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• An accurate and efficent automatic tooth segmentation network on 3D dental models. • A novel two-stage network architecture for tooth centroid extraction and segmentation. • Evaluated on 2000 dental models collected real-world clinics. • Achieved state-of-the-art performance in terms of accuracy and efficiency. Automatic and accurate segmentation of dental models is a fundamental task in computer-aided dentistry. Previous methods can achieve satisfactory segmentation results on normal dental models; however, they fail to robustly handle challenging clinical cases such as dental models with missing, crowding, or misaligned teeth before orthodontic treatments. In this paper, we propose a novel end-to-end learning-based method, called TSegNet , for robust and efficient tooth segmentation on 3D scanned point cloud data of dental models. Our algorithm detects all the teeth using a distance-aware tooth centroid voting scheme in the first stage, which ensures the accurate localization of tooth objects even with irregular positions on abnormal dental models. Then, a confidence-aware cascade segmentation module in the second stage is designed to segment each individual tooth and resolve ambiguities caused by aforementioned challenging cases. We evaluated our method on a large-scale real-world dataset consisting of dental models scanned before or after orthodontic treatments. Extensive evaluations, ablation studies and comparisons demonstrate that our method can generate accurate tooth labels robustly in various challenging cases and significantly outperforms state-of-the-art approaches by 6.5% of Dice Coefficient, 3.0% of F1 score in term of accuracy, while achieving 20 times speedup of computational time. [ABSTRACT FROM AUTHOR]