Reliability of the Nyvad criteria for caries assessment in primary teeth

Abstract

This study assessed the interexaminer and intra-examiner reliability of the Nyvad caries classification system in primary teeth and calculated the mean examination time. The criteria were based on visual and tactile examinations to differentiate active and inactive lesions at cavitated and non-cavitated levels. Eighty children (3-7 yr of age) were examined under standardized conditions by calibrated examiners. At the tooth surface level, reliability was expressed as percentage agreement and kappa coefficient, using four diagnostic thresholds: sound vs. diseased; sound or inactive lesion vs. active lesion; intact surface vs. surface discontinuity; and sound or non-cavitated lesion vs. cavitated lesion. Interexaminer and intra-examiner kappa values were, respectively: 0.82/0.86; 0.80/0.86; 0.90/0.94; and 0.95/0.98. At the individual level, reliability of estimates of the caries prevalence and of the decayed or filled surface (dfs) counts were assessed at three diagnostic thresholds: sound vs. diseased; sound or inactive lesion vs. active lesion; and sound or non-cavitated lesion vs. cavitated lesion. For caries prevalence, interexaminer and intra-examiner kappa values were, respectively: 0.84/0.94; 0.69/0.74; and 0.95/0.97. The mean examination time was 226.5s (SD = 128.5). The use of the Nyvad caries diagnostic criteria in primary teeth showed reliable results. The examination time was acceptable.

Reproducibility and Diagnostic Outcomes of Two Visual-Tactile Criteria Used by Dentists to Assess Caries Lesion Activity: A Cross-Over Study

“…According to our study results, the level of dentists' intra-and inter-examiner agreement was quite high for both diagnostic systems when they were used to assess severity. These results are in agreement with other in vivo studies [Nyvad et al, 1999;Shoaib et al, 2009;Braga et al, 2010;Ferreira Zandoná et al, 2010;Séllos and Soviero, 2011] and confirm the possibility of diagnosing non-cavitated caries lesions with a high level of agreement, even when diagnoses are made by dental practitioners previously inexperienced in the use of the tested diagnostic criteria. For lesion activity assessment, both criteria worked similarly, resulting in low kappa values for the D1 activity diagnostic threshold.…”

“…There are several studies in which the reliability and validity of the Nyvad system is reported [Nyvad et al, 1999[Nyvad et al, , 2003Lima et al, 2008;Braga et al, 2009Braga et al, , 2009aMachiulskiene et al, 2009;Braga et al, 2010;Séllos and Soviero, 2011]; most of them were performed in clinical settings with expert dentists. There are more published studies on the ICDAS II criteria, in which reproducibility and accuracy is measured.…”

Pilot clinical study to assess caries lesion activity using quantitative light-induced fluorescence during dehydration

“…Previous studies demonstrated that both criteria could predict lesion depth and assess caries lesion activity. 21,22,24,[32][33][34] Although not reaching statistical significance, this small, pilot clinical study provided preliminary information to establish the use of the QLF method. Further clinical investigations to establish threshold or cut-off values to distinguish among the lesion stages and a larger sample size for clinical application will be necessary.…”

Nyvad Criteria for Caries Lesion Activity and Severity Assessment: A Validated Approach for Clinical Management and Research

“…These scores include separate codes for sound surfaces, fillings, and active and inactive secondary caries. A full-mouth examination typically takes no more than 5-10 min [Nyvad et al, 1999;Séllos and Soviero, 2011]. The criteria are user friendly and may easily be adapted to statistical analysis.…”