PaXNet: Dental Caries Detection in Panoramic X-ray using Ensemble Transfer Learning and Capsule Classifier

Dental caries is one of the most chronic diseases involving the majority of the population during their lifetime. Caries lesions are typically diagnosed by radiologists relying only on their visual inspection to detect via dental x-rays. In many cases, dental caries is hard to identify using x-rays and can be misinterpreted as shadows due to different reasons such as low image quality. Hence, developing a decision support system for caries detection has been a topic of interest in recent years. Here, we propose an automatic diagnosis system to detect dental caries in Panoramic images for the first time, to the best of authors' knowledge. The proposed model benefits from various pretrained deep learning models through transfer learning to extract relevant features from x-rays and uses a capsule network to draw prediction results. On a dataset of 470 Panoramic images used for features extraction, including 240 labeled images for classification, our model achieved an accuracy score of 86.05% on the test set. The obtained score demonstrates acceptable detection performance and an increase in caries detection speed, as long as the challenges of using Panoramic x-rays of real patients are taken into account. Among images with caries lesions in the test set, our model acquired recall scores of 69.44% and 90.52% for mild and severe ones, confirming the fact that severe caries spots are more straightforward to detect and efficient mild caries detection needs a more robust and larger dataset. Considering the novelty of current research study as using Panoramic images, this work is a step towards developing a fully automated efficient decision support system to assist domain experts. Dental caries, also known as tooth decay, is one of the most prevalent infectious chronic dental diseases in humans, affecting individuals throughout their lifetime [1]. According to the National Health and Nutrition Examination Survey, dental caries involves approximately 90% of adults in the United States [2], [3]. Dental caries is a dynamic disease procedure resulting from dental biofilm's metabolic activity, which gradually demineralizes enamel and dentine [4]. Tooth decay is a preventable disease, and if detected, can be stopped and potentially reversed in its early stages [5]. A standard tool for radiologists to distinguish dental diseases, such as caries, is x-ray radiography.