# Automatic Cephalometric Landmark Localization on CBCT-Derived Digitally Reconstructed Radiographs for Skeletal Malocclusion Classification

arXiv: https://arxiv.org/abs/2608.16535 · HTML: https://mlsanity.com/paper/2608.16535/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 3 of its 25 references that are in the map.
- First posted on arXiv 17 Aug 2026.

## Builds on (most cited first, 3 of 3)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Distribution-Aware Coordinate Representation for Human Pose Estimation](https://mlsanity.com/paper/1910.06278/) (2019)
- [CEPHA29: Automatic Cephalometric Landmark Detection Challenge 2023](https://mlsanity.com/paper/2212.04808/) (2022)

## Abstract (arXiv)

Manual cephalometric landmark annotation is important for craniofacial assessment but is labor-intensive and difficult to scale. We introduce CephViT, a Vision Transformer-based model for automated 2D lateral cephalometric landmark localization, and evaluate its use in downstream skeletal malocclusion classification. CephViT was trained and benchmarked on a public lateral cephalogram dataset, achieving a mean radial error of 1.28 +/- 1.42 mm and a successful detection rate of 92.0% at 3.0 mm. Because the private evaluation cohort consisted of 3D CBCT scans, lateral cephalogram-like digitally reconstructed radiographs (DRRs) were generated from each volume and used as 2D inputs to the landmark localization model. Landmark coordinates were normalized into a common coordinate frame, and skeletal malocclusion classification was performed using landmarks shared between the reference and DRR-based pipelines. Classification performance using DRR-localized landmarks was comparable to that obtained using manually annotated reference landmarks, with accuracies of 70.0% and 68.3%, respectively. These results support the feasibility of automated cephalometric analysis on CBCT-derived DRRs for skeletal malocclusion assessment.