tooth a number corresponding to its location in the dental chart, even in the presence of a missed tooth. The experimental results of teeth classification show that on a large dataset of bitewing and periapical films, the proposed approach achieves overall classification accuracy of 77% and teeth class validation enhances the overall teeth classification accuracy to 87% which is slightly better than the performance obtained from previous methods based on EigenTeeth the performance of which is 75% and 86%, respectively.;We present a new technique that searches the dental database to find a candidate list. We use dental records of the FBI\u27s Criminal Justice Service (CJIC) ADIS database, that contains 104 records (about 500 bitewing and periapical films) involving more than 2000 teeth, 47 Antemortem (AM) records and 57 Postmortem (PM) records with 20 matched records.;The proposed approach consists of two main stages, the first stage is to preprocess the dental records (segmentation and teeth labeling classification) in order to get a reliable, appearance-based, low computational-cost feature. In the second stage, we developed a technique based on LaplacianTeeth using OLPP algorithm to produce a candidate list. The proposed technique can correctly retrieve the dental records 65% in the 5 top ranks while the method based on EigenTeeth remains at 60%. The proposed approach takes about 0.17 seconds to make record to record comparison while the other method based on EigenTeeth takes about 0.09 seconds.;Finally, we address the teeth matching problem by presenting a new technique for dental record retrieval. The technique is based on the matching of the Scale Invariant feature Transform (SIFT) descriptors guided by the teeth contour between the subject and reference dental records. Our fundamental objective is to accomplish a relatively short match list, with a high probability of having the correct match reference. The proposed technique correctly retrieves the dental records with performance rates of 35% and 75% in the 1 and 5 top ranks respectively, and takes only an average time of 4.18 minutes to retrieve a match list. This compares favorably with the existing technique shape-based (edge direction histogram) method which has the performance rates of 29% and 46% in the 1 and 5 top ranks respectively.;In summary, the proposed ADIS system accurately retrieves the dental record with an overall rate of 80% in top 5 ranks when a candidate list of 20 is used (from potential match search) whereas a candidate size of 10 yields an overall rate of 84% in top 5 ranks and takes only a few minutes to search the database, which compares favorably against most of the existing methods in the literature, when both accuracy and computational complexity are considered

A comprehensive artificial intelligence framework for dental diagnosis and charting

Background: The aim of this study was to develop artificial intelligence (AI) guided framework to recognize tooth numbers in panoramic and intraoral radiographs (periapical and bitewing) without prior domain knowledge and arrange the intraoral radiographs into a full mouth series (FMS) arrangement template. This model can be integrated with different diseases diagnosis models, such as periodontitis or caries, to facilitate clinical examinations and diagnoses. Methods: The framework utilized image segmentation models to generate the masks of bone area, tooth, and cementoenamel junction (CEJ) lines from intraoral radiographs. These masks were used to detect and extract teeth bounding boxes utilizing several image analysis methods. Then, individual teeth were matched with a patient’s panoramic images (if available) or tooth repositories for assigning tooth numbers using the multi-scale matching strategy. This framework was tested on 1240 intraoral radiographs different from the training and internal validation cohort to avoid data snooping. Besides, a web interface was designed to generate a report for different dental abnormalities with tooth numbers to evaluate this framework’s practicality in clinical settings. Results: The proposed method achieved the following precision and recall via panoramic view: 0.96 and 0.96 (via panoramic view) and 0.87 and 0.87 (via repository match) by handling tooth shape variation and outperforming other state-of-the-art methods. Additionally, the proposed framework could accurately arrange a set of intraoral radiographs into an FMS arrangement template based on positions and tooth numbers with an accuracy of 95% for periapical images and 90% for bitewing images. The accuracy of this framework was also 94% in the images with missing teeth and 89% with restorations. Conclusions: The proposed tooth numbering model is robust and self-contained and can also be integrated with other dental diagnosis modules, such as alveolar bone assessment and caries detection. This artificial intelligence-based tooth detection and tooth number assignment in dental radiographs will help dentists with enhanced communication, documentation, and treatment planning accurately. In addition, the proposed framework can correctly specify detailed diagnostic information associated with a single tooth without human intervention

Classification of dental x-ray images

Forensic dentistry is concerned with identifying people based on their dental records. Forensic specialists have a large number of cases to investigate and hence, it has become important to automate forensic identification systems. The radiographs acquired after a person is deceased are called the Post-mortem (PM) radiographs, and the radiographs acquired while the person is alive are called the Ante-mortem (AM) radiographs. Dental biometrics automatically analyzes dental radiographs to identify the deceased individuals. While, ante mortem (AM) identification is usually possible through comparison of many biometric identifiers, postmortem (PM) identification is impossible using behavioral biometrics (e.g. speech, gait). Moreover, under severe circumstances, such as those encountered in mass disasters (e.g. airplane crashes and natural disasters such as Tsunami) most physiological biometrics may not be employed for identification, because of the decay of soft tissues of the body to unidentifiable states. Under such circumstances, the best candidates for postmortem biometric identification are the dental features because of their survivability and diversity.;In my work, I present two different techniques to classify periapical images as maxilla (upper jaw) or mandible (lower jaw) images and we show a third technique to classify dental bitewing images as horizontally flipped/rotated or horizontally un-flipped/un-rotated. In our first technique I present an algorithm to classify whether a given dental periapical image is of a maxilla (upper jaw) or a mandible (lower jaw) using texture analysis of the jaw bone. While the bone analysis method is manual, in our second technique, I propose an automated approach for the identification of dental periapical images using the crown curve detection Algorithm. The third proposed algorithm works in an automated manner for a large number of database comprised of dental bitewing images. Each dental bitewing image in the data base can be classified as a horizontally flipped or un-flipped image in a time efficient manner

Automated dental identification: A micro-macro decision-making approach

Identification of deceased individuals based on dental characteristics is receiving increased attention, especially with the large volume of victims encountered in mass disasters. In this work we consider three important problems in automated dental identification beyond the basic approach of tooth-to-tooth matching.;The first problem is on automatic classification of teeth into incisors, canines, premolars and molars as part of creating a data structure that guides tooth-to-tooth matching, thus avoiding illogical comparisons that inefficiently consume the limited computational resources and may also mislead the decision-making. We tackle this problem using principal component analysis and string matching techniques. We reconstruct the segmented teeth using the eigenvectors of the image subspaces of the four teeth classes, and then call the teeth classes that achieve least energy-discrepancy between the novel teeth and their approximations. We exploit teeth neighborhood rules in validating teeth-classes and hence assign each tooth a number corresponding to its location in a dental chart. Our approach achieves 82% teeth labeling accuracy based on a large test dataset of bitewing films.;Because dental radiographic films capture projections of distinct teeth; and often multiple views for each of the distinct teeth, in the second problem we look for a scheme that exploits teeth multiplicity to achieve more reliable match decisions when we compare the dental records of a subject and a candidate match. Hence, we propose a hierarchical fusion scheme that utilizes both aspects of teeth multiplicity for improving teeth-level (micro) and case-level (macro) decision-making. We achieve a genuine accept rate in excess of 85%.;In the third problem we study the performance limits of dental identification due to features capabilities. We consider two types of features used in dental identification, namely teeth contours and appearance features. We propose a methodology for determining the number of degrees of freedom possessed by a feature set, as a figure of merit, based on modeling joint distributions using copulas under less stringent assumptions on the dependence between feature dimensions. We also offer workable approximations of this approach

Künstliche Intelligenz in der Zahnheilkunde: Scoping-Review und Schließung beobachteter Wissenslücken durch eine methodische und eine klinische Studie

Objectives: The aims of this dissertation were to (1) conduct a scoping review of stud-ies on machine learning (ML) in dentistry and appraise their robustness, (2) perform a benchmarking study to systematically compare various ML algorithms for a specific dental task, and (3) evaluate the influence of a ML-based caries detection software on diagnostic accuracy and decision-making in a randomized controlled trial. Methods: The scoping review included studies using ML in dentistry published between 1st January 2015 and 31st May 2021 on MEDLINE, IEEE Xplore, and arXiv. The risk of bias and reporting quality were assessed with the QUADAS‐2 and TRIPOD checklists, respectively. In the benchmarking study, 216 ML models were built using permutations of six ML model architectures (U-Net, U-Net++, Feature Pyramid Networks, LinkNet, Pyramid Scene Parsing Network, and Mask Attention Network), 12 model backbones of varying complexities (ResNet18, ResNet34, ResNet50, ResNet101, ResNet152, VGG13, VGG16, VGG19, DenseNet121, DenseNet161, DenseNet169, and Dense-Net201), and three initialization strategies (random, ImageNet, and CheXpert weights). 1,625 dental bitewing radiographs were used for training and testing. Five-fold cross-validation was carried out and model performance assessed using F1-score. In the clin-ical trial, each one of 22 dentists examined 20 randomly selected bitewing images for proximal caries; 10 images were evaluated with ML and 10 images without ML. Accura-cy in lesion detection and the suggested treatment were evaluated. Results: The scoping review included 168 studies, describing different ML tasks, mod-els, input data, methods to generate reference tests, and performance metrics, imped-ing comparison across studies. The studies showed considerable risk of bias and mod-erate adherence to reporting standards. In the benchmarking study, more complex models only minimally outperformed their simpler counterparts, if at all. Models initial-ized by ImageNet or CheXpert weights outperformed those using random weights (p<0.05). The clinical trial demonstrated that dentists using ML showed increased accu-racy (area under the receiver operating characteristic [mean (95% confidence interval): 0.89 (0.87–0.90)]) compared with those not using ML [0.85 (0.83–0.86); p<0.05], pri-marily due to their higher sensitivity [0.81 (0.74–0.87) compared to 0.72 (0.64–0.79); p<0.05]. Notably, dentists using ML also showed a higher frequency of invasive treat-ment decisions than those not using it (p<0.05). Conclusion: To facilitate comparisons across ML studies in dentistry, a minimum (core) set of outcomes and metrics should be developed, and researchers should strive to improve robustness and reporting quality of their studies. ML model choice should be performed on an informed basis, and simpler models may often be similarly capable as more complex ones. ML can increase dentists’ diagnostic accuracy but also lead to more invasive treatment.Ziele: Die Ziele dieser Dissertation waren, (1) ein Scoping-Review von Studien über maschinelles Lernen (ML) in der Zahnmedizin, (2) eine Benchmarking-Studie zum systematischen Vergleich verschiedener ML-Algorithmen für eine bestimmte zahnmedizinische Aufgabe, und (3) eine randomisierte kontrollierte Studie zur Bewertung einer ML-basierten Karies-Erkennungssoftware bezüglich diagnostischer Genauigkeit und Einfluss auf den Entscheidungsprozess durchzuführen. Methoden: Das Scoping-Review umfasste Studien über ML in der Zahnmedizin, veröffentlicht vom 1. Januar 2015 bis 31. Mai 2021 auf MEDLINE, IEEE Xplore und arXiv. Bias-Risiko und Berichtsqualität wurden mit den Checklisten QUADAS-2 beziehungsweise TRIPOD bewertet. In der Benchmarking-Studie wurden 216 ML-Modelle durch Permutationen von sechs Architekturen (U-Net, U-Net++, Feature Pyramid Networks, LinkNet, Pyramid Scene Parsing Network und Mask Attention Network), 12 Backbones (Res-Net18, ResNet34, ResNet50, ResNet101, ResNet152, VGG13, VGG16, VGG19, DenseNet121, DenseNet161, DenseNet169 und DenseNet201) und drei Initialisierungsstrategien (zufällige-, ImageNet- und CheXpert-Gewichtungen) erstellt. Zum Training und Testen wurden 1.625 Bissflügel-Röntgenaufnahmen genutzt. Es wurde eine fünffache Kreuzvalidierung durchgeführt und die Modellleistung anhand des F1-Scores bewertet. In der klinischen Studie untersuchten 22 Zahnärzte jeweils 20 zufällig ausgewählte Bissflügelbilder auf Approximalkaries; 10 Bilder wurden mit und 10 Bilder ohne ML ausgewertet. Die Genauigkeit in der Erkennung von Läsionen sowie die abgeleitete Therapieempfehlung wurden bewertet. Ergebnisse: Das Scoping-Review schloss 168 Studien ein, in denen verschiedene ML-Aufgaben, Modelle, Eingabedaten, Methoden zur Generierung von Referenztests und Leistungsmetriken beschrieben wurden. Die Studien zeigten ein erhebliches Bias-Risiko und eine mäßige Einhaltung der Berichtsstandards. In der Benchmarking-Studie hatten komplexere Modelle gegenüber einfachen Modellen allenfalls geringe Vorteile. Mit ImageNet- oder CheXpert-Gewichtungen initialisierte Modelle übertrafen solche mit Zufallsgewichtungen (p<0,05). In der klinischen Studie erreichten Zahnärzte mit ML eine höhere Genauigkeit bei der Kariesdetektion (Receiver-Operating-Charakteristik [Mittelwert (95 % Konfidenzintervall) 0,89 (0,87–0,90)]) als ohne ML [0,85 (0,83–0,86); p<0,05], hauptsächlich aufgrund höherer Sensitivität [0,81 (0,74–0,87) verglichen mit 0,72 (0,64–0,79); p<0,05]. Zahnärzte mit ML wählten auffallend häufiger invasive Behandlungen als ohne ML (p<0,05). Schlussfolgerung: Zur besseren Vergleichbarkeit von ML-Studien in der Zahnmedizin, sollten Core Outcomes und Metriken definiert sowie Robustheit und Berichtsqualität verbessert werden. Die Entwicklung von ML-Modellen sollte auf informierter Basis erfolgen, bei oft ähnlicher Leistung von einfacheren und komplexeren Modellen. ML kann die diagnostische Genauigkeit erhöhen, aber auch zu mehr invasiven Behandlungen führen

An evaluation of computer-based radiographic methods in estimating dental caries and periodontal diseases

Reductions in dental diseases have resulted in a need for more accurate diagnostic and monitoring methods. The purpose of this study was to 1) identify the best diagnostic technique, 2) investigate the main factors which limit its validity and reliabilty and 3) devise methods to improve its reliability and 4) investigate ways of automating its use for general dental practice. From the literature review radiography was identified as the best current method with regard to validity, reliability, production of stable objective data and ease of use. However, irradiation geometry variations between serial films and subjective measurement errors were its principle limitations. Although an accurate semi-automatic caries measuring system exists, it is unsuitable for general practice due to lengthy operator interaction. A series of computer-based experiments were devised to evaluate further the digital subtraction radiography technique (DSR); develop a new method using stored regions of interest (ROI) to reduce subjective measurement errors; investigate the feasibility of completely automatic image analysis. In addition, an in vitro caries experiment was designed to demonstrate the effects of irradiation geometry variation on lesion size and caries scores. The results demonstrated that small variations in irradiation geometry can change radiographic scores. Misalignment of subsequent films beneath a video camera can cause significant errors in the DSR technique. The stored ROI method reduced cement-enamel junction to alveolar crest measurement errors to standard deviation 0.15mm. A fully automatic method for recognising teeth and bone crests was demonstrated. It was concluded that 1) radiography is currently the technique of choice, 2) a new significant methodological error for DSR has been demonstrated, 3) the subjective ROI method produced lower intra- and inter-examiner measurement errors compared to similar methods, 4) routine use of automatic methods may be feasible and should be investigated further and 5) standardised irradiation geometry is essential