Which projection would best evaluate interproximal caries and bone levels?

• A. Periapical radiograph
• B. Bitewing radiograph
• C. Occlusal radiograph
• D. Panoramic radiograph

Answer: (B)

Evaluating interproximal caries and bone levels hinges on capturing both the contact areas between adjacent teeth and the crest of the alveolar bone. Bitewing radiographs place the film or sensor at the level of the crowns, showing the proximal surfaces clearly and revealing any caries at the contact points. They also display the alveolar bone crest along multiple teeth in a single view, enabling assessment of bone height and early bone loss around the roots. This makes bitewings especially suited for periodontal monitoring and proximal caries detection.

Periapical radiographs focus on a single tooth or a small group with a view from the root tip upward, which is great for periapical pathology but not as efficient for surveying the entire interproximal region or comparing bone levels across several teeth.

Occlusal radiographs provide a broad view but lack the resolution to reliably detect small proximal lesions or subtle changes in bone height between neighboring teeth.

Panoramic radiographs cover a wide area but sacrifice detail and accuracy in proximal surfaces and bone height measurements due to distortion and lower resolution.

Thus, the bitewing projection is the best choice to evaluate both interproximal caries and bone levels.