Silhouette-to-Contour Registration: Aligning Intraoral Scan Models with Cephalometric Radiographs
This work addresses a critical challenge in orthodontic diagnosis by providing a more reliable 3D-2D alignment method for clinicians, though it is incremental as it builds on existing registration techniques with specific improvements for dental imaging.
The paper tackled the problem of aligning 3D intraoral scan models with 2D cephalometric radiographs for orthodontic diagnosis, which conventional methods struggle with due to clinical variations. The proposed DentalSCR method achieved substantial reductions in landmark error, particularly at posterior teeth, and demonstrated robust performance on 34 clinical cases, outperforming baselines.
Reliable 3D-2D alignment between intraoral scan (IOS) models and lateral cephalometric radiographs is critical for orthodontic diagnosis, yet conventional intensity-driven registration methods struggle under real clinical conditions, where cephalograms exhibit projective magnification, geometric distortion, low-contrast dental crowns, and acquisition-dependent variation. These factors hinder the stability of appearance-based similarity metrics and often lead to convergence failures or anatomically implausible alignments. To address these limitations, we propose DentalSCR, a pose-stable, contour-guided framework for accurate and interpretable silhouette-to-contour registration. Our method first constructs a U-Midline Dental Axis (UMDA) to establish a unified cross-arch anatomical coordinate system, thereby stabilizing initialization and standardizing projection geometry across cases. Using this reference frame, we generate radiograph-like projections via a surface-based DRR formulation with coronal-axis perspective and Gaussian splatting, which preserves clinical source-object-detector magnification and emphasizes external silhouettes. Registration is then formulated as a 2D similarity transform optimized with a symmetric bidirectional Chamfer distance under a hierarchical coarse-to-fine schedule, enabling both large capture range and subpixel-level contour agreement. We evaluate DentalSCR on 34 expert-annotated clinical cases. Experimental results demonstrate substantial reductions in landmark error-particularly at posterior teeth-tighter dispersion on the lower jaw, and low Chamfer and controlled Hausdorff distances at the curve level. These findings indicate that DentalSCR robustly handles real-world cephalograms and delivers high-fidelity, clinically inspectable 3D--2D alignment, outperforming conventional baselines.