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.

A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough “round table” discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.

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Stoll R, Urban-Klein B, Roggendorf MJ, JablonskiMomeni A, Strauch K, Frankenberger R. Effectiveness of four electronic apex locators to determine distance from the apical foramen. International Endodontic Journal, 43, 808-817, 2010.Aim To evaluate the accuracy of four electronic apex locators (EAL) in the apical region (0-3 mm short of the foramen) and to compare the precision of the readings on the display with the real position of the file in the root canal. Methodology Twenty single-rooted extracted teeth with round root canals were used. The canal orifices were preflared, and the length to the major foramen was determined visually under a microscope. Canals were enlarged, so that a size 15 file fitted well inside the canal. Teeth were mounted in acrylic test tubes filled with physiologic saline solution. Electronic length was determined in the region between the major foramen and 3 mm short of it in 0.5 mm steps with the Dentaport ZX, Root ZX mini, Elements Diagnostic Unit and Apex Locator and Raypex 5 using files of size 10 and size 15. The data were analysed using linear regression between true length and EAL reading, Bland-Altman plots and nonparametric tests at a significance level of alpha = 0.05. ResultsThe major foramen was detected by all EALs. With a measurement file positioned directly at the major foramen, meter readings were equivalent to a position 0.01-0.38 mm away. For the Dentaport ZX, a better accuracy using the size 15 file for the area 0-1.5 mm short of the apex was found. The differences in measurements between the two files were smaller for the other EALs. In linear regression, a good linearity for Dentaport ZX and Root ZX mini and moderate linearity for Elements Diagnostic Unit and Apex Locator and Raypex 5 were found. The slope of the measurement curve was too low (0.37-0.57) for the Raypex 5 and almost optimal for the Dentaport ZX (1.01-1.05). The Root ZX mini and the Elements Obturation Unit produced lower slope values and especially the Elements Obturation Unit revealed much higher SDs at the different measurement levels. Conclusion Amongst the four EALs, the Dentaport ZX and Root ZX mini had the best agreement between true lengths and meter readings. For the Raypex 5, an interpretation of the colour-coded zones as distance to the foramen cannot be recommended and might lead to erroneous interpretations.