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Periodontal disease is caused by plaque accumulation. Peri-endo combined lesions include both diseases and significantly affect dental prognosis. The lack of clear symptoms in the early stages of onset makes diagnosis challenging, and delayed treatment can lead to the spread of symptoms. Early infection detection is crucial for preventing complications. PAs used as the database were provided by Chang Gung Memorial Medical Center, Taoyuan, Taiwan, with permission from the Institutional Review Board (IRB): 02002030B0. The tooth apex image enhancement method is a new technology in PA detection. This image enhancement method is used with convolutional neural networks (CNN) to classify apical lesions, peri-endo combined lesions, and asymptomatic cases, and to compare with You Only Look Once-v8-Oriented Bounding Box (YOLOv8-OBB) disease detection results. The contributions lie in the utilization of database augmentation and adaptive histogram equalization on individual tooth images, achieving the highest comprehensive validation accuracy of 95.23% with the ConvNextv2 model. Furthermore, the CNN outperformed YOLOv8 in identifying apical lesions, achieving an F1-Score of 92.45%. For the classification of peri-endo combined lesions, CNN attained the highest F1-Score of 96.49%, whereas YOLOv8 scored 88.49%.<\/jats:p>","DOI":"10.3390\/bioengineering11090877","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T11:33:37Z","timestamp":1724931217000},"page":"877","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Precision Medicine for Apical Lesions and Peri-Endo Combined Lesions Based on Transfer Learning Using Periapical Radiographs"],"prefix":"10.3390","volume":"11","author":[{"given":"Pei-Yi","family":"Wu","sequence":"first","affiliation":[{"name":"Department of General Dentistry, Taoyuan Chang Gung Memorial Hospital, Taoyuan City 32023, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Cheng","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Taoyuan Chang Gung Memorial Hospital, Taoyuan City 32023, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2429-4143","authenticated-orcid":false,"given":"Yuan-Jin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Program on Semiconductor Manufacturing Technology, Academy of Innovative Semiconductor and Sustainable Manufacturing, National Cheng Kung University, Tainan City 701401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Hua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Information Management, Chung Yuan Christian University, Taoyuan City 32023, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Tzu","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Information Management, Chung Yuan Christian University, Taoyuan City 32023, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0110-5491","authenticated-orcid":false,"given":"Kuo-Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Information Management, Chung Yuan Christian University, Taoyuan City 32023, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7605-5214","authenticated-orcid":false,"given":"Chiung-An","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, Feng Chia University, Taichung City 40724, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4079-9350","authenticated-orcid":false,"given":"Shih-Lun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, Chung Yuan Christian University, Taoyuan City 32023, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1134-5859","authenticated-orcid":false,"given":"Wei-Chen","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, National Cheng Kung University, Tainan City 701401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8848-6644","authenticated-orcid":false,"given":"Patricia","family":"Abu","sequence":"additional","affiliation":[{"name":"Ateneo Laboratory for Intelligent Visual Environments, Department of Information Systems and Computer Science, Ateneo de Manila University, Quezon City 1108, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"579","DOI":"10.4103\/0970-9290.74238","article-title":"Endo-perio lesions: Diagnosis and clinical considerations","volume":"21","author":"Shenoy","year":"2010","journal-title":"Indian J. 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