Impact of Different Illumination Conditions on Visual Caries Detection with ICDAS

The aim of this study was to test the influence of different degrees of additional illumination on visual caries detection using the International Caries Detection and Assessment System (ICDAS). Two calibrated examiners assessed 139 occlusal surfaces of extracted permanent molars using a standard operation lamp with or without an additional headlamp providing three default brightness intensities. Histology served as the gold standard. Pooled data showed no differences in sensitivities. Specificities were not influenced by additional light. The area under the curve for the Marthaler classification D3 threshold was significantly lower when an additional strong headlamp was used (0.59 compared to 0.69-0.72 when reduced illumination intensities were used). One of the two examiners also had a significantly lower sensitivity for the D1 threshold when an additional headlamp was used. The use of additional white light led to a reduced detection of dentine lesions.

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Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

Journal of Dental Research ◽

10.1177/0022034514551753 ◽

2014 ◽

Vol 93 (11) ◽

pp. 1070-1075 ◽

Cited By ~ 42

Author(s):

M. Fontana ◽

J.A. Platt ◽

G.J. Eckert ◽

C. González-Cabezas ◽

K. Yoder ◽

...

Keyword(s):

Assessment System ◽

Retention Rates ◽

Caries Detection ◽

Major Barrier ◽

Occlusal Surfaces ◽

Before And After ◽

Permanent Molars ◽

Caries Lesions ◽

Sealant Retention ◽

Lesion Severity

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.

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Accuracy of visual and image-based ICDAS criteria compared with a micro-CT gold standard for caries detection on occlusal surfaces

Brazilian Oral Research ◽

10.1590/1807-3107bor-2018.vol32.0060 ◽

2018 ◽

Vol 32 (0) ◽

Cited By ~ 1

Author(s):

Raquel Nogueira de CARVALHO ◽

Aline dos Santos LETIERI ◽

Thiago Isidro VIEIRA ◽

Thais Maria Pires dos SANTOS ◽

Ricardo Tadeu LOPES ◽

...

Keyword(s):

Gold Standard ◽

Caries Detection ◽

Micro Ct ◽

Occlusal Surfaces

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Development of a Fluorescence-Based Caries Scoring System for an Intraoral Scanner: An in vitro Study

Caries Research ◽

10.1159/000509925 ◽

2020 ◽

Vol 54 (4) ◽

pp. 324-335

Author(s):

Stavroula Michou ◽

Ana Raquel Benetti ◽

Christoph Vannahme ◽

Pétur Gordon Hermannsson ◽

Azam Bakhshandeh ◽

...

Keyword(s):

Scoring System ◽

State Of The Art ◽

Assessment System ◽

Detection Methods ◽

Caries Detection ◽

Fluorescence Signal ◽

Radiographic Assessment ◽

Intraoral Scanner ◽

Posterior Teeth ◽

Occlusal Surfaces

Objectives: To develop an automated fluorescence-based caries scoring system for an intraoral scanner and totest the performance of the system compared to state-of-the-art methods. Methods: Seventy-three permanent posterior teeth were scanned with a three-dimensional (3D) intraoral scanner prototype which emitted light at 415 nm. An overlay representing the fluorescence signal from the tissue was mapped onto 3D models of the teeth. Multiple examination sites (n = 139) on the occlusal surfaces were chosen, and their red and green fluorescence signal components were extracted. These components were used to calculate 4 mathematical functions upon which a caries scoring system for the scanner prototype could be based. Visual-tactile (International Caries Detection and Assessment System, ICDAS), radiographic (ICDAS), and histological assessments were conducted on the same examination sites. Results: Most index tests showed significant correlation with histology. The strongest correlation was observed for the visual-tactile examination (rs = 0.80) followed by the scanner supported by the caries classification function that quantifies the overall fluorescence compared to sound surfaces (rs = 0.78). Additionally, this function resulted in the highest intra-examiner reliability (κ = 0.964), and the highest sum of sensitivity (SE) and specificity (SP) (sum SE-SP: 1.60–1.84) at the 2 histological levels where the comparison with visual-tactile assessment was possible (κ = 0.886, sum SE-SP = 1.57–1.81) and at the 3 out of 4 histological levels where the comparison with radiographic assessment was possible (κ = 0.911, sum SE-SP = 1.37–1.78); the only exception was for the lesions in the outer third of dentin, where the radiographic assessment showed the highest sum SE-SP (1.78). Conclusion: A fluorescence-based caries scoring system was developed for the intraoral scanner showing promising performance compared to state-of-the-art caries detection methods. The intraoral scanner accompanied by an automated caries scoring system may improve objective caries detection and increase the efficiency and effectiveness of oral examinations. Furthermore, this device has the potential to support reliable monitoring of early caries lesions.

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Automated caries detection with smartphone color photography using machine learning

Health Informatics Journal ◽

10.1177/14604582211007530 ◽

2021 ◽

Vol 27 (2) ◽

pp. 146045822110075

Author(s):

Duc Long Duong ◽

Malitha Humayun Kabir ◽

Rong Fu Kuo

Keyword(s):

Clinical Decision Making ◽

Clinical Decision ◽

Clinical Diagnostics ◽

Assessment System ◽

Caries Detection ◽

Support Vector ◽

Detection Scheme ◽

Occlusal Surfaces ◽

Icdas Ii ◽

Untreated Caries

Untreated caries is significant problem that affected billion people over the world. Therefore, the appropriate method and accuracy of caries detection in clinical decision-making in dental practices as well as in oral epidemiology or caries research, are required urgently. The aim of this study was to introduce a computational algorithm that can automate recognize carious lesions on tooth occlusal surfaces in smartphone images according to International Caries Detection and Assessment System (ICDAS). From a group of extracted teeth, 620 unrestored molars/premolars were photographed using smartphone. The obtained images were evaluated for caries diagnosis with the ICDAS II codes, and were labeled into three classes: “No Surface Change” ( NSC); “Visually Non-Cavitated” ( VNC); “Cavitated” ( C). Then, a two steps detection scheme using Support Vector Machine (SVM) has been proposed: “ C versus (VNC + NSC)” classification, and “ VNC versus NSC” classification. The accuracy, sensitivity, and specificity of best model were 92.37%, 88.1%, and 96.6% for “ C versus (VNC + NSC),” whereas they were 83.33%, 82.2%, and 66.7% for “ VNC versus NSC.” Although the proposed SVM system required further improvement and verification, with the data only imaged from the smartphone, it performed an auspicious potential for clinical diagnostics with reasonable accuracy and minimal cost.

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The Effect of Combining Radiographs and DIAGNOdent With Visual Examination on Detection and Treatment Decisions of Noncavitated Occluso-dentinal Caries

Operative Dentistry ◽

10.2341/14-138-l ◽

2015 ◽

Vol 40 (3) ◽

pp. 313-321 ◽

Cited By ~ 6

Author(s):

QD Alomari ◽

M Qudiemat ◽

ME Khalaf ◽

Y Al-Tarakemah

Keyword(s):

Area Under The Curve ◽

Rank Correlation ◽

Correlation Coefficients ◽

Treatment Decisions ◽

Radiographic Examination ◽

Lower Sensitivity ◽

Visual Examination ◽

Posterior Teeth ◽

Restorative Treatment ◽

Occlusal Surfaces

SUMMARY The aim of this laboratory study was to evaluate the effectiveness of incorporating radiographic examination and DIAGNOdent with visual examination for the detection and treatment of noncavitated occluso-dentinal caries. Four examiners examined the occlusal surfaces of 160 extracted posterior teeth. Teeth were examined three times with a one-month interval in between. The first examination was visual (V), the second examination was visual with radiograph (VR), and the third examination was visual with radiograph and DIAGNOdent (VRD). Examiners were asked to detect the presence of caries (if any) and identify the extent of caries (if present; ie, enamel or dentin). The examiners were also asked to choose a treatment for each tooth. The examined teeth were later sectioned, and the presence of caries was charted as 0 = no caries, 1 = caries confined to enamel, 2 = caries in the outer dentin, and 3 = caries in the inner dentin. Sensitivity, specificity, area under the curve (Az values), rank correlation coefficient, interexaminer reproducibility, and McNemar χ2 tests were calculated. VR had statistically higher specificity and lower sensitivity than V and VRD. The means of Az values ranged from 0.58 to 0.63, with no statistical difference between the three examinations (p>0.05). The means of the rank correlation coefficients with histology for detection of dentinal caries were 0.48, 0.23, and 0.44 using V, VR, and VRD, respectively. Interexaminer reproducibility was best for V alone. The percentages of teeth indicated for restorative treatment were 31%, 33%, and 41% using V, VR, and VRD, respectively. The percentages of teeth correctly treated according to histology were 69.4%, 70.0%, and 67.5% using V, VR, and VRD, respectively. There was no difference in the accuracy of treatment decisions between the three examination points (p>0.05). The addition of radiographs and DIAGNOdent to visual examination did not have a significant effect on the improvement of the detection or treatment decisions of examiners of noncavitated occluso-dentinal carious lesions.

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Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial

Caries Research ◽

10.1159/000517390 ◽

2021 ◽

pp. 1-11

Author(s):

Phoebe Pui Ying Lam ◽

Divesh Sardana ◽

Weijia Luo ◽

Manikandan Ekambaram ◽

Gillian Hiu Man Lee ◽

...

Keyword(s):

Preschool Children ◽

Assessment System ◽

Fluoride Varnish ◽

Caries Detection ◽

Caries Experience ◽

Primary Molars ◽

Glass Ionomer ◽

Occlusal Caries ◽

Occlusal Surfaces ◽

Significant Difference

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3–4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0–1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group – application of 5% NaFV at 3-monthly intervals or GIS group – 1 single placement of GIS. A parental questionnaire was used to collect information on the children’s sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (p = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.

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Effects of the intervention of the Multicenter Study IDEFICS on the prevalence of caries in Spanish children

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v20i00.8661359 ◽

2021 ◽

Vol 20 ◽

pp. e211359

Author(s):

Vinícius Aguiar Lages ◽

Maria Paula Rando Meirelles ◽

Marília Jesus Batista ◽

Carolina Matteussi Lino ◽

Andréa Moscardini da Costa ◽

...

Keyword(s):

Assessment System ◽

Caries Detection ◽

Chi Square ◽

White Spots ◽

Two Cities ◽

Chi Square Test ◽

Untreated Caries ◽

Permanent Molars ◽

Age Range ◽

Do So

Aim: To evaluate the effects of an intervention for the prevention of obesity on the prevalence of dental caries disease in Spanish children. Methods: Two cities participated intervention study nested in a cohort IDEFICS (Identification and prevention of dietary and lifestyle induced health effects in children and infants): Huesca, where there was a 2-year intervention, which encouraged less sugar consumption; and Zaragoza (control). The prevalence of caries was evaluated by examining the 1st permanent molars in the 7-11 age range, using the ICDAS (International Caries Detection and Assessment System). These teeth erupt at 6 years of age and at the baseline (2007-2008) were free of caries because they were not present in the oral cavity. As outcomes, white spots were selected, combining the ICDAS criteria 1 and 2, and untreated caries, combining criteria 4, 5 and 6. Their association with socioeconomic variables, BMI (Body Mass Index), frequency of sugar intake, sex and parents’ perceptions of their children, was investigated. To do so, the chi-square test was applied (p<0.05). Results: The sample consisted of 281 children. The prevalence of white spots and untreated caries was higher in Huesca, despite the intervention. There was no association between the outcomes and the variables studied (p>0.05). Conclusion: The intervention for the prevention of obesity did not exert any association with the prevalence of caries in Spanish children.

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Do combinations of clinical parameters related to caries activity status predict progression more accurately than individual parameters?

10.1101/561878 ◽

2019 ◽

Author(s):

I Floriano ◽

R Matos ◽

J Mattos-Silveira ◽

ES Rocha ◽

KR Ekstrand ◽

...

Keyword(s):

Predictive Power ◽

Assessment System ◽

Caries Detection ◽

Clinical Parameters ◽

Caries Lesion ◽

Occlusal Surfaces ◽

Risk Of Progression ◽

Caries Progression ◽

Cavitated Lesions

AbstractFew studies have addressed the predictive power of the clinical parameters used in assessing caries lesion activity. This study assessed the predictive validity of evaluating clinical parameters that are related to caries lesion activity status, individually and combined, in a long-term analysis. The occlusal surfaces of primary molars (1361 surfaces) were examined in 205 children according to the following clinical features: potential for plaque stagnation, colour, luster, cavitation, texture, and clinical depth. Cavities with frankly exposed dentine were excluded from this sample. After 1 year, 148 children (828 surfaces) were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as an outcome to verify the predictive power of the initially assessed clinical parameters. Different combinations of two or more parameters were also tested to check for any association with caries progression. Multilevel Poisson regression analyses were performed and the relative risk for each parameter/combination tested was calculated by considering a confidence interval of 95%. Forty percent of the reassessed surfaces presented caries progression after 1 year. Despite their surface integrity, dentine caries lesions were approximately 10-fold more likely and enamel lesions were approximately three-fold more likely to progress than sound surfaces. Similarly, cavitated lesions showed the highest risk of progression compared to sound/non-cavitated lesions. When only non-cavitated surfaces were considered, roughness proved to be a risk factor for caries progression. In conclusion, the lesions presenting clinical involvement of the dentine and even those cavitations clinically involving only the enamel had a higher risk of progression compared to sound or non-cavitated surfaces. For these lesions, the evaluation of other conjoint parameters seems unnecessary. Nevertheless, surface roughness can be a useful feature in predicting the risk of non-cavitated caries lesion progression.

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Clinical effectiveness of fluorescence, digital images and ICDAS for detecting occlusal caries

Revista de Odontologia da UNESP ◽

10.1590/1807-2577.12416 ◽

2017 ◽

Vol 46 (2) ◽

pp. 109-115 ◽

Cited By ~ 2

Author(s):

Cristina Dupim PRESOTO ◽

Tamara Carolina TREVISAN ◽

Maria Costa de ANDRADE ◽

Andrea Abi-Rached DANTAS ◽

Juliana Alvares Duarte Bonini CAMPOS ◽

...

Keyword(s):

Likelihood Ratio ◽

Roc Curve ◽

Digital Images ◽

Assessment System ◽

Caries Detection ◽

Occlusal Caries ◽

Posterior Teeth ◽

Occlusal Surfaces ◽

Discrimination Capacity ◽

Caries Lesions

Abstract Introduction The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited an acceptable discrimination capacity (AUROC=0.78), although it was lower than the others. The positive likelihood ratio for the fluorescence was only 2.32, compared to 20.58 for the intraoral image and 58.11 for the ICDAS. Conclusion Both methods and the ICDAS exhibited an adequate clinical performance, although the ICDAS and intraoral image were more effective than the fluorescence.

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Behavioral management using sequenced treatment paradigm and audiovisual distraction during dental treatment in children with attention deficit/hyperactivity disorder

European Journal of Dentistry ◽

10.4103/ejd.ejd_59_18 ◽

2018 ◽

Vol 12 (02) ◽

pp. 262-268

Author(s):

Kausar Sadia Fakhruddin ◽

Hisham ElBatawi ◽

Hatem M. El-Damanhoury

Keyword(s):

Pulse Rate ◽

Dental Treatment ◽

Assessment System ◽

Caries Detection ◽

Behavioral Management ◽

Blood Oxygen Saturation ◽

Hyperactivity Disorder ◽

Dental Procedures ◽

Permanent Molars ◽

First Permanent Molars

ABSTRACT Objective: The present study aimed to assess behavioral management using sequenced treatment approach and audiovisual distraction (AVD) with/without video eyewear during dental procedure in children with attention defi cit/hyperactivity disorder (ADHD). Materials and Methods: This clinical trial included 31 children (n = 21 boys; n = 10 girls), aged between 6.5 and 8.1 years, distributed into Group A (n = 17, children not on ADHD medication) and Group B (n = 14, children taking medication for ADHD symptoms). The study involved four sessions, 1 week apart. Sessions I and II included behavioral management assessment and dental screening, respectively, while participants watched cartoon movie using an AV distracter with/without a video eyewear. During Sessions III and IV, dental prophylaxis and sealants were placed on first permanent molars, respectively, for both upper and lower jaws in both the groups. During the procedure, children were distracted with AV distracter with/without a video eyewear, and the mean changes in blood oxygen saturation (SaO2) and pulse rate were recorded every 5 min. Independent samples t-test was used, assessing for significant changes in pulse rate and SaO2 during each visit in both groups. Results: Almost 95% (n = 113) of the first permanent molars showed signs of pit and fissure demineralization of varying severities, classifi ed as the International Caries Detection and Assessment System-codes 1–3. During Session IV, there were significant differences (P ≤ 0.03 and P ≤ 0.05) in mean pulse rate in both groups of children, respectively, during fissure sealants or preventive resin restoration application on their permanent molars while being distracted using AVD with video eyewear. Conclusion: Our study recommends splitting of dental visits into multiple short sessions and video eyewear distraction for optimum behavioral management during dental procedures of children with ADHD.

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