Radiographic diagnosis of incipient proximal caries: an ex-vivo study

Over the years, interproximal radiography has been regarded as an important auxiliary method for proximal caries detection, which provides valuable information for treatment decision. However, its accuracy has been questioned due to induction of mistaken diagnosis because, in several occasions, radiographs do not detect caries progression and give false negative results. Bille and Thylstrup reported visual diagnosis can be more sensitive than radiography for detection of incipient carious lesions, whereas radiographic diagnosis is rather sensitive for dentinal and cavited lesions. Espelid and Tveit  stated that the radiographic examination of deeper and intact surface lesions did not provide an accurate diagnosis with no trustworthy radiographic criteria available to determine the presence of initial or cavited lesions.

Although differences between in vivo and in vitro studies have been emphasized, histological and stereomicroscopic analyses have been considered the most accurate methods for validation of carious lesions.