Beyond Ground Truth: A Heuristic Unsupervised Quality Assurance Engine for Diagnosing Calibrational Blindness in Dental Segmentation

In real-world clinical settings, dental X-ray segmentation using deep learning methods suffers from reliability issues. Even when the segmentation quality is bad, deep learning models show high confidence in their predictions (calibrational blindness). Moreover, in real use, doctors do not have ground-truth masks to check their accuracy. To address this problem, we introduce a simple quality-checking engine called HUS-QA with three stages. We train it on the PRAD (Periapical Dental X-ray) dataset to build our SimCLR self-supervised ResNet-18 U-Net model, which generates the segmentation mask and then evaluates its quality. Our HUS-QA checks the segmentation mask quality without a ground-truth mask. Prediction confidence, edge sharpness, shape connectivity, and area-size penalty are the simple indicators considered in this research. Results show that standard confidence methods fail (r = -0.1394, p = 1.7864e-3, ROC AUC = 0.4275). By contrast, our HUS-QA shows a positive correlation with actual Dice scores (r = 0.4647, p = 3.7510e-28) and achieves a strong ROC-AUC of 0.8405. Therefore, HUS-QA serves as a practical tool for clinical quality control.