How compatible are recent methods for diagnosis of occlusal caries with the ICDAS ll ?

Abstract

Abstract Aim: This study aimed to evaluate the compability of fluorescence-based method and radiographic examination with International Caries Detection and Assessment System(ICDAS II) on detection of carious lesions on occlusal surfaces. Materials and Methods: 63 extracted human molar teeth with occlusal surfaces varying from sound to cavitated were selected. Standardized periapical radiographs were taken. Two experienced dentists examined all teeth using the ICDAS-II graded scores 0–6 and DIAGNOdent Pen® (KaVo,Biberach/Riss,Germany). The teeth were serially sectioned and examined under x25 magnification using a stereomicroscope (LeicaM27.5). Radiographs and microscopic images were scored by using Downer criteria scores 0-4. The results obtained from stereomicroscope used as the gold standard. Correlation of diagnostic methods with microscopic analysis was evaluated using Spearman’s rank correlation coefficients(rho). Results: After visual inspection using ICDAS II 7 teeth were scored 0, 9 were scored 1, 8 were scored 2, 10 were scored 3, 8 were scored 4, 8 were scored 5 and 13 were scored 6. Mean DIAGNOdent pen values were obtained respectively 5, 16, 34, 57, 99, 99 and 99. The diagnostic results obtained using the ICDAS II(rho=0,9672) and DIAGNOdent Pen® (rho=0,9432)were found to correlate better with the results obtained from microscope than those obtained using radiographic examination. The association strength of ICDAS II and DIAGNOdent Pen® with the microscopic evaluation was very strong. Substantial agreement was found for the Radiographic examination(κ=0.68). Conclusion: Data from this investigation suggested that the visual examination (ICDAS II) and DIAGNOdent Pen® showed better performance than radiographic examination for occlusal caries detection. Within the limitations of an in vitro investigation, the ICDAS II visual criteria could be sufficient alone in diagnosis of occlusal caries. The DIAGNOdent Pen® and radiographic examination can be used as an adjunct method for assessment of occlusal caries.