# Periodontal Bone Loss Analysis via Keypoint Detection With Heuristic Post-Processing

arXiv: https://arxiv.org/abs/2503.13477 · HTML: https://mlsanity.com/paper/2503.13477/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 24 of its 71 references that are in the map.
- First posted on arXiv 5 Mar 2025.

## Builds on (most cited first, 24 of 24)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [Mask R-CNN](https://mlsanity.com/paper/1703.06870/) (2017)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [Deep High-Resolution Representation Learning for Human Pose Estimation](https://mlsanity.com/paper/1902.09212/) (2019)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.12620/) (2023)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [DeepPose: Human Pose Estimation via Deep Neural Networks](https://mlsanity.com/paper/1312.4659/) (2013)
- [RTMDet: An Empirical Study of Designing Real-Time Object Detectors](https://mlsanity.com/paper/2212.07784/) (2022)
- [RTMPose: Real-Time Multi-Person Pose Estimation based on MMPose](https://mlsanity.com/paper/2303.07399/) (2023)
- [Medical Image Segmentation Using Deep Learning: A Survey](https://mlsanity.com/paper/2009.13120/) (2020)
- [A Comprehensive Review of YOLO Architectures in Computer Vision: From YOLOv1 to YOLOv8 and YOLO-NAS](https://mlsanity.com/paper/2304.00501/) (2023)
- [Rethinking the Heatmap Regression for Bottom-up Human Pose Estimation](https://mlsanity.com/paper/2012.15175/) (2020)
- [YOLO-Pose: Enhancing YOLO for Multi Person Pose Estimation Using Object Keypoint Similarity Loss](https://mlsanity.com/paper/2204.06806/) (2022)
- [UniHCP: A Unified Model for Human-Centric Perceptions](https://mlsanity.com/paper/2303.02936/) (2023)
- [Human Pose as Compositional Tokens](https://mlsanity.com/paper/2303.11638/) (2023)
- [Poseur: Direct Human Pose Regression with Transformers](https://mlsanity.com/paper/2201.07412/) (2022)
- [Heatmap Distribution Matching for Human Pose Estimation](https://mlsanity.com/paper/2210.00740/) (2022)
- [Sequential anatomy localization in fetal echocardiography videos](https://mlsanity.com/paper/1810.11868/) (2018)

## Abstract (arXiv)

This study proposes a deep learning framework and annotation methodology for the automatic detection of periodontal bone loss landmarks, associated conditions, and staging. 192 periapical radiographs were collected and annotated with a stage agnostic methodology, labelling clinically relevant landmarks regardless of disease presence or extent. We propose a heuristic post-processing module that aligns predicted keypoints to tooth boundaries using an auxiliary instance segmentation model. An evaluation metric, Percentage of Relative Correct Keypoints (PRCK), is proposed to capture keypoint performance in dental imaging domains. Four donor pose estimation models were adapted with fine-tuning for our keypoint problem. Post-processing improved fine-grained localisation, raising average PRCK^{0.05} by +0.028, but reduced coarse performance for PRCK^{0.25} by -0.0523 and PRCK^{0.5} by -0.0345. Orientation estimation shows excellent performance for auxiliary segmentation when filtered with either stage 1 object detection model. Periodontal staging was detected sufficiently, with the best mesial and distal Dice scores of 0.508 and 0.489, while furcation involvement and widened periodontal ligament space tasks remained challenging due to scarce positive samples. Scalability is implied with similar validation and external set performance. The annotation methodology enables stage agnostic training with balanced representation across disease severities for some detection tasks. The PRCK metric provides a domain-specific alternative to generic pose metrics, while the heuristic post-processing module consistently corrected implausible predictions with occasional catastrophic failures. The proposed framework demonstrates the feasibility of clinically interpretable periodontal bone loss assessment, with potential to reduce diagnostic variability and clinician workload.