Comparative analysis of five AI platforms for mandibular canal segmentation on CBCT images


Shujaat S., Alotaibi R., Aldakhil A., Alola B. A., Abolemaaty W., Khinda P., ...Daha Fazla

Journal of Dentistry, cilt.166, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 166
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.jdent.2026.106345
  • Dergi Adı: Journal of Dentistry
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL
  • Anahtar Kelimeler: Artificial intelligence, Computer-generated 3D imaging, Cone-beam computed tomography, Deep learning, Mandibular canal
  • Ankara Üniversitesi Adresli: Evet

Özet

Objectives: Accurate mandibular canal (MC) identification on cone-beam computed tomography (CBCT) is vital to prevent inferior alveolar nerve injury during oral and maxillofacial procedures. Manual segmentation is time-consuming and operator-dependent, while artificial intelligence (AI) offers automated, reproducible alternatives. This study compared the accuracy of automated MC segmentation across five AI platforms using standardized quantitative and qualitative evaluations. Methods: A total of 120 anonymized CBCT scans (240 MCs) were analyzed using five fully automated AI-based segmentation platforms: Atomica (Atomica AI, USA), BlueSkyPlan (Blue Sky Bio, USA), Craniocatch (Craniocatch, Türkiye), 3D Slicer (open-source, USA), and Relu Creator (Relu BV, Belgium). Expert-annotated models served as reference. Accuracy was quantified as unsigned mean surface deviation and categorized as optimal (<0.5 mm), acceptable (0.5–2.0 mm), or unacceptable (>2.0 mm). Qualitative evaluation employed a five-point anatomical fidelity scale. Segment-wise, laterality, and scanner-wise effects were also assessed. Results: Significant performance differences were observed among platforms (p < 0.001). Relu Creator and 3D Slicer achieved the highest overall accuracy (≈0.5 mm) with no >2.0 mm deviations in the complete-canal analysis. Craniocatch showed moderate accuracy, while Atomica and BlueSkyPlan exhibited greater variability and more deviations > 2.0 mm. Qualitative scores reflected similar trends. Regionally, middle canal segments showed the best accuracy, with higher deviations near the mandibular and mental foramina. Scanner- and side-related effects were statistically significant but clinically negligible. Conclusion: AI-based MC segmentation accuracy varies across platforms. Relu Creator and 3D Slicer achieved near-expert performance suitable for clinical use, while others require expert verification. Independent benchmarking and multi-scanner validation are essential for safe implementation. Clinical significance: This study provides evidence-based guidance on the accuracy of AI tools for automated MC segmentation, supporting safer surgical planning by identifying which AI-generated outputs can be trusted and where expert verification remains essential to prevent nerve injury.