## 4 Discussion  
Acknowledging the presence of periodontitis is a critical step in managing patients and preventing periodontal disease [21]. Staging and grading periodontitis can further guide patients to receive individually customized treatment [2; 5]. The primary goal of defining staging in patients with periodontitis is to classify the severity and extent of the disease and assess its complexity [22]. Therefore, it is appropriate to recognize detectable interdental and clinical attachment loss greater than 3 mm in more than two teeth [2]. However, measuring attachment loss is only possible during a clinical examination. In this study, the assessment of periodontal disease in panoramic radiographs was carried out using the standard provided by the WHO Community Periodontal Index probe [17], as it is easy to adapt into X-ray images. Cemento-enamel junction and function involvement were used  
Figure 3: **Two representative cases of Faster-RCNN model in this study. ** The original panoramic radiograph with ground truth labelling is shown in (**A**,**C**), while the bounding box output from the faster R-CNN is shown in (**B**,**D**). The trained network effectively distinguishes between tooth and edentulous areas and displays the predicted probability of periodontal condition as a numerical value. In (**B**), all 12 segments were correctly detected, while in (**D**), 9 out of the 12 segments were correctly detected. \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**All** & **Class** & **Precision** & **Recall** & **F1-Score** & **AUC** \\ \hline \multirow{4}{*}{**Anterior**} & **Edentulous** & 0.96 & 0.93 & 0.95 & 0.96 \\  & **Normal** & 0.88 & 0.88 & 0.88 & 0.87 \\  & **Periodontitis** & 0.85 & 0.85 & 0.85 & 0.87 \\  & **Whole** & 0.90 & 0.89 & 0.89 & 0.90 \\ \hline \multirow{4}{*}{**Premolar**} & **Edentulous** & 0.97 & 0.98 & 0.97 & 0.99 \\  & **Normal** & 0.89 & 0.91 & 0.90 & 0.88 \\  & **Periodontitis** & 0.85 & 0.83 & 0.84 & 0.87 \\  & **Whole** & 0.90 & 0.90 & 0.90 & 0.91 \\ \hline \multirow{4}{*}{**Molar**} & **Edentulous** & 0.98 & 0.98 & 0.98 & 0.99 \\  & **Normal** & 0.88 & 0.89 & 0.88 & 0.89 \\  & **Periodontitis** & 0.87 & 0.86 & 0.87 & 0.88 \\  & **Whole** & 0.91 & 0.91 & 0.91 & 0.92 \\ \hline \multicolumn{2}{c}{**Total**} & 0.90 & 0.90 & 0.90 & 0.91 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Average performance indices of the 5-fold cross-validation result with detailed region and class information. as landmarks to measure alveolar bone defects. With the lack of furcation in single-rooted teeth, the compromised bone level was evaluated with respect to the entire length of the tooth. [PERSON] et al. [5] used panoramic radiographs to classify the stages of periodontitis and the extent of the disease by calculating the percentage rate of alveolar bone loss in relation to its ratio of the intersection length of the periodontal bone level and the other cemento-enamel junction level. The stages of this study were determined according to the criteria proposed at the 2017 World Workshop 4 on the Classification of Periodontal and Peri-implant Disease and Conditions [2]. To effectively communicate and include the status of the disease, the stage or severity can aid in the management of periodontitis. Regarding the severity of periodontitis, terms such as mild, moderate, and severe may be subjective. These descriptions may not be straightforward but can be used in the clinical interpretation of one's condition as a whole. In fact, severity is frequently defined based on the measurement of clinical attachment loss as slight, moderate, and severe. Radiographic examinations are often used to categorize teeth affected by mild, moderate, or severe periodontitis in many cases [2]. Therefore, despite its subjectivity, it is adequate to inform clinicians about the general condition of periodondually compromised teeth. Numerous studies have been conducted to investigate the accuracy of various imaging methods in dentistry, which still remain to be controversial [23; 24; 25; 26].