Tooth recognition of 32 tooth types by branched single shot multibox detector and integration processing in panoramic radiographs

Purpose: The purpose of our study was to analyze dental panoramic radiographs and contribute to dentists' diagnosis by automatically extracting the information necessary for reading them. As the initial step, we detected teeth and classified their tooth types in this study. Approach: We propose single-shot multibox detector (SSD) networks with a side branch for 1-class detection without distinguishing the tooth type and for 16-class detection (i.e., the central incisor, lateral incisor, canine, first premolar, second premolar, first molar, second molar, and third molar, distinguished by the upper and lower jaws). In addition, post-processing was conducted to integrate the results of the two networks and categorize them into 32 classes, differentiating between the left and right teeth. The proposed method was applied to 950 dental panoramic radiographs obtained at multiple facilities, including a university hospital and dental clinics. Results: The recognition performance of the SSD with a side branch was better than that of the original SSD. In addition, the detection rate was improved by the integration process. As a result, the detection rate was 99.03%, the number of false detections was 0.29 per image, and the classification rate was 96.79% for 32 tooth types. Conclusions: We propose a method for tooth recognition using object detection and post-processing. The results show the effectiveness of network branching on the recognition performance and the usefulness of post-processing for neural network output.

Performance of deep learning technology for evaluation of positioning quality in periapical radiography of the maxillary canine

Objectives

The aim of the present study was to create and test an automatic system for assessing the technical quality of positioning in periapical radiography of the maxillary canines using deep learning classification and segmentation techniques.

Methods

We created and tested two deep learning systems using 500 periapical radiographs (250 each of good- and bad-quality images). We assigned 350, 70, and 80 images as the training, validation, and test datasets, respectively. The learning model of system 1 was created with only the classification process, whereas system 2 consisted of both the segmentation and classification models. In each model, 500 epochs of training were performed using AlexNet and U-net for classification and segmentation, respectively. The segmentation results were evaluated by the intersection over union method, with values of 0.6 or more considered as success. The classification results were compared between the two systems.

Results

The segmentation performance of system 2 was recall, precision, and F measure of 0.937, 0.961, and 0.949, respectively. System 2 showed better classification performance values than those obtained by system 1. The area under the receiver operating characteristic curve values differed significantly between system 1 (0.649) and system 2 (0.927).

Conclusions

The deep learning systems we created appeared to have potential benefits in evaluation of the technical positioning quality of periapical radiographs through the use of segmentation and classification functions.

Performance of deep learning models constructed using panoramic radiographs from two hospitals to diagnose fractures of the mandibular condyle

OBJECTIVE

The present study aimed to verify the classification performance of deep learning (DL) models for diagnosing fractures of the mandibular condyle on panoramic radiographs using data sets from two hospitals and to compare their internal and external validities.

METHODS

Panoramic radiographs of 100 condyles with and without fractures were collected from two hospitals and a fivefold cross-validation method was employed to construct and evaluate the DL models. The internal and external validities of classification performance were evaluated as accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC).

RESULTS

For internal validity, high classification performance was obtained, with AUC values of >0.85. Conversely, external validity for the data sets from the two hospitals exhibited low performance. Using combined data sets from both hospitals, the DL model exhibited high performance, which was slightly superior or equal to that of the internal validity but without a statistically significant difference.

CONCLUSION

The constructed DL model can be clinically employed for diagnosing fractures of the mandibular condyle using panoramic radiographs. However, the domain shift phenomenon should be considered when generalizing DL systems.

Isothermal Growth and Stacking Evolution in Highly Uniform Bernal-Stacked Bilayer Graphene

Controlling the stacking order in bilayer graphene (BLG) allows realizing interesting physical properties. In particular, the possibility of tuning the band gap in Bernal-stacked (AB) BLG (AB-BLG) has a great technological importance for electronic and optoelectronic applications. Most of the current methods to produce AB-BLG suffer from inhomogeneous layer thickness and/or coexistence with twisted BLG. Here, we demonstrate a method to synthesize highly pure large-area AB-BLG by chemical vapor deposition using Cu-Ni films. Increasing the reaction time resulted in a gradual increase of the AB stacking, with the BLG eventually free from twist regions for the longer growth times (99.4% of BLG has AB stacking), due to catalyst-assisted continuous BLG reconstruction driven by carbon dissolution-segregation processes. The band gap opening was confirmed by the electrical measurements on field-effect transistors using two different device configurations. The concept of the continuous reconstruction to achieve highly pure AB-BLG offers a way to control the stacking order of catalytically grown two-dimensional materials.

Potential clinical application of masseter and temporal muscle massage treatment using an oral rehabilitation robot in temporomandibular disorder patients with myofascial pain

OBJECTIVES

To investigate the safety, suitable treatment regimen, and efficacy of masseter and temporal muscle massage treatment using an oral rehabilitation robot.

METHODS

Forty-one temporomandibular disorder (TMD) patients with myofascial pain (8 men, 33 women, median age: 46 years) were enrolled. The safety, suitable massage regimen, and efficacy of this treatment were investigated. Changes in masseter muscle thickness were evaluated on sonograms.

RESULTS

No adverse events occurred with any of the treatment sessions. Suitable massage was at pressure of 10 N for 16 minutes. Five sessions were performed every 2 weeks. Total duration of treatment was 9·5 weeks in median. Massage treatment was effective in 70·3% of patients. Masseter muscle thickness decreased with treatment in the therapy-effective group.

CONCLUSION

This study confirmed the safety of massage treatment, and established a suitable regimen. Massage was effective in 70·3% of patients and appeared to have a potential as one of the effective treatments for myofascial pain.

Shear-wave sonoelastography for assessing masseter muscle hardness in comparison with strain sonoelastography: study with phantoms and healthy volunteers

Objectives Shear-wave sonoelastography is expected to facilitate low operator dependency, high reproducibility and quantitative evaluation, whereas there are few reports on available normative values of in vivo tissue in head and neck fields. The purpose of this study was to examine the reliabilities on measuring hardness using shear-wave sonoelastography and to clarify normal values of masseter muscle hardness in healthy volunteers. Methods Phantoms with known hardness ranging from 20 to 140 kPa were scanned with shear-wave sonoelastography, and inter- and intraoperator reliabilities were examined compared with strain sonoelastography. The relationships between the actual and measured hardness were analyzed. The masseter muscle hardness in 30 healthy volunteers was measured using shear-wave sonoelastography.

RESULTS

The inter- and intraoperator intraclass correlation coefficients were almost perfect. Strong correlations were seen between the actual and measured hardness. The mean hardness of the masseter muscles in healthy volunteers was 42.82 ± 5.56 kPa at rest and 53.36 ± 8.46 kPa during jaw clenching.

CONCLUSIONS

The hardness measured with shear-wave sonoelastography showed high-level reliability. Shear-wave sonoelastography may be suitable for evaluation of the masseter muscles.

Observation of maxillary incisive canal using dry skulls between Hellman's dental age IA and IIIC

The maxillary incisive canals were observed in childhood from infancy to school-aged children to clarify their development. Cone-beam computed tomography was performed to investigate 44 dry child skulls. Two-dimensional images of various planes in the maxillary incisive canal were reconstructed on a computer using 3-dimensional visualization and measurement software. Then, antero-posterior angulation, and antero-posterior and lateral axes of the maxillary incisive canal were measured at the inferior and middle levels. The mean difference of angulation between the inferior and middle levels was 2.3 degrees in IIC, and 11.1 degrees in IIIC. The mean ratio of the lateral axis to antero-posterior axis at the middle level was 2.54 in IIC, and 1.93 in IIIC. In conclusion, it was antero-posteriorly straight from IA to IIC, and, after IIIA, it curved at the middle level. The cross-sectional shape in IIC was depressed with a larger lateral axis.

Evaluation of the masseter muscle elasticity with the use of acoustic coupling agents as references in strain sonoelastography

OBJECTIVES

To verify the use of a single coupling agent as a reference to obtain the elasticity index (EI) ratios and to investigate the EI ratios of the masseter muscles of healthy volunteers.

METHODS

Muscle phantoms with known elasticity (20, 40 and 60 kPa in the Young's modulus) were examined by strain-type sonoelastography using a coupling agent as the reference. Eight examiners tested soft (with 7 kPa) and hard (with 40 kpa) reference coupling agents separately. The correlation coefficients were determined between the EI ratio and Young's modulus of muscle phantoms. The interclass correlation coefficients were calculated for inter- and intraexaminer agreement.

RESULTS

Strong correlations were found between the EI ratios and Young's modulus for both soft and hard references. The variations of the EI ratios were larger with soft coupling agents than those with hard coupling agents, and they increased in phantoms with 60 kPa elasticity. There were no differences in the EI ratios of the masseter muscle at rest between males and females or between the right and left sides. The ratio increased during clenching.

CONCLUSIONS

The hard reference coupling agent was suitable for obtaining EI ratio of the masseter muscle. No differences were found in the EI ratios of the masseter muscle either between sexes or between the right and left sides at rest, and the ratios increased with the widening of their variations during clenching.

Can sonographic features be efficacy predictors of robotic massage treatment for masseter and temporal muscle in patients with temporomandibular disorder with myofascial pain?

OBJECTIVE

The aim of this study was to detect sonographic predictors for the efficacy of massage treatment of masseter and temporal muscle in temporomandibular disorders (TMDs) patients with myofascial pain.

METHODS

Thirty-seven TMD patients with myofascial pain (6 men and 31 women, a median age of 45 years) were enrolled. An oral rehabilitation robot massaged the patient's masseter and temporal muscles with a standard massage pressure of 10 N for 16 min. The standard treatment protocol was set five sessions every 2 weeks. The median total duration of treatment was 9.5 weeks. Efficacy of treatment was evaluated based on maximum mouth opening and visual analog scale scores of muscle pain and daily life impediments. The intramuscular echogenic bands and elasticity index ratios of the masseter muscles were evaluated on sonographic or sonoelastographic images obtained before treatment and after the third and last treatment sessions.

RESULTS

The sonographic features detected different changes after the third treatment session between the therapy-effective and therapy-ineffective groups: in the therapy-effective group, the frequency of visibility of the distinct echogenic bands increased, and the elasticity index ratio decreased.

CONCLUSION

Sonographic features after the third treatment session may be useful as predictors of therapeutic efficacy.

[A case of cystic mediastinal lymphangioma]

A 41-year-old man was admitted to our hospital because of an abnormal shadow which was pointed out on the chest x-ray film in mass screening. The operation was performed through left thoracotomy. The cyst was unilobular and 43 x 36 x 36 mm in size, located in the middle position of upper mediastinum. This localization has not been reported among 46 cases of the mediastinal lymphangiomas in Japan. Preoperative diagnosis is very difficult since roentogenographic feature is few for ruling out other mediastinal tumors. The complete resection of the cyst is recommended.