Do image enhancement filters in complementary metal oxide semiconductor and photostimulable phosphor imaging systems improve the detection of fractured endodontic instruments in periapical radiography?

Objective: The aim of this study was to evaluate the influence of image enhancement filters on detection of fractured endodontic instruments and on image noise and pixel intensity.
Study Design: In total, 26 mandibular molars (68 root canals), divided into 4 groups (presence/absence of root canal filling, and presence/absence of a fractured endodontic instrument) were radiographed by using a complementary metal oxide semiconductor (CMOS) and a photostimulable phosphor (PSP) system. Images with 4 enhancement filters (Sharpen UM, Edges All, BC Low, and BC High) were compared with nonfiltered images. The area under the receiver operating characteristic curve (Az), sensitivity, and specificity in detection of fractured instruments were compared for each imaging condition. Means and standard deviations (SD) to measure noise and changes in pixel intensity were calculated. Analysis of variance was used to analyze the data.
Results: There were no significant differences in Az, sensitivity, and specificity values between nonfiltered and filtered images in detection of instruments in root canals without and with root canal filling (P ≥ .360). SD was reduced by filters in CMOS but not PSP radiographs. Sharpen UM caused more changes in the mean values in both systems.
Conclusions: Filters did not improve diagnostic performance in detecting instruments. Noise and pixel intensity were affected differently.
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