Automated Dental Caries Segmentation in Panoramic Radiographs Using Dual-Stage Deep Learning

Early detection of dental caries remains challenging due to limitations in traditional diagnostic methods, particularly for proximal lesions in posterior teeth. Deep learning models show promise for automated caries detection but face scalability constraints due to requirements for large volumes of expertly annotated training data. This study presents a dual-stage deep learning framework combining Faster R-CNN for tooth localization with U-Net for pixel-wise caries segmentation in panoramic radiographs. We developed a systematic transformation pipeline to convert large-scale polygon-annotated datasets into high-resolution binary segmentation masks, enabling pixel-wise supervised learning. The framework was trained using both expert-verified datasets and algorithmically processed labels from 3,000 panoramic images. Our approach achieved robust performance with an IoU of 0.9013, Dice coefficient of 0.9482, Recall of 0.9433, and Precision of 0.9774, demonstrating superior accuracy compared to existing methods while significantly reducing false-positive rates. The dual-stage framework effectively addresses data annotation bottlenecks in dental AI applications and demonstrates potential for scalable, automated caries detection systems that can improve diagnostic consistency and support clinical decision-making.