Visual Fixation and Scan Patterns of Dentists Viewing Dental Periapical Radiographs: An Eye Tracking Pilot Study

Introduction The visual search patterns of dentists and the areas that attract their attention when interpreting dental periapical radiographs are currently unknown. This research identifies areas and patterns of visual fixation when observing dental periapical radiographs. Methods In an observational study using eye tracking technology and a convenience sample of 44 observers, the interpretations of 4 dental periapical radiographs were recorded using Camtasia Software (TechSmith, Okemos, MI) with a gaze tracking “bubble” denoting where within the radiograph the observers' eyes gazed. The recorded observations included the scanning pattern, the area of first fixation, and revisits of areas. Also noted was whether the area of first fixation or revisit was radiopaque, radiolucent, or of normal radiodensity and whether it was a coronal or radicular area. Results The first fixation is more likely to be an area of high contrast that is either radiopaque or radiolucent compared with areas that were normal or of average gray scale. Significantly more revisits occurred on areas that were radiopaque and located in the radicular area. Of the 4 categorized scanning patterns, tooth by tooth scanning predominated. Conclusions When interpreting dental periapical radiographs, significantly more observers initially fixated on areas of the radiograph that were of high contrast (ie, radiopaque or radiolucent) compared with “normal areas.” A tooth by tooth scanning pattern was most commonly used.