A small radiolucent notch in enamel just apical to the contact area is most consistent with which lesion?

• A. Early proximal caries
• B. Recurrent caries
• C. Root caries
• D. Facial-lingual caries

Answer: (A)

This radiographic pattern shows early proximal caries. When caries begin in the proximal enamel, they often appear as a small radiolucent notch right apical to the contact area on bitewing views. This location reflects initial demineralization confined to the enamel along the proximal surface as plaque accumulates at the contact point. The notch is shallow and narrow because the lesion is just starting and has not yet penetrated deeply into dentin.

Recurrent caries would occur along the margins of a restoration, not as a new enamel notch at a natural proximal contact. Root caries affect the root surface and are seen at cementum/dentin near or below the CEJ, not as a proximal enamel notch. Facial-lingual caries affect the buccal or lingual surfaces and are not described by a proximal radiolucent notch just beneath the contact on a bitewing.