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Article

Improving Endodontic Radiograph Interpretation with TV-CLAHE for Enhanced Root Canal Detection

by
Barbara Obuchowicz
1,
Joanna Zarzecka
1,
Michał Strzelecki
2,*,
Marzena Jakubowska
1,
Rafał Obuchowicz
3,
Adam Piórkowski
4,
Elżbieta Zarzecka-Francica
5 and
Julia Lasek
6
1
Department of Conservative Dentistry with Endodontics, Jagiellonian University Collegium Medicum, Montelupich 4, 31-155 Cracow, Poland
2
Institute of Electronics, Lodz University of Technology, 93-590 Lodz, Poland
3
Department of Diagnostic Imaging, Jagiellonian University Medical College, 30-663 Krakow, Poland
4
Department of Biocybernetics and Biomedical Engineering, AGH University of Krakow, 30-059 Krakow, Poland
5
Department of Prosthodonics with Orthodontics, Institute of Dentistry Jagiellonian University Medical College, 30-059 Krakow, Poland
6
Faculty of Geology, Geophysics and Environmental Protection, AGH University of Krakow, 30-059 Krakow, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(15), 5554; https://doi.org/10.3390/jcm14155554
Submission received: 27 June 2025 / Revised: 25 July 2025 / Accepted: 4 August 2025 / Published: 6 August 2025
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)

Abstract

Objective: The accurate visualization of root canal systems on periapical radiographs is critical for successful endodontic treatment. This study aimed to evaluate and compare the effectiveness of several image enhancement algorithms—including a novel Total Variation–Contrast-Limited Adaptive Histogram Equalization (TV-CLAHE) technique—in improving the detectability of root canal configurations in mandibular incisors, using cone-beam computed tomography (CBCT) as the gold standard. A null hypothesis was tested, assuming that enhancement methods would not significantly improve root canal detection compared to original radiographs. Method: A retrospective analysis was conducted on 60 periapical radiographs of mandibular incisors, resulting in 420 images after applying seven enhancement techniques: Histogram Equalization (HE), Contrast-Limited Adaptive Histogram Equalization (CLAHE), CLAHE optimized with Pelican Optimization Algorithm (CLAHE-POA), Global CLAHE (G-CLAHE), k-Caputo Fractional Differential Operator (KCFDO), and the proposed TV-CLAHE. Four experienced observers (two radiologists and two dentists) independently assessed root canal visibility. Subjective evaluation was performed using an own scale inspired by a 5-point Likert scale, and the detection accuracy was compared to the CBCT findings. Quantitative metrics including Peak Signal-to-Noise Ratio (PSNR), Signal-to-Noise Ratio (SNR), image entropy, and Structural Similarity Index Measure (SSIM) were calculated to objectively assess image quality. Results: Root canal detection accuracy improved across all enhancement methods, with the proposed TV-CLAHE algorithm achieving the highest performance (93–98% accuracy), closely approaching CBCT-level visualization. G-CLAHE also showed substantial improvement (up to 92%). Statistical analysis confirmed significant inter-method differences (p < 0.001). TV-CLAHE outperformed all other techniques in subjective quality ratings and yielded superior SNR and entropy values. Conclusions: Advanced image enhancement methods, particularly TV-CLAHE, significantly improve root canal visibility in 2D radiographs and offer a practical, low-cost alternative to CBCT in routine dental diagnostics. These findings support the integration of optimized contrast enhancement techniques into endodontic imaging workflows to reduce the risk of missed canals and improve treatment outcomes.
Keywords: root canal anatomy; image enhancement; CLAHE; dental radiography; endodontics root canal anatomy; image enhancement; CLAHE; dental radiography; endodontics

Share and Cite

MDPI and ACS Style

Obuchowicz, B.; Zarzecka, J.; Strzelecki, M.; Jakubowska, M.; Obuchowicz, R.; Piórkowski, A.; Zarzecka-Francica, E.; Lasek, J. Improving Endodontic Radiograph Interpretation with TV-CLAHE for Enhanced Root Canal Detection. J. Clin. Med. 2025, 14, 5554. https://doi.org/10.3390/jcm14155554

AMA Style

Obuchowicz B, Zarzecka J, Strzelecki M, Jakubowska M, Obuchowicz R, Piórkowski A, Zarzecka-Francica E, Lasek J. Improving Endodontic Radiograph Interpretation with TV-CLAHE for Enhanced Root Canal Detection. Journal of Clinical Medicine. 2025; 14(15):5554. https://doi.org/10.3390/jcm14155554

Chicago/Turabian Style

Obuchowicz, Barbara, Joanna Zarzecka, Michał Strzelecki, Marzena Jakubowska, Rafał Obuchowicz, Adam Piórkowski, Elżbieta Zarzecka-Francica, and Julia Lasek. 2025. "Improving Endodontic Radiograph Interpretation with TV-CLAHE for Enhanced Root Canal Detection" Journal of Clinical Medicine 14, no. 15: 5554. https://doi.org/10.3390/jcm14155554

APA Style

Obuchowicz, B., Zarzecka, J., Strzelecki, M., Jakubowska, M., Obuchowicz, R., Piórkowski, A., Zarzecka-Francica, E., & Lasek, J. (2025). Improving Endodontic Radiograph Interpretation with TV-CLAHE for Enhanced Root Canal Detection. Journal of Clinical Medicine, 14(15), 5554. https://doi.org/10.3390/jcm14155554

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