Objective

To assess the accuracy of identification and/or classification of the stage of cervical vertebrae maturity on lateral cephalograms by neural networks as compared with the ground truth determined by human observers.

Materials and Methods

Search results from four electronic databases (PubMed [MEDLINE], Embase, Scopus, and Web of Science) were screened by two independent reviewers, and potentially relevant articles were chosen for full-text evaluation. Articles that fulfilled the inclusion criteria were selected for data extraction and methodologic assessment by the QUADAS-2 tool.

Results

The search identified 425 articles across the databases, from which 8 were selected for inclusion. Most publications concerned the development of the models with different input features. Performance of the systems was evaluated against the classifications performed by human observers. The accuracy of the models on the test data ranged from 50% to more than 90%. There were concerns in all studies regarding the risk of bias in the index test and the reference standards. Studies that compared models with other algorithms in machine learning showed better results using neural networks.

Conclusions

Neural networks can detect and classify cervical vertebrae maturation stages on lateral cephalograms. However, further studies need to develop robust models using appropriate reference standards that can be generalized to external data.

This content is only available as a PDF.

Author notes

a

Associate Professor, Department of Oral and Maxillofacial Radiology, College of Dental Medicine, Midwestern University, Downers Grove, Illinois, USA.

b

Professor and Director of Clinical Faculty, Dental Institute, College of Dental Medicine, Midwestern University, Downers Grove, Illinois, USA.

c

Assistant Professor and Director of Orthodontics, Rush Orthodontics and Craniofacial Center, Department of Plastic Surgery and Reconstruction, Rush University Medical Center, Chicago, Illinois, USA.

d

Assistant Professor, Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

e

Assistant Professor, Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

f

Private Practice, Cochin, Kerala, India.

g

Associate Professor, Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia and Professor, Department of Oral Pathology, Saveetha Dental College, Chennai, Tamil Nadu, India.