A comparison of digitally scanned radiographs with conventional film for the detection of small endodontic instruments.

The use of computers in dentistry is becoming common as a practice tool for a diverse number of tasks, including the storage and enhancement of intra-oral radiographs. Several systems of digital radiography are available to produce a digital image including irradiation of a charged-couple device and scanning conventional radiographs. This study compared various digital images of scanned periapical radiographs with the original radiographs to determine whether the digitized images offered any advantage when viewing small files at the radiographic apex. Twenty extracted permanent molar teeth were prepared by gaining straight line access to the root canals and a ISO size 06 K-file was introduced into one of the canals until the tip was flush with the apical foramen. Using a standardized technique, radiographs were taken of the teeth using E-speed film. The radiographs were scanned and five digital images: original, enhanced, negative to positive conversion, zoom and zoom of negative to positive were produced. Three evaluators compared each of the images with the radiograph for clarity of the endodontic file in relation to the radiographic apex. Results were analysed using the Wilcoxon signed rank test and the Kappa (kappa) test was used to measure the level of agreement between the three evaluators. The results revealed that all the digital images produced by this scanner were inferior to the radiograph (P < 0.001) and that there was high agreement between evaluators.