Clinical-oriented 3D visualization and quantitative analysis of gingival thickness using convolutional neural networks and CBCT

Objective Traditional gingival thickness (GT) assessment methods provide only point measurements or simple classifications, lacking spatial distribution information. This study aimed to develop a CBCT-based 3D visualization system for gingival thickness using deep learning, providing a novel spatial assessment tool for implant surgery planning. Methods CBCT and intraoral scanning (IOS) data from 50 patients with tooth loss were collected to establish a standardized dataset. DeepLabV3+ architecture was employed for semantic segmentation of gingival and bone tissues. A 3D visualization algorithm incorporating vertical scanning strategy, triangular mesh construction, and gradient color mapping was innovatively developed to transform 2D slices into continuous 3D surfaces. Results The semantic segmentation model achieved a mIoU of 85.92 ± 0.43%. The 3D visualization system successfully constructed a comprehensive spatial distribution model of gingival thickness, clearly demonstrating GT variations from alveolar ridge to labial aspect through gradient coloration. The 3D model enabled millimeter-precision quantification, supporting multi-angle and multi-level GT assessment that overcame the limitations of traditional 2D measurements. Conclusion This system represents a methodological advancement from qualitative to spatial quantitative GT assessment. The intuitive 3D visualization serves as an innovative preoperative tool that identifies high-risk areas and guides personalized surgical planning, enhancing predictability for aesthetic and complex implant cases.