Diagnostic Challange: Instances Mimicking a Proximal Carious Lesion Detected by Bitewing Radiography

Prevention of more invasive restorative treatment modalities requires early caries diagnosis which dental clinicians face during everyday practice. The primary visual inspection method has partial reliability for detecting noncavitated lesions, especially on proximal surfaces. Thus, dentists regularly prefer bitewing radiographs as an adjunct method for diagnosis of the carious lesions. Many radiologic factors can affect the ability to accurately detect the carious lesions; exposure parameters, type of image receptor, image processing, display system, viewing conditions and visual illusions. Beside these radiologic factors, various morphologic phenomena, such as pits and fissures, dental anomalies, such as hypoplastic pits and concavities and acquired changes of dentition, such as abrasion and erosion can mimic the appearance of a carious lesion. Thus, the outcome of a false positive diagnose is the initiation of unnecessary invasive restorative treatment. Dentists’ knowledge about the entities mimicking the proximal carious lesion detected by bitewing radiography is important for clinical practice to keep the patient out of these unnecessary treatments.