Diagnostic validity of the use of ICDAS II and DIAGNOdent pen verified by micro-computed tomography for the detection of occlusal caries lesions—an in vitro evaluation

Abstract

The aim of this study is to assess the extent of early carious lesions using the International Caries Detection and Assessment System (ICDAS) II and DIAGNOdent pen compared with microCT examination. Forty-eight molars and premolars were qualified for the study. The visual and the DIAGNOdent pen device examinations were carried out by two examiners. The actual extent of the lesions was determined using micro-CT examination. The optimal cutoff test value was determined using the Youden index. For the two methods, inter-and intra-examiner reproducibility was calculated using intraclass correlation coefficient. The sensitivity, specificity, and accuracy of these methods were compared using the mid-P McNemar test. The level of significance was set at p < 0.05. In terms of the enamel threshold for the ICDAS II scale, insignificantly higher mean evaluated parameters were noticed in comparison with the DIAGNOdent pen device. For the dentin threshold, all the assessed parameters had higher mean values on the ICDAS II scale compared with the DIAGNOdent pen. The optimal cutoff points of the enamel and dentin thresholds are lower than that suggested by the manufacturer. The ICDAS II and the DIAGNOdent pen device were characterized by high inter -and intra-observer reproducibility of the test results. To improve the diagnostic efficiency of the DIAGNOdent pen, modifying the cutoff values recommended by the manufacturers should be considered. After modifying the cutoff values, the combination ICDAS II and DIAGNOdent pen device would be the better choice in order to detect caries on occlusal surfaces.

Laser fluorescence as an alternative for digital radiography in detecting caries lesions

“…They proved to be reproducible methods with similar performance in the detection of occlusal carious lesions in dentine.The ability of DIAGNOdent to detect initial enamel lesions was higher than that of ICDAS, but with low specificity. Similar results were achieved with orthodontic, periodontal, and surgical indications extracted from permanent teeth by Luczaj-Cepowicz et al19 High specificity values of the ICDAS II were also noted by Iranzo-Cortés et al22 and Jablonski-Momeni et al27 As the LFpen showed a tendency to underestimate enamel and dentin carious lesions, the ICDAS criteria showed a tendency to overestimate the presence of caries around amalgam restorations when no caries were present, indicating that ICDAS should be interpreted with care when assessing amalgam restorations when the gold standard involved microscopic examinations 28,29. Menem et al30 observed the difference in the mean of LFpen readings between the three groups of approximal surfaces (intact, with white/brown spots and cavitated) and the standard deviation.…”

“…[12][13][14][15][16] Laser diagnostic devices such as DIAGNOdent shown this method as being the most effective. 18,19 More recent research suggests complementing this method with photosensitizers and thus increasing the sensitivity and specificity of the The FC device showed good performance with Considering ethical concerns, some studies including in vivo samples used BW (bitewing) as a gold standard 3,9,12,30-32 and others used ICDAS. 10,33 Based on their results Melo et al, 9 Menem et al, 30 Bizhang et al 31 affirms that DIAGNOpen is an alternative to avoid ionizing radiation for the patients, but despite having similar findings, Schwendicke et al 12 and Anauate-Neto et al 32 indicates it only as a complement.…”

“…Indication for replacing BW for LFpen occurred by those authors that found high levels for sensitivity and specificity 9,13,14,20,24,34,35 but many others recommend it as adjunct method for ICDAS exams. 8, 18,19,22,25,26,[36][37][38][39] However, weak specif icit y and sensitiv it y results led other authors to not indicate its use without BW or CT, invalidating the aim of the studies about these appliances. 18,22,[27][28][29][40][41][42][43][44] A study by Subka et al 44 Kühnisch et al 45 and Ozkan et al 46…”

Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children

“…The most modern systems for caries detection are the intraoral cameras, equipped in light-emitting diode (LED). They include fluorescent camera VistaProof (Dűrr Dental SE, Germany) brought to the medical market in 2007, and its modernized version VistaCam iX, introduced by the same company in 2011 as well as SoproLife camera [6][7][8]. Other modern techniques of caries diagnostics are based on the phenomenon of digital transillumination DIFOTI (digital fiber-optic trans-illumination).…”

Validation of the laser‐induced fluorescence effect of aromatic amino acids, protoporphyrin IX, and tetracycline hydrochloride on hydroxyapatite

“…[3,6] Recently, DD has been widely used for the early detection of enamel degeneration and demineralisation because of the increased sensitivity for detecting dental caries. [7][8][9][10] The increased DD readings in carious enamel are thought to be related to the presence of caries bacterial metabolites, likely including protoporphyrin IX. However, intrinsic enamel stains and "irregular" enamel structures without dental caries also produce very high readings by the DD device.…”