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ArticleInternational dental journal2026

Development and Validation of AI System for Tooth Detection and Diagnosis in Dental Radiographs.

Niels van Nistelrooij, Peter Jurkáček, Julian Runge, Wesley Do, Khalid El Ghoul, Tong Xi, Maximiliano Sergio Cenci, Bas A C Loomans, Shankeeth Vinayahalingam

Abstract readValidation Study
In one paragraph

Article in International dental journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Niels van NistelrooijDepartment of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Niels.vanNistelrooij@radboudumc.nl.
Peter JurkáčekAID s.r.o., Bratislava, Slovakia.
Julian RungeDepartment of Oral, Maxillofacial, and Plastic Facial Surgery, University Hospital Münster, Münster, Germany.
Wesley DoDepartment of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Khalid El GhoulDepartment of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Tong XiDepartment of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Maximiliano Sergio CenciDepartment of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
Bas A C LoomansDepartment of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
Shankeeth VinayahalingamDepartment of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION AND

aimsTo develop and validate an AI-automated system for dental charting that accounts for multiple radiograph types and younger patients.

methodsA total of 3705 dental radiographs were collected in Slovakia and Egypt between 2023 and 2024, including orthopantomograms (OPGs) and intraoral radiographs (e.g. bitewings). Complete teeth were manually annotated with bounding boxes and tooth numbers by 2 calibrated annotators. Subsequently, teeth were assessed by at least 3 trained clinicians (10 total, 2-13 years of clinical experience) for the presence of ten dental findings (caries, crown, filling, implant, pontic, periapical lesion, primary tooth, retained root, root canal treatment, unerupted tooth). Assessments were aggregated using the Dawid-Skene model. The AI system comprised 3 deep learning stages for modality classification (OPG or intraoral radiograph; EfficientNetV2), tooth detection per modality (RTMDet), and dental finding classification (EfficientNetV2) and was evaluated with 5-fold cross-validation on 400 held-out radiographs against the clinicians and 3 independent dentists.

resultsTooth detection was highly effective (F1-score: OPG = 0.99, intraoral = 0.98; tooth number accuracy: OPG = 0.98, intraoral = 0.96) with decreased effectiveness for primary teeth. Dental finding classification saw mixed effectiveness (F1-score: 0.52 to 0.99) with a lower effectiveness for disease-related findings. The system was more accurate than the dentists for caries, crowns, fillings, primary teeth, root canal treatments, and unerupted teeth.

conclusionThe AI system outperformed dentists for common findings, but more radiographs and annotations are required to effectively interpret rare conditions. Overall, it can support radiographic diagnosis and speed up dental charting for most patients. CLINICAL RELEVANCE: Interpretation of dental radiographs requires clinical experience and remains challenging. An effective AI system was developed for tooth detection and diagnosis in several types of dental radiographs of young and adult patients. Its findings can enhance the clinical workflow, facilitate dentist-patient communication, and improve diagnostic consistency for prevalent findings.

Indexed as

Artificial IntelligenceRadiography, DentalTooth DiseasesDeep LearningHumansIntelligent SystemsRadiography, PanoramicArtificial intelligenceBitewing radiographyDental cariesMixed dentitionPanoramic radiographyPrimary teeth

Identifiers

PMID42044605
PMCPMC13134024

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.