Introduction: Many researchers have evaluated the interpretation of dental radiography, but few have considered the effect of coronal and intraradicular conditions on their perception of the periapical area. Purpose The purpose of this study is to determine if coronal and intraradicular conditions increase the perception of a periradicular finding in a population of general dentists.

Materials and Methods: A survey was emailed to general dentists and specialists. A split study design was implemented, where two groups studied two image pairs. The image pairs were created with identical periapical areas but different coronal and intraradicular findings. One image was presented at a time and the clinicians were asked to "evaluate the periradicular area." The answer options were in the form of a 5 point Likert scale. Participants were also asked to list their years of clinical practice and whether they were a specialist or a general dentist. A Mann-Whitney U test was completed on each test image pair separately to determine the difference between the altered and unaltered images. An effect size of each image pair was calculated using Vargha-Delany A test. Correlation between general dentists' years of experience and the probability to observe a periradicular finding was examined using Kendall's tau-beta.

Results: The Mann-Whitney U test showed a significant difference between images in each image pair with a P-Value of p < 2.2 x 10--16. The effect size for Image Pair 1 was medium at 0.677, and large at 0.836 for Image Pair 2. A small but significant correlation was found between years of experience and observing finding.

Conclusions: The null hypothesis was rejected. Coronal and intraradicular conditions increased the perception of a periapical finding in a population of general dentists.