Orthopantomogram (OPGs) and Cone-Beam Computed Tomography (CBCT) are vital for dentistry, but creating large datasets for automated tooth segmentation is hindered by the labor-intensive process of manual instance-level annotation. This research aimed to benchmark and advance semi-supervised learning (SSL) as a solution for this data scarcity problem. We organized the 2nd Semi-supervised Teeth Segmentation (STS 2024) Challenge at MICCAI 2024. We provided a large-scale dataset comprising over 90,000 2D images and 3D axial slices, which includes 2,380 OPG images and 330 CBCT scans, all featuring detailed instance-level FDI annotations on part of the data. The challenge attracted 114 (OPG) and 106 (CBCT) registered teams. To ensure algorithmic excellence and full transparency, we rigorously evaluated the valid, open-source submissions from the top 10 (OPG) and top 5 (CBCT) teams, respectively. All successful submissions were deep learning-based SSL methods. The winning semi-supervised models demonstrated impressive performance gains over a fully-supervised nnU-Net baseline trained only on the labeled data. For the 2D OPG track, the top method improved the Instance Affinity (IA) score by over 44 percentage points. For the 3D CBCT track, the winning approach boosted the Instance Dice score by 61 percentage points. This challenge confirms the substantial benefit of SSL for complex, instance-level medical image segmentation tasks where labeled data is scarce. The most effective approaches consistently leveraged hybrid semi-supervised frameworks that combined knowledge from foundational models like SAM with multi-stage, coarse-to-fine refinement pipelines. Both the challenge dataset and the participants' submitted code have been made publicly available on GitHub (https://github.com/ricoleehduu/STS-Challenge-2024), ensuring transparency and reproducibility.

Efficient analysis and processing of dental images are crucial for dentists to achieve accurate diagnosis and optimal treatment planning. However, dental imaging inherently poses several challenges, such as low contrast, metallic artifacts, and variations in projection angles. Combined with the subjectivity arising from differences in clinicians' expertise, manual interpretation often proves time-consuming and prone to inconsistency. Artificial intelligence (AI)-based automated dental image analysis (DIA) offers a promising solution to these issues and has become an integral part of computer-aided dental diagnosis and treatment. Among various AI technologies, deep learning (DL) stands out as the most widely applied and influential approach due to its superior feature extraction and representation capabilities. To comprehensively summarize recent progress in this field, we focus on the two fundamental aspects of DL research-datasets and models. In this paper, we systematically review 260 studies on DL applications in DIA, including 49 papers on publicly available dental datasets and 211 papers on DL-based algorithms. We first introduce the basic concepts of dental imaging and summarize the characteristics and acquisition methods of existing datasets. Then, we present the foundational techniques of DL and categorize relevant models and algorithms according to different DIA tasks, analyzing their network architectures, optimization strategies, training methods, and performance. Furthermore, we summarize commonly used training and evaluation metrics in the DIA domain. Finally, we discuss the current challenges of existing research and outline potential future directions. We hope that this work provides a valuable and systematic reference for researchers in this field. All supplementary materials and detailed comparison tables will be made publicly available on GitHub.

Oral diseases remain one of the most pervasive global health issues, affecting over 3.5 billion individuals, which accounts for over 43% of the global population as reported by the World Health Organization [1]. This widespread prevalence underscores the critical importance of dentistry, not only for clinical needs but also for enhancing the overall quality of life for a large portion of the global population. In modern dental practice, digital dentistry plays a crucial role in streamlining workflows and enhancing patient outcomes. Cone-Beam Computed Tomography (CBCT) visualizes 3D anatomical structures, including tooth morphology, alveolar bone, and surrounding tissues [2], while intraoral scans (IOS) provide high-resolution images of occlusal surfaces that are crucial for treatment planning and prosthesis design [3]. However, these imaging modalities still require extensive manual and time-consuming analysis to identify and plan treatments [4]. Consequently, numerous research efforts now focus on automating key tasks such as caries detection [5-7], orthodontic treatment planning [8-10], and designing dental prostheses, including implants, crowns, and bridges [11-13].

Tooth segmentation in Cone-Beam Computed Tomography (CBCT) remains challenging, especially for fine structures like root apices, which is critical for assessing root resorption in orthodontics. We introduce GEPAR3D, a novel approach that unifies instance detection and multi-class segmentation into a single step tailored to improve root segmentation. Our method integrates a Statistical Shape Model of dentition as a geometric prior, capturing anatomical context and morphological consistency without enforcing restrictive adjacency constraints. We leverage a deep watershed method, modeling each tooth as a continuous 3D energy basin encoding voxel distances to boundaries. This instance-aware representation ensures accurate segmentation of narrow, complex root apices. Trained on publicly available CBCT scans from a single center, our method is evaluated on external test sets from two in-house and two public medical centers. GEPAR3D achieves the highest overall segmentation performance, averaging a Dice Similarity Coefficient (DSC) of 95.0% (+2.8% over the second-best method) and increasing recall to 95.2% (+9.5%) across all test sets. Qualitative analyses demonstrated substantial improvements in root segmentation quality, indicating significant potential for more accurate root resorption assessment and enhanced clinical decision-making in orthodontics. We provide the implementation and dataset at https://github.com/tomek1911/GEPAR3D.

Cone beam computed tomography (CBCT) is a common way of diagnosing dental related diseases. Accurate segmentation of 3D tooth is of importance for the treatment. Although deep learning based methods have achieved convincing results in medical image processing, they need a large of annotated data for network training, making it very time-consuming in data collection and annotation. Besides, domain shift widely existing in the distribution of data acquired by different devices impacts severely the model generalization. To resolve the problem, we propose a multi-stage framework for 3D tooth segmentation in dental CBCT, which achieves the third place in the "Semi-supervised Teeth Segmentation" 3D (STS-3D) challenge. The experiments on validation set compared with other semi-supervised segmentation methods further indicate the validity of our approach.

Optical Intraoral Scanners (IOS) are widely used in digital dentistry to provide detailed 3D information of dental crowns and the gingiva. Accurate 3D tooth segmentation in IOSs is critical for various dental applications, while previous methods are error-prone at complicated boundaries and exhibit unsatisfactory results across patients. In this paper, we propose TSegFormer which captures both local and global dependencies among different teeth and the gingiva in the IOS point clouds with a multi-task 3D transformer architecture. Moreover, we design a geometry-guided loss based on a novel point curvature to refine boundaries in an end-to-end manner, avoiding time-consuming post-processing to reach clinically applicable segmentation. In addition, we create a dataset with 16,000 IOSs, the largest ever IOS dataset to the best of our knowledge. The experimental results demonstrate that our TSegFormer consistently surpasses existing state-of-the-art baselines. The superiority of TSegFormer is corroborated by extensive analysis, visualizations and real-world clinical applicability tests.

Teeth localization, segmentation, and labeling from intra-oral 3D scans are essential tasks in modern dentistry to enhance dental diagnostics, treatment planning, and population-based studies on oral health. However, developing automated algorithms for teeth analysis presents significant challenges due to variations in dental anatomy, imaging protocols, and limited availability of publicly accessible data. To address these challenges, the 3DTeethSeg'22 challenge was organized in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2022, with a call for algorithms tackling teeth localization, segmentation, and labeling from intraoral 3D scans. A dataset comprising a total of 1800 scans from 900 patients was prepared, and each tooth was individually annotated by a human-machine hybrid algorithm. A total of 6 algorithms were evaluated on this dataset. In this study, we present the evaluation results of the 3DTeethSeg'22 challenge. The 3DTeethSeg'22 challenge code can be accessed at: https://github.com/abenhamadou/3DTeethSeg22_challenge

Tooth segmentation from intraoral scans is a crucial part of digital dentistry. Many Deep Learning based tooth segmentation algorithms have been developed for this task. In most of the cases, high accuracy has been achieved, although, most of the available tooth segmentation techniques make an implicit restrictive assumption of full jaw model and they report accuracy based on full jaw models. Medically, however, in certain cases, full jaw tooth scan is not required or may not be available. Given this practical issue, it is important to understand the robustness of currently available widely used Deep Learning based tooth segmentation techniques. For this purpose, we applied available segmentation techniques on partial intraoral scans and we discovered that the available deep Learning techniques under-perform drastically. The analysis and comparison presented in this work would help us in understanding the severity of the problem and allow us to develop robust tooth segmentation technique without strong assumption of full jaw model.

Accurate tooth volume segmentation is a prerequisite for computer-aided dental analysis. Deep learning-based tooth segmentation methods have achieved satisfying performances but require a large quantity of tooth data with ground truth. The dental data publicly available is limited meaning the existing methods can not be reproduced, evaluated and applied in clinical practice. In this paper, we establish a 3D dental CBCT dataset CTooth+, with 22 fully annotated volumes and 146 unlabeled volumes. We further evaluate several state-of-the-art tooth volume segmentation strategies based on fully-supervised learning, semi-supervised learning and active learning, and define the performance principles. This work provides a new benchmark for the tooth volume segmentation task, and the experiment can serve as the baseline for future AI-based dental imaging research and clinical application development. The codebase and dataset are released here.

Convolutional neural networks (CNNs) are used in many areas of computer vision, such as object tracking and recognition, security, military, and biomedical image analysis. This review presents the application of convolutional neural networks in one of the fields of dentistry - orthodontics. Advances in medical imaging technologies and methods allow CNNs to be used in orthodontics to shorten the planning time of orthodontic treatment, including an automatic search of landmarks on cephalometric X-ray images, tooth segmentation on Cone-Beam Computed Tomography (CBCT) images or digital models, and classification of defects on X-Ray panoramic images. In this work, we describe the current methods, the architectures of deep convolutional neural networks used, and their implementations, together with a comparison of the results achieved by them. The promising results and visualizations of the described studies show that the use of methods based on convolutional neural networks allows for the improvement of computer-based orthodontic treatment planning, both by reducing the examination time and, in many cases, by performing the analysis much more accurately than a manual orthodontist does.