ProtoPointNet: Prototype-Based Interpretable Classification of 3D Dental Point Clouds with Verifiable Spatial Activations

George V. Jose, Thao Liang Chiam, Toby Hughes, Dilan Patel, Alan Brook, Lyle J. Palmer, Nikhil Cherian Kurian

Prototype-based networks provide inherently interpretable classification by linking predictions to learned exemplars, but their use in 3D point clouds and clinical surface-pair reasoning remains limited. We introduce ProtoPointNet, a prototype-based model for dental occlusion classification from registered upper--lower intraoral arch pairs. Each point is encoded by a 14-dimensional descriptor combining local surface geometry, curvature, and explicit inter-arch displacement and clearance, exposing occlusal relationships to prototype matching. A shared multi-task point-cloud backbone learns axis-specific prototype heads for sagittal-left, sagittal-right, vertical, transverse, and midline classification. To support limited clinical data, we train prototypes from scratch using auxiliary supervision and encoder-freeze hand-off. On Bits2Bites, ProtoPointNet achieves mean test macro-F1 of 0.724 and AUROC of 0.825, with strongest performance on vertical (F1 0.828) and sagittal-left classification (F1 0.807). Projected prototype activations localise to anatomically plausible regions, including posterior molars and premolars for cross-bite evidence and anterior incisors for bite-depth evidence. These results support prototype-based reasoning as a transparent, spatially grounded alternative to black-box 3D classifiers for dental surface-pair analysis.