  Individual tooth segmentation and identification from cone-beam computed
tomography images are preoperative prerequisites for orthodontic treatments.
Instance segmentation methods using convolutional neural networks have
demonstrated ground-breaking results on individual tooth segmentation tasks,
and are used in various medical imaging applications. While point-based
detection networks achieve superior results on dental images, it is still a
challenging task to distinguish adjacent teeth because of their similar
topologies and proximate nature. In this study, we propose a point-based tooth
localization network that effectively disentangles each individual tooth based
on a Gaussian disentanglement objective function. The proposed network first
performs heatmap regression accompanied by box regression for all the
anatomical teeth. A novel Gaussian disentanglement penalty is employed by
minimizing the sum of the pixel-wise multiplication of the heatmaps for all
adjacent teeth pairs. Subsequently, individual tooth segmentation is performed
by converting a pixel-wise labeling task to a distance map regression task to
minimize false positives in adjacent regions of the teeth. Experimental results
demonstrate that the proposed algorithm outperforms state-of-the-art approaches
by increasing the average precision of detection by 9.1%, which results in a
high performance in terms of individual tooth segmentation. The primary
significance of the proposed method is two-fold: 1) the introduction of a
point-based tooth detection framework that does not require additional
classification and 2) the design of a novel loss function that effectively
separates Gaussian distributions based on heatmap responses in the point-based
detection framework.
