Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-903, Brazil.
Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. do Cafe, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil.
Clin Oral Investig. 2021 Jan;25(1):195-202. doi: 10.1007/s00784-020-03353-x. Epub 2020 Jun 6.
To evaluate the effect of enhancement tools of intraoral digital radiographs on the assessment of vertical root fracture (VRF) and to quantify the resultant image noise.
Thirty single-rooted human teeth (15 control and 15 fractured) were each radiographed in four intracanal conditions: no filling, gutta-percha, metal post, and fiberglass post, totaling 120 original images. Two filters were applied to the original images-Sharpen filter (SF) and Edge Enhancement filter (EE), and brightness and contrast were adjusted in four combinations (B&C1 to 4), resulting in 840 images. Five oral radiologists analyzed the images for VRF detection. Pixel intensity was obtained in two regions from the radiographs. Diagnostic values were calculated and compared by two-way ANOVA, and the SD values of pixel intensity values were compared by one-way ANOVA (α = 0.05).
There were no significant differences in accuracy for VRF detection between the experimental groups (p > 0.05). Teeth with metal post presented the lowest sensitivity (p < 0.05) for all experimental conditions, except for SF and EE (p > 0.05). B&C2, B&C3, and B&C4 had higher specificity than SF (p ≤ 0.05) for all intracanal conditions. Analysis of pixel intensity showed that all enhanced images presented statistically significant higher noise compared to those of the original images (p ≤ 0.05).
Digital enhancement tools in digital radiography increase image noise; however, they can be used without compromising VRF detection.
The use of digital enhancement does not impair the detection of VRF and, therefore, can be applied for this purpose according to the observer preference.
评估口内数字化射线照片的增强工具对垂直根折（VRF）评估的影响，并量化由此产生的图像噪声。
30 颗单根人牙（15 颗对照牙和 15 颗折裂牙）分别在四种根管内条件下拍摄：无填充、牙胶、金属桩和玻璃纤维桩，共拍摄 120 张原始图像。对原始图像应用两种滤波器-锐化滤波器（SF）和边缘增强滤波器（EE），并在四种组合（B&C1 至 4）中调整亮度和对比度，共得到 840 张图像。五位口腔放射科医生分析图像以检测 VRF。从射线照片中获得两个区域的像素强度。通过双向方差分析计算并比较诊断值，并通过单向方差分析（α = 0.05）比较像素强度值的 SD 值。
实验各组的 VRF 检测准确性无显著差异（p > 0.05）。除 SF 和 EE 外（p > 0.05），所有实验条件下金属桩的牙齿的敏感性最低（p < 0.05）。对于所有根管内条件，B&C2、B&C3 和 B&C4 的特异性均高于 SF（p ≤ 0.05）。像素强度分析表明，与原始图像相比，所有增强图像的噪声均具有统计学意义（p ≤ 0.05）。
数字化射线照片中的数字增强工具会增加图像噪声；然而，在不影响 VRF 检测的情况下，可以使用它们。
数字增强的使用不会损害 VRF 的检测，因此可以根据观察者的偏好应用于该目的。
