DIAGNOdent versus International Caries Detection and Assessment System (ICDAS) in Detection of Incipient Carious Lesions: A Diagnostic Accuracy study

Abstract

Objectives: The present investigation aimed at assessing the diagnostic accuracy of DIAGNOdent compared to the ICDAS-II in the detection of facial, smooth surface non-cavitated carious lesions. Materials and methods: 60 patients were enrolled in the current study according to the eligibility criteria. There were 161 teeth with non-cavitated, white spot carious lesions and 32 sound teeth. All teeth were assessed by each examiner individually at different times without any contact using ICDAS II and DIAGNOdent. The diagnostic accuracy of DIAGNOdent device was determined, including sensitivity, specificity, overall accuracy, positive and negative predictive values and ROC curve analysis. Results: In the current study, DIAGNOdent had overall accuracy of 84.45% with sensitivity and specificity of 87.58% and 96.87% respectively, when score 0 represented sound tooth surface, while scores 1 and 2 were considered as clinically non-cavitated carious lesions. Moreover, when only ICDAS score 1 was considered representing first visual change in enamel, DIAGNOdent had accuracy of 74.15% with sensitivity and specificity of 83.53% and 90.62% respectively. In the present study, when only ICDAS score 2 was considered representing distinct visual change in enamel, DIAGNOdent had accuracy of 100% with sensitivity and specificity of 100% and 100% respectively. Conclusions: DIAGNOdent has shown high sensitivity and specificity and excellent association with ICDAS II despite being less accurate in detecting the first visual change in enamel compared to visual examination.Clinical relevance: The overall performance of DIAGNOdent was equivalent to the visual inspection using ICDAS II, therefore, DIAGNOdent might be considered as a useful adjunctive device for detecting in vivo non-cavitated carious lesions on facial smooth surfaces.