Effect of Contrast Inversion Enhancement on the Accuracy of Endodontic File Length Determination in Digital Radiography.

Abstract

The aim of this ex vivo study was to evaluate the accuracy of endodontic file length measurement on digital periapical radiographs after application of contrast inversion digital enhancement. Forty single-rooted single-canal mature permanent human teeth with canals measuring 20-24 mm in length were used in this study. ISO #08 K-files were placed in the root canals of the teeth. The file lengths were measured with a digital caliper as the gold standard. Standard periapical digital images were obtained with the Digora storage phosphor plates and Digora Optime scanner as the original images. The contrast inversion option of Scanora software program version 5.1 was used to produce enhanced images. Three radiologists and three endodontists measured file lengths on the original and enhanced images. The measurements were compared using repeated measures ANOVA and Bonferroni tests (α=0.05). There were significant differences between the measurement accuracy of the original and enhanced images (p<0.05). The enhanced images exhibited longer measurements compared to the original images. However, the two sets of digital radiographs provided significantly longer measurements compared to the gold standard (p<0.05). The contrast inversion tool of Scanora software program decreases measurement accuracy of the length of small endodontic files on digital periapical radiographs. It is suggested that contrast inversion should not be used in determining the lengths of small endodontic files.