The study aims were to assess the precision and time required to conduct cephalometric analysis with cone-beam computed tomography (CBCT) in vivo on both three-dimensional (3D) surface models and multi-planar reformations (MPR) images. Datasets from 10 patients scanned with CBCT were used to create two types of images: 1. axial, coronal, and sagittal MPR images and 2. 3D surface models. Eleven observers identified 22 cephalometric landmarks on 3D surface models first and then using 3D in combination with MPR images twice independently. Tracing time was recorded in both methods. Precision was defined as the absolute difference between an observer's repeated measurements and the mean of all measurements per landmark. Inter- and intra-observer agreements were defined as the absolute difference of the observers' measurements from each other and from their repeated measurements averaged over all landmarks, respectively. The precision of measurements ranged between 0.29 ± 0.17 and 2.82 ± 7.53. Adding MPR alongside, 3D surfaces improved the precision of tracing for 15 of 22 of the landmark but it took on average twice as much time. Mean time required to trace one patient was 6:03 ± 2:48 and 10:41 ± 4:01 minutes for 3D and 3D + MPR, respectively (P = 0.0001).

Objective: In diagnostic imaging; human perception is the most prominent, yet least studied, source of error. A better understanding of image perception will help to improve diagnostic performance. This study focuses on the perception of coarseness of trabecular patterns on dental radiographs. Comparison of human vision with machine vision should yield knowledge on human perception. Method: In a study on identifying osteoporotic patients, dental radiographs were made from 505 post-menopausal women aged 45-70 years. Intra-oral radiographs of the lower and upper jaws were made. Five observers graded the trabecular pattern as dense, sparse or mixed. The five gradings were combined into a single averaged observer score per jaw. The radiographs were scanned and a region of interest (ROI) was indicated on each. The ROIs were processed with image analysis software measuring 25 image features. Pearson correlation and multiple linear regression were used to compare the averaged observer score with the image features. Results: 14 image features correlated significantly with the observer judgement for both jaws. The strongest correlation was found for the average grey value in the ROI. Other features, describing that osteoporotic patients have fewer but bigger marrow spaces than controls, correlated less with the sparseness of the trabecular pattern than a rather crude measure for structure such as the average grey value. Conclusion: Human perception of the sparseness of trabecular patterns is based more on average grey values of the ROI than on geometric details within the ROI.

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We conclude that the number of CT projections used can be reduced at least to 20 with the diagnostic performance still markedly better than that of conventional film, provided that the observer can make use of both axial and vertical stacks of CT slices.

A field study was conducted to investigate the psychological characteristics of dissatisfied denture patients using validated personality inventories. In the present study dissatisfied denture patients are patients that keep complaining about their dentures and are referred to a psychologist because it was suspected that their complaints may also be due to psychological factors. The results show that these patients feel more inhibited in their social contacts and more often have the opinion that wearing dentures is unacceptable. Also these patients are high on neuroticism, less social adequate, more rigid, have less self-esteem and are more externally oriented.