title: Can dentists recognize manipulated digital radiographs?
abstract: OBJECTIVE
  To determine the ability of dentists to recognize digitally manipulated radiographs.
  
  
  METHODS
  A poster was presented at the Annual Meeting of the German Society for Periodontology displaying the intra-oral radiographs of 12 different patients. Half of the radiographs were subjected to digital manipulation to add or remove specific features. Dentists were asked to identify these radiographs by means of a questionnaire.
  
  
  RESULTS
  Thirty-nine dentists submitted usable questionnaires. Statistical evaluation revealed a distribution of hits similar to the random distribution. None of the dentists detected all the six manipulated radiographs; three dentists had five correct, but there were five with only one. An authentic radiograph scored highest as a manipulation.
  
  
  CONCLUSIONS
  Image manipulations which alter the diagnostic content of a radiograph are unlikely to be detected by dentists. Digital radiography requires additional measures for data protection.
authors.affiliation: Department of Periodontology, Dental School, Georg-August-University Göttingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Visser
authors.forename: W
authors.initials: W
authors.lastname: Krüger
mesh_terms: D002983:Clinical Competence; D003815:Dentists; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D015588:Observer Variation; D011336:Probability; D019252:Radiography, Dental, Digital; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires