<h3>Background</h3> There is evidence that capture and processing of the digital radiographic images may contain artifacts that could reduce the diagnostic value of dental radiographs. This phenomenon has been reported through various case reports. However, its effect on radiographic image quality has not been studied. <h3>Objective(s)</h3> The purpose of this study was to evaluate the effect of image processing on the quality of dental digital radiographs using the most common type of filter—sharpening. <h3>Study Design</h3> Three imaging modalities (2 complementary metal-oxide-semiconductor [CMOS], 1 photostimulable phosphor [PSP]) were used to image a DDQA imaging phantom (Digital Dental Quality Assurance phantom) and to create a flatfield radiograph. Contrast resolution, spatial resolution, dynamic range, and radiographic noise were assessed for image quality. Overshoot artifact was also assessed. Each image was sharpened and then highly sharpened. Images were compared using Friedman's 2-way nonparametric analysis of variance (ANOVA). <h3>Results</h3> Image sharpening significantly affected spatial resolution and noise. Conversely, dynamic range and contrast resolution were not significantly affected by image sharpening. Overshoot artifact increased with image sharpening. <h3>Discussion/Conclusions</h3> Image sharpening can create artifacts that could be misinterpreted. Although image sharpening significantly affects spatial resolution, no significant effect was seen on dynamic range or contrast resolution.
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