Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (1): 113-120. doi: 10.19723/j.issn.1671-167X.2025.01.017

Previous Articles     Next Articles

Deep learning algorithms for intelligent construction of a three-dimensional maxillofacial symmetry reference plane

Yujia ZHU1, Hua SHEN2, Aonan WEN1, Zixiang GAO1, Qingzhao QIN1, Shenyao SHAN3, Wenbo LI3, Xiangling FU2, Yijiao ZHAO1,3,*(), Yong WANG1,*()   

  1. 1. Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digi-tal Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
    2. School of Computer Science, Beijing University of Posts and Telecommunications (National Pilot Software Engineering School); Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing 100876, China
    3. Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
  • Received:2024-10-09 Online:2025-02-18 Published:2025-01-25
  • Contact: Yijiao ZHAO, Yong WANG E-mail:kqcadcs@bjmu.edu.cn;kqcadc@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundation of China(82071171);the National Natural Science Foundation of China(82271039);National Key Research and Development Program of China(2022YFC2405401);Beijing Natural Science Foundation(L232100);Beijing Natural Science Foundation(L242132);Open Subject Foundation of Peking University Hospital of Stomatology(PKUSS20230201)

RICH HTML

  

Abstract:

Objective: To develop an original-mirror alignment associated deep learning algorithm for intelligent registration of three-dimensional maxillofacial point cloud data, by utilizing a dynamic graph-based registration network model (maxillofacial dynamic graph registration network, MDGR-Net), and to provide a valuable reference for digital design and analysis in clinical dental applications. Methods: Four hundred clinical patients without significant deformities were recruited from Peking University School of Stomatology from October 2018 to October 2022. Through data augmentation, a total of 2 000 three-dimensional maxillofacial datasets were generated for training and testing the MDGR-Net algorithm. These were divided into a training set (1 400 cases), a validation set (200 cases), and an internal test set (200 cases). The MDGR-Net model constructed feature vectors for key points in both original and mirror point clouds (X, Y), established correspondences between key points in the X and Y point clouds based on these feature vectors, and calculated rotation and translation matrices using singular value decomposition (SVD). Utilizing the MDGR-Net model, intelligent registration of the original and mirror point clouds were achieved, resulting in a combined point cloud. The principal component analysis (PCA) algorithm was applied to this combined point cloud to obtain the symmetry reference plane associated with the MDGR-Net methodology. Model evaluation for the translation and rotation matrices on the test set was performed using the coefficient of determination (R2). Angle error evaluations for the three-dimensional maxillofacial symmetry reference planes were constructed using the MDGR-Net-associated method and the "ground truth" iterative closest point (ICP)-associated method were conducted on 200 cases in the internal test set and 40 cases in an external test set. Results: Based on testing with the three-dimensional maxillofacial data from the 200-case internal test set, the MDGR-Net model achieved an R2 value of 0.91 for the rotation matrix and 0.98 for the translation matrix. The average angle error on the internal and external test sets were 0.84°±0.55° and 0.58°±0.43°, respectively. The construction of the three-dimensional maxillofacial symmetry reference plane for 40 clinical cases took only 3 seconds, with the model performing optimally in the patients with skeletal Class Ⅲ malocclusion, high angle cases, and Angle Class Ⅲ orthodontic patients. Conclusion: This study proposed the MDGR-Net association method based on intelligent point cloud registration as a novel solution for constructing three-dimensional maxillofacial symmetry reference planes in clinical dental applications, which can significantly enhance diagnostic and therapeutic efficiency and outcomes, while reduce expert dependence.

Key words: Maxillofacial, Symmetry reference plane, Imaging, three-dimensional, Deep learning, Algorithm

CLC Number: 

  • R78

Figure 1

Processing of three-dimensional maxillofacial data augmentation and normalization processing"

Figure 2

Diagram of the MDGR-Net network framework R and t represent the ground-truth rotation and translation matrices from the ICP algorithm. DGCNN and Transformer are utilized to construct feature vectors for key points in the original and mirrored point clouds, with Leaky ReLU and ReLU as activation functions. The Gumbel-Softmax and λ are used to obtain the key point correspondences m, R ′, t ′ denote the rotation and translation matrices predicted by the MDGR-Net network. ICP, iterative closest point; DGCNN, dynamic graph convolutional neural network; MDGR-Net, maxillofacial dynamic graph registration network."

Figure 3

Keypoint feature map of maxillofacial dataset"

Figure 4

Training loss curve of MDGR-Net MDGR-Net, maxillofacial dynamic graph registration network."

Table 1

Clinical evaluation results of the three-dimensional maxillofacial symmetry reference plane constructed using the MDGR-Net method"

Dataset Angle error/(°) Accuracy rate/%
${\bar x}$±s Minimum Maximum < 1° < 2°
Internal test set 0.84±0.55 0.02 3.75 71 96
External test set 0.58±0.43 0.02 1.97 93 100

Figure 5

Illustrative comparison of the three-dimensional maxillofacial symmetry reference planes constructed using the MDGR-Net method and the ICP method Green plane: Symmetry reference plane constructed using the MDGR-Net method; Red plane: Symmetry reference plane constructed using the ICP method. MDGR-Net, maxillofacial dynamic graph registration network; ICP, iterative closest point."

Table 2

Clinical evaluation results of the three-dimensional maxillofacial symmetry reference plane constructed using the MDGR-Net method on the external test set"

Items n Angle error/(°),${\bar x}$±s
Sagittal skeletal patterns
Skeletal class Ⅰ 18 0.71±0.54
Skeletal class Ⅱ 10 0.56±0.32
Skeletal class Ⅲ 12 0.39±0.27
Vertical skeletal patterns
High angle 11 0.33±0.25
Average angle 17 0.59±0.46
Low angle 12 0.66±0.52
Angle classification
Angle class Ⅰ 18 0.56±0.30
Angle class Ⅱ 11 0.58±0.55
Angle class Ⅲ 11 0.44±0.28

Figure 6

Box plot of angle error for three-dimensional maxillofacial symmetry reference plane constructed using the MDGR-Net method on the external test set MDGR-Net, maxillofacial dynamic graph registration network."

1 Khambay BS , Lowney CJ , Hsung T , et al. Fluctuating asymmetry of dynamic smiles in normal individuals[J]. Int J Oral Maxillofac Surg, 2019, 48 (10): 1372- 1379.
doi: 10.1016/j.ijom.2019.01.032
2 Hoenn M , Goez G . The ideal of facial beauty: A review[J]. J Orofac Orthop, 2007, 68 (1): 6- 16.
doi: 10.1007/s00056-007-0604-6
3 Huang CS , Liu XQ , Chen YR . Facial asymmetry index in normal young adults[J]. Orthod Craniofac Res, 2013, 16 (2): 97- 104.
doi: 10.1111/ocr.12010
4 Arora KS , Bansal R , Mohapatra S , et al. Review and classification update: Unilateral condylar hyperplasia[J]. BMJ Case Rep, 2019, 12 (2): e227569.
5 Brown JS , Barry C , Ho M , et al. A new classification for mandi-bular defects after oncological resection[J]. Lancet Oncol, 2016, 17 (1): E23- E30.
doi: 10.1016/S1470-2045(15)00310-1
6 Li Y , Shao Z , Zhu Y , et al. Virtual surgical planning for successful second-stage mandibular defect reconstruction using vascula-rized iliac crest bone flap a valid and reliable method[J]. Ann Plast Surg, 2020, 84 (2): 183- 187.
doi: 10.1097/SAP.0000000000002102
7 顾晓宇, 陈晓波, 焦婷, 等. 三维打印数字化阴模辅助制作口腔颌面缺损赝复体的临床应用[J]. 中华口腔医学杂志, 2017, 52 (6): 336- 341.
doi: 10.3760/cma.j.issn.1002-0098.2017.06.003
8 Maesschalck TD , Courvoisier DS , Scolozzi P . Computer-assisted versus traditional freehand technique in fibular free flap mandibular reconstruction: A morphological comparative study[J]. Eur Arch Otorhinolaryngol, 2017, 274 (1): 517- 526.
doi: 10.1007/s00405-016-4246-4
9 Shin SM , Kim Y , Kim N , et al. Statistical shape analysis-based determination of optimal midsagittal reference plane for evaluation of facial asymmetry[J]. Am J Orthod Dentofacial Orthop, 2016, 150 (2): 252- 260.
doi: 10.1016/j.ajodo.2016.01.017
10 Dobai A , Markella Z , Vizkelety T , et al. Landmark-based midsagittal plane analysis in patients with facial symmetry and asymmetry based on CBCT analysis tomography[J]. J Orofac Orthop, 2018, 79 (6): 371- 379.
doi: 10.1007/s00056-018-0151-3
11 Klingenberg CP , Barluenga M , Meyer A . Shape analysis of symmetric structures: Quantifying variation among individuals and asymmetry[J]. Evolution, 2002, 56 (10): 1909- 1920.
12 Hartmann J , Meyer-Marcotty P , Benz M , et al. Reliability of a method for computing facial symmetry plane and degree of asymmetry based on 3D-data[J]. J Orofac Orthop, 2007, 68 (6): 477- 490.
doi: 10.1007/s00056-007-0652-y
13 刘筱菁, 李倩倩, 王晓霞, 等. 基于本体-镜像关联的三维头颅正中矢状面自动构建法[J]. 中华口腔正畸学杂志, 2014, 21 (3): 148- 150.
doi: 10.3760/cma.j.issn.1674-5760.2014.03.006
14 Djordjevic J , Pirttiniemi P , Harila V , et al. Three-dimensional longitudinal assessment of facial symmetry in adolescents[J]. Eur J Orthod, 2013, 35 (2): 143- 151.
doi: 10.1093/ejo/cjr006
15 浙江大学, 中国食品药品检定研究院, 海军军医大学第二附属医院. 人工智能医疗器械性能评价通用方法专家共识(2023)[J]. 协和医学杂志, 2023, 14 (3): 494- 503.
16 Du S , Xu Y , Wan T , et al. Robust iterative closest point algorithm based on global reference point for rotation invariant registration[J]. PLoS One, 2017, 12 (11): e18803911.
17 Xiong Y , Zhao Y , Yang H , et al. Comparison between interactive closest point and procrustes analysis for determining the median sagittal plane of three-dimensional facial data[J]. J Craniofac Surg, 2016, 27 (2): 441- 444.
doi: 10.1097/SCS.0000000000002376
18 Zelditch , Leah M . Geometric morphometrics for biologists: A primer[M]. New York and London: Elsevier Academic Press, 2004.
19 Redmon J, Divvala S, Girshick R, et al. You only look once: Unified, real-time object detection[C]/ /Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition (CVPR), 2016. Las Vegas, Nevada, USA: Institute of Electrical and Electronics Engineers, 2016: 779-788.
20 Ronneberger O, Fischer P, Brox T. U-Net: Convolutional networks for biomedical image segmentation[C]/ /Navab N, Hornegger J, Wells WM, et al. Proccedings of the International Confe-rence on Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2015. Germany: Springer International Publishing, 2015: 234-241.
21 Schwendicke F , Singh T , Lee J , et al. Artificial intelligence in dental research: Checklist for authors, reviewers, readers[J]. J Dent, 2021, 107, 103610.
doi: 10.1016/j.jdent.2021.103610
22 Schwendicke F , Samek W , Krois J . Artificial intelligence in dentistry: Chances and challenges[J]. J Dent Res, 2020, 99 (7): 769- 774.
doi: 10.1177/0022034520915714
23 Wang Y , Sun Y , Liu Z , et al. Dynamic graph CNN for learning on point clouds[J]. ACM Transactions On Graphics (TOG), 2019, 38 (5): 1- 12.
24 Vaswani A, Shazeer N, Parmar N, et al. Attention is all you need[C]/ /Proceedings of the 31st International Conference on Neural Information Processing Systems (NIPS 2017). Red Hook, NY, USA: Curran Associates, Inc., 2017.
25 Wu J , Heike C , Birgfeld C , et al. Measuring symmetry in children with unrepaired cleft lip: Defining a standard for the three-dimensional midfacial reference plane[J]. Cleft Palate Craniofac J, 2016, 53 (6): 695- 704.
doi: 10.1597/15-053
[1] Zunan TANG,Leihao HU,Zhen CHEN,Yao YU,Wenbo ZHANG,Xin PENG. Evaluation of augmented reality technology in the recognizing of oral and maxillofacial anatomy [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 541-545.
[2] Zhe WANG,Wei SUN,Xue YANG,Ying SONG,Ai-ping JI,Jie BAI. Clinical analysis of patients with oral and maxillofacial infections in oral emergency [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 543-547.
[3] Qian SU,Xin PENG,Chuan-xiang ZHOU,Guang-yan YU. Clinicopathological characteristics and prognosis of non-Hodgkin lymphoma in oral and maxillofacial regions: An analysis of 369 cases [J]. Journal of Peking University (Health Sciences), 2023, 55(1): 13-21.
[4] Rui MA,Yan XUAN,Yao DUAN,Ting SHUAI. Investigation on mindfulness level of patients with oral and maxillofacial malignant tumor after operation and analysis of its influencing factors [J]. Journal of Peking University (Health Sciences), 2022, 54(4): 727-734.
[5] ZHU Yu-jia,XU Qing,ZHAO Yi-jiao,ZHANG Lei,FU Zi-wang,WEN Ao-nan,GAO Zi-xiang,ZHANG Jun,FU Xiang-ling,WANG Yong. Deep learning-assisted construction of three-demensional facial midsagittal plane [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 134-139.
[6] Cheng WANG,Ling-yu MENG,Na-yun CHEN,Dai LI,Jian-quan WANG,Ying-fang AO. Management algorithm for septic arthritis after anterior cruciate ligament reconstruction [J]. Journal of Peking University (Health Sciences), 2021, 53(5): 850-856.
[7] ZHU Yu-jia,ZHAO Yi-jiao,ZHENG Sheng-wen,WEN Ao-nan,FU Xiang-ling,WANG Yong. A method for constructing three-dimensional face symmetry reference plane based on weighted shape analysis algorithm [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 220-226.
[8] Zu-nan TANG,Yuh SOH Hui,Lei-hao HU,Yao YU,Wen-bo ZHANG,Xin PENG. Application of mixed reality technique for the surgery of oral and maxillofacial tumors [J]. Journal of Peking University (Health Sciences), 2020, 52(6): 1124-1129.
[9] Fei WANG,Yang-yang ZHAO,Ming GUAN,Jing WANG,Xiang-liang XU,Yu LIU,Xin-li ZHAI. Application of intravenous sedation in 2 582 cases of oral and maxillofacial surgery [J]. Journal of Peking University(Health Sciences), 2020, 52(1): 181-186.
[10] Shun-ji WANG,Wen-bo ZHANG,Yao YU,Xiao-yan XIE,Hong-yu YANG,Xin PENG. Application of computer-assisted design for anterolateral thigh flap in oral and maxillofacial reconstruction [J]. Journal of Peking University(Health Sciences), 2020, 52(1): 119-123.
[11] QU Jing-wei, LV Xiao-qing, LIU Zhen-ming, LIAO Yuan, SUN Peng-hui, WANG Bei, TANG Zhi. A retrieval method of drug molecules based on graph collapsing [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 368-374.
[12] WANG Si-wei, LI Min, YANG Hui-fang, ZHAO Yi-jiao, WANG Yong, LIU Yi1. Evaluation of three methods for constructing craniofacial mid-sagittal plane based on the cone beam computed tomography [J]. Journal of Peking University(Health Sciences), 2016, 48(2): 330-335.
[13] YAO Yi-Sang, GAO Ling, LI Yu-Ling, MA Shao-Li, WU Zi-Mei, TAN Ning-Zhi, WU Jian-Yong, NI Lu-Qun, ZHU Jia-Shi. Amplicon density-weighted algorithms for analyzing dissimilarity and dynamic alterations of RAPD polymorphisms of Cordyceps sinensis [J]. Journal of Peking University(Health Sciences), 2014, 46(4): 618-628.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!