Enhanced Panoramic Radiograph-Based Tooth Segmentation and Identification Using an Attention Gate-Based Encoder-Decoder Network.

Background: Dental disorders are one of the most important health problems, affecting billions of people all over the world. Early diagnosis is important for effective treatment planning. Precise dental disease segmentation requires reliable tooth numbering, which may be prone to errors if performed manually. These steps can be automated using artificial intelligence, which may provide fast and accurate results. Among the AI methodologies, deep learning has recently shown excellent performance in dental image processing, allowing effective tooth segmentation and numbering.

Methods: This paper proposes the Squeeze and Excitation Inception Block-based Encoder-Decoder (SE-IB-ED) network for teeth segmentation in panoramic X-ray images. It combines the InceptionV3 model for encoding with a custom decoder for feature integration and segmentation, using pointwise convolution and an attention mechanism. A dataset of 313 panoramic radiographs from private clinics was annotated using the Fédération Dentaire Internationale (FDI) system. PSPL and SAM augmented the annotation precision and effectiveness, with SAM automating teeth labeling and subsequently applying manual corrections.

Results: The proposed SE-IB-ED network was trained and tested using 80% training and 20% testing of the dataset, respectively. Data augmentation techniques were employed during training. It outperformed the state-of-the-art models with a very high F1-score of 92.65%, mIoU of 86.38%, and 92.84% in terms of accuracy, precision of 92.49%, and recall of 99.92% in the segmentation of teeth.

Conclusions: According to the results obtained, the proposed method has great potential for the accurate segmentation of all teeth regions and backgrounds in panoramic X-ray images.