[Fraudulent use of digital radiographs: secret reality or fiction?].

Digital radiography has several advantages and has become an indispensable diagnostic tool for many dentists in daily practice. Once the digital captation appears on screen, the dental x-ray software allows image enhancement, to get a better vision and diagnosis. This image enhancement is acquired for example by adjusting the colour, density, sharpness, brightness or contrast. If the digital radiographs are exported, using various software packages created for graphic design and image manipulation, digital information can be altered, added or removed. Dental radiographs are easily duplicated, stored or spread in digital format. How can their authenticity be guaranteed, especially in insurance cases? Image enhancement features of digital radiography allow mishandling or potential abuse. Recently published studies illustrate the potential fraudulent use of digital radiography. In this article, some manipulated radiographic images are presented, to raise concerns about security, reliability and the potential for fraud.