What common error in a bite-wing view can lead to misdiagnosis due to the overlapping of proximal surfaces?

In dental radiography, a bite-wing view is primarily used to examine the proximal surfaces of the teeth, aiding in the detection of cavities and assessing periodontal health. Overlapping of proximal surfaces in a bite-wing radiograph occurs when the images of adjacent teeth are not clearly separated, which can lead to misdiagnosis as it may obscure dental caries or other underlying issues.

The overlapping happens commonly due to improper horizontal angulation of the x-ray beam. When the x-ray beam is not aligned correctly, it may cause the images of adjacent teeth to superimpose over one another, making it difficult for the dentist to distinguish between healthy tooth structure and potential carious lesions. This misalignment can potentially lead to the misinterpretation of the radiograph, resulting in missed diagnoses.

In contrast, other factors such as underexposure, foreshortening, or distortion would not primarily result in overlapping but could still affect the clarity or overall quality of the radiograph. For instance, underexposure typically results in a radiograph that is too dark, making it hard to decipher details, but it wouldn't cause overlapping images. Foreshortening and distortion relate more to the angles and distances between the x-ray source and the film, affecting the image size