Introduction: The utilization of eye-tracking technology to determine the gaze and search patterns of dentists during periapical radiograph interpretation can help facilitate further research in the underlying perception processes. The research on the effect of clinical history, or a localizing prompt, being provided to a dentist prior to the initiation of the radiographic interpretation process task is scant.

Purpose: The purpose of this study is to use eye-tracking technology to evaluate the differences in a dentist's interpretation process of a periapical radiograph when a localizing prompt, a tooth-specific referral, has been provided, as compared to when no such pre-interpretation prompt has been given.

Materials and Methods: Ten periapical radiographic images were examined twice by ten observers; the sessions were separated by 1 month. An eye-tracking device (Tobii Technology, Danderyd, Sweden) was connected to the monitor to track the eye movements of each participant. During the first session, participants were provided a localizing prompt, in the form of a tooth-specific referral, prior to each radiographic image interpretation compared to the second session, where no tooth-specific referral was provided. Areas of interest on each image were pre-determined and outlined using the Tobii studio lab software (Tobii Technology, Danderyd, Sweden). The observations recorded the area of first fixation, time spent in each outlined area of interest, and visit count during each session. These parameters were compared during the radiographic interpretation process of each image, both with and without the provided localizing prompt.

Results: Generally, observers were more likely to spend more time and have more fixations on the prompted tooth during the prompt condition compared to the no prompt condition. During the prompted condition there was no significance among the among the other teeth in the radiographs. During the no prompt condition, observers tended to spend more time and have more fixations on the other teeth in the radiograph that were not prompted previously.

Conclusion: The study found that the presence of a prompted tooth altered the fixation duration and total fixation count under the conditions of the study in the cases presented.