title: Influence of cone beam CT enhancement filters on diagnosis ability of longitudinal root fractures.
abstract: OBJECTIVE
  To determine whether cone beam CT (CBCT) enhancement filters influence the diagnosis of longitudinal root fractures.
  
  
  METHODS
  40 extracted human posterior teeth were endodontically prepared, and fractures with no separation of fragments were made in 20 teeth of this sample. The teeth were placed in a dry mandible and scanned using a Classic i-CAT® CBCT device (Imaging Sciences International, Inc., Hatfield, PA). Evaluations were performed with and without CBCT filters (Sharpen Mild, Sharpen Super Mild, S9, Sharpen, Sharpen 3 × 3, Angio Sharpen Medium 5 × 5, Angio Sharpen High 5 × 5 and Shadow 3 × 3) by three oral radiologists. Inter- and intraobserver agreement was calculated by the kappa test. Accuracy, sensitivity, specificity and positive and negative predictive values were determined. McNemar test was applied for agreement between all images vs the gold standard and original images vs images with filters (p < 0.05).
  
  
  RESULTS
  Means of intraobserver agreement ranged from good to excellent. Angio Sharpen Medium 5 × 5 filter obtained the highest positive predictive value (80.0%) and specificity value (76.5%). Angio Sharpen High 5 × 5 filter obtained the highest sensitivity (78.9%) and accuracy (77.5%) value. Negative predictive value was the highest (82.9%) for S9 filter. The McNemar test showed no statistically significant differences between images with and without CBCT filters (p > 0.05).
  
  
  CONCLUSIONS
  Although no statistical differences was observed in the diagnosis of root fractures when using filters, these filters seem to improve diagnostic capacity for longitudinal root fractures. Further in vitro studies with endodontic-treated teeth and research in vivo should be considered.
authors.affiliation: Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil ;
authors.forename: M C C
authors.initials: MC
authors.lastname: Nascimento
authors.forename: Y
authors.initials: Y
authors.lastname: Nejaim
authors.forename: S M
authors.initials: SM
authors.lastname: de Almeida
authors.forename: F N
authors.initials: FN
authors.lastname: Bóscolo
authors.forename: F
authors.initials: F
authors.lastname: Haiter-Neto
authors.forename: L C
authors.initials: LC
authors.lastname: Sobrinho
authors.forename: E J N L
authors.initials: EJ
authors.lastname: Silva
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000295:instrumentation* / Q000706:statistics & numerical data; D005374:Filtration / Q000295:instrumentation*; D006801:Humans; D015588:Observer Variation; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D014082:Tooth Fractures / Q000145:classification / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging
keywords: cone beam computed tomography; radiographic image enhancement; root fractures