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.