Expert System for Mandibular Condyle Detection and Osteoarthritis Classification in Panoramic Imaging Using R-CNN and CNN

Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative condition of the TMJ led by a pathological tissue response of the joint under mechanical loading. It is characterized by the progressive destruction of the internal surfaces of the joint, which can result in debilitating pain and joint noise. Panoramic imaging can be used as a basic screening tool with thorough clinical examination in diagnosing TMJ OA. This paper proposes an algorithm that can extract the condylar region and determine its abnormality by using convolutional neural networks (CNNs) and Faster region-based CNNs (R-CNNs). Panoramic images are collected retrospectively and 1000 images are classified into three categories—normal, abnormal, and unreadable—by a dentist or orofacial pain specialist. Labels indicating whether the condyle is detected and its location enabled more clearly recognizable panoramic images. The uneven proportion of normal to abnormal data is adjusted by duplicating and rotating the images. An R-CNN model and a Visual Geometry Group-16 (VGG16) model are used for learning and condyle discrimination, respectively. To prevent overfitting, the images are rotated ±10° and shifted by 10%. The average precision of condyle detection using an R-CNN at intersection over union (IoU) >0.5 is 99.4% (right side) and 100% (left side). The sensitivity, specificity, and accuracy of the TMJ OA classification algorithm using a CNN are 0.54, 0.94, and 0.84, respectively. The findings demonstrate that classifying panoramic images through CNNs is possible. It is expected that artificial intelligence will be more actively applied to analyze panoramic X-ray images in the future.