Intra-YOLO: A Small Object Detection Model for Caries and Molar-Incisor Hypomineralization in Intraoral Photography Based on Transfer Learning with Reinforcement Learning

As dental caries appear as subtle, low-contrast lesions in intraoral imaging, existing deep learning models face significant challenges in the early detection of caries. While recent Transformer-based detectors have shown promising results in natural images, they often fail to capture the domain-specific anatomical priors crucial for dental caries detection. In this paper, we propose Caries-DETR, a specialized Transformer framework for caries detection in intraoral images. A Tooth Structure-aware Query Initialization (TSQI) is designed, leveraging large-scale intraoral photograph pre-training and a structure perception branch (SPB) to integrate high-frequency structural priors, guiding the model to focus on anatomically significant lesion areas. Furthermore, we design a Lesion-aware Dynamic Loss Refinement (LDLR) to implement quality-driven hard mining through adaptive loss reweighting based on lesion size, anatomical relevance, and prediction quality, optimizing detection for subtle lesions. Extensive experiments on two public datasets (i.e., AlphaDent and DentalAI) demonstrate that Caries-DETR achieves a state-of-the-art performance compared to existing methods and exhibits good generalization and robustness. Code and data at https://github.com/XuefenLiu-SZU/Caries-DETR}{https://github.com/XuefenLiu-SZU/Caries-DETR.

Vision-Language Models (VLMs) have demonstrated significant potential in medical image analysis, yet their application in intraoral photography remains largely underexplored due to the lack of fine-grained, annotated datasets and comprehensive benchmarks. To address this, we present MetaDent, a comprehensive resource that includes (1) a novel and large-scale dentistry image dataset collected from clinical, public, and web sources; (2) a semi-structured annotation framework designed to capture the hierarchical and clinically nuanced nature of dental photography; and (3) comprehensive benchmark suites for evaluating state-of-the-art VLMs on clinical image understanding. Our labeling approach combines a high-level image summary with point-by-point, free-text descriptions of abnormalities. This method enables rich, scalable, and task-agnostic representations. We curated 60,669 dental images from diverse sources and annotated a representative subset of 2,588 images using this meta-labeling scheme. Leveraging Large Language Models (LLMs), we derive standardized benchmarks: approximately 15K Visual Question Answering (VQA) pairs and an 18-class multi-label classification dataset, which we validated with human review and error analysis to justify that the LLM-driven transition reliably preserves fidelity and semantic accuracy. We then evaluate state-of-the-art VLMs across VQA, classification, and image captioning tasks. Quantitative results reveal that even the most advanced models struggle with a fine-grained understanding of intraoral scenes, achieving moderate accuracy and producing inconsistent or incomplete descriptions in image captioning. We publicly release our dataset, annotations, and tools to foster reproducible research and accelerate the development of vision-language systems for dental applications.

Oral 3D modelling is one of the most essential stages in dentistry, and many different approaches, such as impression taking and intraoral scanning, are commonly used for this phase, each with notable limitations. Impression taking, which involves placing alginate or silicone material in a tray and inserting it into the patient's oral cavity to form a negative mold, suffers from significant patient discomfort, material deformation errors, and difficulties in storage and transportation. Intraoral scanners, which directly scan oral structures in real time using structured light or laser technology, produce state-of-the-art results but are associated with substantially high equipment costs. To address these limitations, this paper proposes a software-based approach that reconstructs a 3D oral model using only ten 2D intraoral images captured from different angles, requiring no dedicated hardware devices. The proposed method reduces cost, eliminates the need for physical scanning equipment, minimises patient discomfort, and enables automated 3D reconstruction. The model is trained on the publicly available Dental3DS dataset, comprising 950 upper jaw samples, and employs MobileNetV2 as the image encoder combined with Multi-head Attention for multi-view feature fusion. The proposed model achieves an accuracy of 77.49%, measured by nearest-neighbor matching with a distance threshold of 0.035. However, predicted vertices tend to concentrate in high-density regions of the ground truth, resulting in uneven point distribution across the reconstructed model.