Domain shift analysis of deep learning models for tooth detection in pediatric panoramic radiographs.

The aim of this study was to externally validate object detection models for comprehensive tooth detection on pediatric panoramic radiographs, quantify the impact of domain shift across institutions and imaging protocols, and compare YOLOv8 and YOLOv10. Two datasets were used: an internal set of 200 images of early mixed dentition without bite blocks, and an external, open-source set of 192 images acquired with bite blocks. Performance was assessed using mean average precision (mAP), per‑class AP, precision‑recall curves, and confusion matrix. Overall performance was high but domain dependent. mAP was 0.958/0.941 (YOLOv8/v10) in Experiment 1; 0.910/0.906 in Experiment 2; and 0.906/0.901 in Experiment 3. Error analysis revealed domain‑specific failure modes: bite blocks were occasionally mistaken for the primary central incisor. Deep learning enables accurate and comprehensive detection of teeth on pediatric panoramic radiographs. However, domain shift alters error patterns and impairs the detection of rare yet clinically important classes.