Reproducibility and Accuracy of the ICDAS-II for Detection of Occlusal Caries in vitro

Abstract

Aim: The aim of this study was to assess inter- and intra-examiner reproducibility and accuracy in the detection and assessment of occlusal caries in extracted human teeth using a newly developed visual method for caries diagnosis (International Caries Detection and Assessment System, ICDAS-II). Serial sectioning and microscopy were used as the ‘gold standard’. Methods: The occlusal surfaces of 100 teeth were examined by 4 dentists using the ICDAS-II graded scores 0–6. Thereafter the teeth were serially sectioned and assessed for depth of the lesion with two histological classification systems. Results: The weighted kappa values for inter- and intra-examiner reproducibility for the ICDAS-II examination were 0.62–0.83. There was a moderate relationship between the visual and both histological examinations (r_s = 0.43–0.72). At the D1 diagnostic threshold (enamel and dentine lesions) specificity was 0.74–0.91 and sensitivity was 0.59–0.73. At the D3 diagnostic threshold (dentine lesions) specificity was 0.82–0.94 and sensitivity was 0.48–0.83 for the 4 examiners. Conclusion: The ICDAS-II system has demonstrated reproducibility and diagnostic accuracy for the detection of occlusal caries at varying stages of the disease process which are comparable to previously reported data using similar visual classification systems.

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

“…The International Caries Detection & Assessment System (ICDAS) 17 is an accessible set of criteria for dentists, researchers and professors and presents acceptable sensitivity and specificity to the detection of occlusal caries 4,5,10,18,19 . According to this system, caries detection on coronal teeth surfaces is a process that comprises two stages.…”

Reproducibilidad Intraexaminador en La Aplicación Del Sistema Internacional De Detección Y Valoración De Caries Dental (Icdas Ii)

“…17 Así mismo, Jablonski-Momeni y colaboradores encontraron una reproducibilidad intraexaminador de 0.73 a 0.83. 15 Estos dos estudios fueron realizados in vitro.…”

“…[12][13][14] Adicionalmente, se han realizado varios estudios para evaluar su reproducibilidad inter e intraexaminador. [15][16][17][18] Jablonsski-Momeni y colaboradores (2008) demostraron reproducibilidad y precisión diagnóstica al usar ICDAS II en 100 molares extraídos, en las diferentes etapas del proceso carioso. Los valores Kappa estuvieron entre 0.62 y 0.83 para los examinadores evaluados.…”

“…Los valores Kappa estuvieron entre 0.62 y 0.83 para los examinadores evaluados. 15 En Colombia, se han realizado varios estudios de calibración por un examinador entrenado (Examinador Estándar). Se realizan conferencias sobre los conceptos actuales de caries dental, explicaciones sobre los códigos ICDAS, discusiones de casos clí-nicos, exámenes preclínicos en dientes naturales y exámenes clínicos en pacientes.…”

Reliability and validity of ICDAS II coding for occlusal caries using magnification: an in-vitro study

“…7 Studies have demonstrated good sensitivity, specificity, reproducibility and diagnostic accuracy for this system. [8][9][10] Though the occlusal pit and fissure areas are approachable and accessible for cleansing and examination, the incidence of carious lesion is more in these sites. This can be attributed to the complex invaginated anatomy of the pits and the fissures.…”