Browsing by Subject "ICDAS"

Now showing 1 - 5 of 5
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    Ability of Caries Detection Methods to Determine Caries Lesion Activity
    (2019-12) Aldawood, Fatma; Ando, Masatoshi; Hara, Anderson T.; Diefenderfer, Kim E.
    Background: Non-cavitated caries lesions form due to acid diffusion and demineralization of enamel subsurface with an intact surface layer (SL). Caries lesions progress when the outcome of demineralization and remineralization processes over time is net mineral loss. Lesions that continue to demineralize are called active, while those that display no evidence of further demineralization are called inactive. Micro-computed-tomography (µCT) analysis provides objective non-destructive measurements of the thickness of the surface layer (SL) and severity of caries lesions. Aims: 1) To investigate if visual/tactile suspected active non-cavitated early white spot lesions present a thinner surface layer than inactive ones; 2) To investigate if there is an association between the thickness of the surface layer (SLT) and caries activity, as determined by QLF during dehydration (△QD); 3) To determine lesion severity by comparing lesion volume and maximum depth correlation with △Q value at 15 s from QLF during dehydration. Materials and Methods: Thirty extracted human premolars exhibiting non-cavitated approximal white spot early lesions stored in 0.1.-percent thymol/4C and treated with 5.0-percent NaOCl/30 min were included in the study. Fifteen active and 15 inactive lesions were determined by visual/tactile examinations by consensus of two experienced examiners. Roughness measurements (Ra) were acquired using non-contact optical profilometry. Two-dimensional minimum (2D-min), maximum (2D-max), average (2D-avg) SL and three-dimensional (3D) analyses, volume and depth of lesions were determined from µCT image analysis. A series of fluorescence images were acquired at baseline (hydrated), at 1 s, at 5 s, at 10 s and at 15 s by QLF. During image acquisition, surfaces were dehydrated with continuous-compressed-air. △Q and △Q/s (△QD) were calculated. Data were analyzed using two-sample t-tests and Pearson correlation coefficients (p < 0.05). Results: Surface roughness of active and inactive lesions was not significantly different (p > 0.08). Overall lesion volume and depth in dentin were significantly larger in active lesions (p = 0.022, p = 0.009). SL thickness of active and inactive lesions was not significantly different (2D = 0.121, 3D = 0.080, 2D-avg = 0.446, 2D-min = 0.197, 2D-max = 0.122). △QD at 1s was significantly larger for active lesions (p = 0.046). ΔQ at 15 s of dehydration had a moderate positive association with lesion volume (r = 0.56). △QD had a weak negative association with SL thickness (2D-avg) and (2D-min). Conclusions: 1) Active and inactive non-cavitated lesions show no difference in SL thickness; 2) QLF during dehydration (△QD) does not correlate well with SL thickness; 3) ΔQ at 15 s of dehydration correlates moderately well with lesion volume and is consistent with caries activity assessed by visual/tactile examination.
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    In vitro Detection of Occlusal Caries on Permanent Teeth by a Visual, Light-Induced Fluorescence and Photothermal Radiometry and Modulated Luminescence Methods
    (Karger, 2015-10) Jallad, Mahmoud; Zero, Domenick; Eckert, George; Ferreira Zandona, Ag; Department of Cariology, Operative Dentistry, and Dental Public Health, IU School of Dentistry
    Background: The paradigm shift towards the nonsurgical management of dental caries relies on the early detection of the disease. Detection of caries at an early stage is of unequivocal importance for early preventive intervention. Objective: The aim of this in vitro study is to evaluate the performance of a visual examination using the International Caries Detection and Assessment System (ICDAS) criteria, two quantitative light-induced fluorescence (QLF) systems - Inspektor™ Pro and QLF-D Biluminator™ 2 (Inspektor Research Systems B.V., Amsterdam, The Netherlands) - and a photothermal radiometry and modulated luminescence, The Canary System® (Quantum Dental Technologies, Toronto, Ont., Canada) on the detection of primary occlusal caries on permanent teeth. Methods: A total of 60 teeth with occlusal surface sites ranging from sound to noncavitated lesions (ICDAS 0-4) were assessed with each detection method twice in a random order. Histological validation was used to compare methods for sensitivity, specificity, percent correct, and the area under the receiver operating characteristic curve (AUC), at standard and optimum sound thresholds. Interexaminer agreement and intraexaminer repeatability were measured using intraclass correlation coefficients. Results: Interexaminer agreement ranged between 0.48 (The Canary System®) and 0.96 (QLF-D Biluminator™ 2). Intraexaminer repeatability ranges were 0.33-0.63 (The Canary System®) and 0.96-0.99 (QLF-D Biluminator™ 2). The sensitivity range was 0.75-0.96 while that of specificity was 0.43-0.89. The AUC were 0.79 (The Canary System®), 0.87 (ICDAS), 0.90 (Inspektor™ Pro), and 0.94 (QLF-D Biluminator™ 2). Conclusion: ICDAS had the best combination of sensitivity and specificity followed by QLF-D Biluminator™ 2 at optimum threshold.
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    Learning experience about the use of the ICDAS by dental students in the clinic
    (2024) Alfawaz, Ibrahim; Soto Rojas, Armando E.; Al Dehailan, Laila A.; Willis, Lisa
    Background: The International Caries Detection and Assessment System (ICDAS), established in 2002, is a method to detect and assess the severity of dental caries. It provides scores ranging from 0 (sound tooth) to 6 (extensive cavitation). This system enhances the accuracy of caries diagnosis and assists in conducting research related to public health. Objective: This study aims to explore the knowledge and learning experience of ICDAS in the third-year (D3) and fourth-year (D4) students at Indiana University School of Dentistry (IUSD), evaluate how well they can utilize it, and determine whether they use the ICDAS in clinics. Material and Methods: A questionnaire to assess knowledge and use of ICDAS in the clinic was developed by the student investigator and committee members. The initial questionnaire underwent pilot testing, received feedback from faculty and alums, and was evaluated by the Center for Survey Research. Institutional Review Board (IRB) was obtained. The questionnaire included open-ended and Likert scale questions to assess students' attitudes, knowledge, perceptions, and potential behavioral modifications regarding the ICDAS. The questionnaire was anonymously distributed through Qualtrics and designed to ensure all responses were obtained, specifically targeting D3 and D4 dental students. The responses were gathered and subjected to statistical analysis. Results: 75 Out of 229 dental students (32% of D3 and D4) responded to the survey. This group had 40% D3 and 60% D4 respondents. D4 students were more confident in identifying ICDAS 1 lesions (p=0.041). Students with prior experience were less likely to correctly identify an ICDAS 3 (p=0.034). Additionally, they were less likely to accurately identify an ICDAS 4 (p=0.010). 93% of students stated that ICDAS scores affected treatment. Four ICDAS scoring systems were also discussed with students. About 90% of students indicated that ICDAS caries stages helped them choose preventive or restorative treatments to enhance minimally invasive dentistry. Over 90% of students disagreed with negative statements such as difficulty understanding, learning, having too many scores, and being inadequate for the clinical setting. Conclusion: Third and fourth-year dental students in IUSD exhibit positive learning experiences in their continuing clinical practice with ICDAS and demonstrate adequate knowledge of ICDAS.
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    Performance of near infared digital imaging transillumination for detection of non-cavitated approximal caries
    (2016-06-01) Abogazalah, Naif Nabel Fouad; Ando, Masatoshi; Diefenderfer, Kim Edward; Platt, Jeffrey A.; Hara, Anderson T.; Cook, Norman Blaine
    Objective: The objectives of this in-vitro study were: 1) to evaluate the ability of Near-Infrared Digital Imaging Transillumination (NIDIT) to detect non-cavitated approximal caries lesions; and 2) to compare the performance among NIDIT, Digital Radiography (DR), Digital Imaging Fiber-Optic Trans-Illumination (DIFOTI) and International Caries Detection and Assessment System (ICDAS). Methods: Thirty human extracted premolars were selected. The approximal surface status ranged from sound to surfaces with non-cavitated caries lesions into the outer one-third of the dentin. Lesion depth was determined by micro-computed tomography (μ-CT) and used as a gold standard. Teeth were mounted in a custom-made device to simulate approximal contact. ICDAS, DR, DIFOTI and NIDIT examinations were performed and repeated by three trained and calibrated examiners. Sensitivity, specificity, area under ROC curve (Az), inter- and intra-class correlation coefficients (ICCs) of each method, and correlation among the methods were determined. Results: ICCs for intra-/inter-examiner agreement were almost perfect for DIFOTI (0.85/0.83), substantial for ICDAS (0.79/0.72) and NIDIT (0.69/0.64), and moderate for DR (0.52/0.48). Sensitivity/specificity for DIFOTI, ICDAS, DR, and NIDIT were 0.91/0.69, 0.89/0.83, 0.50/0.64, and 0.68/0.93, respectively. Az of DR (0.61) was significantly lower than that of DIFOTI (0.91, p = 0.002) and ICDAS (0.90, p = 0.005), but was not significantly different from NIDIT (0.81, p = 0.052). DIFOTI, ICDAS, and NIDIT were not significantly different from each other (p > 0.13). Spearman correlation coefficients for DIFOTI (0.79, p < 0.001), ICDAS (0.74, p < 0.001), and NIDIT (0.65, p < 0.001) demonstrated a moderate association with μ-CT, while that of DR suggested no association (0.19, p = 0.289). Conclusion: Within the limitations of this in-vitro study, NIDIT system demonstrated a potential for early approximal caries detection. ICDAS, DIFOTI, and NIDIT were superior to DR in terms of validity and reliability.
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    Performance of several diagnostic systems on detection of occlusal primary caries in permanent teeth
    (2014) Jallad, Mahmoud; Zero, Domenick T.; Chu, Tien-Min Gabriel; Cochran, Michael A. (Michael Alan), 1944-; Cook, Norman Blaine, 1954-; Zandoná, Andréa F.
    Detection of caries at an early stage is unequivocally essential for early preventive intervention. Longitudinal assessment of caries lesions, especially under the opaque preventive sealant, would be of utmost importance to the dental community. OBJECTIVES: The aim of this two-part in-vitro study is to evaluate the performance of multiple detection methods: The International Caries Detection and Assessment System (ICDAS); two quantitative light-induced fluorescence systems QLF; Inspektor™ Pro and QLF-D Biluminator™2 (Inspektor Research Systems B.V.; Amsterdam, The Netherlands); and photothermal radiometry and modulated luminescence (PTR/LUM) of The Canary System® (Quantum Dental Technologies; Toronto, Canada). All these are to be evaluated on their detection of caries on posterior human permanent teeth for 1) of primary occlusal lesions, and 2) under the sealant of primary occlusal lesions. METHODS: One hundred and twenty (N = 120) human posterior permanent teeth, selected in compliance with IU-IRB “Institutional Review Board” standards, with non-cavitated occlusal lesions ICDAS (scores 0 to 4) were divided into two equal groups. The second group (N = 60) received an opaque resin dental sealant (Delton® Light-Curing Pit and Fissure Sealant Opaque, Dentsply, York, PA). All lesions were assessed with each detection method twice in a random order except for ICDAS, which was not used following the placement of the sealant. Histological validation was used to compare methods in regard to sensitivity, specificity, % correct, and the area under receiver- operating characteristic curve (AUC). Intra-examiner repeatability and inter-examiner agreement were measured using intraclass correlation coefficient (ICC). RESULTS: 1) Of primary occlusal lesions, sensitivity, specificity, and AUC values were respectively: 0.82, 0.86 and 0.87 (ICDAS); 0.89, 0.60 and 0.90 (Inspektor Pro); 0.96, 0.57 and 0.94 (QLF-D Biluminator 2); and 0.85, 0.43 and 0.79 (The Canary System). Intra-examiner repeatability and inter-examiner agreement were respectively: 0.81 to 0.87: 0.72 (ICDAS); 0.49 to 0.97: 0.73 (Inspektor Pro); 0.96 to 0.99: 0.96 (QLF-D Biluminator 2); and 0.33 to 0.63: 0.48 (The Canary System). 2) Of primary occlusal lesions under the opaque dental sealants, sensitivity, specificity, and AUC values were respectively: 0.99, 0.03 and 0.67 (Inspektor Pro); 1.00, 0.00 and 0.70 (QLF-D Biluminator 2); and 0.54, 0.50 and 0.58 (The Canary System). Intra-examiner repeatability and inter-examiner agreement were respectively: 0.24 to 0.37: 0.29 (Inspektor Pro); 0.80 to 0.84: 0.74 (QLF-D Biluminator 2); and 0.22 to 0.47: 0.01 (The Canary System). CONCLUSION: Limited to these in-vitro conditions, 1) ICDAS remains the method of choice for detection of early caries lesion due to its adequately high accuracy and repeatability. QLF systems demonstrate potential in longitudinal monitoring due to an almost perfect repeatability of QLF-D Biluminator 2. The Canary System performance and repeatability were not acceptable as a valid method of early caries detection. 2) None of the methods demonstrated acceptable ability in detecting of occlusal caries under the opaque sealant. However, QLF-D Biluminator 2, with limitation to these in-vitro conditions and Delton opaque sealant, demonstrated a fair accuracy AUC (0.70) in detecting of caries under sealants at an experimental threshold of 12.5% ΔF.