Effect of Image Processing on the Diagnosis of Root Fractures in Digital Periapical Radiography

Background: Two-dimensional digital radiography is the most common diagnostic tool for detecting root fractures. Contrast, sharpness, and colorization are tools used to enhance radiographic images. Any activity aimed at improving, restoring, analyzing, or altering a digital image in any manner is referred to as image processing. This study aimed to evaluate the effects of utilizing image editing features on the diagnosis of root fractures in digital radiographs. Methods: A total of 70 single-rooted teeth were examined in this cross-sectional study. The teeth were initially endodontically treated, and the coronal third of the gutta-percha was removed to induce fractures. The crowns of the teeth were then sectioned, and the samples were randomly divided into two groups. In the first group, controlled fractures were induced using gentle hammer blows, while the teeth in the second group remained intact. The teeth were placed in the bovine rib bone, and red wax was used to simulate the gingiva. Digital periapical radiographs of all teeth were captured using a size 2 sensor. Modifications were then made to the sharpness, contrast, and colorization of the radiographic images to investigate the impact of these alterations on the precision of diagnosing root fractures. The obtained data were analyzed using SPSS. Results: The results showed that the area under the receiver operating characteristic curve was higher when the sharpness (62.8%) and colorization (65.71%) of the images were altered compared to other cases. Considering that this value is an appropriate criterion for selecting the optimal point for sensitivity and specificity, it appears that enhancing images in terms of sharpness and colorization can improve the accuracy of specialists in diagnosing root fractures. Conclusion: Enhancing images through adjustments in sharpness and colorization can improve the diagnostic accuracy for root fractures.