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Santos CV, Correia VAG, Felizardo HMA, Esteves A, Rossi-Júnior WC, Pigossi SC, Gaêta-Araujo H. The effect of different spatial resolutions and enhancement filters on radiographic detection of simulated furcation defects with intraoral digital radiography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:518-528. [PMID: 37407350 DOI: 10.1016/j.oooo.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/20/2023] [Accepted: 05/18/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the effects of spatial resolution and the application of enhancement filters in the diagnosis of simulated furcation defects and image quality with intraoral radiographs. STUDY DESIGN Periapical images were acquired with photostimulable phosphor plates of molars in dry skulls (n = 8) and mandibles (n = 10) with 4 stages of furcation defect simulation. The plates were scanned in fast scan and high resolution modes to produce different spatial resolutions. Four image filters were applied. Six observers scored the detection of furcation defects. Mean values of area under the curve in receiver operating characteristic evaluation, accuracy, sensitivity, and specificity were calculated. Mean gray value (brightness), noise, and contrast-to-noise ratio (CNR) were calculated for enamel, dentin, and alveolar bone to evaluate image quality. Analysis of variance compared the values between the different spatial resolutions and filters. The significance of difference was established at P < .05. RESULTS There were no significant differences in overall diagnostic values comparing image spatial resolutions and filters. Diagnostic outcomes were significantly better for the largest defects than the smallest lesions but were generally poor in detecting lesions. All structures showed greater brightness in high resolution. . Noise was greater in all structures with all enhancement filters except inversion. Dentin and alveolar bone exhibited more noise and lower CNR in high resolution. CONCLUSIONS Varying spatial resolution and applying enhancement filters did not significantly affect the diagnosis of furcation defects.
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Affiliation(s)
| | | | | | - Alessandra Esteves
- Department of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Wagner Costa Rossi-Júnior
- Department of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Suzane Cristina Pigossi
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Hugo Gaêta-Araujo
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
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Evaluation of resolution characteristics of digital intraoral radiographic images using a task transfer function. Oral Radiol 2022; 38:638-644. [PMID: 35767125 DOI: 10.1007/s11282-022-00633-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES This study aimed to quantitatively examine the effect of digital image processing of digital intraoral radiographic images on the resolution characteristics of the output image using a task transfer function (TTF). METHODS A photostimulable phosphor system with three types of image processing filters, including periodontal, endodontic, and dentine-to-enamel junction filters, was used. Each filter can be used in conjunction with the sharpness filter (+ S). Images were obtained from the original phantom, which combined aluminum disk and plate. The TTF, which indicates the resolution characteristics, was calculated. A one-dimensional profile curve was also measured, and the fluctuation in the pixel value was evaluated in detail. The results were compared to investigate the effects of digital image processing on digital intraoral radiographic images. RESULTS The TTF values were specific to each filter. The change in the TTF strongly reflected the characteristics of the one-dimensional profile curve. The TTF was compared with a one-dimensional profile curve and was able to quantitatively express the resolution characteristics of all directions in the image. CONCLUSIONS We attempted to evaluate the resolution characteristics of digital intraoral radiographic images with image processing filters using the TTF. The effect of each image processing filter and the + S filter on the resolution can be simply expressed using the TTF. Our results show that the TTF is useful for characterizing the resolution characteristics of image processing filters for image quality.
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The impact of digital filters on the diagnosis of simulated root resorptions in digital radiographic systems. Clin Oral Investig 2022; 26:4743-4752. [PMID: 35267096 DOI: 10.1007/s00784-022-04438-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the influence of digital filters of intraoral radiographic systems on the diagnosis of simulated internal and external root resorptions and image quality. MATERIALS AND METHODS Internal root resorption (IRR) and external root resorption (ERR) were simulated in 34 teeth. For image acquisition, two radiographic systems were used: Digora Toto and VistaScan. All filters available in these systems were applied. Three observers scored the detection of root resorptions in a 5-point scale. The noise and the contrast-to-noise ratio (CNR) were calculated. The area under ROC curve, sensitivity, specificity, and accuracy were obtained. One-way ANOVA with Tukey's post hoc tests compared the diagnostic values, noise, and CNR between the filters (α = 0.05). RESULTS For ERR, there were no significant differences in diagnostic values between the filters tested for both systems. For IRR, Original and Noise Reduction filters presented higher sensitivity than the Sharpen2 filter for images from Digora Toto, with no differences between the other groups. For VistaScan, there were no significant differences of diagnostic values between the groups studied. Noise values differed among the filters of both systems. The CNR of the filters differed only for the bone region for Digora Toto, while for VistaScan, both tooth and bone regions differed. CONCLUSIONS Despite promoting changes in pixel intensities and affecting the noise level of the radiographic images, the digital filters of Digora Toto and VistaScan systems do not affect the diagnosis of internal or external root resorptions. CLINICAL RELEVANCE Digital filters are common tools in digital radiographic systems and may be used by the professional without impairment in root resorptions diagnosis.
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da Silveira Tiecher PF, Assein Arús N, Adams Hilgert E, Dias da Silveira HE, Pante Fontana M, Dias da Silveira HL, Vizzotto MB. Exploring digital filters for internal root resorption: how can we improve the diagnosis of small lesions? Dentomaxillofac Radiol 2021; 51:20210314. [PMID: 34767483 PMCID: PMC9499201 DOI: 10.1259/dmfr.20210314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the impact of enhancement filters in detecting small simulated internal root resorptions (IRR). METHODS: Forty-two extracted human teeth were sectioned, connected, and stored in a dry human jaw and X-rayed with photostimulable phosphor plates (PSPs), composing the control group (CG). In the middle-third of the root canals, IRR lesions were simulated using Da Silveira protocol. Later, the specimens were X-rayed to create the test group (TG). All images acquired were exported with seven enhancement filters plus the original image. Three examiners used a five-point Likert scale to evaluate the images regarding the presence/absence of IRR. Diagnostic efficacy was assessed from sensitivity and specificity results. Comparison among filters was performed by using receiver operating characteristic (ROC) curve analysis. RESULTS: Moderate values of Kappa interexaminer (0.403-0.620) and high values of Kappa intraexaminer (0.757-0.915) were observed. The best performance occurred in the CG (p < 0.05). Original images presented the greatest sensitivity and area under the ROC curve (0.595-0.750), while the Endo filter presented the greatest specificity (0.952). Inversion and Pseudo-3D images produced the greatest doubt in the diagnosis, significant for CG with the Pseudo-3D filter (p < 0.05). CONCLUSIONS: The Original and 'Endo' filters should be chosen as it offers greater diagnostic ability and allows more confidence during the evaluation.
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Affiliation(s)
| | - Nádia Assein Arús
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduarda Adams Hilgert
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Heloisa Emilia Dias da Silveira
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Heraldo Luís Dias da Silveira
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana Boessio Vizzotto
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Evaluation of the combined assessment of two digital enhancement filters in periapical radiographs obtained with different projection angles in the detection of simulated dental root fractures. Oral Radiol 2021; 38:234-239. [PMID: 34195932 DOI: 10.1007/s11282-021-00550-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the diagnostic efficacy of the combined assessment of the original radiographic image with the Invert or Emboss digital enhancement filters in periapical radiographs obtained with different horizontal projection angles in the detection of simulated dental root fracture. MATERIALS AND METHODS Thirty-four single-rooted teeth were selected, out of which 17 teeth were subjected to root fracture. Each tooth was individually placed in an empty socket of a dry human maxilla or mandible and X-rayed following the paralleling technique at three horizontal projections: mesial, right angle, distal. Then, the Invert and Emboss enhancement filters were applied. Five examiners independently evaluated all the images and rated the fractures using a 5-point scale. Weighted kappa test assessed the intra- and interexaminer agreements. Diagnostic values were calculated and the areas under the receiver operating characteristic curve (AUC) were compared using two-way ANOVA with Tukey test as post hoc (α = 0.05). RESULTS The inter- and intraexaminer agreement ranged from moderate to almost perfect and from substantial to almost perfect, respectively. Diagnostic values were considerably high for all conditions with no significant difference between the AUC values (p > 0.05). CONCLUSIONS The combined use of the original radiographic image with the Invert or Emboss digital enhancement filters in periapical radiographs obtained with different projection angles did not influence the detection of simulated dental root fracture.
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Application of image processing techniques to aid in the detection of vertical root fractures in digital periapical radiography. Clin Oral Investig 2021; 25:5077-5085. [PMID: 33543383 DOI: 10.1007/s00784-021-03820-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To present an image processing framework to improve the detection of vertical root fractures (VRFs) in digital periapical radiography. MATERIALS AND METHODS Thirty endodontically treated human teeth (15 of them fractured with a metal post inserted into them, and 15 for the control) were enclosed in a dry mandible and radiographed individually. The proposed framework was applied to the raw data, as a preprocessing step, and was composed of four stages: geometric adjustment and negative, denoising, adaptive contrast enhancement, and gamma correction. The contrast-to-noise ratio (CNR) and sharpness of the image's VRF region were used for the objective evaluation of the method. In addition, five examiners evaluated the original and enhanced images, using a 5-point scale to assess confidence. RESULTS The objective results showed that the proposed framework increased the CNR of the VRF region by 173% compared to the standard preprocessing method provided by the detector's manufacturer. The results found by the human observers indicated that the area under the curve (AUC) and sensitivity of the diagnosis of VRF significantly increased by 4% and 17% (p ≤ 0.05), respectively, when the examiners evaluated the image with the proposed method concomitantly with the image available in the commercial software. However, the specificity was reduced. CONCLUSIONS The proposed image processing framework can be used as an additional tool to that provided by the manufacturer to increase the sensitivity and AUC of the diagnosis of VRF. CLINICAL RELEVANCE The proposed method can be easily used in clinical practice to aid VRF detection, since it does not incur high computational costs and does not increase the radiation dose applied to the patient.
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Costa ED, Brasil DM, Gaêta-Araujo H, Oliveira-Santos C, Freitas DQ. Do image enhancement filters in complementary metal oxide semiconductor and photostimulable phosphor imaging systems improve the detection of fractured endodontic instruments in periapical radiography? Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:247-255. [DOI: 10.1016/j.oooo.2020.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 11/26/2022]
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Effect of digital enhancement on the radiographic assessment of vertical root fractures in the presence of different intracanal materials: an in vitro study. Clin Oral Investig 2020; 25:195-202. [PMID: 32506327 DOI: 10.1007/s00784-020-03353-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES 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. MATERIALS AND METHODS 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). RESULTS 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). CONCLUSION Digital enhancement tools in digital radiography increase image noise; however, they can be used without compromising VRF detection. CLINICAL RELEVANCE 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.
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Farias Gomes A, Nejaim Y, Fontenele RC, Haiter-Neto F, Freitas DQ. Influence of the incorporation of a lead foil to intraoral digital receptors on the image quality and root fracture diagnosis. Dentomaxillofac Radiol 2019; 48:20180369. [PMID: 30982341 DOI: 10.1259/dmfr.20180369] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the quality of images obtained with the addition of a lead foil to intraoral digital receptors. METHODS Radiographic images of 34 single-rooted human teeth - 19 with vertical root fracture (VRF) and 15 of the control group - were obtained with and without the addition of a lead foil, using the VistaScan, Express, Digora Optime and Digora Toto systems. Images were evaluated by five observers regarding the diagnosis of VRF, using a 5-point scale. In a second moment, an observer preference analysis related to the presence of the lead foil was performed. Images of an acrylic phantom were also obtained with and without the addition of a lead foil, and the quantities of uniformity, grey value and standard deviation of grey values were obtained. RESULTS There were no significant differences in the VRF diagnostic values, considering the presence of the lead foil. Regarding the image quality preference, the observers preferred images acquired with the lead foil for all systems tested, but with greater values for Digora Optime (61.33%) and Express (61.33%). The presence of the lead foil did influence the image uniformity in all systems tested ( p < 0.05). Moreover, the lead foil increased the mean of grey values for Digora Optime and Express images ( p < 0.05), however it did not influence the SD in any of the digital systems ( p > 0.05). CONCLUSION The addition of a lead foil to intraoral digital receptors produces a positive effect in the image quality objectively detected by means of uniformity and subjective visual preference.
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Affiliation(s)
- Amanda Farias Gomes
- Department of Oral Diagnosis - Dental Radiology, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Yuri Nejaim
- Department of Oral Diagnosis - Dental Radiology, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis - Dental Radiology, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis - Dental Radiology, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis - Dental Radiology, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
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Montesinos GA, de Castro Lopes SLP, Trivino T, Sánchez JA, Maeda FA, de Freitas CF, Costa ALF. Subjective analysis of the application of enhancement filters on magnetic resonance imaging of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:552-559. [PMID: 30587453 DOI: 10.1016/j.oooo.2018.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 10/11/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of enhancement filters on magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). STUDY DESIGN In total, 66 MRI scans of the TMJ were analyzed without filtration and with the application of 2 filters: Sharpen 1 and Sharpen 2 (OnDemand software). Two dentomaxillofacial radiologists examined the original and filtered images individually. Intra- and interobserver concordance was measured by using generalized estimating equations. The observers evaluated the subjective image quality and the visibility of 3 components of the TMJ: disk, condyle, and articular eminence. The images were ranked on a 4-point scale, from poor to excellent. The image quality of all filtered images was compared by using the χ2 test and Bonferroni correction for multiple comparisons. RESULTS Intra- and interobserver concordance was good. The images filtered with Sharpen 1 and Sharpen 2 provided better definition of the structures compared with nonfiltered images, providing the highest scores for subjective image quality for all structures (P < .0001). CONCLUSIONS The use of enhancement filters led to improved subjective quality and may improve the diagnostic efficacy of MRI in TMJ evaluation.
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Affiliation(s)
- Gonzalo André Montesinos
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | | | - Tarcila Trivino
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | | | - Fernando Akio Maeda
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | - Claudio Fróes de Freitas
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | - Andre Luiz Ferreira Costa
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil.
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Barayan M, Nasseh I, Geha H, Noujeim M. The Effects of Imaging Enhancement Tools in the Detection of Horizontal Root Fractures. J Clin Diagn Res 2017; 11:ZC98-ZC101. [PMID: 28969284 DOI: 10.7860/jcdr/2017/26775.10490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/13/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Detection of root fracture is challenging both clinically and radiographically. Root fractures occur in different planes with unpredictable presentations. AIM The aim of the study was to evaluate the diagnostic accuracy of selected digital image enhancement tools in the detection of horizontal Root Fracture (RF). MATERIALS AND METHODS Fifty three roots, of single and multi-rooted teeth, in eight dentate human cadaver mandibles were selected for this study. Following minimally traumatic extraction of the teeth, horizontal fractures were induced in 23 roots and remounted in the empty sockets of their respective human dry mandibles. The remaining teeth with no fractures were used as the control group. Twenty two periapical radiographs were obtained by using the paralleling technique and using Complementary Metal Oxide Semiconductor (CMOS). Image J software was used to enhance the original images with the Inversion (IN), Histogram-Equalization (EQ) and Polynomial (Poly) tools. A total of 88 periapical images (original and three enhanced images) were reviewed independently by three Oral and Maxillofacial Radiologists and two Endodontists. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the accuracy of fracture detection and the kappa statistic was used to assess agreement among reviewers. RESULTS The diagnostic accuracy for one of the observers was significantly different in detection of RF with only EQ enhancement tool. Sensitivity and specificity were not significantly different. Interobserver agreement showed no significant difference between imaging methods. Intra-observer agreement was high to moderate. CONCLUSION There was no significant difference between the different imaging modalities. No statistical difference for the agreement was found among or between the endodontists and radiologists in this study.
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Affiliation(s)
- Mohammed Barayan
- Oral Radiology Graduate, Department of Comprehensive Dentistry, University of Texas, Health Science Center, San Antonio, Texas, USA
| | - Ibrahim Nasseh
- Professor and Chairman, Department of Dentomaxillofacial Radiology and Imaging, Faculty of Dentistry, Beirut, Lebanon
| | - Hassem Geha
- Assistant Professor, Department of Comprehensive Dentistry, University of Texas, Health Science Center, San Antonio, Texas, USA
| | - Marcel Noujeim
- Professor, Department of Comprehensive Dentistry, University of Texas, Health Science Center, San Antonio, Texas, USA
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Verner FS, D'Addazio PS, Campos CN, Devito KL, Almeida SM, Junqueira RB. Influence of Cone-Beam Computed Tomography filters on diagnosis of simulated endodontic complications. Int Endod J 2017; 50:1089-1096. [DOI: 10.1111/iej.12732] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 12/07/2016] [Indexed: 12/25/2022]
Affiliation(s)
- F. S. Verner
- Division of Oral Radiology; Department of Dentistry; Federal University of Juiz de Fora; Governador Valadares Minas Gerais Brazil
| | - P. S. D'Addazio
- Hospital Maternidade Therezinha de Jesus-HMTJ/JF and Suprema-Faculdade Ciências Médicas e da Saúde Juiz de Fora; Juiz de Fora Minas Gerais Brazil
| | - C. N. Campos
- Division of Endodontics; Department of Dental Clinics; School of Dentistry; Federal University of Juiz de Fora; Juiz de Fora Minas Gerais Brazil
| | - K. L. Devito
- Division of Oral Radiology; Department of Dental Clinics; School of Dentistry; Federal University of Juiz de Fora; Juiz de Fora Minas Gerais Brazil
| | - S. M. Almeida
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - R. B. Junqueira
- Division of Endodontics; Department of Dentistry; Federal University of Juiz de Fora; Governador Valadares Minas Gerais Brazil
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Queiroz PM, Nascimento HAR, da Paz TDJ, Anacleto FN, Freitas DQ. Accuracy of Digital Subtraction Radiography in the Detection of Vertical Root Fractures. J Endod 2016; 42:896-9. [PMID: 27080116 DOI: 10.1016/j.joen.2016.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 03/01/2016] [Accepted: 03/06/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate the accuracy of digital subtraction radiography in the diagnosis of vertical root fractures (VRFs). METHODS Twenty decoronated uniradicular human teeth were placed in the alveoli of a dry mandible and radiographed twice, first without (unfilled roots) and then with (filled roots) a gutta-percha cone placed into the root canal. Roots were then removed from the dry mandible, and vertical fractures were created with the aid of a universal testing machine. The fractured roots were repositioned in the mandibular alveoli and again radiographed twice. Radiographic images were subtracted by using the Regeemy software in 3 test situations: group 1, initial radiographic images of unfilled roots and images of fractured or non-fractured unfilled roots; group 2, initial radiographic images of unfilled roots and images of fractured or non-fractured filled roots; and group 3, initial radiographic images of filled roots and images of fractured or non-fractured filled roots. Three examiners evaluated all the original digital radiographs, as well as the subtracted images, for the presence or absence of VRFs. Numerical data were subject to statistical analysis with the use of receiver operator characteristic (ROC) curves. RESULTS The areas under the ROC curve for groups 1, 2, and 3 were 0.86, 0.73, and 0.66, respectively. For the original digital radiographs, areas under the ROC curve were 0.80 (without gutta-percha) and 0.73 (with gutta-percha). No statistically significant differences were found between subtracted and original images. CONCLUSIONS Digital subtraction radiography could be considered as an alternative tool for the investigation of VRFs because of its comparable diagnostic accuracy to existing methods.
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Affiliation(s)
- Polyane Mazucatto Queiroz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Helena Aguiar Ribeiro Nascimento
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil.
| | - Thais Diniz Jacome da Paz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Felipe Nogueira Anacleto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
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Nascimento HAR, Visconti MAPG, Ferreira LM, Suarez MA, Haiter Neto F, Freitas DQ. Effect of delayed scanning on imaging and on the diagnostic accuracy of vertical root fractures in two photostimulable phosphor plates digital systems. Int Endod J 2015; 49:973-9. [PMID: 26354080 DOI: 10.1111/iej.12547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/05/2015] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the influence of delayed scanning on images obtained with two PSPs digital systems and on the diagnostic accuracy of vertical root fracture (VRF) by means of objective and subjective analyses. METHODOLOGY Forty single-rooted human teeth were divided into two groups, one without VRFs and another with VRFs induced by a universal testing machine. Two digital systems (VistaScan(®) and Express(®) ) were used to radiograph all teeth, and the resulting plates were scanned at four time-points: T0-immediately, T1-30 min, T2-2 h and T3-4 h after exposure. An aluminium (Al) wedge was used to evaluate the change in mean grey values as each scan was delayed. Three observers screened all images for VRFs, and one-fourth of the sample was revaluated after thirty days. Areas under the receiver operating characteristic (ROC) curve, sensitivity, specificity and accuracy values were compared by anova. RESULTS Intra- and interobserver agreement ranged from moderate to substantial and fair to moderate, respectively. There was no significant difference amongst scan delays with regard to sensitivity, specificity and accuracy; however, there were significant differences in the area under the ROC curve, with the 4-h delayed scan being associated with lower values compared to the others (P = 0.019). As for objective analysis, there was a significant difference amongst all different scanning time-points for the two systems (P = 0.001), except between the 30-min and 2-h delayed scans in the VistaScan(®) system. CONCLUSION Whilst delayed scanning caused changes to the density of images acquired with the systems studied, it did not seem to interfere with VRF diagnosis except when scanning was delayed for 4 h, which should therefore be avoided.
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Affiliation(s)
- H A R Nascimento
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil.
| | - M A P G Visconti
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - L M Ferreira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - M A Suarez
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - F Haiter Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - D Q Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
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15
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Ferreira LM, Visconti MAPG, Nascimento HA, Dallemolle RR, Ambrosano GM, Freitas DQ. Influence of CBCT enhancement filters on diagnosis of vertical root fractures: a simulation study in endodontically treated teeth with and without intracanal posts. Dentomaxillofac Radiol 2015; 44:20140352. [PMID: 25666446 DOI: 10.1259/dmfr.20140352] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To evaluate the influence of CBCT enhancement filters on the diagnosis of vertical root fractures (VRFs) in teeth with and without metal posts. METHODS The crowns of 40 uniradicular human teeth were removed and all roots were prepared. 20 teeth were randomly selected, and VRFs were induced using a universal testing machine. The i-CAT (Imaging Sciences International, Hatfield, PA) CBCT was used to scan teeth with and without intracanal metal posts using the following parameters: 0.2 voxel size, 8 × 8-cm scan size and acquisition time of 26.9 s. Images were evaluated by three observers with and without the use of the following filters: S9, smooth, smooth 3 × 3, sharpen, sharpen-mild and sharpen 3 × 3. RESULTS Intra- and interobserver agreement ranged from poor to moderate. Images with and without CBCT filters did not show significant differences regarding the area under the receiver operating characteristic curve, as well as sensitivity (p > 0.05). As for accuracy, the sharpen-mild filter was superior to the sharpen (p = 0.03), but these filters did not differ from all others. For specificity, S9, smooth and original images were superior to sharpen (p < 0.01). Results for teeth without posts differed from those for teeth with metal posts in all cases (p < 0.05). CONCLUSIONS The use of enhancement filters in CBCT images has no influence on the diagnosis of VRFs in teeth with metal posts, and their use is not justified.
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Affiliation(s)
- L M Ferreira
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
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16
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Nascimento HAR, Neves FS, de-Azevedo-Vaz SL, Duque TM, Ambrosano GMB, Freitas DQ. Impact of root fillings and posts on the diagnostic ability of three intra-oral digital radiographic systems in detecting vertical root fractures. Int Endod J 2014; 48:864-71. [DOI: 10.1111/iej.12382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/20/2014] [Indexed: 11/30/2022]
Affiliation(s)
- H. A. R. Nascimento
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba Brazil
| | - F. S. Neves
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba Brazil
| | - S. L. de-Azevedo-Vaz
- Department of Clinical Dentistry; Faculty of Dentistry; Federal University of Espírito Santo; Vitória Brazil
| | - T. M. Duque
- Division of Endodontics; Department of Clinical Dentistry; Piracicaba Dental School; State University of Campinas; Piracicaba Brazil
| | - G. M. B. Ambrosano
- Division of Bioestatistcs; Department of Community Dentistry; Dental School of Piracicaba; State University of Campinas; Piracicaba Brazil
| | - D. Q. Freitas
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba Brazil
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