Landmark-Guided Geometric Warping and GAN Refinement for Controllable and Explainable Cephalometric Profile Transformation

Orthodontic treatment planning often involves visualizing skeletal profile modifications, with CONVEX and CONCAVE morphologies frequently requiring geometric corrections toward more balanced configurations. However, existing GAN-based latent editing methods achieve insufficient skeletal control for clinically significant Pogonion displacement. A hybrid geometric–generative framework is introduced thatdecouples deterministic skeletal modification from photorealistic synthesis to address the manipulability limits of StyleGAN-based editing. Radial basis function warping with adaptive amplification (1.8–4.5×) produces controlled mandibular advancement or setback, while StyleGAN2 refinement with 100× landmark weighting restores anatomical realism without compromising structural accuracy. Multi-task regularization combining diversity loss with landmark-consistency constraints mitigates dataset imbalance and enables balanced generation across profile classes (approximately 31% each), countering the predominance of CONVEX cases (63%). The system achieves 10–15 pixel Pogonion displacement with < 3-pixel landmark drift (0.9 mm average), providing reliable and anatomically stable correction. Interactive profile morphing animations provide explainable visualization of transformation trajectories through transparent, frame-by-frame display, enabling clinically interpretable exploration of treatment outcomes across the full CONVEX-to-CONCAVE spectrum. Integrated Vision Transformer classifiers and regressors automate the Visual Treatment Objective workflow, reaching 89% profile-classification accuracy and 95.6% landmark-regression accuracy within a 2-pixel tolerance. Ablation analysis confirms that standard latent editing produces only1.4 pixels of Pogonion movement, demonstrating the necessity of explicit geometric control for skeletal transformations where skeletal landmarks define individual patient morphology.