Enhancing panoramic dental imaging with AI-driven arch surface fitting: Achieving improved clarity and accuracy through an optimal reconstruction zone.

Abstract

Objectives: This study aimed to develop an automated method for generating clearer, well-aligned panoramic views by creating an optimized three-dimensional (3D) reconstruction zone centered on the teeth. The approach focused on achieving high contrast and clarity in key dental features, including tooth roots, morphology, and periapical lesions, by applying a 3D U-Net deep learning model to generate an arch surface and align the panoramic view.

Methods: This retrospective study analyzed anonymized cone-beam CT (CBCT) scans from 312 patients (mean age 40 years; range 10-78; 41.3% male, 58.7% female). A 3D U-Net deep learning model segmented the jaw and dentition, facilitating panoramic view generation. During preprocessing, CBCT scans were binarized, and a cylindrical reconstruction method aligned the arch along a straight coordinate system, reducing data size for efficient processing. The 3D U-Net segmented the jaw and dentition in two steps, after which the panoramic view was reconstructed using 3D spline curves fitted to the arch, defining the optimal 3D reconstruction zone. This ensured the panoramic view captured essential anatomical details with high contrast and clarity. To evaluate performance, we compared contrast between tooth roots and alveolar bone and assessed intersection over union (IoU) values for tooth shapes and periapical lesions (#42, #44, #46) relative to the conventional method, demonstrating enhanced clarity and improved visualization of critical dental structures.

Results: The proposed method outperformed the conventional approach, showing significant improvements in the contrast between tooth roots and alveolar bone, particularly for tooth #42. It also demonstrated higher IoU values in tooth morphology comparisons, indicating superior shape alignment. Additionally, when evaluating periapical lesions, our method achieved higher performance with thinner layers, resulting in several statistically significant outcomes. Specifically, average pixel values within lesions were higher for certain layer thicknesses, demonstrating enhanced visibility of lesion boundaries and better visualization.

Conclusions: The fully automated AI-based panoramic view generation method successfully created a 3D reconstruction zone centered on the teeth, enabling consistent observation of dental and surrounding tissue structures with high contrast across reconstruction widths. By accurately segmenting the dental arch and defining the optimal reconstruction zone, this method shows significant advantages in detecting pathological changes, potentially reducing clinician fatigue during interpretation while enhancing clinical decision-making accuracy. Future research will focus on further developing and testing this approach to ensure robust performance across diverse patient cases with varied dental and maxillofacial structures, thereby increasing the model's utility in clinical settings.

Advances in knowledge: This study introduces a novel method for achieving clearer, well-aligned panoramic views focused on the dentition, providing significant improvements over conventional methods.