Artificial Intelligence (AI) for Detection and Localization of Unobturated Second Mesial Buccal (MB2) Canals in Cone-Beam Computed Tomography (CBCT)

The aim of this study was to develop a deep learning model to automatically detect and segment unobturated mesial buccal 2 (MB2) canals on endodontically obturated maxillary molars depicted in CBCT studies. Fifty-seven deidentified CBCT studies of maxillary molars with clinically confirmed unobturated MB2 canals were retrieved from a dental institution radiology database. One-hundred and two maxillary molar roots with and without unobturated MB2 canals were segmented using ITK-SNAP. The data were split into training and testing samples designated to train and evaluate the performance, respectively, of a convolutional neural network (CNN), U-Net. The detection performance revealed a sensitivity of 0.8, a specificity of 1, a high PPV of 1, and a NPV of 0.83 for the testing set, along with an accuracy of 0.9. The segmentation performance of unobturated MB2 canals, assessed using the custom metric, rendered a mean value of 0.3018 for the testing set. The current AI algorithm has the potential to identify obturated and unobturated canals in endodontically treated teeth. However, the AI algorithm is still somewhat affected by metallic artifacts, variations in canal calcifications, and the applied configuration. Thus, further development is needed to improve the algorithm and validate the accuracy using external validation data sets.