Texture Components of the Radiographic Image Assist in the Detection of Periapical Periodontitis

Objectives: Periapical periodontitis, which is a periodontal dysfunction, is a current clinical problem. Due to the frequency of occurrence and the adverse effects they cause, they are considered a social disease. They require detailed diagnostics to implement appropriate treatment. Mathematical calculations based on data obtained from radiological images used in routine clinical practice may help differentiate the forms of periodontitis. This study aimed to evaluate the areas affected by periodontitis in comparison to the healthy tissues of the periapical area. Methods: The study analyzed texture components using the gray-level co-occurrence matrix (GLCM) and the gray-level run-length matrix (GRLM) on an orthopantomogram (OPG) from 50 patients with clinically confirmed periodontitis treated at the Department of Maxillofacial and Plastic Surgery, University of Bialystok. Texture analysis was performed on defined regions of interest (ROIs) to distinguish diseased from healthy tissues. We employed four classification algorithms to assess model performance. Results: The data set included 50 patients, with 76 cases of periodontitis and 50 healthy ROIs. The reference standard was clinical diagnosis confirmed by two specialist doctors. The best-performing algorithm achieved an AUC of 98%. Conclusions: The obtained results showed significant statistical differences in the inflamed regions compared to the control, which may aid in diagnosing and selecting the treatment method for periodontitis.