This study investigated the radiographic pattern of underlying dark shadow from dentin (ICDAS 4) in permanent molars and assessed the association between enamel breakdown and radiographic features. Ninety-five teeth (54 patients) were clinically and radiographically assessed. The majority of ICDAS 4 caries lesions presented enamel breakdown (n = 78, 82.1%) and no radiographic image (n = 64, 67.4%) or a radiolucent zone restricted to the enamel-dentin junction (n = 17, 17.9%). No association was found between enamel breakdown and radiographic features. This study suggests that a radiographic examination is needed prior to the decision making process for underlying dark shadows from dentin.

1.
Alves LS, Damé-Teixeira N, Susin C, Maltz M: Association among quality of life, dental caries treatment and intraoral distribution in 12-year-old South Brazilian schoolchildren. Community Dent Oral Epidemiol 2013;41:22-29.
2.
Diniz MB, Rodrigues JA, Hug I, Cordeiro ReC, Lussi A: Reproducibility and accuracy of the ICDAS-II for occlusal caries detection. Community Dent Oral Epidemiol 2009;37:399-404.
3.
Ekstrand KR, Martignon S, Ricketts DJ, Qvist V: Detection and activity assessment of primary coronal caries lesions: a methodologic study. Oper Dent 2007;32:225-235.
4.
Ekstrand KR, Ricketts DN, Kidd EA: Reproducibility and accuracy of three methods for assessment of demineralization depth of the occlusal surface: an in vitro examination. Caries Res 1997;31:224-231.
5.
Espelid I, Tveit AB, Mejàre I, Sundberg H, Hallonsten AL: Restorative treatment decisions on occlusal caries in Scandinavia. Acta Odontol Scand 2001;59:21-27.
6.
Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB: The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 2007;35:170-178.
7.
Jablonski-Momeni A, Stachniss V, Ricketts DN, Heinzel-Gutenbrunner M, Pieper K: Reproducibility and accuracy of the ICDAS-II for detection of occlusal caries in vitro. Caries Res 2008;42:79-87.
8.
Mejàre I, Sundberg H, Espelid I, Tveit B: Caries assessment and restorative treatment thresholds reported by Swedish dentists. Acta Odontol Scand 1999;57:149-154.
9.
Mejàre I, Stenlund H, Zelezny-Holmlund C: Caries incidence and lesion progression from adolescence to young adulthood: a prospective 15-year cohort study in Sweden. Caries Res 2004;38:130-141.
10.
Mitropoulos P, Rahiotis C, Stamatakis H, Kakaboura A: Diagnostic performance of the visual caries classification system ICDAS II versus radiography and micro-computed tomography for proximal caries detection: an in vitro study. J Dent 2010;38:859-867.
11.
Rodrigues JA, Hug I, Diniz MB, Lussi A: Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro. Caries Res 2008;42:297-304.
12.
van Amerongen JP, Penning C, Kidd EA, ten Cate JM: An in vitro assessment of the extent of caries under small occlusal cavities. Caries Res 1992;26:89-93.
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