A Novel Thresholding Based Algorithm for Detection of Vertical Root Fracture in Nonendodontically Treated Premolar Teeth.

In this paper, an efficient algorithm is proposed for detection of vertical root fractures (VRFs) in periapical (PA), and cone-beam computed tomography (CBCT) radiographs of nonendodontically treated premolar teeth. PA and CBCT images are divided into some sub-categories based on the fracture space between the two fragments as small, medium, and large for PAs and large for CBCTs. These graphics are first denoised using the combination of block matching 3-D filtering, and principle component analysis model. Then, we proposed an adaptive thresholding algorithm based on the modified Wellner model to segment the fracture and canal. Finally, VRFs are identified with a high accuracy through applying continuous wavelet transform on the segmented radiographs and choosing the most optimal value for sub-images based on the lowest interclass variance. Performance of the proposed algorithm is evaluated utilizing the different tested criteria. Results illustrate that the range of specificity deviations for PA and CBCT radiographs are 99.69 ± 0.22 and 99.02 ± 0.77, respectively. Furthermore, the sensitivity changes from 61.90 to 77.39 in the case of PA and from 79.54 to 100 in the case of CBCT. Based on our statistical evaluation, the CBCT imaging has the better performance in comparison with PA ones, so this technique could be a useful tool for clinical applications in determining the VRFs.