Evaluation of deep learning and convolutional neural network algorithms for mandibular fracture detection using radiographic images: A systematic review and meta-analysis

The use of artificial intelligence (AI) and deep learning algorithms in dentistry, especially for processing radiographic images, has markedly increased. However, detailed information remains limited regarding the accuracy of these algorithms in detecting mandibular fractures. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Specific keywords were generated regarding the accuracy of AI algorithms in detecting mandibular fractures on radiographic images. Then, the PubMed/Medline, Scopus, Embase, and Web of Science databases were searched. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was employed to evaluate potential bias in the selected studies. A pooled analysis of the relevant parameters was conducted using STATA version 17 (StataCorp, College Station, TX, USA), utilizing the metandi command. Of the 49 studies reviewed, 5 met the inclusion criteria. All of the selected studies utilized convolutional neural network algorithms, albeit with varying backbone structures, and all evaluated panoramic radiography images. The pooled analysis yielded a sensitivity of 0.971 (95% confidence interval [CI]: 0.881-0.949), a specificity of 0.813 (95% CI: 0.797-0.824), and a diagnostic odds ratio of 7.109 (95% CI: 5.27-8.913). This review suggests that deep learning algorithms show potential for detecting mandibular fractures on panoramic radiography images. However, their effectiveness is currently limited by the small size and narrow scope of available datasets. Further research with larger and more diverse datasets is crucial to verify the accuracy of these tools in in practical dental settings.