Classification of Periapical and Bitewing Radiographs as Periodontally Healthy or Diseased by Deep Learning Algorithms.

Objectives The aim of this artificial intelligence (AI) study was to develop a deep learning algorithm capable of automatically classifying periapical and bitewing radiography images as either periodontally healthy or unhealthy and to assess the algorithm's diagnostic success. Materials and methods The sample of the study consisted of 1120 periapical radiographs (560 periodontally healthy, 560 periodontally unhealthy) and 1498 bitewing radiographs (749 periodontally healthy, 749 periodontally ill). From the main datasets of both radiography types, three sub-datasets were randomly created: a training set (80%), a validation set (10%), and a test set (10%). Using these sub-datasets, a deep learning algorithm was developed with the YOLOv8-cls model (Ultralytics, Los Angeles, California, United States) and trained over 300 epochs. The success of the developed algorithm was evaluated using the confusion matrix method. Results The AI algorithm achieved classification accuracies of 75% or higher for both radiograph types. For bitewing radiographs, the sensitivity, specificity, precision, accuracy, and F1 score values were 0.8243, 0.7162, 0.7439, 0.7703, and 0.7821, respectively. For periapical radiographs, the sensitivity, specificity, precision, accuracy, and F1 score were 0.7500, 0.7500, 0.7500, 0.7500, and 0.7500, respectively. Conclusion The AI models developed in this study demonstrated considerable success in classifying periodontal disease. Future applications may involve employing AI algorithms for assessing periodontal status across various types of radiography images and for automated disease detection.