|Abstract||Background: In the dentistry field, the analysis of dental plaque is vital because it is the main etiological factor in the two most prevalent oral diseases: caries and periodontitis. In most of the papers published in the dental literature, the quantification of dental plaque is carried out using traditional, non-automated, and time-consuming indices. Therefore, the development of an automated plaque quantification tool would be of great value to clinicians and researchers.
Objective: To develop a web-based tool called DenTiUS and various clinical indices to evaluate dental plaque levels using image analysis techniques.
Methods: The tool is executed as a web-based application to facilitate its use by researchers. Expert users are free to define experiments, including images from either a single patient (to observe an individual plaque growth pattern) or several patients (to perform a group characterization), at a particular moment or over time. A novel approach for detecting visible plaque has been developed as well as a new concept known as non-visible plaque. This new term implies the classification of the remaining dental area into three subregions, according to the risk of accumulating plaque in the near future. New metrics have also been created to describe visible and non-visible plaque levels.
Results: The system generates results tables on the quantitative analysis with absolute averages obtained in each image (indices about visible plaque) and relative measurements (indices about visible and non-visible plaque) relating to the reference moment. The clinical indices that can be calculated are the following: the plaque index of an area per intensity (API index, a value between 0-100); the area growth index (growth rate of plaque per unit of time in hours - percentage area/hour); and the area time index (the time, in days, needed to achieve a plaque area of 100% concerning the initial area at the same moment). Images and graphics can be obtained for a moment from a patient and in addition to a full report presenting all the processing data.
Dentistry experts evaluated the DenTiUS Plaque software through a usability test, giving the best-scoring questions those related to the workflow efficiency, the value of the online help, the attractiveness of the user interface, and the overall satisfaction.
Conclusions: The DenTiUS software allows an automatic, reliable and repeatable quantification of dental plaque levels, providing information about area, intensity and growth pattern. Dentistry experts recognized that DenTiUS Plaque software is suitable for quantification of dental plaque levels. Consequently, its application in the analysis of plaque evolution patterns associated with different oral conditions, as well as to evaluate the effectiveness of various oral hygiene measures, can represent an improvement in the clinical setting and the methodological quality of research studies.|