This study aimed to investigate the difference that convolutional neural network(CNN) shows in the determining osteoporosis on panoramic radiograph by performing a paired test by inputting the original image and the limited image including the cortical bone of the posterior border of the mandible used by radiologists. On panoramic radiographs of a total of 661 subjects (mean age 66.3 years ± 11.42), the area including the cortical bone of the posterior part of the mandible was divided into the left and right sides, and the ROI was set, and the remaining area was masked in black to form the limited image. For training of VGG-16, panoramic radiographs of 243 osteoporosis subjects (mean age 72.67 years ± 7.97) and 222 normal subjects (mean age 53.21 years ± 2.46) were used, and testing 1 and testing 2 were performed on the original and limited images, respectively, using panoramic radiographs of 51 osteoporosis subjects (mean age 72.78 years ± 8.3) and 47 normal subjects (mean age 53.32 years ± 2.81). The accuracy of VGG-16 for determining osteoporosis was 97%, in the testing 1 and 100% in the testing 2. When determining osteoporosis on the original image, CNN showed sensitivity in a wide range of areas including not only the inferior cortical bone of the mandible but also the maxillary and mandibular cancellous bone, cervical spine, and zygomatic bone. When the same ROI including the lower inferior cortical border of the mandible of the osteoporosis group was applied and the sensitive region was compared between the original image and the limited image, the original image showed wider sensitive region in cancellous bone and cortical bone than on the limited image (p<.05). Since osteoporosis is a disease that affects throughout the skeletal system, this finding seems very valid.
Localized juvenile spongiotic gingival hyperplasia (LJSGH) is an exceedingly rare gingival disease. Most LJSGH occur in children, predominantly on the labial gingiva of the maxilla, and exhibit clinical manifestations similar to pyogenic granuloma or puberty gingivitis. This report presents a case of LJSGH. A 15-year-old male referred for evaluation of red lesions on the labial gingiva of the maxillary anterior teeth. Clinical examination revealed redness and swelling of the labial marginal gingiva, with no associated pain. After an incisional biopsy, the lesion was histopathologically diagnosed as LJSGH. We present this case to suggest that LJSGH should be considered in the differential diagnosis of patients presenting with painless gingival redness and swelling. We also report that we have obtained satisfactory aesthetic results by applying CO2 laser to LJSGH.