What cannot be determined from a bitewing X-ray?

The width of alveolar bone cannot be determined from a bitewing X-ray due to the inherent limitations of this imaging modality. Bitewing X-rays primarily capture a two-dimensional view of the dental arches and are designed to visualize the interproximal spaces, which are crucial for detecting caries and assessing the height of the alveolar bone in relation to the tooth structures.

While bitewing images can provide some information about the height of the alveolar bone, offering a view of its relationship to the periodontal structures, they do not provide specific measurements of width. The width of alveolar bone is typically evaluated through other imaging techniques, such as periapical or panoramic radiographs, or through three-dimensional imaging like cone beam computed tomography.

In contrast, bitewing X-rays are effective for identifying the presence of caries due to their ability to capture interproximal areas where cavities frequently develop, and they offer insights into the condition of periodontal structures by reflecting how the bone supports the adjacent teeth.