Radiographic Diagnosis of Mineral Loss in Approximal Enamel

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Abstract
The relationship between mineral loss in approximal enamel and the precision of the radiographic diagnosis was investigated using experimental lesions and Receiver Operating Characteristic (ROC) technique. The ROC curves indicated a substantial loss of radiographic information concerning the presence or absence of a lesion when mineral loss was reduced from 10 to 5%, but the diagnoses were better than pure guessing. Variations in horizontal angulation within a range of 25 ° did not affect detection, but lesion depth was overestimated more often at eccentric projections. The results indicate that radiographic diagnosis is unreliable for small carious lesions with about 5% mineral loss in the X-ray beam direction, and that positive diagnosis is frequently due to observer error.

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