Automatic Detection and Classification of Dental Restorations in Panoramic Radiographs
Authors: Yeshua Talia , Mandelbaum Ya'akov , Abdalla-Aslan Ragda , Nadler Chen , Cohen Laureen , Zemour Levana , Kabla Daniel , Gleisner Ori , Leichter Isaac 
Published: May 2019

Aim/Purpose: The aim of this study was to develop a prototype of an information-generating computer tool designed to automatically map the dental restorations in a panoramic radiograph.

Background: A panoramic radiograph is an external dental radiograph of the oro-maxillofacial region, obtained with minimal discomfort and significantly lower radiation dose compared to full mouth intra-oral radiographs or cone-beam computed tomography (CBCT) imaging. Currently, however, a radiologic informative report is not regularly designed for a panoramic radiograph, and the referring doctor needs to interpret the panoramic radiograph manually, according to his own judgment.

Methodology: An algorithm, based on techniques of computer vision and machine learning, was developed to automatically detect and classify dental restorations in a panoramic radiograph, such as fillings, crowns, root canal treatments and implants. An experienced dentist evaluated 63 panoramic anonymized images and marked on them, manually, 316 various restorations. The images were automatically cropped to obtain a region of interest (ROI) containing only the upper and lower alveolar ridges. The algorithm automatically segmented the restorations using a local adaptive threshold. In order to improve detection of the dental restorations, morphological operations such as opening, closing and hole-filling were employed. Since each restoration is characterized by a unique shape and unique gray level distribution, 20 numerical features describing the contour and the texture were extracted in order to classify the restorations. Twenty-two different machine learning models were evaluated, using a cross-validation approach, to automatically classify the dental restorations into 9 categories.

Contribution: The computer tool will provide automatic detection and classification of dental restorations, as an initial step toward automatic detection of oral pathologies in a panoramic radiograph. The use of this algorithm will aid in generating a radiologic report which includes all the information required to improve patient management and treatment outcome.

Findings: The automatic cropping of the ROI in the panoramic radiographs, in order to include only the alveolar ridges, was successful in 97% of the cases. The developed algorithm for detection and classification of the dental restorations correctly detected 95% of the restorations. ‘Weighted k-NN’ was the machine-learning model that yielded the best classification rate of the dental restorations - 92%.

Impact on Society: Information that will be extracted automatically from the panoramic image will provide a reliable, reproducible radiographic report, currently unavailable, which will assist the clinician as well as improve patients’ reliance on the diagnosis.

Future Research: The algorithm for automatic detection and classification of dental restorations in panoramic imaging must be trained on a larger dataset to improve the results. This algorithm will then be used as a preliminary stage for automatically detecting incidental oral pathologies exhibited in the panoramic images.