Objective:

The aim of this study is to develop an artificial intelligence model to detect cephalometric landmark automatically enabling the automatic analysis of cephalometric radiographs which have a very important place in dental practice and is used routinely in the diagnosis and treatment of dental and skeletal disorders.

Methods:

In this study, 1620 lateral cephalograms were obtained and 21 landmarks were included. The coordinates of all landmarks in the 1620 films were obtained to establish a labeled data set: 1360 were used as a training set, 140 as a validation set, and 180 as a testing set. A convolutional neural network-based artificial intelligence algorithm for automatic cephalometric landmark detection was developed. Mean radial error and success detection rate within the range of 2 mm, 2.5 mm, 3 mm, and 4 mm were used to evaluate the performance of the model.

Results:

Presented artificial intelligence system (CranioCatch, Eskişehir, Turkey) could detect 21 anatomic landmarks in a lateral cephalometric radiograph. The highest success detection rate scores of 2 mm, 2.5 mm, 3 mm, and 4 mm were obtained from the sella point as 98.3, 99.4, 99.4, and 99.4, respectively. The mean radial error ± standard deviation value of the sella point was found as 0.616 ± 0.43. The lowest success detection rate scores of 2 mm, 2.5 mm, 3 mm, and 4 mm were obtained from the Gonion point as 48.3, 62.8, 73.9, and 87.2, respectively. The mean radial error ± standard deviation value of Gonion point was found as 8.304 ± 2.98.

Conclusion:

Although the success of the automatic landmark detection using the developed artificial intelligence model was not insufficient for clinical use, artificial intelligence-based cephalometric analysis systems seem promising to cephalometric analysis which provides a basis for diagnosis, treatment planning, and following-up in clinical orthodontics practice.

Keywords: Anatomic landmark, lateral cephalometric radiograph, deep learning, artificial intelligence