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<p>Artificial intelligence (AI) and deep learning (DL) techniques have great potential to accelerate diagnostic processes, increase accuracy, and support clinical decision-making in healthcare. In this study, we propose a transfer learning-based approach–one of the DL techniques–to improve subluxation (SL) detection in temporomandibular joint panoramic radiography (TMJ-PR) images. For this purpose, we prepared and publicly released a dataset comprising 3,425 annotated TMJ-PR images to encourage reproducibility and further research in this domain. Several transfer learning models including MobileNet, ResNet50V2, InceptionV3, Xception, EfficientNetV2B0, InceptionResNetV2, and DenseNet201 were trained and evaluated using a 5-fold cross-validation method. By integrating a self-attention mechanism into the DenseNet201 model which achieved the highest baseline performance across all metrics, the proposed attention-based version yielded further improvements, achieving an accuracy of 90.7%, precision of 90.7%, recall of 90.7%, specificity of 89.4%, and F1-score of 90.7%. The results indicate that the proposed model achieves superior F1-score performance compared to all baseline models with relative improvements ranging from +2.40% (vs. DenseNet201) to +14.26% (vs. EfficientNetV2B0). The findings demonstrate that the proposed model not only improves subluxation detection performance but also offers a promising foundation for integration into a clinical decision support system (CDSS), enhancing early diagnosis and treatment planning using low-cost TMJ-PR images. The publicly shared dataset further supports transparency and reproducibility in future medical AI research.</p>

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An attention-based transfer learning model for diagnosing subluxation in temporomandibular joint panoramic radiographs

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月18日

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  • Yasin Sancar,
  • Isil Karabey Aksakalli,
  • Ozlem Sokmen,
  • Hande Barin,
  • Kubra Torenek-Agirman

摘要

Artificial intelligence (AI) and deep learning (DL) techniques have great potential to accelerate diagnostic processes, increase accuracy, and support clinical decision-making in healthcare. In this study, we propose a transfer learning-based approach–one of the DL techniques–to improve subluxation (SL) detection in temporomandibular joint panoramic radiography (TMJ-PR) images. For this purpose, we prepared and publicly released a dataset comprising 3,425 annotated TMJ-PR images to encourage reproducibility and further research in this domain. Several transfer learning models including MobileNet, ResNet50V2, InceptionV3, Xception, EfficientNetV2B0, InceptionResNetV2, and DenseNet201 were trained and evaluated using a 5-fold cross-validation method. By integrating a self-attention mechanism into the DenseNet201 model which achieved the highest baseline performance across all metrics, the proposed attention-based version yielded further improvements, achieving an accuracy of 90.7%, precision of 90.7%, recall of 90.7%, specificity of 89.4%, and F1-score of 90.7%. The results indicate that the proposed model achieves superior F1-score performance compared to all baseline models with relative improvements ranging from +2.40% (vs. DenseNet201) to +14.26% (vs. EfficientNetV2B0). The findings demonstrate that the proposed model not only improves subluxation detection performance but also offers a promising foundation for integration into a clinical decision support system (CDSS), enhancing early diagnosis and treatment planning using low-cost TMJ-PR images. The publicly shared dataset further supports transparency and reproducibility in future medical AI research.