Digital file format does not influence the radiographic diagnosis of vertical root fracture

Abstract

Objective: To evaluate the influence of the file format of digital periapical radiographs on the diagnosis of vertical root fracture (VRF). Study design: Periapical radiographic images of 34 single-rooted teeth—19 with VRF, and 15 without VRF were acquired using two digital systems—Digora Toto, and Digora Optime, and exported into four different file formats—TIFF, BMP, PNG, and JPEG, totaling 272 radiographs. The radiographs were assessed by five examiners for the detection of VRF, using a 5-point scale (1—definitely absent; 2—probably absent; 3—uncertain; 4—probably present; 5—definitely present). Diagnostic values of area under the ROC curve, specificity, and sensitivity for the diagnosis of VRF were calculated. The results were compared by two-way Analysis of Variance with post hoc Tukey’s test. The intra- and inter-examiner agreements were measured by the Kappa test. The significance level was set at 5% for all analyses. Results: The values of intra-examiner agreement varied from moderate (0.56) to almost perfect (0.81), while the values of inter-examiner agreement varied from fair (0.29) to moderate (0.60). The image file format did not influence the diagnostic values for VRF for any of the radiographic systems tested (p > 0.05). Digora Toto had significantly greater values of area under the ROC curve than Digora Optime for all file formats (p = 0.001). Conclusion: The image file format of periapical radiographs does not influence the diagnosis of VRF, regardless of the digital radiography system.