An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems

Lateral cephalometric analysis is commonly used in orthodontics for skeletal classification to ensure an accurate and reliable diagnosis for treatment planning. However, most current research depends on analyzing different type of radiographs, which requires more computational time than 3D analysis....

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Main Authors: Laurine A. Ashame, Sherin M. Youssef, Mazen Nabil Elagamy, Sahar M. El-Sheikh
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Computers
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Online Access:https://www.mdpi.com/2073-431X/14/6/223
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author Laurine A. Ashame
Sherin M. Youssef
Mazen Nabil Elagamy
Sahar M. El-Sheikh
author_facet Laurine A. Ashame
Sherin M. Youssef
Mazen Nabil Elagamy
Sahar M. El-Sheikh
author_sort Laurine A. Ashame
collection DOAJ
description Lateral cephalometric analysis is commonly used in orthodontics for skeletal classification to ensure an accurate and reliable diagnosis for treatment planning. However, most current research depends on analyzing different type of radiographs, which requires more computational time than 3D analysis. Consequently, this study addresses fully automatic orthodontics tracing based on the usage of artificial intelligence (AI) applied to 2D and 3D images, by designing a cephalometric system that analyzes the significant landmarks and regions of interest (ROI) needed in orthodontics tracing, especially for the mandible and maxilla teeth. In this research, a computerized system is developed to automate the tasks of orthodontics evaluation during 2D and Cone-Beam Computed Tomography (CBCT or 3D) systems measurements. This work was tested on a dataset that contains images of males and females obtained from dental hospitals with patient-informed consent. The dataset consists of 2D lateral cephalometric, panorama and CBCT radiographs. Many scenarios were applied to test the proposed system in landmark prediction and detection. Moreover, this study integrates the Grad-CAM (Gradient-Weighted Class Activation Mapping) technique to generate heat maps, providing transparent visualization of the regions the model focuses on during its decision-making process. By enhancing the interpretability of deep learning predictions, Grad-CAM strengthens clinical confidence in the system’s outputs, ensuring that ROI detection aligns with orthodontic diagnostic standards. This explainability is crucial in medical AI applications, where understanding model behavior is as important as achieving high accuracy. The experimental results achieved an accuracy exceeding 98.9%. This research evaluates and differentiates between the two-dimensional and the three-dimensional tracing analyses applied to measurements based on the practices of the European Board of Orthodontics. The results demonstrate the proposed methodology’s robustness when applied to cephalometric images. Furthermore, the evaluation of 3D analysis usage provides a clear understanding of the significance of integrated deep-learning techniques in orthodontics.
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spelling doaj-art-b69635e4a14e4473aff4a40fbd378ce52025-08-20T03:27:30ZengMDPI AGComputers2073-431X2025-06-0114622310.3390/computers14060223An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) SystemsLaurine A. Ashame0Sherin M. Youssef1Mazen Nabil Elagamy2Sahar M. El-Sheikh3Computer Engineering Department, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Abu Qir, Alexandria 1029, EgyptComputer Engineering Department, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Abu Qir, Alexandria 1029, EgyptComputer Engineering Department, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Abu Qir, Alexandria 1029, EgyptDepartment of Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria 21521, EgyptLateral cephalometric analysis is commonly used in orthodontics for skeletal classification to ensure an accurate and reliable diagnosis for treatment planning. However, most current research depends on analyzing different type of radiographs, which requires more computational time than 3D analysis. Consequently, this study addresses fully automatic orthodontics tracing based on the usage of artificial intelligence (AI) applied to 2D and 3D images, by designing a cephalometric system that analyzes the significant landmarks and regions of interest (ROI) needed in orthodontics tracing, especially for the mandible and maxilla teeth. In this research, a computerized system is developed to automate the tasks of orthodontics evaluation during 2D and Cone-Beam Computed Tomography (CBCT or 3D) systems measurements. This work was tested on a dataset that contains images of males and females obtained from dental hospitals with patient-informed consent. The dataset consists of 2D lateral cephalometric, panorama and CBCT radiographs. Many scenarios were applied to test the proposed system in landmark prediction and detection. Moreover, this study integrates the Grad-CAM (Gradient-Weighted Class Activation Mapping) technique to generate heat maps, providing transparent visualization of the regions the model focuses on during its decision-making process. By enhancing the interpretability of deep learning predictions, Grad-CAM strengthens clinical confidence in the system’s outputs, ensuring that ROI detection aligns with orthodontic diagnostic standards. This explainability is crucial in medical AI applications, where understanding model behavior is as important as achieving high accuracy. The experimental results achieved an accuracy exceeding 98.9%. This research evaluates and differentiates between the two-dimensional and the three-dimensional tracing analyses applied to measurements based on the practices of the European Board of Orthodontics. The results demonstrate the proposed methodology’s robustness when applied to cephalometric images. Furthermore, the evaluation of 3D analysis usage provides a clear understanding of the significance of integrated deep-learning techniques in orthodontics.https://www.mdpi.com/2073-431X/14/6/223AIlateral cephalometricCBCTdeep learninghandcrafted featuressegmentation
spellingShingle Laurine A. Ashame
Sherin M. Youssef
Mazen Nabil Elagamy
Sahar M. El-Sheikh
An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems
Computers
AI
lateral cephalometric
CBCT
deep learning
handcrafted features
segmentation
title An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems
title_full An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems
title_fullStr An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems
title_full_unstemmed An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems
title_short An Efficient Hybrid 3D Computer-Aided Cephalometric Analysis for Lateral Cephalometric and Cone-Beam Computed Tomography (CBCT) Systems
title_sort efficient hybrid 3d computer aided cephalometric analysis for lateral cephalometric and cone beam computed tomography cbct systems
topic AI
lateral cephalometric
CBCT
deep learning
handcrafted features
segmentation
url https://www.mdpi.com/2073-431X/14/6/223
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