Objectives
Malocclusion and the treatment process can affect the person's quality of life, which includes physical and psychological effects. Classifying the patient accurately is critical to achieving the desired output. This study aimed to improve the current diagnostic process with artificial-intelligence algorithms using the lateral cephalogram.
Materials and Methods
The study sample consisted of 1014 Arab patients diagnosed with skeletal class I, II, or III. In this study, we used linear discriminant analysis (LDA), random forest (RF), decision tree (DT), K-nearest neighbors (KNN), support vector machine (SVM), and naive Bayes (NB) as classification models. In addition, we calculated the parameters' importance using two techniques—the impurity decreases and the leave-one-feature-out (LOFO) technique. Finally, we applied an artificial neural network (ANN) to classify the patients accurately.
Results
One of the influential models presented in this study was the model that included only the parameters Wits appraisal, SNB, SNA, and ML-NSL angles. It could classify the patients with an accuracy of 0.98. In addition, we applied the leave-one-feature-out technique (LOFO) for multiple random forest models and found that the Calculated_ANB (ANB angle-individualized ANB) and Wits appraisal were the most important parameters in the random forest models. Besides, age and gender were in 8th and 21st places (out of 26 variables). Furthermore, the decision tree results demonstrated the distinct characteristics of this ethnic group, which were presented by different ranges of ANB angles that define every skeletal class. The results showed that the tree's root classified the patient as skeletal class III when the ANB angle is less than 0.084 degrees, and skeletal class II if the ANB angle is greater than 1.23.
Conclusions
In summary, this research presented a model enabling orthodontists to precisely classify orthodontic patients. Further research should include different ethnic groups to validate our findings.