Diagnosis of non-cavernous posterior proximal caries: Radiographic observer performance

Accuracy in detecting non-cavernous posterior proximal caries from radiographs was determined. Ninety-seven surfaces including 45 surfaces without caries, 15 with caries limited to the outer half of the enamel, 17 with caries limited to the inner half of enamel, and 20 with caries penetrating into dentin, as determined by the histological appearance, were examined by ten dentists reading radiographs twice in the interval of two weeks. The detection rate of true positive findings and results derived from receiver operating characteristic (ROC) analysis in terms of the area under the curve (ROC area) demonstrated to be significant in caries penetration. However, detection rate and ROC analysis showed no significant differences between the two observations. These results indicate that the relatively low accuracy in detecting these lesions, especially those limited to the outer enamel might justify an additional mode of diagnosis to supplement radiography. The caries penetration determined by radiographs underestimated the actual state as previously reported.