Objective: This study developed and evaluated a computer-based method for automating the registration of scanned dental models with 3D reconstructed skulls and segmentation of the temporomandibular joint (TMJ). Methods: A dataset comprising 1274 skull models and corresponding scanned dental models was collected. In total, 1066 cases were used for the development of the computer-based method, while 208 cases were used for validation. Performance was evaluated by comparing the automated results with manual registration and segmentation performed by clinicians, using accuracy and completeness metrics (e.g. intersection of union [IoU] and Dice similarity coefficient [DSC]). Results: The automated registration achieved a mean absolute error of 0.35 mm for the maxilla and 0.38 mm for the mandible, and a root mean squared error of 0.46 mm and 0.39 mm, respectively. The automatic TMJ segmentation exhibited an accuracy of 97.48%, a precision of 97.06%, a IoU of 95.72%, DSC of 97.3%, and a Hausdorff value of 1.87 mm, which were sufficient for clinical application. Conclusion: The proposed method significantly improved the efficiency of orthognathic surgical planning by automating the registration and segmentation processes. The accuracy and precision of the automated results were sufficient for clinical use, reducing the workload on clinicians and facilitating faster and more reliable surgical planning. Clinical significance: The computer-based method streamlines orthognathic surgical planning, enhancing precision and efficiency without compromising clinical accuracy, ultimately improving patient outcomes and reducing the workload of surgeons.
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