Objectives: The aims of this study were to explore how image compression affects density, fractal dimension, linear and angular measurements on digital panoramic images and assess inter and intra-observer repeatability of these measurements. Study Design: Sixty-one digital panoramic images in TIFF format (Tagged Image File Format) were compressed to JPEG (Joint Photographic Experts Group) images. Two observers measured gonial angle, antegonial angle, mandibular cortical width, coronal pulp width of maxillary and mandibular first molar, tooth length of maxillary and mandibular first molar on the left side of these images twice. Fractal dimension of the selected regions of interests were calculated and the density of each panoramic radiograph as a whole were also measured on TIFF and JPEG compressed images. Intra-observer and inter-observer consistency was evaluated with Cronbach’s alpha. Paired samples t-test and Kolmogorov-Smirnov test was used to evaluate the difference between the measurements of TIFF and JPEG compressed images. Results: The repeatability of angular measurements had the highest Cronbach’s alpha value (0.997). There was statistically significant difference for both of the observers in mandibular cortical width (MCW) measurements (1st ob. p: 0.002; 2nd ob. p: 0.003), density (p<0.001) and fractal dimension (p<0.001) between TIFF and JPEG images. There was statistically significant difference for the first observer in antegonial angle (1st ob p< 0.001) and maxillary molar coronal pulp width (1st ob. p<0.001) between JPEG and TIFF files. Conclusions: The repeatability of angular measurements is better than linear measurements. Mandibular cortical width, fractal dimension and density are affected from compression. Observer dependent factors might also cause statistically significant differences between the measurements in TIFF and JPEG images. Key words:Digital panoramic radiography, image compression, linear measurements, angular measurements, fractal dimension.

Size reduction through compression is an important issue that needs to be investigated for possible effects on image quality. The aim of the present study was to evaluate the subjective image quality of digital panoramic radiographs which were lossless and lossy compressed for the visualization of various anatomical structures. Fifty-five digital panoramic radiographs in Tagged Image File Format (Tiff) were used in the study. Two types of lossy (Joint Photographic Experts Group (Jpeg)) and one type of lossless (Lempel-Ziv-Welch) compression were applied to the original radiographs. These radiographs were evaluated by two observers separately for the visibility of some anatomical structures with visual grading. Mean quality number for each radiograph was obtained. The differences between the mean quality numbers in each compression and original image mode were evaluated with Friedman test. Pair-wise comparisons revealed that there were statistically significant differences between all groups (p = 0.000) for all comparisons except for Jpeg_1 and Jpeg_2 groups. Kappa statistics was used to evaluate inter- and intra-observer agreements. Intra-observer agreements were ranging from 0.229 to 1.000 and inter-observer agreements were ranging from 0.154 to 1.000. The observers had better inter- and intra-observer agreements in highly compressed Jpeg_1 images. The anatomical structures evaluated in this study had better visibility in Tiff images than Jpeg images except for mandibular canal and mental foramen. While Jpeg compressed images offer high inter- and intra-observer agreements, the visibility of anatomical structures are better in Tiff images except for mandibular canal and mental foramen.