Convolutional Neural Networks (CNNs) such as U-Net have been widely used for medical image segmentation. Dental restorations are prominent features of dental radiographs. Applying U-Net on the panoramic image is challenging, as the shape, size and frequency of different restoration types vary. We hypothesized that models trained on smaller, equally spaced rectangular image crops (tiles) of the panoramic would outperform models trained on the full image. A total of 1781 panoramic radiographs were annotated pixelwise for fillings, crowns, and root canal fillings by dental experts. We used different numbers of tiles for our experiments. Five-times-repeated three-fold cross-validation was used for model evaluation. Training with more tiles improved model performance and accelerated convergence. The F1-score for the full panoramic image was 0.7, compared to 0.83, 0.92 and 0.95 for 6, 10 and 20 tiles, respectively. For root canals fillings, which are small, cone-shaped features that appear less frequently on the radiographs, the performance improvement was even higher (+294%). Training on tiles and pooling the results thereafter improved pixelwise classification performance and reduced the time to model convergence for segmenting dental restorations. Segmentation of panoramic radiographs is biased towards more frequent and extended classes. Tiling may help to overcome this bias and increase accuracy.
