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The objective of this study is to improve traditional convolutional neural networks for more accurate children dental caries diagnosis on panoramic radiographs. A context aware convolutional neural network (CNN) is proposed by considering information among adjacent teeth, based on the fact that caries of teeth often affects each other due to the same growing environment. Specifically, when performing caries diagnosis on a tooth, information from its adjacent teeth will be collected and adaptively fused for final classification. Children panoramic radiographs of 210 patients with one or more caries and 94 patients without caries are utilized, among which there are a total of 6028 teeth with 3039 to be caries. The proposed context aware CNN outperforms typical CNN baseline with the accuracy, precision, recall, F 1 score, and area-under-the-curve (AUC) being 0.8272, 0.8538, 0.8770, 0.8652, and 0.9005, respectively, showing potential to improve typical CNN instead of just copying them in previous works. Specially, the proposed method performs better than two five-year attending doctors for the second primary molar caries diagnosis. Considering the results obtained, it is beneficial to promote CNN based deep learning methods for assisting dentists for caries diagnosis in hospitals., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Xiaojie Zhou et al.)

The objective of this study was to introduce a novel deep learning technique for more accurate children caries diagnosis on dental panoramic radiographs. Specifically, a swin transformer is introduced, which is compared with the state-of-the-art convolutional neural network (CNN) methods that are widely used for caries diagnosis. A tooth type enhanced swin transformer is further proposed by considering the differences among canine, molar and incisor. Modeling the above differences in swin transformer, the proposed method was expected to mine domain knowledge for more accurate caries diagnosis. To test the proposed method, a children panoramic radiograph database was built and labeled with a total of 6028 teeth. Swin transformer shows better diagnosis performance compared with typical CNN methods, which indicates the usefulness of this new technique for children caries diagnosis on panoramic radiographs. Furthermore, the proposed tooth type enhanced swin transformer outperforms the naive swin transformer with the accuracy, precision, recall, F1 and area-under-the-curve being 0.8557, 0.8832, 0.8317, 0.8567 and 0.9223, respectively. This indicates that the transformer model can be further improved with a consideration of domain knowledge instead of a copy of previous transformer models designed for natural images. Finally, we compare the proposed tooth type enhanced swin transformer with two attending doctors. The proposed method shows higher caries diagnosis accuracy for the first and second primary molars, which may assist dentists in caries diagnosis. [ABSTRACT FROM AUTHOR]