Accuracy of digital Radiography in the detection of Root Fractures in Multirooted Teeth

This study aimed to evaluate the contribution of filters of CliniViewTM software on detection of vertical root fractures of multirooted teeth with intracanal metal retainers on periapical digital radiographs. For this, 22 human teeth were randomly divided into fractured group and control group, each one containing 11 teeth. The teeth were endodontically treated and after desobturation of ⅔ from the root, intracanal metallic posts were installed. The fractures were made only in the fractured group, and all teeth were x-rayed using an Express™ intraoral digital system and the images optimized in Cliniview™ software. The analysis of radiographs was made for 2 specialists with, at least, five years of experience in the area. The original images were evaluated, with application of filters Sharpen 1, grayscale inversion, emboss, vertical and vertical + horizontal, separately. After analysis, the accuracy, sensitivity, specificity, positive and negative predictive value of original periapical radiography were calculated and with the use of filters, for each evaluator. The filter “sharpen 1” had the highest accuracy (0.652) and sensibility (0,543). On the other, the filter “grayscale inversion” had the highest specificity (0.955). The interobserver kappa index was 0,351, considering p<0,001 and interobserver kappa 0,333 and 0,512 for the evaluators 1 and 2 respectively. It is concluded that the contribution of the filters is professional-dependent and, in this study, the filter “sharpen 1” contributed to all of images evaluated, differently from the filter “grayscale inversion”, that disturbed the radiographic diagnosis of root fracture in multirooted teeth.