To determine the impact of an image processing technique on diagnostic accuracy of digital panoramic radiographs for the assessment of anatomical structures in paediatric patients with mixed dentition.

The study consisted of 50 digital panoramic radiographs of children aged from 6 to 12 years, which were later on processed using a dedicated image processing method. A modified clinical image quality evaluation chart was used to evaluate the diagnostic accuracy of anatomical structures in maxillary and mandibular anterior and maxillary premolar region of processed images.

A statistically significant difference was observed between pre and post-processed evaluation of anatomical structures ( P <0.05) in the maxillary and mandibular anterior region. The anterior region was found to be more accurate in post-processed images. No significant difference was observed in the maxillary premolar region ( P >0.05). The Inter-observer and intra-observer reliability of both pre and post processed images were excellent (>0.82) for anterior region and good (>0.63) for premolar region.

The application of image processing technique in digital panoramic radiography can be considered a reliable method for improving the quality of anatomical structures in paediatric patients with mixed dentition.