## 4 Discussion  
Segmented images appear to improve the visualization of root morphology, inferior alveolar nerve canal course and mandibular cortical bone. Higher ICCs were found for segmented images compared to CBCT images. Importantly, the visualization of the anatomical structures of interest improved in all groups regardless of the experience level when evaluating segmented images, thus suggesting that this technique can be supportive in achieving better CBCT imaging interpretation. \begin{table}
\begin{tabular}{c c c c} \hline  & & **ICC (95\% CIs)** & **ICC (95\% CIs)** \\  & **CBCT** & **Segmented Images** \\ \hline Root morphology & & & \\ Root axis parallel to the major tooth axis & 0.912 (0.899, 0.947) & 0.941 (0.879, 0.972) * \\ Presence of root curvature & 0.961 (0.954, 0.973) & 0.973 (0.964, 0.998) \\ Bifid apex & 0.936 (0.902, 0.958) & 0.985 (0.971, 0.993) * \\ Canal course & & & \\ Absence of relationship with third molar roots & 0.969 (0.954, 0.983) & 0.987 (0.974, 0.991) * \\ Contact with IAN (preservation of lamina dura) & 0.865 (0.857, 0.872) & 0.954 (0.949, 0.963) * \\ Close contact with IAN (loss of lamina dura) & 0.842 (0.821, 0.856) & 0.921(0.909, 0.927) * \\ Cortical bone & & & \\ Preserved bone thickness & 0.934 (0.926, 0.939) & 0.992 (0.988, 0.999) * \\ Thinning of the cortical bone & 0.949 (0.919, 0.964) & 0.967 (0.964, 0.971) \\ Cortical bone fenestration & 0.893 (0.889, 0.897) & 0.996 (0.982, 0.99) * \\ \hline \end{tabular} ICC, intraclass correlation coefficient; CI, confidence interval; IAN, inferior alveolar nerve; \(p<0.05\).  
\end{table} 
Table 1: Inter-rater agreement evaluated with the intraclass correlation coefficient (ICC) for examiners of all skill levels. Assessment of the root morphology, canal course, and cortical bone through CBCT and segmented images. \begin{table}
\begin{tabular}{c c c c c} \hline  & & & **ICC (95\% CIs)** & \\ \hline  & & **Oral Surgeons** & **General Practitioners** & **Residents in Oral Surgery** \\ \hline Root morphology & & & & \\  & CBCT & 0.97 (0.89, 0.99) * & 0.93 (0.86, 0.95) & 0.94 (0.90, 0.96) \\  & Segmented images & 0.99 (0.97, 0.99) * & 0.95 (0.92, 0.98) & 0.97 (0.95, 0.99) \\ CBCT & & & & \\ CBCT & & & & \\ Segmented images & 0.96 (0.91, 0.99) & 0.94 (0.87, 0.96) & 0.94 (0.93, 0.96) \\  & Segmented images & 0.98 (0.96, 0.99) * & 0.95 (0.87, 0.95) & 0.96 (0.94, 0.97) \\ CBCT & & & & \\ CBCT & & 0.96 (0.93, 0.97) & 0.93 (0.88, 0.94) & 0.93 (0.89, 0.95) \\  & Segmented images & 0.99 (0.97, 0.99) * & 0.97 (0.95, 0.98) & 0.95 (0.93, 0.96) \\ \hline \end{tabular} ICC, intraclass correlation coefficient; CI, confidence interval; \(\star\)\(p<0.05\).  
\end{table} 
Table 2: Inter-rater agreement evaluated with the intraclass correlation coefficient (ICC) for examiners of different skill level. Assessment of the root morphology, canal course, and cortical bone through CBCT and segmented images. The use of 3D models has been previously employed for the analysis of various pathological conditions of the oral and maxillofacial region. [PERSON] et al. [19] evaluated the effectiveness of 3D models obtained from CBCT datasets in localizing unerupted maxillary canines. According to their results, conventional 2D techniques--including panoramic radiography, lateral cephalogram, and periapical radiographs--appeared less reliable than 3D reconstructions, in particular when evaluating the mesio-distal position of the apex, the bucco-palatal position of the canine, and the overlap with the lateral incisor. Overall, 3D images provided increased precision in the localization of the maxillary canines and improved the estimation of the space conditions in the arch, resulting in a change in diagnosis and treatment planning. Similarly, [PERSON] et al. [20] reported a strong correlation in the evaluation of root canal anatomy between 3D post-processed images from CBCT datasets and histologic sections on ex-vivo specimens. In both studies, 3D models provided improved visualization of the structures of interest compared to 2D imaging and native CBCT datasets.