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Background Radiographic periodontal bone loss is one of the most important basis for periodontitis staging, with problems such as limited accuracy, inconsistency, and low efficiency in imaging diagnosis. Deep learning network may be a solution to improve the accuracy and efficiency of periodontitis imaging staging diagnosis. This study aims to establish a comprehensive and accurate radiological staging model of periodontal alveolar bone loss based on panoramic images. Methods A total of 640 panoramic images were included, and 3 experienced periodontal physicians marked the key points needed to calculate the degree of periodontal alveolar bone loss and the specific location and shape of the alveolar bone loss. A two-stage deep learning architecture based on UNet and YOLO-v4 was proposed to localize the tooth and key points, so that the percentage of periodontal alveolar bone loss was accurately calculated and periodontitis was staged. The ability of the model to recognize these features was evaluated and compared with that of general dental practitioners. Results The overall classification accuracy of the model was 0.77, and the performance of the model varied for different tooth positions and categories; model classification was generally more accurate than that of general practitioners. Conclusions It is feasible to establish deep learning model for assessment and staging radiographic periodontal alveolar bone loss using two-stage architecture based on UNet and YOLO-v4.

A two-stage deep learning architecture for radiographic staging of periodontal bone loss