Accuracy of Digital Bitewing Radiography versus Different Views of Digital Panoramic Radiography for Detection of Proximal Caries

<p><strong>O</strong><strong>bjectives</strong>: Dental caries are common and have a high incidence among populations. Radiographs are essential for detecting proximal caries. The best technique should be recognized for accurate detection of caries. The aim of this study was to compare the accuracy of detection of proximal caries using intra oral bitewing, extra oral bitewing, improved interproximal panoramic, improved orthogonality panoramic and digital con- ventional panoramic radiographs.</p><p><strong>Materials and Methods</strong>: In this descriptive cross sectional study, 100 extracted human teeth with and without proximal caries were used. Intra and extra oral radiographs were taken. Images were evaluated and scored by two observers. Scores were compared with the histological gold standard. The diagnostic accuracy of radiographs was assessed by means of receiver operating characteristic (ROC) curve analysis (P&lt;0.05).</p><p><strong>R</strong><strong>esults</strong>: Microscopic evaluation of proximal surfaces revealed that 54.8% of the sur- faces were sound and 45.2% were carious (with different depths). The differences in the area under the ROC curve (Az value) among the five techniques were not statisti- cally significant.</p><p><strong>C</strong><strong>onclusion: </strong>Improved interproximal panoramic and extra oral bitewing radiographs were superior to conventional panoramic radiography for detection of proximal caries ex vivo and should be considered for patients with contraindications for intra oral radi- ographs.