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OBJECTIVES: The objective of this study is to assess accuracy, time-efficiency and consistency of a novel artificial intelligence (AI)-driven automated tool for cone-beam computed tomography (CBCT) and intraoral scan (IOS) registration compared with manual and semi-automated approaches. MATERIALS AND METHODS: A dataset of 31 intraoral scans (IOSs) and CBCT scans was used to validate automated IOS-CBCT registration (AR) when compared with manual (MR) and semi-automated registration (SR). CBCT scans were conducted by placing cotton rolls between the cheeks and teeth to facilitate gingival delineation. The time taken to perform multimodal registration was recorded in seconds. A qualitative analysis was carried out to assess the correspondence between hard and soft tissue anatomy on IOS and CBCT. In addition, a quantitative analysis was conducted by measuring median surface deviation (MSD) and root mean square (RMS) differences between registered IOSs. RESULTS: AR was the most time-efficient, taking 51.4 ± 17.2 s, compared with MR (840 ± 168.9 s) and SR approaches (274.7 ± 100.7 s). Both AR and SR resulted in significantly higher qualitative scores, favoring perfect IOS-CBCT registration, compared with MR (p = .001). Additionally, AR demonstrated significantly superior quantitative performance compared with SR, as indicated by low MSD (0.04 ± 0.07 mm) and RMS (0.19 ± 0.31 mm). In contrast, MR exhibited a significantly higher discrepancy compared with both AR (MSD = 0.13 ± 0.20 mm; RMS = 0.32 ± 0.14 mm) and SR (MSD = 0.11 ± 0.15 mm; RMS = 0.40 ± 0.30 mm). CONCLUSIONS: The novel AI-driven method provided an accurate, time-efficient, and consistent multimodal IOS-CBCT registration, encompassing both soft and hard tissues. This approach stands as a valuable alternative to manual and semi-automated registration approaches in the presurgical implant planning workflow.
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BACKGROUND: Primary teeth segmentation on cone beam computed tomography (CBCT) scans is essential for paediatric treatment planning. Conventional methods, however, are time-consuming and necessitate advanced expertise. AIM: The aim of this study was to validate an artificial intelligence (AI) cloud-based platform for automated segmentation (AS) of primary teeth on CBCT. Its accuracy, time efficiency, and consistency were compared with manual segmentation (MS). DESIGN: A dataset comprising 402 primary teeth (37 CBCT scans) was retrospectively retrieved from two CBCT devices. Primary teeth were manually segmented using a cloud-based platform representing the ground truth, whereas AS was performed on the same platform. To assess the AI tool's performance, voxel- and surface-based metrics were employed to compare MS and AS methods. Additionally, segmentation time was recorded for each method, and intra-class correlation coefficient (ICC) assessed consistency between them. RESULTS: AS revealed high performance in segmenting primary teeth with high accuracy (98 ± 1%) and dice similarity coefficient (DSC; 95 ± 2%). Moreover, it was 35 times faster than the manual approach with an average time of 24 s. Both MS and AS demonstrated excellent consistency (ICC = 0.99 and 1, respectively). CONCLUSION: The platform demonstrated expert-level accuracy, and time-efficient and consistent segmentation of primary teeth on CBCT scans, serving treatment planning in children.
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The process of creating virtual models of dentomaxillofacial structures through three-dimensional segmentation is a crucial component of most digital dental workflows. This process is typically performed using manual or semi-automated approaches, which can be time-consuming and subject to observer bias. The aim of this study was to train and assess the performance of a convolutional neural network (CNN)-based online cloud platform for automated segmentation of maxillary impacted canine on CBCT image. A total of 100 CBCT images with maxillary canine impactions were randomly allocated into two groups: a training set (n = 50) and a testing set (n = 50). The training set was used to train the CNN model and the testing set was employed to evaluate the model performance. Both tasks were performed on an online cloud-based platform, 'Virtual patient creator' (Relu, Leuven, Belgium). The performance was assessed using voxel- and surface-based comparison between automated and semi-automated ground truth segmentations. In addition, the time required for segmentation was also calculated. The automated tool showed high performance for segmenting impacted canines with a dice similarity coefficient of 0.99 ± 0.02. Moreover, it was 24 times faster than semi-automated approach. The proposed CNN model achieved fast, consistent, and precise segmentation of maxillary impacted canines.
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Aprendizaje Profundo , Diente Impactado , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Diente Canino/diagnóstico por imagen , Redes Neurales de la Computación , Procesamiento de Imagen Asistido por Computador/métodosRESUMEN
OBJECTIVES: To train and validate a cloud-based convolutional neural network (CNN) model for automated segmentation (AS) of dental implant and attached prosthetic crown on cone-beam computed tomography (CBCT) images. METHODS: A total dataset of 280 maxillomandibular jawbone CBCT scans was acquired from patients who underwent implant placement with or without coronal restoration. The dataset was randomly divided into three subsets: training set (n = 225), validation set (n = 25) and testing set (n = 30). A CNN model was developed and trained using expert-based semi-automated segmentation (SS) of the implant and attached prosthetic crown as the ground truth. The performance of AS was assessed by comparing with SS and manually corrected automated segmentation referred to as refined-automated segmentation (R-AS). Evaluation metrics included timing, voxel-wise comparison based on confusion matrix and 3D surface differences. RESULTS: The average time required for AS was 60 times faster (<30 s) than the SS approach. The CNN model was highly effective in segmenting dental implants both with and without coronal restoration, achieving a high dice similarity coefficient score of 0.92±0.02 and 0.91±0.03, respectively. Moreover, the root mean square deviation values were also found to be low (implant only: 0.08±0.09 mm, implant+restoration: 0.11±0.07 mm) when compared with R-AS, implying high AI segmentation accuracy. CONCLUSIONS: The proposed cloud-based deep learning tool demonstrated high performance and time-efficient segmentation of implants on CBCT images. CLINICAL SIGNIFICANCE: AI-based segmentation of implants and prosthetic crowns can minimize the negative impact of artifacts and enhance the generalizability of creating dental virtual models. Furthermore, incorporating the suggested tool into existing CNN models specialized for segmenting anatomical structures can improve pre-surgical planning for implants and post-operative assessment of periimplant bone levels.