Johan Andreas Balle Rubak

Johan Andreas Balle Rubak, Sara Haghighat, Sanyam Jain et al.

Impaction of the mandibular third molar in proximity to the mandibular canal increases the risk of inferior alveolar nerve injury. Panoramic radiography is routinely used to assess this relationship. Automated classification of molar-canal overlap could support clinical triage and reduce unnecessary CBCT referrals, while federated learning (FL) enables multi-center collaboration without sharing patient data. We compared Local Learning (LL), FL, and Centralized Learning (CL) for binary overlap/no-overlap classification on cropped panoramic radiographs partitioned across eight independent labelers. A pretrained ResNet-34 was trained under each paradigm and evaluated using per-client metrics with locally optimized thresholds and pooled test performance with a global threshold. Performance was assessed using area under the receiver operating characteristic curve (AUC) and threshold-based metrics, alongside training dynamics, Grad-CAM visualizations, and server-side aggregate monitoring signals. On the test set, CL achieved the highest performance (AUC 0.831; accuracy = 0.782), FL showed intermediate performance (AUC 0.757; accuracy = 0.703), and LL generalized poorly across clients (AUC range = 0.619-0.734; mean = 0.672). Training curves suggested overfitting, particularly in LL models, and Grad-CAM indicated more anatomically focused attention in CL and FL. Overall, centralized training provided the strongest performance, while FL offers a privacy-preserving alternative that outperforms LL.

Johan Andreas Balle Rubak, Khuram Naveed, Sanyam Jain et al.

Objectives: Federated learning (FL) may mitigate privacy constraints, heterogeneous data quality, and inconsistent labeling in dental diagnostic AI. We compared FL with centralized (CL) and local learning (LL) for tooth segmentation in panoramic radiographs across multiple data corruption scenarios. Methods: An Attention U-Net was trained on 2066 radiographs from six institutions across four settings: baseline (unaltered data); label manipulation (dilated/missing annotations); image-quality manipulation (additive Gaussian noise); and exclusion of a faulty client with corrupted data. FL was implemented via the Flower AI framework. Per-client training- and validation-loss trajectories were monitored for anomaly detection and a set of metrics (Dice, IoU, HD, HD95 and ASSD) was evaluated on a hold-out test set. From these metrics significance results were reported through Wilcoxon signed-rank test. CL and LL served as comparators. Results: Baseline: FL achieved a median Dice of 0.94889 (ASSD: 1.33229), slightly better than CL at 0.94706 (ASSD: 1.37074) and LL at 0.93557-0.94026 (ASSD: 1.51910-1.69777). Label manipulation: FL maintained the best median Dice score at 0.94884 (ASSD: 1.46487) versus CL's 0.94183 (ASSD: 1.75738) and LL's 0.93003-0.94026 (ASSD: 1.51910-2.11462). Image noise: FL led with Dice at 0.94853 (ASSD: 1.31088); CL scored 0.94787 (ASSD: 1.36131); LL ranged from 0.93179-0.94026 (ASSD: 1.51910-1.77350). Faulty-client exclusion: FL reached Dice at 0.94790 (ASSD: 1.33113) better than CL's 0.94550 (ASSD: 1.39318). Loss-curve monitoring reliably flagged the corrupted site. Conclusions: FL matches or exceeds CL and outperforms LL across corruption scenarios while preserving privacy. Per-client loss trajectories provide an effective anomaly-detection mechanism and support FL as a practical, privacy-preserving approach for scalable clinical AI deployment.