How massed practice improves visual expertise in reading panoramic radiographs in dental students: An eye tracking study

[Prevalence of dental anomalies in panoramic radiographs of patients aged 10 to 30 from a radiographic center: a cross-sectional study]

Introduction

Dental anomalies are associated with developmental problems, affecting facial and dental structures with potential functional, occlusal and aesthetic repercussions. Early detection using panoramic radiographs is crucial for adequate treatment and management of these alterations. Objective: Determine the prevalence of dental anomalies in radiographs in patients treated in a radiological center during the year 2023.

Materials and Methods

a retrospective, observational and descriptive study was carried out, analyzing 1500 panoramic radiographs. A simple random sampling method was used and various variables such as types and number of anomalies, age, gender, and location in the oral quadrants were evaluated. The Romexis Viewer program was used for image analysis.

Results

In the prevalence of dental anomalies of structure, it was observed that enamel hypoplasia and hypercementosis presented a lower number of cases, with a prevalence of 1%. In size anomalies, it was found that microdontia had a prevalence of 10.5%. Also, in eruption anomalies, it was observed that the ectopic position affected 6.7% of cases. On the other hand, in number anomalies, it was observed that agenesis had a prevalence of 5.2%. In morphology anomalies, there were no cases of union, while dilaceration was present in 58.6% of cases. Rhizomicri had a prevalence of 12.4%.

Conclusions

Dental anomalies observed in the radiographs of the evaluated patients show variable prevalence rates. The study reaffirms the importance of panoramic radiography in the early detection of dental anomalies, crucial for planning adequate and personalized treatment in dentistry.

Examining gaze behavior in undergraduate students and educators during the evaluation of tooth preparation: an eye-tracking study

BACKGROUND

Gaze behavior can serve as an objective tool in undergraduate pre-clinical dental education, helping to identify key areas of interest and common pitfalls in the routine evaluation of tooth preparations. Therefore, this study aimed to investigate the gaze behavior of undergraduate dental students and dental educators while evaluating a single crown tooth preparation.

METHODS

Thirty-five participants volunteered to participate in the study and were divided into a novice group (dental students, n = 18) and an expert group (dental educators, n = 17). Each participant wore a binocular eye-tracking device, and the total duration of fixation was evaluated as a metric to study the gaze behavior. Sixty photographs of twenty different tooth preparations in three different views (buccal, lingual, and occlusal) were prepared and displayed during the experimental session. The participants were asked to rate the tooth preparations on a 100 mm visual analog rating scale and were also asked to determine whether each tooth preparation was ready to make an impression. Each view was divided into different areas of interest. Statistical analysis was performed with a three-way analysis of the variance model with repeated measures.

RESULTS

Based on the participants' mean rates, the "best" and the "worst" tooth preparations were selected for analysis. The results showed a significantly longer time to decision in the novices compared to the experts (P = 0.003) and a significantly longer time to decision for both the groups in the best tooth preparation compared to the worst tooth preparation (P = 0.002). Statistical analysis also showed a significantly longer total duration of fixations in the margin compared to all other conditions for both the buccal (P < 0.012) and lingual (P < 0.001) views.

CONCLUSIONS

The current study showed distinct differences in gaze behavior between the novices and the experts during the evaluation of single crown tooth preparation. Understanding differences in gaze behavior between undergraduate dental students and dental educators could help improve tooth preparation skills and provide constructive customized feedback.

Visual Behaviour During the Interpretation of Cone-Beam Computed Tomography Images of Traumatic Dental Injuries: An Eye-Tracking Study

BACKGROUND

This cross-sectional observational study aimed to investigate the visual attention patterns of postgraduate endodontic residents during the interpretation of cone-beam computed tomography (CBCT) scans for traumatic dental injuries (TDIs) using eye-tracking technology.

METHODS

A cohort of 10 residents who were recruited from King Abdulaziz University Dental Hospital (KAUDH) underwent interpretation of seven CBCT images of TDIs. Eye-tracking metrics, including dwell time, entry time, end time, and the number of revisits, were recorded and analyzed using nonparametric statistical tests.

RESULTS

Eye-tracking data revealed that patients with lateral luxation and extrusive luxation pathologies had the longest mean dwell times (1.82 seconds and 1.50 seconds, respectively). These findings were statistically significant compared to other pathologies (p<0.001). Conversely, horizontal root fractures and periapical radiolucency were identified more quickly by the participants (mean entry times of 6.60 seconds and 8.84 seconds, respectively).

CONCLUSIONS

The findings indicate variability in visual attention metrics depending on the type of TDI, suggesting that certain injuries may require more focused attention for accurate diagnosis. Specifically, lateral and extrusive luxation injuries attracted longer dwell times, possibly due to their unique diagnostic challenges. This research provides a basis for future studies aiming to optimize education and training related to CBCT interpretation of traumatic dental injuries.

A time slice analysis of dentistry students' visual search strategies and pupil dilation during diagnosing radiographs

Diagnosing orthopantomograms (OPTs: panoramic radiographs) is an essential skill dentistry students acquire during university training. While prior research described experts' visual search behavior in radiology as global-to-focal for chest radiographs and mammography, generalizability to a hybrid search task in OPTs (i.e., searching for multiple, diverse anomalies) remains unclear. Addressing this gap, this study investigated visual search of N = 107 dentistry students while they were diagnosing anomalies in OPTs. Following a global-to-focal expert model, we hypothesized that students would use many, short fixations representing global search in earlier stages, and few, long fixations representing focal search in later stages. Furthermore, pupil dilation and mean fixation duration served as cognitive load measures. We hypothesized that later stages would be characterized by elaboration and a reflective search strategy, leading to higher cognitive load being associated with higher diagnostic performance in late compared to earlier stages. In line with the first hypothesis, students' visual search comprised of a three-stage process that grew increasingly focal in terms of the number of fixations and anomalies fixated. Contrary to the second hypothesis, mean fixation duration during anomaly fixations was positively associated with diagnostic performance across all stages. As OPTs greatly varied in how difficult it was to identify the anomalies contained therein, OPTs with above-average difficulty were sampled for exploratory analysis. Pupil dilation predicted diagnostic performance for difficult OPTs, possibly capturing elaborative cognitive processes and cognitive load compared to mean fixation duration. A visual analysis of fine-grained time slices indicated large cognitive load differences towards the end of trials, showcasing a richness-resolution-trade-off in data sampling crucial for future studies using time-slicing of eye tracking data.

Dental diagnosis for inlay restoration using an intraoral optical coherence tomography system: A case report

PATIENTS

The patient was a 32-year-old man who underwent amalgam restoration of the mandibular right second molar. An amalgam restoration fracture was diagnosed by intraoral optical coherence tomography (OCT), and pulp exposure was examined during cavity preparation. Subsequently, a definitive ceramic restoration was fabricated, and the marginal fit in the oral cavity was evaluated using the OCT system.

DISCUSSION

The existing OCT system cannot acquire images inside the oral cavity because of the large probe size. However, the proposed intraoral OCT system can access the prostheses in the mandibular right second molar. Therefore, dental diagnosis for restoration treatment with dental prosthesis fracture, marginal gap, and pulp exposure after tooth preparation is possible using the proposed intraoral OCT system.

CONCLUSIONS

The use of the intraoral OCT system improved dental diagnosis by allowing the dentist to confirm quantitative values through cross-sectional images, rather than that by determining a treatment plan after visual dental diagnosis.

Age-Related Differences in the Neural Processing of Idioms: A Positive Perspective

We examined whether older adults benefit from a larger mental-lexicon size and world knowledge to process idioms, one of few abilities that do not stop developing until later adulthood. Participants viewed four-character sequences presented one at a time that combined to form (1) frequent idioms, (2) infrequent idioms, (3) random sequences, or (4) perceptual controls, and judged whether the four-character sequence was an idiom. Compared to their younger counterparts, older adults had higher accuracy for frequent idioms and equivalent accuracy for infrequent idioms. Compared to random sequences, when processing frequent and infrequent idioms, older adults showed higher activations in brain regions related to sematic representation than younger adults, suggesting that older adults devoted more cognitive resources to processing idioms. Also, higher activations in the articulation-related brain regions indicate that older adults adopted the thinking-aloud strategy in the idiom judgment task. These results suggest re-organized neural computational involvement in older adults' language representations due to life-long experiences. The current study provides evidence for the alternative view that aging may not necessarily be solely accompanied by decline.

Front-loading of anatomy content has no effect on long-term anatomy knowledge retention among physical therapy students: a prospective cohort study

BACKGROUND

Information learned over a longer period of time has been shown to result in better long-term knowledge retention than information learned over a shorter period of time. In order to address multiple curricular goals, the timing and spacing of anatomy content within the Doctor of Physical Therapy (DPT) program at our institution recently changed from a very spaced to a very compressed format. The purpose of the present study was to assess differences in anatomy knowledge retention that might have been impacted by this change. The research hypothesis was that students receiving spaced instruction would have significantly better anatomy knowledge retention than students receiving massed instruction.

METHODS

Participants consisted of two cohorts of DPT students that both received 45 contact hours of anatomy lecture and 90 contact hours of anatomy lab. The LONG cohort experienced anatomy through a lecture and lab taught over a 30-week, 2 semester period as separate courses. In contrast, the SHORT cohort took their anatomy lecture and lab concurrently over one 10-week semester. A pre-test was administered on the first day of their anatomy lecture course, and a post-test was administered to each cohort 18 months after completion of their last anatomy exam.

RESULTS

After controlling for age-related differences in the two groups, no significant differences in mean pre-test, post-test, or percentage improvement were found between cohorts (p = 0.516; 0.203; and 0.152, respectively).

CONCLUSION

These findings refute the hypothesis and show that both spaced and massed instruction in these cohorts resulted in the same level of long-term anatomy knowledge retention.

Comparing the Visual Perception According to the Performance Using the Eye-Tracking Technology in High-Fidelity Simulation Settings

Introduction: We used eye-tracking technology to explore the visual perception of clinicians during a high-fidelity simulation scenario. We hypothesized that physicians who were able to successfully manage a critical situation would have a different visual focus compared to those who failed. Methods: A convenience sample of 18 first-year emergency medicine residents were enrolled voluntarily to participate in a high-fidelity scenario involving a patient in shock with a 3rd degree atrioventricular block. Their performance was rated as pass or fail and depended on the proper use of the pacing unit. Participants were wearing pre-calibrated eye-tracking glasses throughout the 9-min scenario and infrared (IR) markers installed in the simulator were used to define various Areas of Interest (AOI). Total View Duration (TVD) and Time to First Fixation (TFF) by the participants were recorded for each AOI and the results were used to produce heat maps. Results: Twelve residents succeeded while six failed the scenario. The TVD for the AOI containing the pacing unit was significantly shorter (median [quartile]) for those who succeeded compared to the ones who failed (42 [31–52] sec vs. 70 [61–90] sec, p = 0.0097). The TFF for the AOI containing the ECG and vital signs monitor was also shorter for the participants who succeeded than for those who failed (22 [6–28] sec vs. 30 [27–77] sec, p = 0.0182). Discussion: There seemed to be a connection between the gaze pattern of residents in a high-fidelity bradycardia simulation and their performance. The participants who succeeded looked at the monitor earlier (diagnosis). They also spent less time fixating the pacing unit, using it promptly to address the bradycardia. This study suggests that eye-tracking technology could be used to explore how visual perception, a key information-gathering element, is tied to decision-making and clinical performance.

How to support dental students in reading radiographs: effects of a gaze-based compare-and-contrast intervention

In dental medicine, interpreting radiographs (i.e., orthopantomograms, OPTs) is an error-prone process, even in experts. Effective intervention methods are therefore needed to support students in improving their image reading skills for OPTs. To this end, we developed a compare-and-contrast intervention, which aimed at supporting students in achieving full coverage when visually inspecting OPTs and, consequently, obtaining a better diagnostic performance. The comparison entailed a static eye movement visualization (heat map) on an OPT showing full gaze coverage from a peer-model (other student) and another heat map showing a student's own gaze behavior. The intervention group (N = 38) compared five such heat map combinations, whereas the control group (N = 23) diagnosed five OPTs. Prior to the experimental variation (pre-test) and after it (post-test), students in both conditions searched for anomalies in OPTs while their gaze was recorded. Results showed that students in the intervention group covered more areas of the OPTs and looked less often and for a shorter amount of time at anomalies after the intervention. Furthermore, they fixated on low-prevalence anomalies earlier and high-prevalence anomalies later during the inspection. However, the students in the intervention group did not show any meaningful improvement in detection rate and made more false positive errors compared to the control group. Thus, the intervention guided visual attention but did not improve diagnostic performance substantially. Exploratory analyses indicated that further interventions should teach knowledge about anomalies rather than focusing on full coverage of radiographs.