Machine learning models for prognosis prediction in endodontic microsurgery.

[OBJECTIVES] This study aimed to establish and validate machine learning models for prognosis prediction in endodontic microsurgery, avoiding treatment failure and supporting clinical decision-making.

[METHODS] A total of 234 teeth from 178 patients were included in this study. We developed gradient boosting machine (GBM) and random forest (RF) models. For each model, 80% of the data were randomly selected for the training set and the remaining 20% were used as the test set. A stratified 5-fold cross-validation approach was used in model training and testing. Correlation analysis and importance ranking were conducted for feature selection. The predictive accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, and the area under the curve (AUC) of receiver operating characteristic (ROC) curves were calculated to evaluate the predictive performance.

[RESULTS] There were eight important predictors, including tooth type, lesion size, type of bone defect, root filling density, root filling length, apical extension of post, age, and sex. For the GBM model, the predictive accuracy was 0.80, with a sensitivity of 0.92, specificity of 0.71, PPV of 0.71, NPV of 0.92, F1 of 0.80, and AUC of 0.88. For the RF model, the accuracy was 0.80, with a sensitivity of 0.85, specificity of 0.76, PPV of 0.73, NPV of 0.87, F1 of 0.79, and AUC of 0.83.

[CONCLUSIONS] The trained models were developed by eight common variables, showing the potential ability to predict the prognosis of endodontic microsurgery. The GBM model outperformed the RF model slightly on our dataset.

[CLINICAL SIGNIFICANCE] Clinicians can use machine learning models for preoperative analysis in endodontic microsurgery. The models are expected to improve the efficiency of clinical decision-making and assist in clinician-patient communication.