Restrictive Hierarchical Semantic Segmentation for Stratified Tooth Layer Detection

Accurate understanding of anatomical structures is essential for reliably staging certain dental diseases. A way of introducing this within semantic segmentation models is by utilising hierarchy-aware methodologies. However, existing hierarchy-aware segmentation methods largely encode anatomical structure through the loss functions, providing weak and indirect supervision. We introduce a general framework that embeds an explicit anatomical hierarchy into semantic segmentation by coupling a recurrent, level-wise prediction scheme with restrictive output heads and top-down feature conditioning. At each depth of the class tree, the backbone is re-run on the original image concatenated with logits from the previous level. Child class features are conditioned using Feature-wise Linear Modulation of their parent class probabilities, to modulate child feature spaces for fine grained detection. A probabilistic composition rule enforces consistency between parent and descendant classes. Hierarchical loss combines per-level class weighted Dice and cross entropy loss and a consistency term loss, ensuring parent predictions are the sum of their children. We validate our approach on our proposed dataset, TL-pano, containing 194 panoramic radiographs with dense instance and semantic segmentation annotations, of tooth layers and alveolar bone. Utilising UNet and HRNet as donor models across a 5-fold cross validation scheme, the hierarchical variants consistently increase IoU, Dice, and recall, particularly for fine-grained anatomies, and produce more anatomically coherent masks. However, hierarchical variants also demonstrated increased recall over precision, implying increased false positives. The results demonstrate that explicit hierarchical structuring improves both performance and clinical plausibility, especially in low data dental imaging regimes.

H-FCBFormer Hierarchical Fully Convolutional Branch Transformer for Occlusal Contact Segmentation with Articulating Paper

Occlusal contacts are the locations at which the occluding surfaces of the maxilla and the mandible posterior teeth meet. Occlusal contact detection is a vital tool for restoring the loss of masticatory function and is a mandatory assessment in the field of dentistry, with particular importance in prosthodontics and restorative dentistry. The most common method for occlusal contact detection is articulating paper. However, this method can indicate significant medically false positive and medically false negative contact areas, leaving the identification of true occlusal indications to clinicians. To address this, we propose a multiclass Vision Transformer and Fully Convolutional Network ensemble semantic segmentation model with a combination hierarchical loss function, which we name as Hierarchical Fully Convolutional Branch Transformer (H-FCBFormer). We also propose a method of generating medically true positive semantic segmentation masks derived from expert annotated articulating paper masks and gold standard masks. The proposed model outperforms other machine learning methods evaluated at detecting medically true positive contacts and performs better than dentists in terms of accurately identifying object-wise occlusal contact areas while taking significantly less time to identify them. Code is available at https://github.com/Banksylel/H-FCBFormer.