title: The effect of two enhancement tools on the assessment of the relationship between third molars and the inferior alveolar canal.
abstract: OBJECTIVE
  This study aims to assess the relationship between the inferior alveolar canal (IAC) and inferior third molars using digital panoramic images (DPI) with and without enhancement and compare the panoramic signs with cone beam computed tomography (CBCT) findings.
  
  
  METHODS
  The DPIs and CBCT of 50 patients were analyzed. The DPIs were copied and enhanced using edge enhancement and an invert tool and then analyzed by two observers using the scores: darkening of the root; deflection of the root; narrowing of the root; superimposition of the root; bifurcation of the root over the IAC; diversion of the IAC; interruption of the cortex of the IAC, and no radiographic findings noted. Kappa and exact binominal tests were used to analyze the correlation between DPIs and CBCT images. The intimate relationship scores were evaluated using a t-test and Mann-Whitney test.
  
  
  RESULTS
  The original DPIs, and the edge enhanced and invert tool images produced kappa coefficients of 0.528, 0.528 and 0.551, respectively. There was no difference among the methods evaluated in this study (p = 0.981).
  
  
  CONCLUSIONS
  Similar agreement was observed between DPIs with and without enhancement. However, panoramic radiography is not the ideal method to analyze the relationship between lower third molars and the IAC.
authors.affiliation: Department of Oral Diagnosis, Federal University of Paraíba, João Pessoa, PB, Brazil. Electronic address: larissarngl@gmail.com.
authors.forename: Larissa Rangel
authors.initials: LR
authors.lastname: Peixoto
authors.affiliation: Department of Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address: amandaggonzaga@gmail.com.
authors.forename: Amanda Katarinny Goes
authors.initials: AK
authors.lastname: Gonzaga
authors.affiliation: Department of Oral Pathology, Radiology & Medicine, The University of Iowa College of Dentistry, Iowa City, IA, USA. Electronic address: sauloleonardo-sousamelo@uiowa.edu.
authors.forename: Saulo Leonardo Sousa
authors.initials: SL
authors.lastname: Melo
authors.affiliation: Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, PE, Brazil. Electronic address: mlpontual@gmail.com.
authors.forename: Maria Luiza Dos Anjos
authors.initials: ML
authors.lastname: Pontual
authors.affiliation: Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, PE, Brazil. Electronic address: andreapontual@hotmail.com.
authors.forename: Andrea Dos Anjos
authors.initials: Ados A
authors.lastname: Pontual
authors.affiliation: Department of Oral Diagnosis, State University of Paraíba, Campina Grande, PB, Brazil. Electronic address: danipita@gmail.com.
authors.forename: Daniela Pita
authors.initials: DP
authors.lastname: de Melo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D008340:Mandibular Nerve / Q000000981:diagnostic imaging; D008875:Middle Aged; D008964:Molar, Third / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods*; D019252:Radiography, Dental, Digital / Q000379:methods*; D011862:Radiography, Panoramic / Q000379:methods*; D014092:Tooth Root / Q000000981:diagnostic imaging; D014095:Tooth, Impacted / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Mandibular nerve; Panoramic radiography; Third molar; X-ray computed tomography