Diagnostic Accuracy of Digital Phosphor Plates Using Pseudo-Color Enhancement for Detection of Horizontal Root Fractures in Single-Rooted Teeth

If root fractures remain undetected, pulp necrosis will occur in 25% of cases leading to eventual tooth loss. The purpose of this study was to evaluate the diagnostic accuracy of digital phosphor plates using pseudo-color enhancement for detection of horizontal root fractures in single-rooted teeth. Eighty-two human single-rooted teeth were evaluated (41 with no horizontal fracture and 41 with horizontal fractures). Digital intraoral imaging plate system. (Digora® Optime PSP System, Soredex) was used to obtain 16-bit gray scale images. Five 16-bit images were obtained from each specimen and saved (one original and four with pseudo-color enhancement). Four observers evaluated the images twice with a 2-week interval. Accuracy, positive predictive value (PPV), negative predictive value (NPV), specificity and sensitivity for each observer and each image group were calculated. The diagnostic sensitivities were not significantly different among the five images (P absolute=0.125, P complete=0.170). But, statistically significant differences were found in the diagnostic specificity (P absolute=0.019, P complete=0.016) among the five views. Cool and Summer views had higher diagnostic specificity than Bone, Copper and Original views (P=0.025). Kappa and Weighted Kappa values showed statistically significant differences for intra- and inter-observer reliability in the five views (P=0.032). Both Cool and Summer views were suitable for detection of horizontal root fractures and had statistically significant differences with the original view