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  4. Determination of Kennedy’s classification in panoramic X-rays by automated tooth labeling
 
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2025
Journal Article
Title

Determination of Kennedy’s classification in panoramic X-rays by automated tooth labeling

Abstract
Purpose: Panoramic X-rays (PX) are extensively utilized in dental and maxillofacial diagnostics, offering comprehensive imaging of teeth and surrounding structures. This study investigates the automatic determination of Kennedy’s classification in partially edentulous jaws.
Methods: A retrospective study involving 209 PX images from 206 patients was conducted. The established Mask R-CNN, a deep learning-based instance segmentation model, was trained for the automatic detection, position labeling (according to the international dental federation’s scheme), and segmentation of teeth in PX. Subsequent post-processing steps filter duplicate outputs by position label and by geometric overlap. Finally, a rule-based determination of Kennedy’s class of partially edentulous jaws was performed.
Results: In a fivefold cross-validation, Kennedy’s classification was correctly determined in 83.0% of cases, with the most common errors arising from the mislabeling of morphologically similar teeth. The underlying algorithm demonstrated high sensitivity (97.1%) and precision (98.1%) in tooth detection, with an F1 score of 97.6%. FDI position label accuracy was 94.7%. Ablation studies indicated that post-processing steps, such as duplicate filtering, significantly improved algorithm performance.
Conclusion: Our findings show that automatic dentition analysis in PX images can be extended to include clinically relevant jaw classification, reducing the workload associated with manual labeling and classification.
Author(s)
Meine, Hans
Fraunhofer-Institut für Digitale Medizin MEVIS  
Metzger, Marc Christian
Universitätsklinikum Freiburg
Weingart, Patrick
Universitätsklinikum Freiburg
Wüster, Jonas
Universitätsklinikum Freiburg
Schmelzeisen, Rainer
Universitätsklinikum Freiburg
Rörich, Anna
Fraunhofer-Institut für Digitale Medizin MEVIS  
Georgii, Joachim  
Fraunhofer-Institut für Digitale Medizin MEVIS  
Brandenburg, Leonard Simon
Universitätsklinikum Freiburg
Journal
International journal of computer assisted radiology and surgery  
Open Access
DOI
10.1007/s11548-025-03469-z
Additional link
Full text
Language
English
Fraunhofer-Institut für Digitale Medizin MEVIS  
Keyword(s)
  • Kennedy’s classification

  • Mask R-CNN

  • Panoramic X-ray

  • Tooth detection

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