Automated tooth numbering on panoramic radiographs versus cone-beam computed tomographs: A diagnostic accuracy study of a commercial artificial intelligence system

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ID: 313361
2026
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Abstract
Abstract Objectives To assess the diagnostic accuracy of a commercial artificial intelligence system for automated tooth numbering on panoramic radiographs and cone-beam computed tomography and to quantify case-level reliability. Methods In this retrospective single-centre diagnostic accuracy study, consecutive patients who underwent both panoramic radiography and cone-beam computed tomography in 2024 were included. The index test was automated tooth numbering generated by Diagnocat using the Fédération Dentaire Internationale numbering scheme. The reference standard was modality-specific consensus of two experienced, blinded readers. Tooth-position performance metrics with 95% confidence intervals were estimated using patient-level cluster bootstrap. Case-level reliability was defined as the proportion of examinations with completely error-free numbering across all evaluated tooth positions. Results The study analysed 178 panoramic radiographs and 174 cone-beam computed tomography examinations. Tooth-position performance was near-perfect and similar across modalities (overall accuracy 99.79% for panoramic radiographs and 99.80% for cone-beam computed tomography). At the case level, 154/178 (86.5%) panoramic radiographs and 156/174 (89.7%) cone-beam computed tomography examinations were error-free. Conclusions Despite near-perfect tooth-position metrics, approximately one in ten to one in seven examinations required at least one manual correction, demonstrating a gap between granular accuracy and case-level reliability. Advances in knowledge Reporting case-level, error-free outputs alongside tooth-position metrics provides a more clinically meaningful estimate of reliability for automated tooth numbering and supports safer workflow implementation.
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openalex_W7161262935 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Nora Sultani, Natalia Kazimierczak, Zbigniew Serafin, Wojciech Kazimierczak
Journal dentomaxillofacial radiology
Year 2026
DOI
10.1093/dmfr/twag026
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