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Natural Sciences, Stomotology, 2026

AI-POWERED CARIES DETECTION IN PRIMARY TEETH USING DEEP LEARNING ANALYSIS OF DIGITAL RADIOGRAPHS AND INTRAORAL IMAGES

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Submitted: 2026-04-08
CC BY-NC 4.0 This work is licensed under Creative Commons Attribution–NonCommercial International License (CC BY-NC 4.0).

Abstract

Background: Dental caries in primary teeth remains a significant global health challenge, with early detection critical
for preventing complications. Traditional diagnostic methods rely on subjective visual-tactile examination and
radiography, which exhibit limitations in sensitivity and reproducibility. Artificial intelligence (AI) offers promising
solutions for objective caries detection.
Objective: To develop and validate a deep learning (DL) model for detecting caries in primary teeth using digital
radiographs and intraoral images, and compare its performance against expert dentists.
Methods: A retrospective study included 600 digital radiographs (bitewing) and 600 intraoral images from 320
children (aged 3–8 years). A convolutional neural network (CNN) was trained on 70% of the data, validated on 15%,
and tested on 15%. Ground truth was established by two pediatric dentists. Performance metrics (accuracy, sensitivity,
specificity) were calculated and compared to three general dentists using McNemar’s test.
Key Findings: The DL model achieved an accuracy of 94.3% ± 1.4 for radiographs and 92.7% ± 1.6 for intraoral
images. Sensitivity and specificity were 93.5% and 95.1% for radiographs, and 91.8% and 93.6% for intraoral images,
respectively. The model significantly outperformed general dentists (accuracy: 84.2% ± 3.1; p < 0.001) and matched
pediatric dentists (accuracy: 93.8% ± 1.2; p = 0.21).
Conclusion: The DL model demonstrates high diagnostic accuracy for caries detection in primary teeth, surpassing
general dentists and offering a reliable adjunctive tool for clinical practice.

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