Accuracy of artificial intelligence-based segmentation of the mandibular canal in CBCT.

Objectives: To investigate the accuracy of artificial intelligence (AI)-based segmentation of the mandibular canal, compared to the conventional manual tracing, implementing implant planning software.

Materials And Methods: Localization of the mandibular canals was performed for 104 randomly selected patients. A localization was performed by three experienced clinicians in order to serve as control. Five tracings were performed: One from a clinician with a moderate experience with a manual tracing (I), followed by the implementation of an automatic refinement (I), one manual from a dental student (S), and one from the experienced clinician, followed by an automatic refinement (E). Subsequently, two fully automatic AI-driven segmentations were performed (A,A). The accuracy between each method was measured using root mean square error calculation.

Results: The discrepancy among the models of the mandibular canals, between the experienced clinicians and each investigated method ranged from 0.21 to 7.65 mm with a mean of 3.5 mm RMS error. The analysis of each separate mandibular canal's section revealed that mean RMS error was higher in the posterior and anterior loop compared to the middle section. Regarding time efficiency, tracing by experienced users required more time compared to AI-driven segmentation.

Conclusions: The experience of the clinician had a significant influence on the accuracy of mandibular canal's localization. An AI-driven segmentation of the mandibular canal constitutes a time-efficient and reliable procedure for pre-operative implant planning. Nevertheless, AI-based segmentation results should always be verified, as a subsequent manual refinement of the initial segmentation may be required to avoid clinical significant errors.