Academic Journal
Automated prediction of hand-wrist maturation stage from lateral cephalometric and panoramic radiographs using a deep learning approach.
| Τίτλος: | Automated prediction of hand-wrist maturation stage from lateral cephalometric and panoramic radiographs using a deep learning approach. |
|---|---|
| Συγγραφείς: | Edik M; Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Kosk Mah. Ahmet El Biruni Cad. No: 52, Melikgazi, Kayseri 38030, Turkey., Çelebi F; Department of Software Engineering, Faculty of Engineering, Erciyes University, Kosk Mah. Ahmet El Biruni Cad. No: 52, Melikgazi, Kayseri 38030, Turkey., Etöz M; Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Kosk Mah. Ahmet El Biruni Cad. No: 52, Melikgazi, Kayseri 38030, Turkey. |
| Πηγή: | European journal of orthodontics [Eur J Orthod] 2026 Aug 06; Vol. 48 (5). |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Oxford University Press Country of Publication: England NLM ID: 7909010 Publication Model: Print Cited Medium: Internet ISSN: 1460-2210 (Electronic) Linking ISSN: 01415387 NLM ISO Abbreviation: Eur J Orthod Subsets: MEDLINE |
| Imprint Name(s): | Publication: Oxford : Oxford University Press Original Publication: [London] Churchill Livingstone. |
| Ιατρικοί όροι (MeSH): | Radiography, Panoramic*/methods , Cephalometry*/methods , Age Determination by Skeleton*/methods , Hand Bones*/growth & development , Hand Bones*/diagnostic imaging , Deep Learning*, Anatomic Landmarks/diagnostic imaging ; Humans ; Female ; Retrospective Studies ; Male ; Adolescent ; Child ; Convolutional Neural Networks ; Detection Algorithms |
| Περίληψη: | Objectives: This study aimed to predict hand-wrist developmental stages, the most reliable indicator of skeletal maturation, from panoramic radiographs (PRs) and lateral cephalometric radiographs (LCRs) using deep learning and to compare the two methods. The goal was to provide a rapid and objective method for growth assessment in orthodontic planning without additional radiation exposure. Methods: A total of 3703 patients who underwent hand-wrist radiographs (HWRs), PRs, and LCRs prior to orthodontic treatment were retrospectively analyzed. HWRs were classified according to Björk's 9-stage system and reduced to 5- and 3-group schemes. YOLOv5 was used for automated reference point detection, and the extracted regions were classified using a multimodal deep learning framework. EfficientNet-B0 was used for 9-stage classification, and EfficientNet-B4 was used for 5- and 3-group classifications. Clinical variables (age, gender) were included, and hybrid loss strategies addressed class imbalance while preserving sequential stage relationships. Performance metrics included accuracy, recall, mAP@0.5, balanced accuracy, Cohen's Kappa coefficient, and detailed error analysis; 5-fold cross-validation and ensemble learning were used to improve robustness. Results: YOLOv5 detected tooth roots in PRs (accuracy 92.5%, recall 93.3%, mAP@0.5 = 0.942) and cervical vertebrae in LCRs (accuracy 98.9%, recall 99.9%, mAP@0.5 = 0.995). In PRs, the standard accuracy in 9-, 5-, and 3-stage classifications was 0.3648, 0.5307, and 0.7520, respectively, while in LCRs, the standard accuracy in 9-, 5-, and 3-stage classifications was 0.4350, 0.6336, and 0.8975, respectively. Conclusion: Deep learning can reliably automate skeletal maturation assessment across imaging methods and resolutions. Appropriately optimized models provide valuable decision support in orthodontic treatment, increasing efficiency and consistency. (© The Author(s) 2026. Published by Oxford University Press on behalf of the European Orthodontic Society.) |
| Competing Interests: | Conflicts of interest: The authors declare that they have no conflicts of interest. |
| References: | J Periodontal Implant Sci. 2018 Apr 30;48(2):114-123. (PMID: 29770240) Comput Biol Med. 2016 May 1;72:108-19. (PMID: 27035862) Am J Orthod Dentofacial Orthop. 2009 Oct;136(4):478.e1-7; discussion 478-80. (PMID: 19815136) Dentomaxillofac Radiol. 2017 Oct;46(7):20170006. (PMID: 28707523) BMC Med Imaging. 2024 Jul 11;24(1):172. (PMID: 38992601) Orthod Craniofac Res. 2025 Dec;28(6):943-954. (PMID: 40704688) Eur J Paediatr Dent. 2010 Dec;11(4):176-80. (PMID: 21250767) Orthod Craniofac Res. 2021 Dec;24 Suppl 2:68-75. (PMID: 34405944) Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:1966-1969. (PMID: 33018388) Acta Odontol Scand. 2024 May 03;83:230-237. (PMID: 38699981) World J Orthod. 2010 Winter;11(4):e78-84. (PMID: 21490993) Prog Orthod. 2024 Jun 24;25(1):28. (PMID: 38910180) Dentomaxillofac Radiol. 2018 May;47(4):20170362. (PMID: 29241366) BMC Oral Health. 2024 Apr 6;24(1):426. (PMID: 38582843) J Dent. 2018 Oct;77:106-111. (PMID: 30056118) Dentomaxillofac Radiol. 2020 Jan;49(1):20190107. (PMID: 31386555) Sci Rep. 2022 Jul 9;12(1):11703. (PMID: 35810213) Sci Rep. 2020 Mar 31;10(1):5711. (PMID: 32235882) J Dent. 2025 Mar;154:105560. (PMID: 39826609) J Clin Med. 2022 Dec 21;12(1):. (PMID: 36614860) Trans Eur Orthod Soc. 1972;:61-74. (PMID: 4363429) J Int Soc Prev Community Dent. 2018 Nov-Dec;8(6):482-487. (PMID: 30596037) Angle Orthod. 2002 Aug;72(4):316-23. (PMID: 12169031) Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Dec;106(6):879-84. (PMID: 18718785) Hum Biol. 1973 May;45(2):211-27. (PMID: 4714564) Oral Radiol. 2026 Jul;42(3):520-530. (PMID: 41432878) Nat Commun. 2022 Apr 19;13(1):2096. (PMID: 35440592) Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Aug;140(2):237-250. (PMID: 40263038) Am J Orthod Dentofacial Orthop. 2011 Aug;140(2):182-8. (PMID: 21803255) Biomed Res Int. 2021 Jun 09;2021:9986498. (PMID: 34212048) J Med Syst. 2014 Sep;38(9):87. (PMID: 25012476) Prog Orthod. 2012 Sep;13(2):126-31. (PMID: 23021115) Turk J Orthod. 2025 Mar 27;38(1):36-48. (PMID: 40150851) Iran J Radiol. 2016 Jun 25;13(3):e21695. (PMID: 27853487) |
| Grant Information: | Scientific and Technological Research Council of Turkey |
| Contributed Indexing: | Keywords: EfficientNet; deep learning; hand–wrist maturation; lateral cephalometric radiography; panoramic radiography |
| Entry Date(s): | Date Created: 20260811 Date Completed: 20260811 Latest Revision: 20260813 |
| Update Code: | 20260814 |
| PubMed Central ID: | PMC13458939 |
| DOI: | 10.1093/ejo/cjag054 |
| PMID: | 42578573 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!