Evaluation by dental professionals of an artificial intelligence-based application to measure alveolar bone loss.

Background: Several commercial programs incorporate artificial intelligence in diagnosis, but very few dental professionals have been surveyed regarding its acceptability and usability. Furthermore, few have explored how these advances might be incorporated into routine practice.

Methods: Our team developed and implemented a deep learning (DL) model employing semantic segmentation neural networks and object detection networks to precisely identify alveolar bone crestal levels (ABCLs) and cemento-enamel junctions (CEJs) to measure change in alveolar crestal height (ACH). The model was trained and validated using a 550 bitewing radiograph dataset curated by an oral radiologist, setting a gold standard for ACH measurements. A twenty-question survey was created to compare the accuracy and efficiency of manual X-ray examination versus the application and to assess the acceptability and usability of the application.

Results: In total, 56 different dental professionals classified severe (ACH > 5 mm) vs. non-severe (ACH ≤ 5 mm) periodontal bone loss on 35 calculable ACH measures. Dental professionals accurately identified between 35-87% of teeth with severe periodontal disease, whereas the artificial intelligence (AI) application achieved an 82-87% accuracy rate. Among the 65 participants who completed the acceptability and usability survey, more than half the participants (52%) were from an academic setting. Only 21% of participants reported that they already used automated or AI-based software in their practice to assist in reading of X-rays. The majority, 57%, stated that they only approximate when measuring bone levels and only 9% stated that they measure with a ruler. The survey indicated that 84% of participants agreed or strongly agreed with the AI application measurement of ACH. Furthermore, 56% of participants agreed that AI would be helpful in their professional setting.

Conclusion: Overall, the study demonstrates that an AI application for detecting alveolar bone has high acceptability among dental professionals and may provide benefits in time saving and increased clinical accuracy.