Effect of brightness and contrast variation for detectability of root resorption lesions in digital intraoral radiographs

  • Eduarda Helena Leandro NascimentoEmail author
  • Hugo Gaêta-Araujo
  • Neiandro Santos Galvão
  • Larissa Moreira-Souza
  • Christiano Oliveira-Santos
  • Deborah Queiroz Freitas
Original Article



To evaluate the performance of periapical radiography assessed under different radiographic brightness and contrast variations in the detection of simulated internal (IRR) and external (ERR) root resorption lesions. Additionally, observers’ preferences related to image quality for these diagnostic tasks were evaluated.


Thirty single-root teeth were divided into two groups (n = 15): IRR, in which lesions were simulated using mechanical and biochemical processes; and ERR, in which cavities standardized with drills of different sizes were performed on the root surfaces. Digital radiographs were obtained and subsequently adjusted in 4 additional combinations, resulting in 5 brightness/contrast variations (V1–V5). Five radiologists evaluated the radiographs. The observers’ preference on the image quality was also recorded.


For both conditions, there were no differences in the accuracy and specificity between the five brightness/contrast variations (p > 0.05), but the sensitivity for ERR was significantly lower in V4 (+ 15% brightness/−15% contrast) in the large size (p < 0.05). The observers classified V2 (− 15% brightness/+15% contrast) as the “best” image quality for IRR and ERR evaluation.


For IRR and ERR lesions, brightness and contrast variation does not affect the diagnostic performance of digital intraoral radiography within the tested range. The observers prefer images with a reasonable decrease in brightness and increase in contrast.

Clinical relevance

Brightness and contrast enhancement tools are commonly applied in digital radiographic assessment. The use of these tools for detection of root resorptions can be applied according to the observer preference without influence on diagnostic accuracy.


Endodontics Digital radiography Radiographic image enhancement Root resorption 



The work was supported by the Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, SP, Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were conducted in accordance with the ethical standards of the institutional Research Ethics Committee of the Piracicaba Dental School, UNICAMP (#2.057.024), and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Patel S, Ricucci D, Durak C, Tay F (2010) Internal root resorption: a review. J Endod 36:1107–1121. CrossRefPubMedGoogle Scholar
  2. 2.
    Asgary S, Nosrat A, Seifi A (2011) Management of inflammatory external root resorption by using calcium-enriched mixture cement: a case report. J Endod 37:411–413. CrossRefPubMedGoogle Scholar
  3. 3.
    Gabor C, Tam E, Shen Y, Haapasalo M (2012) Prevalence of internal inflammatory root resorption. J Endod 38:24–27. CrossRefPubMedGoogle Scholar
  4. 4.
    Darcey J, Qualtrough A (2013) Resorption: part 1. Pathology, classification and aetiology. Br Dent J 214:439–451. CrossRefPubMedGoogle Scholar
  5. 5.
    Lima TF, Gamba TO, Zaia AA, Soares AJ (2016) Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption. Aust Dent J 61:425–431. CrossRefPubMedGoogle Scholar
  6. 6.
    Vasconcelos K de F, Rovaris K, Nascimento EHL et al (2017) Diagnostic accuracy of phosphor plate systems and conventional radiography in the detection of simulated internal root resorption. Acta Odontol Scand 75:573–576. CrossRefGoogle Scholar
  7. 7.
    Westphalen VPD, De Moraes IG, Westphalen FH et al (2004) Conventional and digital radiographic methods in the detection of simulated external root resorptions: a comparative study. Dentomaxillofacial Radiol 33:233–235. CrossRefGoogle Scholar
  8. 8.
    Parks ET (2008) Digital radiographic imaging. J Am Dent Assoc 139:477–481. CrossRefPubMedGoogle Scholar
  9. 9.
    Rovaris K, de Vasconcelos KF, do Nascimento EHL et al (2016) Brazilian young dental practitioners’ use and acceptance of digital radiographic examinations. Imaging Sci Dent 46:239–244. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kamburoǧlu K, Barenboim SF, Kaffe I (2008) Comparison of conventional film with different digital and digitally filtered images in the detection of simulated internal resorption cavities-an ex vivo study in human cadaver jaws. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 105:790–797. CrossRefGoogle Scholar
  11. 11.
    Kamburoǧlu K, Tsesis I, Kfir A, Kaffe I (2008) Diagnosis of artificially induced external root resorption using conventional intraoral film radiography, CCD, and PSP: an ex vivo study. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 106:885–891. CrossRefGoogle Scholar
  12. 12.
    Kumar V, Gossett L, Blattner A, Iwasaki LR, Williams K, Nickel JC (2011) Comparison between cone-beam computed tomography and intraoral digital radiography for assessment of tooth root lesions. Am J Orthod Dentofac Orthop 139:e533–e541. CrossRefGoogle Scholar
  13. 13.
    Neves FS, Vasconcelos TV, Vaz SLA, Freitas DQ, Haiter-Neto F (2012) Evaluation of reconstructed images with different voxel sizes of acquisition in the diagnosis of simulated external root resorption using cone beam computed tomography. Int Endod J 45:234–239. CrossRefPubMedGoogle Scholar
  14. 14.
    De Azevedo Vaz SL, Vasconcelos TV, Neves FS et al (2012) Influence of cone-beam computed tomography enhancement filters on diagnosis of simulated external root resorption. J Endod 38:305–308. CrossRefPubMedGoogle Scholar
  15. 15.
    Soares CJ, Fonseca RB, Gomide HA, Correr-Sobrinho L (2008) Cavity preparation machine for the standardization of in vitro preparations. Braz Oral Res 22:281–287. CrossRefPubMedGoogle Scholar
  16. 16.
    Da Silveira PF, Vizzotto MB, Montagner F et al (2014) Development of a new in vitro methodology to simulate internal root resorption. J Endod 40:211–216. CrossRefPubMedGoogle Scholar
  17. 17.
    Nascimento EH, Gaêta-Araujo H, Vasconcelos KF et al (2018) Influence of brightness and contrast adjustments on the diagnosis of proximal caries lesions. Dentomaxillofacial Radiol 20180100:20180100. CrossRefGoogle Scholar
  18. 18.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefGoogle Scholar
  19. 19.
    Creanga AG, Geha H, Sankar V, Teixeira FB, McMahan CA, Noujeim M (2015) Accuracy of digital periapical radiography and cone-beam computed tomography in detecting external root resorption. Imaging Sci Dent 45:153–158. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Gunraj MN (1999) Dental root resorption. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88:647–653. CrossRefPubMedGoogle Scholar
  21. 21.
    Durack C, Patel S, Davies J, Wilson R, Mannocci F (2011) Diagnostic accuracy of small volume cone beam computed tomography and intraoral periapical radiography for the detection of simulated external inflammatory root resorption. Int Endod J 44:136–147. CrossRefPubMedGoogle Scholar
  22. 22.
    Patel S, Dawood A, Wilson R, Horner K, Mannocci F (2009) The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography - an in vivo investigation. Int Endod J 42:831–838. CrossRefPubMedGoogle Scholar
  23. 23.
    Ono E, Medici Filho E, Faig Leite H, Tanaka JLO, de Moraes MEL, de Melo Castilho JC (2011) Evaluation of simulated external root resorptions with digital radiography and digital subtraction radiography. Am J Orthod Dentofac Orthop 139:324–333. CrossRefGoogle Scholar
  24. 24.
    Ren H, Chen J, Deng F, Zheng L, Liu X, Dong Y (2013) Comparison of cone-beam computed tomography and periapical radiography for detecting simulated apical root resorption. Angle Orthod 83:189–195. CrossRefPubMedGoogle Scholar
  25. 25.
    Ponder SN, Benavides E, Kapila S, Hatch NE (2013) Quantification of external root resorption by low- vs high-resolution cone-beam computed tomography and periapical radiography: a volumetric and linear analysis. Am J Orthod Dentofac Orthop 143:77–91. CrossRefGoogle Scholar
  26. 26.
    Sousa Melo SL, Belem MDF, Prieto LT, Tabchoury CPM, Haiter-Neto F (2017) Comparison of cone beam computed tomography and digital intraoral radiography performance in the detection of artificially induced recurrent caries-like lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 124:306–314. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Eduarda Helena Leandro Nascimento
    • 1
    Email author
  • Hugo Gaêta-Araujo
    • 1
  • Neiandro Santos Galvão
    • 1
  • Larissa Moreira-Souza
    • 1
  • Christiano Oliveira-Santos
    • 2
  • Deborah Queiroz Freitas
    • 1
  1. 1.Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental SchoolUniversity of Campinas (UNICAMP)PiracicabaBrazil
  2. 2.Department of Stomatology, Public Healthand Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao PretoUniversity of Sao PauloRibeirao PretoBrazil

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