Validity and Reproducibility of ICDAS II in Primary Teeth

Abstract

The aim of this in vitro study was to assess the validity and reproducibility of the ICDAS II (International Caries Detection and Assessment System) criteria in primary teeth. Three trained examiners independently examined 112 extracted primary molars, ranging from clinically sound to cavitated, set up in groups of 4 to mimic their anatomical positions. The most advanced caries on the occlusal and approximal surfaces was recorded. Subsequently the teeth were serially sectioned and histological validation was undertaken using the Downer and Ekstrand-Ricketts-Kidd (ERK) scoring systems. For occlusal surfaces at the D₁/ERK₁ threshold, the mean specificity was 90.0%, with a sensitivity of 75.4%. For approximal surfaces, the specificity and sensitivity were 85.4 and 66.4%, respectively. For occlusal surfaces at ICDAS code ≥3 (ERK₃ threshold), the mean specificity and sensitivity were 87.0 and 78.1%, respectively. For approximal surfaces, the equivalent values were 90.6 and 75.3%. At the D₃ threshold for occlusal surfaces, the mean specificity and sensitivity were 92.8 and 63.1%, and for approximal surfaces 94.2 and 58.3%, respectively. Mean intraexaminer reproducibility (Cohen’s kappa) ranged from 0.78 to 0.81 at the ICDAS code ≥1 cut-off and at the ICDAS code ≥3 cut-off from 0.74 to 0.76. Interexaminer reproducibility was lower, ranging from 0.68 to 0.70 at the ICDAS code ≥1 cut-off and from 0.66 to 0.73 at the ICDAS code ≥3 cut-off. In conclusion, the validity and reproducibility of the ICDAS II criteria were acceptable when applied to primary molar teeth.

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

“…The reliability for the visual examination with ICDAS, when used by six different examiners, ranged from "regular" (κ=.59) to "great" (κ=.82) in a previous study 17 , which described this criterion as a practical system with content validity. Similar reproducibility was found by Shoaib et al 15 when assessing the occlusal surfaces of deciduous teeth.…”

“…An ideal method to detect caries lesions should be fast and easy to use, with high sensitivity and specificity 14,15 , as well as reliability and an accessible cost. This will enable the documentation and detection of caries at an early stage, without causing discomfort for the patient, as well as the possibility of differentiating reversible and irreversible damage, with similar effectiveness when applied to all dental surfaces 16 .…”

Natural history of dental caries in very young Australian children

“…This measure provides triggers for clinical care and for predicting which lesions will progress to cavitation and speed of progression8. Research on the ICDAS II shows it is valid for use within children, comparable to standard criteria in epidemiological surveys15, and has acceptable validity and reproducibility for all codes when used with primary molar teeth16.…”

Avaliação dos benefícios dos métodos radiográfico e de fluorescência a laser associados à inspeção visual na detecção de lesões de cárie em dentes decíduos

“…O método é de fácil execução, rápido, provoca pouco desconforto no paciente, e tem sido utilizado de forma rotineira na prática clínica (BRAGA; MENDES; EKSTRAND, 2010;EKSTRAND, 2004;NYVAD, 2004;PITTS, 1993 (BRAGA et al, 2009a;DINIZ et al, 2009;EKSTRAND et al, 2007;ISMAIL et al, 2007;SHOAIB et al, 2009).…”

“…Conseqüentemente, o exame radiográfico pode ser considerado um exame auxiliar na detecção de lesões de cárie (BAELUM, 2010;EKSTRAND, 2010;WENZEL, 2004 LFpen pode ser um substituto do exame radiográfico na detecção de lesões oclusais (HUTH et al, 2008;LUSSI;HELLWIG, 2006; 2008) e em lesões proximais (BRAGA et al, 2009b;110 NOVAES et al, 2009 (DE ARAUJO et al, 1996;HINTZE et al, 1998 BRAGA et al, 2009a;JABLONSKI-MOMENI et al, 2008;SHOAIB et al, 2009). A reprodutibilidade variou de 0,7 a 0,9 nos diferentes estudos (BRAGA et al, 2009a;JABLONSKI-MOMENI et al, 2008;SHOAIB et al, 2009).…”