Receiver operating characteristics analysis was performed to demonstrate differences in diagnostic performance among conventional tomograms, digitized tomograms, and subtraction tomograms. Digital subtraction tomography was found to be the best imaging modality for detecting artificially created lesions in the two selected temporomandibular joint locations. There was a statistically significant difference in diagnostic performance between conventional tomograms and subtraction tomograms for the detection of temporomandibular joint bony lesions. There was also a statistically significant difference in diagnostic performance between digitized tomograms and subtraction tomograms in the detection of these bony lesions. There was no statistically significant difference in diagnostic performance between conventional tomograms and digitized tomograms for the detection of temporomandibular joint bony lesions. The significance level was set at p = 0.05. Results of the analyses of variance showed that with digital subtraction tomograms, observer reliabilities were higher than with conventional and digitized tomograms.