In Vitro Evaluation of ICDAS and Radiographic Examination of Occlusal Surfaces and Their Association With Treatment Decisions

2011 ◽  
Vol 36 (2) ◽  
pp. 133-142 ◽  
Author(s):  
MB Diniz ◽  
LM Lima ◽  
G Eckert ◽  
AG Ferreira Zandona ◽  
RCL Cordeiro ◽  
...  

Clinical RelevanceIt has been suggested that occlusal caries detection has become more difficult due to the widespread use of fluoride, which slows down lesion progression and delays cavitation. The ability to detect caries lesions at an early stage has a significant impact on treatment decisions, improving the possibility for a successful preventive intervention. In this investigation, the authors found that the International Caries Detection and Assessment System associated with radiographic examination has the potential to support treatment decisions for occlusal surfaces.

2015 ◽  
Vol 49 (5) ◽  
pp. 523-530 ◽  
Author(s):  
Mahmoud Jallad ◽  
Domenick Zero ◽  
George Eckert ◽  
Andrea Ferreira Zandona

Background: The paradigm shift towards the nonsurgical management of dental caries relies on the early detection of the disease. Detection of caries at an early stage is of unequivocal importance for early preventive intervention. Objective: The aim of this in vitro study is to evaluate the performance of a visual examination using the International Caries Detection and Assessment System (ICDAS) criteria, two quantitative light-induced fluorescence (QLF) systems - Inspektor™ Pro and QLF-D Biluminator™ 2 (Inspektor Research Systems B.V., Amsterdam, The Netherlands) - and a photothermal radiometry and modulated luminescence, The Canary System® (Quantum Dental Technologies, Toronto, Ont., Canada) on the detection of primary occlusal caries on permanent teeth. Methods: A total of 60 teeth with occlusal surface sites ranging from sound to noncavitated lesions (ICDAS 0-4) were assessed with each detection method twice in a random order. Histological validation was used to compare methods for sensitivity, specificity, percent correct, and the area under the receiver operating characteristic curve (AUC), at standard and optimum sound thresholds. Interexaminer agreement and intraexaminer repeatability were measured using intraclass correlation coefficients. Results: Interexaminer agreement ranged between 0.48 (The Canary System®) and 0.96 (QLF-D Biluminator™ 2). Intraexaminer repeatability ranges were 0.33-0.63 (The Canary System®) and 0.96-0.99 (QLF-D Biluminator™ 2). The sensitivity range was 0.75-0.96 while that of specificity was 0.43-0.89. The AUC were 0.79 (The Canary System®), 0.87 (ICDAS), 0.90 (Inspektor™ Pro), and 0.94 (QLF-D Biluminator™ 2). Conclusion: ICDAS had the best combination of sensitivity and specificity followed by QLF-D Biluminator™ 2 at optimum threshold.


2020 ◽  
Vol 9 (10) ◽  
pp. e1859108490
Author(s):  
Tânia Cristina Simões ◽  
Leonardo Carmezini Marques ◽  
André Tomazini Gomes de Sá ◽  
Sandra Mara Maciel ◽  
Marcelo Lupion Poleti ◽  
...  

Objective: We investigated the precision and accuracy of methods to detect caries lesions on the occlusal surface in vitro using ICDAS and radiological image. Methodology: Human third molars (n=14) were placed in an acrylic resin base and maintained wet during the study. The occlusal surfaces were visually inspected by three examiners using the International Caries Detection and Assessment System (ICDAS) method. The condition of each tooth was registered by images obtained with Digital Radiography (DR), Microcomputed Tomography (µ-CT) and Histologic Specimen (HS). For each tooth and method utilized in the study, an image was selected based on the largest extension of caries found, wherein the three examiners attributed a score to the lesion in accordance with the visual description of each method. The Kappa index, Fisher’s exact test and the Spearman´s correlation coefficient were used for evaluating reliability and accuracy, with a significance level of 5%. Results: Considerable interobserver reliability values were found for ICDAS (k = 0.701), almost perfect for µ-CT (k = 0.855) and HS (k = 0.920), and reasonable for DR (k = 0.221). Significant statistical difference was observed for ICDAS (p < 0.05), and for DR and µ-CT methods (p < 0.01). The correlation was moderate for ICDAS (r = 0.597), high for DR (r = 0.764) and perfect for µ-CT (1.000). Conclusions: the most reliability method for detecting caries lesions on occlusal surfaces in vitro was µ-CT, followed by ICDAS and DR. The most accurate method was µ-CT, followed by DR and ICDAS.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Timucin Ari ◽  
Nilgun Ari

Early detection of occlusal caries in children is challenging for the dentists, because of the morphology of pit and fissures. The aim of this study was to compare in vitro the diagnostic performance of low-powered magnification with light-emitting diode headlight (LPMLED) using ICDAS-II criteria and AC Impedance Spectroscopy (ACIS) device, on occlusal surfaces of primary molars. The occlusal surfaces of 18 extracted primary molars were examined blindly by two examiners. The teeth were sectioned and examined under light microscopy using Downer’s histological criteria as gold standard. Good to excellent inter- and intraexaminer reproducibility, higher sensitivity, specificity, and AUC values were achieved by LPMLED at D1 threshold. Also the relationship between histology and LPMLED was statistically significant. In conclusion visual aids have the potential to improve the performance of early caries detection and clinical diagnostics in children. Despite its potential, ACIS device should be considered as an adjunct method in detecting caries on primary teeth.


2021 ◽  
pp. 1-11
Author(s):  
Phoebe Pui Ying Lam ◽  
Divesh Sardana ◽  
Weijia Luo ◽  
Manikandan Ekambaram ◽  
Gillian Hiu Man Lee ◽  
...  

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 (<i>p</i> = 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.


2015 ◽  
Vol 49 (4) ◽  
pp. 401-407 ◽  
Author(s):  
Qingguang Chen ◽  
Haihua Zhu ◽  
Ying Xu ◽  
Bin Lin ◽  
Hui Chen

The feasibility of colorimetric parameters for the discrimination of the stages of dental caries based on a light-induced autofluorescence spectrum at a 405-nm excitation wavelength was investigated. The fluorescence spectra of 4 groups of tooth samples (10 sound, 10 early-stage decay, 14 established decay, and 10 severe decay), which were classified by the International Caries Detection and Assessment System, were experimentally measured in vitro. The carious lesion samples had an additional fluorescence peak at around 627 nm. The mathematical relation of the fluorescence spectrum and human color perception was established and computed. With increasing severity, the fluorescence color changed from green to yellow according to the colorimetric parameters of the CIE 1931 (x, y) chromaticity coordinates and dominant wavelengths. The results from a one-way ANOVA of the dominant wavelength showed a statistically significant difference among the 4 classified groups. The colorimetric parameters of the light-induced fluorescence spectrum can potentially be applied to evaluate the various carious levels.


2017 ◽  
Vol 46 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Cristina Dupim PRESOTO ◽  
Tamara Carolina TREVISAN ◽  
Maria Costa de ANDRADE ◽  
Andrea Abi-Rached DANTAS ◽  
Juliana Alvares Duarte Bonini CAMPOS ◽  
...  

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.


Author(s):  
Rabia Sannam Khan

Introduction: Dental care for older population is becoming a matter of concern within the National health services (NHS) United Kingdom (UK) due to increasing life expectancy of older people and retention of their natural teeth. The aim of study was to relate the International Caries Detection and Assessment System (ICDAS) scores with severity index in order to detect root caries and DIAGNOdent readings, at an early stage, to manage these lesions non-invasively. Methods: Fresh 95 extracted teeth were collected from Oral Surgery and Dental Emergency Department at Barts and the London, Queen Mary University of London. In this in vitro study, 19 out of 95 teeth had root caries. Prior to recording the readings, extracted teeth were cleaned and polished. Each lesion underwent clinical examination. To detect root caries DIAGNOdent readings (ICDAS), severity index were obtained. Pearson’s correlation coefficients tests were applied. Results: The correlation between cavitation and ICDAS scores shows the significant value of 0.01. The DIAGNOdent reading with momentum and peak values was 45.37 with standard deviation of 32.16 and for peak with the mean value of 49.79 and 31.72 of standard deviation. Regarding, readings of DIAGNOdent and severity index establishment of correlation was difficult to establish. The reason was score of severity index regarding specimen no.1 is 3.3 was illustrative of lesion that is leathery. Conclusion: The DIAGNOdent readings system did not support the detection of root caries. However, the severity index scoring system is in need of greater categories regarding caries of the root.


Author(s):  
Marta Mazur ◽  
Maciej Jedliński ◽  
Artnora Ndokaj ◽  
Denise Corridore ◽  
Antonello Maruotti ◽  
...  

Background: Early diagnosis of occlusal caries is of paramount importance for a minimally invasive approach in dentistry. The aim of the present in vivo clinical prospective study was to compare the diagnostic outcomes of visual subjective evaluation between the International Caries Detection and Assessment System (ICDAS-II) and an intraoral fluorescence-based camera (VistaCam iX Proof, Dürr Dental, Bietigheim-Bissingen, Germany) for the detection of pits and fissures in early caries lesions of posterior teeth. Methods: The study included 1011 posterior teeth in 255 patients aged 13–20 years (mean age 16 ± 2.2 years). Two blinded operators evaluated all the occlusal surfaces and the first assigned an ICDAS-II code, while the second assessed the VistaCam score: sound enamel (score 0–1.2); initial enamel decay (score 1.2–1.5); dentine caries (score 1.5–3). Results: Some 283 (28%) of the assessed teeth were ICDAS-II code 0; 334 (33%) code 1; 189 (18.7%) code 2; 176 (17.4%) code 3; and 29 (2.9%) code 4. The level of agreement between the two procedures was expressed by using Cohen’s and Fleiss’ kappa statistics and performing McNemar’s test. VistaCam assessed in 513 (50.7%) sound enamel; in 292 (28.9%) initial enamel decay; and in 206 (20.4%) dentine caries. Conclusions: This comparative study showed a poor agreement between the two diagnostic methods, especially between ICDAS-II 0, 1 and 2 codes and fluorescence assessments.


2015 ◽  
Vol 49 (4) ◽  
pp. 458-466 ◽  
Author(s):  
Sisko Honkala ◽  
Mohamed ElSalhy ◽  
Maddi Shyama ◽  
Sabiha A. Al-Mutawa ◽  
Hanan Boodai ◽  
...  

Objectives: The objectives of this study were to measure the caries preventive effect of sealants applied to occlusal surfaces of primary molars compared to fluoride varnish applications, and to assess the retention rate of sealants after 1 year. Methods: 147 first-grade pupils from two kindergarten schools in Kuwait, whose parents gave their written consent, were included. The children were examined by one dentist using the International Caries Detection and Assessment System. After the examination, sealants and fluoride varnish were applied on the selected occlusal surfaces of primary molars by another dentist. The jaw quadrant for intervention was selected randomly; molars on the contralateral side of the mouth received the contralateral intervention. Examinations and intervention were provided on the school premises in the mobile dental unit with a portable spotlight. Moisture was controlled by cotton rolls, suction and air drying. The follow-up examinations were conducted after 1 year. All children received fluoride varnish before and 6 months after the intervention. Results: From 267 matched pairs of occlusal surfaces of primary molars, varnished surfaces were significantly more likely to develop new caries lesions than the sealed ones (odds ratio = 2.92; 95% confidence interval = 1.82-4.71) during the 1-year follow-up. The majority (73.0%) of the sealants were completely retained and 15.1% partially. Conclusions: Sealing fissures seems to be better in preventing occlusal caries lesions in primary molars than applying only fluoride varnish. After 1 year, the majority of sealants were retained sound.


2018 ◽  
Vol 43 (3) ◽  
pp. E152-E157 ◽  
Author(s):  
JK Mitchell ◽  
AR Furness ◽  
RJ Sword ◽  
SW Looney ◽  
WW Brackett ◽  
...  

SUMMARYDiagnosis of the extent of pit-and-fissure caries has been subjective and thus difficult to teach and categorize for treatment planning. This in vitro study compares occlusal caries diagnosis of extracted posterior teeth (n=49) using three-dimensional (3D) scanned images vs visual examination, according to the International Caries Detection and Assessment System (ICDAS). The surfaces chosen for study represent all ICDAS classifications. Five experienced restorative faculty members examined scanned images for 60 seconds from a standardized series of views of each surface and scored them independently. One month later, the same teeth were examined visually by the same five raters with magnification and LED headlamps, with compressed air available. Intrarater and interrater agreement and validity were assessed using intraclass correlation coefficients (ICCs). The ICCs, ranging from 0.90 to 0.93, indicated excellent agreement between and within raters and between the raters and the gold standard ICDAS determination. This suggests that both photographs and 3D scans of pits and fissures are equally effective in diagnosing caries.


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