{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:20Z","timestamp":1792785860946,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"am","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Scientific and Technological Research Council of T\u00fcrkiye","award":["53325897-115.02-644008"],"award-info":[{"award-number":["53325897-115.02-644008"]}],"id":[{"id":"https:\/\/ror.org\/04w9kkr77","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate whether synthesized extraoral bitewing views generated from existing cone-beam CT (CBCT) scans can support posterior-tooth assessment when CBCT is the initial imaging modality, without additional radiographic acquisition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively assembled 60 CBCT scans from 3 datasets encompassing diverse posterior jaw morphologies. We developed a computational pipeline to compute a patient-specific dental arch, define a focal trough, and simulate extraoral bitewing acquisition using a panoramic-inspired rotating source trajectory. Synthetic projections were generated using a Beer-Lambert forward model implemented in Tomographic Iterative GPU-based Reconstruction (TIGRE)\u00a0and reconstructed into right and left synthesized extraoral bitewing views. Eight observers, including dental students and residents in endodontics, periodontics, and oral radiology, scored posterior teeth for caries, periapical lesions, and periodontal bone loss using original CBCT images and synthesized extraoral bitewing views in separate sessions. A consensus of 2 oral radiology experts served as the reference. Performance was evaluated with false-positive and false-negative rates, specificity, F1 score, and Area Under the Curve (AUC). Interobserver agreement was assessed with (weighted) kappa. Differences in AUC (\u0394AUC) between CBCT and synthesized extraoral bitewing views were evaluated using bootstrap-derived 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with CBCT alone, synthesized extraoral bitewing views were associated with lower overdiagnosis for dental caries and periapical lesions (95% CI, 5.87-12.00 and 3.87-8.12, respectively) and reduced underdiagnosis for periodontal bone loss (95% CI, 10.12-18.37). Synthesized extraoral bitewing views showed higher ordinal AUC for dental caries and periodontal bone loss (mean \u0394AUC,\u22120.12 to \u22120.05 and \u22120.11 to \u22120.04, respectively). No consistent improvement was observed for periapical lesion AUC, possibly due to small sample size and limited power.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>When CBCT is the initial imaging modality, synthesized extraoral bitewing views derived from the existing scan may provide a complementary 2D visualization for posterior-tooth assessment. In this reader study, the derived views were associated with shorter interpretation time and task-dependent changes in diagnostic performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/dmfr\/twag066","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:05:03Z","timestamp":1791173103000},"source":"Crossref","is-referenced-by-count":0,"title":["From cone-beam CT to synthesized extraoral bitewing: a patient-specific pipeline for dose- and cost-free 2D information presentation and clinical decision support"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2508-3620","authenticated-orcid":false,"given":"Kemal Sel\u00e7uk","family":"Y\u00fccel","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, David Geffen School of Medicine, University of California , Los Angeles, CA 90095,","place":["United States"]},{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes 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38039,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferhat","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Erciyes University , Kayseri 38039,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2120-7292","authenticated-orcid":false,"given":"Kadir","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Faculty of Dentistry, Erciyes University , Kayseri 38039,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7956-175X","authenticated-orcid":false,"given":"Osman Furkan","family":"\u00c7akmak","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Faculty of Dentistry, Erciyes University , Kayseri 38039,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2183-1241","authenticated-orcid":false,"given":"Duygu","family":"Kara\u00e7a\u011flar","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry, Erciyes University , Kayseri 38039,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9865-4641","authenticated-orcid":false,"given":"B\u00fc\u015franur","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry, Erciyes University , Kayseri 38039,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0798-9355","authenticated-orcid":false,"given":"Emin Murat","family":"Canger","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes 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