Tooth Instance Segmentation from Cone-Beam CT Images through Point-based Detection and Gaussian Disentanglement

Individual tooth segmentation and identification from cone-beam computed tomography images are preoperative prerequisites for orthodontic treatments. Instance segmentation methods using convolutional neural networks have demonstrated ground-breaking results on individual tooth segmentation tasks, and are used in various medical imaging applications. While point-based detection networks achieve superior results on dental images, it is still a challenging task to distinguish adjacent teeth because of their similar topologies and proximate nature. In this study, we propose a point-based tooth localization network that effectively disentangles each individual tooth based on a Gaussian disentanglement objective function. The proposed network first performs heatmap regression accompanied by box regression for all the anatomical teeth. A novel Gaussian disentanglement penalty is employed by minimizing the sum of the pixel-wise multiplication of the heatmaps for all adjacent teeth pairs. Subsequently, individual tooth segmentation is performed by converting a pixel-wise labeling task to a distance map regression task to minimize false positives in adjacent regions of the teeth. Experimental results demonstrate that the proposed algorithm outperforms state-of-the-art approaches by increasing the average precision of detection by 9.1%, which results in a high performance in terms of individual tooth segmentation. The primary significance of the proposed method is two-fold: 1) the introduction of a point-based tooth detection framework that does not require additional classification and 2) the design of a novel loss function that effectively separates Gaussian distributions based on heatmap responses in the point-based detection framework.

Individual Tooth Detection and Identification from Dental Panoramic X-Ray Images via Point-wise Localization and Distance Regularization

Dental panoramic X-ray imaging is a popular diagnostic method owing to its very small dose of radiation. For an automated computer-aided diagnosis system in dental clinics, automatic detection and identification of individual teeth from panoramic X-ray images are critical prerequisites. In this study, we propose a point-wise tooth localization neural network by introducing a spatial distance regularization loss. The proposed network initially performs center point regression for all the anatomical teeth (i.e., 32 points), which automatically identifies each tooth. A novel distance regularization penalty is employed on the 32 points by considering $L_2$ regularization loss of Laplacian on spatial distances. Subsequently, teeth boxes are individually localized using a cascaded neural network on a patch basis. A multitask offset training is employed on the final output to improve the localization accuracy. Our method successfully localizes not only the existing teeth but also missing teeth; consequently, highly accurate detection and identification are achieved. The experimental results demonstrate that the proposed algorithm outperforms state-of-the-art approaches by increasing the average precision of teeth detection by 15.71% compared to the best performing method. The accuracy of identification achieved a precision of 0.997 and recall value of 0.972. Moreover, the proposed network does not require any additional identification algorithm owing to the preceding regression of the fixed 32 points regardless of the existence of the teeth.

Pose-Aware Instance Segmentation Framework from Cone Beam CT Images for Tooth Segmentation

Individual tooth segmentation from cone beam computed tomography (CBCT) images is an essential prerequisite for an anatomical understanding of orthodontic structures in several applications, such as tooth reformation planning and implant guide simulations. However, the presence of severe metal artifacts in CBCT images hinders the accurate segmentation of each individual tooth. In this study, we propose a neural network for pixel-wise labeling to exploit an instance segmentation framework that is robust to metal artifacts. Our method comprises of three steps: 1) image cropping and realignment by pose regressions, 2) metal-robust individual tooth detection, and 3) segmentation. We first extract the alignment information of the patient by pose regression neural networks to attain a volume-of-interest (VOI) region and realign the input image, which reduces the inter-overlapping area between tooth bounding boxes. Then, individual tooth regions are localized within a VOI realigned image using a convolutional detector. We improved the accuracy of the detector by employing non-maximum suppression and multiclass classification metrics in the region proposal network. Finally, we apply a convolutional neural network (CNN) to perform individual tooth segmentation by converting the pixel-wise labeling task to a distance regression task. Metal-intensive image augmentation is also employed for a robust segmentation of metal artifacts. The result shows that our proposed method outperforms other state-of-the-art methods, especially for teeth with metal artifacts. The primary significance of the proposed method is two-fold: 1) an introduction of pose-aware VOI realignment followed by a robust tooth detection and 2) a metal-robust CNN framework for accurate tooth segmentation.