Evaluation of Caries Detection on Bitewing Radiographs: A Comparative Analysis of the Improved Deep Learning Model and Dentist Performance

OBJECTIVES: The application of deep learning techniques for detecting caries in bitewing radiographs has gained significant attention in recent years. However, the comparative performance of various modern deep learning models and strategies to enhance their accuracy remains an area requiring further investigation. METHODS: This study explored the capabilities of 11 widely used YOLO (You Only Look Once) object detection models to automatically identify enamel and dentin caries from bitewing radiographs. To further optimize detection performance, the YOLOv9c model's backbone architecture was refined, reducing both model size and computational requirements. The enhanced model was assessed alongside six dentists, using the same test dataset for direct comparison. RESULTS: The proposed YOLOv9c model achieved the highest performance among the evaluated models, with recall, precision, specificity, F1-score, and Youden index values of 0.727, 0.651, 0.726, 0.687, and 0.453, respectively. Notably, the YOLOv9c model surpassed the performance of the dentists, as indicated by its recall and F1-score values. CONCLUSIONS: The proposed YOLOv9c model proved to be highly effective in detecting enamel and dentin caries, outperforming other models and even clinical evaluations by dentists in this study. Its high accuracy positions it as a valuable tool to augment dentists' diagnostic capabilities. CLINICAL SIGNIFICANCE: The results emphasize the potential of the YOLOv9c model to assist dentists in clinical settings, offering accurate and efficient support for caries detection and contributing to improved patient outcomes.