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Published in: Clinical Oral Investigations 7/2023

06-05-2023 | Review

Tooth automatic segmentation from CBCT images: a systematic review

Authors: Alessandro Polizzi, Vincenzo Quinzi, Vincenzo Ronsivalle, Pietro Venezia, Simona Santonocito, Antonino Lo Giudice, Rosalia Leonardi, Gaetano Isola

Published in: Clinical Oral Investigations | Issue 7/2023

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Abstract

Objectives

To describe the current state of the art regarding technological advances in full-automatic tooth segmentation approaches from 3D cone-beam computed tomography (CBCT) images.

Materials and methods

In March 2023, a search strategy without a timeline setting was carried out through a combination of MeSH terms and free text words pooled through Boolean operators (‘AND’, ‘OR’) on the following databases: PubMed, Scopus, Web of Science and IEEE Explore. Randomized and non-randomized controlled trials, cohort, case–control, cross-sectional and retrospective studies in the English language only were included.

Results

The search strategy identified 541 articles, of which 23 have been selected. The most employed segmentation methods were based on deep learning approaches. One article exposed an automatic approach for tooth segmentation based on a watershed algorithm and another article used an improved level set method. Four studies presented classical machine learning and thresholding approaches. The most employed metric for evaluating segmentation performance was the Dice similarity index which ranged from 90 ± 3% to 97.9 ± 1.5%.

Conclusions

Thresholding appeared not reliable for tooth segmentation from CBCT images, whereas convolutional neural networks (CNNs) have been demonstrated as the most promising approach. CNNs could help overcome tooth segmentation’s main limitations from CBCT images related to root anatomy, heavy scattering, immature teeth, metal artifacts and time consumption. New studies with uniform protocols and evaluation metrics with random sampling and blinding for data analysis are encouraged to objectively compare the different deep learning architectures’ reliability.

Clinical relevance

Automatic tooth segmentation’s best performance has been obtained through CNNs for the different ambits of digital dentistry.
Literature
1.
go back to reference Leonardi R (2019) Cone-beam computed tomography and three-dimensional orthodontics. Where we are and future perspectives. J Orthod 46:45–48CrossRefPubMed Leonardi R (2019) Cone-beam computed tomography and three-dimensional orthodontics. Where we are and future perspectives. J Orthod 46:45–48CrossRefPubMed
2.
go back to reference Nota A, Quinzi V, Floriani F, Cappelli C, Tecco S, Marzo G (2021) 3D morphometric analysis of human primary second molar crowns and its implications on interceptive orthodontics. Int J Environ Res Public Health 18:6201CrossRefPubMedPubMedCentral Nota A, Quinzi V, Floriani F, Cappelli C, Tecco S, Marzo G (2021) 3D morphometric analysis of human primary second molar crowns and its implications on interceptive orthodontics. Int J Environ Res Public Health 18:6201CrossRefPubMedPubMedCentral
3.
go back to reference Leite AF, Van Gerven A, Willems H, Beznik T, Lahoud P, Gaêta-Araujo H, Vranckx M, Jacobs R (2021) Artificial intelligence-driven novel tool for tooth detection and segmentation on panoramic radiographs. Clin Oral Invest 25:2257–2267CrossRef Leite AF, Van Gerven A, Willems H, Beznik T, Lahoud P, Gaêta-Araujo H, Vranckx M, Jacobs R (2021) Artificial intelligence-driven novel tool for tooth detection and segmentation on panoramic radiographs. Clin Oral Invest 25:2257–2267CrossRef
4.
go back to reference Naumovich S, Naumovich S, Goncharenko V (2015) Three-dimensional reconstruction of teeth and jaws based on segmentation of CT images using watershed transformation. Dentomaxillofacial Radiol 44:20140313CrossRef Naumovich S, Naumovich S, Goncharenko V (2015) Three-dimensional reconstruction of teeth and jaws based on segmentation of CT images using watershed transformation. Dentomaxillofacial Radiol 44:20140313CrossRef
5.
go back to reference Jiang F, Kula K, Chen J (2016) Estimating the location of the center of resistance of canines. Angle Orthod 86:365–371CrossRefPubMed Jiang F, Kula K, Chen J (2016) Estimating the location of the center of resistance of canines. Angle Orthod 86:365–371CrossRefPubMed
6.
go back to reference Shaheen E, Khalil W, Ezeldeen M, Van de Casteele E, Sun Y, Politis C, Jacobs R (2017) Accuracy of segmentation of tooth structures using 3 different CBCT machines. Oral Surg Oral Med Oral Pathol Oral Radiol 123:123–128CrossRefPubMed Shaheen E, Khalil W, Ezeldeen M, Van de Casteele E, Sun Y, Politis C, Jacobs R (2017) Accuracy of segmentation of tooth structures using 3 different CBCT machines. Oral Surg Oral Med Oral Pathol Oral Radiol 123:123–128CrossRefPubMed
7.
go back to reference Ralph W, Jefferies J (1984) The minimal width of the periodontal space. J Oral Rehabil 11:415–418CrossRefPubMed Ralph W, Jefferies J (1984) The minimal width of the periodontal space. J Oral Rehabil 11:415–418CrossRefPubMed
8.
go back to reference Brüllmann D, Schulze R (2015) Spatial resolution in CBCT machines for dental/maxillofacial applications—what do we know today? Dentomaxillofacial Radiol 44:20140204CrossRef Brüllmann D, Schulze R (2015) Spatial resolution in CBCT machines for dental/maxillofacial applications—what do we know today? Dentomaxillofacial Radiol 44:20140204CrossRef
9.
go back to reference Chen Y, Du H, Yun Z, Yang S, Dai Z, Zhong L, Feng Q, Yang W (2020) Automatic segmentation of individual tooth in dental CBCT images from tooth surface map by a multi-task FCN. IEEE Access 8:97296–97309CrossRef Chen Y, Du H, Yun Z, Yang S, Dai Z, Zhong L, Feng Q, Yang W (2020) Automatic segmentation of individual tooth in dental CBCT images from tooth surface map by a multi-task FCN. IEEE Access 8:97296–97309CrossRef
10.
go back to reference Galibourg A, Dumoncel J, Telmon N, Calvet A, Michetti J, Maret D (2017) Assessment of automatic segmentation of teeth using a watershed-based method. Dentomaxillofacial Radiol 47:20170220CrossRef Galibourg A, Dumoncel J, Telmon N, Calvet A, Michetti J, Maret D (2017) Assessment of automatic segmentation of teeth using a watershed-based method. Dentomaxillofacial Radiol 47:20170220CrossRef
11.
go back to reference Evain T, Ripoche X, Atif J and Bloch I (2017) Semi-automatic teeth segmentation in Cone-Beam Computed Tomography by graph-cut with statistical shape priors. Book title. IEEE Evain T, Ripoche X, Atif J and Bloch I (2017) Semi-automatic teeth segmentation in Cone-Beam Computed Tomography by graph-cut with statistical shape priors. Book title. IEEE
12.
go back to reference Barone S, Paoli A, Razionale AV (2016) CT segmentation of dental shapes by anatomy-driven reformation imaging and B-spline modelling. Int J Numer Methods Biomed Eng 32:e02747CrossRef Barone S, Paoli A, Razionale AV (2016) CT segmentation of dental shapes by anatomy-driven reformation imaging and B-spline modelling. Int J Numer Methods Biomed Eng 32:e02747CrossRef
13.
go back to reference Gan Y, Xia Z, Xiong J, Li G, Zhao Q (2017) Tooth and alveolar bone segmentation from dental computed tomography images. IEEE J Biomed Health Inform 22:196–204CrossRefPubMed Gan Y, Xia Z, Xiong J, Li G, Zhao Q (2017) Tooth and alveolar bone segmentation from dental computed tomography images. IEEE J Biomed Health Inform 22:196–204CrossRefPubMed
14.
go back to reference Gao H, Chae O (2010) Individual tooth segmentation from CT images using level set method with shape and intensity prior. Pattern Recogn 43:2406–2417CrossRef Gao H, Chae O (2010) Individual tooth segmentation from CT images using level set method with shape and intensity prior. Pattern Recogn 43:2406–2417CrossRef
15.
go back to reference Hosntalab M, Zoroofi RA, Tehrani-Fard AA, Shirani G (2008) Segmentation of teeth in CT volumetric dataset by panoramic projection and variational level set. Int J Comput Assist Radiol Surg 3:257–265CrossRef Hosntalab M, Zoroofi RA, Tehrani-Fard AA, Shirani G (2008) Segmentation of teeth in CT volumetric dataset by panoramic projection and variational level set. Int J Comput Assist Radiol Surg 3:257–265CrossRef
16.
go back to reference Wang Y, Liu S, Wang G, Liu Y (2018) Accurate tooth segmentation with improved hybrid active contour model. Phys Med Biol 64:015012CrossRefPubMed Wang Y, Liu S, Wang G, Liu Y (2018) Accurate tooth segmentation with improved hybrid active contour model. Phys Med Biol 64:015012CrossRefPubMed
17.
go back to reference Fenster A, Chiu B (2006) Evaluation of segmentation algorithms for medical imaging. Book title. IEEE Fenster A, Chiu B (2006) Evaluation of segmentation algorithms for medical imaging. Book title. IEEE
19.
go back to reference Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34CrossRefPubMed Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34CrossRefPubMed
20.
go back to reference Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536CrossRefPubMed Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536CrossRefPubMed
21.
go back to reference Cui Z, Li C, Wang W (2019) Toothnet: automatic tooth instance segmentation and identification from cone beam ct images. Book title Cui Z, Li C, Wang W (2019) Toothnet: automatic tooth instance segmentation and identification from cone beam ct images. Book title
22.
23.
go back to reference Deleat-Besson R, Le C, Zhang W, Turkestani NA, Cevidanes L, Bianchi J, Ruellas A, Gurgel M, Massaro C, Del Castillo AA, Ioshida M, Yatabe M, Benavides E, Rios H, Soki F, Neiva G, Najarian K, Gryak J, Styner M, Aristizabal JF, Rey D, Alvarez MA, Bert L, Soroushmehr R, Prieto J (2021) Merging and annotating teeth and roots from automated segmentation of multimodal images. Book title Deleat-Besson R, Le C, Zhang W, Turkestani NA, Cevidanes L, Bianchi J, Ruellas A, Gurgel M, Massaro C, Del Castillo AA, Ioshida M, Yatabe M, Benavides E, Rios H, Soki F, Neiva G, Najarian K, Gryak J, Styner M, Aristizabal JF, Rey D, Alvarez MA, Bert L, Soroushmehr R, Prieto J (2021) Merging and annotating teeth and roots from automated segmentation of multimodal images. Book title
24.
go back to reference Dou WH, Gao SS, Mao DQ, Dai HH, Zhang CH, Zhou YF (2022) Tooth instance segmentation based on capturing dependencies and receptive field adjustment in cone beam computed tomography. Comput Animat Virtual Worlds 33. https://doi.org/10.1002/cav.2100 Dou WH, Gao SS, Mao DQ, Dai HH, Zhang CH, Zhou YF (2022) Tooth instance segmentation based on capturing dependencies and receptive field adjustment in cone beam computed tomography. Comput Animat Virtual Worlds 33. https://​doi.​org/​10.​1002/​cav.​2100
26.
go back to reference Hsu K, Yuh DY, Lin SC, Lyu PS, Pan GX, Zhuang YC, Chang CC, Peng HH, Lee TY, Juan CH, Juan CE, Liu YJ, Juan CJ (2022) Improving performance of deep learning models using 3.5D U-Net via majority voting for tooth segmentation on cone beam computed tomography. Sci Rep 12. https://doi.org/10.1038/s41598-022-23901-7 Hsu K, Yuh DY, Lin SC, Lyu PS, Pan GX, Zhuang YC, Chang CC, Peng HH, Lee TY, Juan CH, Juan CE, Liu YJ, Juan CJ (2022) Improving performance of deep learning models using 3.5D U-Net via majority voting for tooth segmentation on cone beam computed tomography. Sci Rep 12. https://​doi.​org/​10.​1038/​s41598-022-23901-7
27.
go back to reference Indraswari R, Kurita T, Arifin AZ, Suciati N, Astuti ER, Navastara DA (2018) 3D region merging for segmentation of teeth on cone-beam computed tomography images. Book title Indraswari R, Kurita T, Arifin AZ, Suciati N, Astuti ER, Navastara DA (2018) 3D region merging for segmentation of teeth on cone-beam computed tomography images. Book title
29.
go back to reference Jiang B, Zhang Y, Tang X, Shi H (2019) Region growing model with edge restrictions for multiple roots tooth segmentation. Book title Jiang B, Zhang Y, Tang X, Shi H (2019) Region growing model with edge restrictions for multiple roots tooth segmentation. Book title
33.
go back to reference Macho P, Kurz N, Ulges A, Brylka R, Gietzen T, Schwanecke U (2018) Segmenting teeth from volumetric ct data with a hierarchical cnn-based approach. Book title Macho P, Kurz N, Ulges A, Brylka R, Gietzen T, Schwanecke U (2018) Segmenting teeth from volumetric ct data with a hierarchical cnn-based approach. Book title
38.
go back to reference Shaheen E, Leite A, Alqahtani KA, Smolders A, Van Gerven A, Willems H, Jacobs R (2021) A novel deep learning system for multi-class tooth segmentation and classification on cone beam computed tomography. A validation study: deep learning for teeth segmentation and classification. J Dent 115. https://doi.org/10.1016/j.jdent.2021.103865 Shaheen E, Leite A, Alqahtani KA, Smolders A, Van Gerven A, Willems H, Jacobs R (2021) A novel deep learning system for multi-class tooth segmentation and classification on cone beam computed tomography. A validation study: deep learning for teeth segmentation and classification. J Dent 115. https://​doi.​org/​10.​1016/​j.​jdent.​2021.​103865
41.
go back to reference Wu X, Chen H, Huang Y, Guo H, Qiu T, Wang L (2020) Center-sensitive and boundary-aware tooth instance segmentation and classification from cone-beam CT. Book title Wu X, Chen H, Huang Y, Guo H, Qiu T, Wang L (2020) Center-sensitive and boundary-aware tooth instance segmentation and classification from cone-beam CT. Book title
43.
go back to reference Qiu B, van der Wel H, Kraeima J, Glas HH, Guo J, Borra RJ, Witjes MJH, van Ooijen P (2021) Automatic segmentation of mandible from conventional methods to deep learning—a review. J Personalized Med 11:629CrossRef Qiu B, van der Wel H, Kraeima J, Glas HH, Guo J, Borra RJ, Witjes MJH, van Ooijen P (2021) Automatic segmentation of mandible from conventional methods to deep learning—a review. J Personalized Med 11:629CrossRef
45.
go back to reference Nackaerts O, Depypere M, Zhang G, Vandenberghe B, Maes F, Jacobs R, Consortium S (2015) Segmentation of trabecular jaw bone on cone beam CT datasets. Clin Implant Dent Relat Res 17:1082–1091CrossRefPubMed Nackaerts O, Depypere M, Zhang G, Vandenberghe B, Maes F, Jacobs R, Consortium S (2015) Segmentation of trabecular jaw bone on cone beam CT datasets. Clin Implant Dent Relat Res 17:1082–1091CrossRefPubMed
46.
go back to reference Hapca SM, Houston AN, Otten W, Baveye PC (2013) New local thresholding method for soil images by minimizing grayscale intra-class variance. Vadose Zone J 12 Hapca SM, Houston AN, Otten W, Baveye PC (2013) New local thresholding method for soil images by minimizing grayscale intra-class variance. Vadose Zone J 12
47.
go back to reference O’Mahony N, Campbell S, Carvalho A, Harapanahalli S, Hernandez GV, Krpalkova L, Riordan D, Walsh J (2019) Deep learning vs. traditional computer vision. Book title. Springer O’Mahony N, Campbell S, Carvalho A, Harapanahalli S, Hernandez GV, Krpalkova L, Riordan D, Walsh J (2019) Deep learning vs. traditional computer vision. Book title. Springer
48.
go back to reference Zijdenbos AP, Dawant BM, Margolin RA, Palmer AC (1994) Morphometric analysis of white matter lesions in MR images: method and validation. IEEE Trans Med Imaging 13:716–724CrossRefPubMed Zijdenbos AP, Dawant BM, Margolin RA, Palmer AC (1994) Morphometric analysis of white matter lesions in MR images: method and validation. IEEE Trans Med Imaging 13:716–724CrossRefPubMed
Metadata
Title
Tooth automatic segmentation from CBCT images: a systematic review
Authors
Alessandro Polizzi
Vincenzo Quinzi
Vincenzo Ronsivalle
Pietro Venezia
Simona Santonocito
Antonino Lo Giudice
Rosalia Leonardi
Gaetano Isola
Publication date
06-05-2023
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2023
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-023-05048-5

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