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      Developments, application, and performance of artificial intelligence in dentistry – A systematic review

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          Abstract

          Background/purpose

          Artificial intelligence (AI) has made deep inroads into dentistry in the last few years. The aim of this systematic review was to identify the development of AI applications that are widely employed in dentistry and evaluate their performance in terms of diagnosis, clinical decision-making, and predicting the prognosis of the treatment.

          Materials and methods

          The literature for this paper was identified and selected by performing a thorough search in the electronic data bases like PubMed, Medline, Embase, Cochrane, Google scholar, Scopus, Web of science, and Saudi digital library published over the past two decades (January 2000–March 15, 2020).After applying inclusion and exclusion criteria, 43 articles were read in full and critically analyzed. Quality analysis was performed using QUADAS-2.

          Results

          AI technologies are widely implemented in a wide range of dentistry specialties. Most of the documented work is focused on AI models that rely on convolutional neural networks (CNNs) and artificial neural networks (ANNs). These AI models have been used in detection and diagnosis of dental caries, vertical root fractures, apical lesions, salivary gland diseases, maxillary sinusitis, maxillofacial cysts, cervical lymph nodes metastasis, osteoporosis, cancerous lesions, alveolar bone loss, predicting orthodontic extractions, need for orthodontic treatments, cephalometric analysis, age and gender determination.

          Conclusion

          These studies indicate that the performance of an AI based automated system is excellent. They mimic the precision and accuracy of trained specialists, in some studies it was found that these systems were even able to outmatch dental specialists in terms of performance and accuracy.

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          Most cited references64

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          QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.

          In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk of bias. The QUADAS-2 tool is applied in 4 phases: summarize the review question, tailor the tool and produce review-specific guidance, construct a flow diagram for the primary study, and judge bias and applicability. This tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.
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            Detection and diagnosis of dental caries using a deep learning-based convolutional neural network algorithm

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              Diagnosis and prediction of periodontally compromised teeth using a deep learning-based convolutional neural network algorithm

              Purpose The aim of the current study was to develop a computer-assisted detection system based on a deep convolutional neural network (CNN) algorithm and to evaluate the potential usefulness and accuracy of this system for the diagnosis and prediction of periodontally compromised teeth (PCT). Methods Combining pretrained deep CNN architecture and a self-trained network, periapical radiographic images were used to determine the optimal CNN algorithm and weights. The diagnostic and predictive accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve, area under the ROC curve, confusion matrix, and 95% confidence intervals (CIs) were calculated using our deep CNN algorithm, based on a Keras framework in Python. Results The periapical radiographic dataset was split into training (n=1,044), validation (n=348), and test (n=348) datasets. With the deep learning algorithm, the diagnostic accuracy for PCT was 81.0% for premolars and 76.7% for molars. Using 64 premolars and 64 molars that were clinically diagnosed as severe PCT, the accuracy of predicting extraction was 82.8% (95% CI, 70.1%–91.2%) for premolars and 73.4% (95% CI, 59.9%–84.0%) for molars. Conclusions We demonstrated that the deep CNN algorithm was useful for assessing the diagnosis and predictability of PCT. Therefore, with further optimization of the PCT dataset and improvements in the algorithm, a computer-aided detection system can be expected to become an effective and efficient method of diagnosing and predicting PCT.
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                Author and article information

                Contributors
                Journal
                J Dent Sci
                J Dent Sci
                Journal of Dental Sciences
                Association for Dental Sciences of the Republic of China
                1991-7902
                2213-8862
                30 June 2020
                January 2021
                30 June 2020
                : 16
                : 1
                : 508-522
                Affiliations
                [a ]Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
                [b ]King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
                [c ]Dental Services, King Abdulaziz Medical City- Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
                [d ]Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
                [e ]Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
                [f ]Consultant in Orthodontics, Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
                [g ]Department of Oral and Maxillofacial Pathology, Dr. D.Y.Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
                [h ]Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Saudi Arabia
                Author notes
                []Corresponding author. Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Heath Affairs, Riyadh, Saudi Arabia. khanagars@ 123456ksau-hs.edu.sa
                [∗∗ ]Corresponding author. Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia. prabhadevi.maganur@ 123456gmail.com
                Article
                S1991-7902(20)30143-4
                10.1016/j.jds.2020.06.019
                7770297
                33384840
                30a31908-6599-486a-add2-c693933c4122
                © 2020 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 2 June 2020
                : 19 June 2020
                Categories
                Review Article

                artificial intelligence dentistry,machine learning,computer-aided diagnosis,deep learning models,convolutional neural networks,artificial neural networks

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