Abstract

Periodontitis, the most prevalent chronic inflammatory condition affecting teeth-supporting tissues, is diagnosed and classified through clinical and radiographic examinations. The staging of periodontitis using panoramic radiographs provides information for designing computer-assisted diagnostic systems. Performing image segmentation in periodontitis is required for image processing in diagnostic applications. This study evaluated image segmentation for periodontitis staging based on deep learning approaches. Multi-Label U-Net and Mask R-CNN models were compared for image segmentation to detect periodontitis using 100 digital panoramic radiographs. Normal conditions and 4 stages of periodontitis were annotated on these panoramic radiographs. A total of 1100 original and augmented images were then randomly divided into a training (75%) dataset to produce segmentation models and a testing (25%) dataset to determine the evaluation metrics of the segmentation models. The performance of the segmentation models against the radiographic diagnosis of periodontitis conducted by a dentist was described by evaluation metrics (i.e., dice coefficient and intersection-over-union [IoU] score). Multi-Label U-Net achieved a dice coefficient of 0.96 and an IoU score of 0.97. Meanwhile, Mask R-CNN attained a dice coefficient of 0.87 and an IoU score of 0.74. U-Net showed the characteristic of semantic segmentation, and Mask R-CNN performed instance segmentation with accuracy, precision, recall, and F1-score values of 95%, 85.6%, 88.2%, and 86.6%, respectively. Multi-Label U-Net produced superior image segmentation to that of Mask R-CNN. The authors recommend integrating it with other techniques to develop hybrid models for automatic periodontitis detection.

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