A deep learning based automated maxillary sinus segmentation and bone grafts analysis in CBCT images

Precise evaluation of bone gain after maxillary sinus augmentation is critical for optimizing implant therapy yet manual measurements remain time consuming. This study validated a fully automated deep learning system named SA-ai to quantify bone augmentation. A paired CBCT dataset from 85 patients was used to train and test the system which integrates a 2D U-Net for sinus contour and a 3D V-Net for maxilla segmentation. The system achieved a Dice coefficient of 93.2% and registration RMSE of 1.046 mm. Clinical validation against manual measurements showed excellent agreement for bone volume (ICC = 0.993) and other parameters. Bias analysis confirmed measurement stability while workflow efficiency improved over 20-fold compared to manual methods. This registration subtraction paradigm delivers an automated and objective solution for longitudinal monitoring of bone graft volume including one-stage implant cases potentially standardizing clinical evaluation of post augmentation bone dynamics.