Effect of Lower Third Molar Segmentations on Automated Tooth Development Staging using a Convolutional Neural Network

Staging third molar development is commonly used for age estimation in subadults. Automated developmental stage allocation to the mandibular left third molar in panoramic radiographs has been examined in a pilot study. This method used an AlexNet Deep Convolutional Neural Network (CNN) approach to stage lower left third molars, which had been selected by manually drawn bounding boxes around them. This method (bounding box AlexNet = BA) still contained parts of surrounding structures which may have affected the automated stage allocation performance. We hypothesize that segmenting only the third molar could further improve the automated stage allocation performance. Therefore, the current study aimed to determine and validate the effect of lower third molar segmentations on automated tooth development staging. Retrospectively, 400 panoramic radiographs were collected, processed and segmented in three ways: bounding box (BB), rough (RS), and full (FS) tooth segmentation. A DenseNet201 CNN was used for automated stage allocation. Automated staging results were compared with reference stages – allocated by human observers – overall and per stage. FS rendered the best results with a stage allocation accuracy of 0.61, a mean absolute difference of 0.53 stages and a Cohen's linear κ of 0.84. Misallocated stages were mostly neighboring stages, and DenseNet201 rendered better results than AlexNet by increasing the percentage of correctly allocated stages by 3% (BA compared to BB). FS increased the percentage of correctly allocated stages by 7% compared to BB. In conclusion, full tooth segmentation and a DenseNet CNN optimize automated dental stage allocation for age estimation.     

Reliability of Third Molar Development for Age Estimation in a Texas Hispanic Population: A Comparison Study*

Abstract: Evaluating third molars from 950 Hispanic individuals aged 12–22 years using Demirjian’s schematic for crown and root formation found that Hispanic third molar development was 8–18 months faster than American Caucasians as reported by Mincer, Harris and Berryman in 1993. This represents a statistically significant increase. Earlier development was more apparent in the later stages F through H. Hispanic males reach developmental stages faster than Hispanic females and maxillary third molars reach developmental stages faster than mandibular third molars in both sexes. The earliest age observed for stages B–H (e.g., Stage H first observed at age 13.92 years in females) and the oldest age observed for Stages B–G were developed to facilitate age prediction of unknown individuals. Prediction tables for minimum and maximum age for an observed stage (e.g., if a female maxillary third molar is stage F it means she is older than 13 years) for each sex‐jaw group were calculated.