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Clinical Oral Investigations

, Volume 18, Issue 3, pp 737–744 | Cite as

An in vivo and in vitro investigation of the use of ICDAS, DIAGNOdent pen and CarieScan PRO for the detection and assessment of occlusal caries in primary molar teeth

  • Terry Kuo-Yih TeoEmail author
  • Paul Francis Ashley
  • Chris Louca
Original Article

Abstract

Objectives

The aim of this study was to investigate the in vivo and in vitro validity of International Caries Detection and Assessment System (ICDAS), DIAGNOdent pen and CarieScan PRO in the detection and assessment of occlusal caries in primary teeth.

Methods

Sixty-four molars were assessed using all three systems under standardised in vivo conditions. They were then extracted and assessed by two examiners in vitro along with an additional 38 teeth (102 teeth in total from 45 children). Downer’s histological scoring criterion was the validation gold standard. Sensitivity, specificity, positive and negative likelihood ratios and area under the receiver–operator curves were calculated for all caries and dentine caries. Repeatability was analysed using Cohen’s Kappa and the performance of the systems between in vivo and in vitro settings by the same examiner were compared.

Results

ICDAS showed the highest validity and repeatability. The DIAGNOdent pen’s overall clinical validity was comparable to that of ICDAS, but it demonstrated only moderate repeatability. CarieScan PRO had negligible validity in vivo, and there was no relationship between in vivo and in vitro parameters.

Conclusions

The in vivo results of ICDAS and DIAGNOdent pen were satisfactory and comparable to those obtained in vitro, with ICDAS performing better. The CarieScan PRO performed poorly under both conditions.

Clinical relevance

ICDAS should be the index of choice when detecting and assessing occlusal caries in the primary dentition, and in vitro data can be safely extrapolated in vivo. The DIAGNOdent pen must be employed with caution. Currently, the CarieScan PRO is unsuitable for use in the primary dentition.

Keywords

Occlusal caries Primary molar ICDAS DIAGNOdent pen CarieScan PRO Caries detection 

Notes

Acknowledgments

We would like to thank Dr Graham Palmer, Dr Susan Parekh and Dr Adrian Moles for their contributions.

Conflict of interests

The authors declare that they have no conflict of interests.

References

  1. 1.
    Bader JD, Shugars DA, Bonito AJ (2002) A systematic review of the performance of methods for identifying carious lesions. J Public Health Dent 62:201–213PubMedCrossRefGoogle Scholar
  2. 2.
    Dunkley S, Ashley P (2007) Use of a ranked scoring system to detect occlusal caries in primary molars. Int J Paediatric Dent 17:267–273CrossRefGoogle Scholar
  3. 3.
    Shoaib L, Deery C, Ricketts DNJ, Nugent ZJ (2009) Validity and reproducibility of ICDAS II in primary teeth. Caries Res 3:442–448CrossRefGoogle Scholar
  4. 4.
    Neuhaus KW, Rodrigues JA, Hug I, Stich H, Lussi A (2011) Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars. Clin Oral Investig 15(5):653–641Google Scholar
  5. 5.
    Attrill DC, Ashley PF (2001) Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods. Br Dent J 190:440–443PubMedGoogle Scholar
  6. 6.
    Rocha RO, Ardenghi TM, Oliveira LB, Rodrigues CRMD, Ciamponi AL (2003) In vivo effectiveness of laser fluorescence compared to visual inspection and radiography for the detection of occlusal caries in primary teeth. Caries Res 37:437–441PubMedCrossRefGoogle Scholar
  7. 7.
    Matos R, Novaes TF, Braga MM, Siqueira WL, Duarte DA, Mendes FM (2011) Clinical performance of two fluorescence-based methods in detecting occlusal caries lesions in primary teeth. Caries Res 45:294–302PubMedCrossRefGoogle Scholar
  8. 8.
    Novaes TF, Matos R, Gimenez T, Braga MM, DE Benedetto MS, Mendes FM (2012) Performance of fluorescence-based and conventional methods of occlusal caries detection in primary molars—an in vitro study. Int J Paediatr Dent 22(6):459–466PubMedCrossRefGoogle Scholar
  9. 9.
    Dias da Silva PR, Martins Marques M, Steagal W Jr, Medeiros Mendes F, Lascala CA (2010) Accuracy of direct digital radiography for detecting occlusal caries in primary teeth compared with conventional radiography and visual inspection: an in vitro study. Dentomaxillofac Radiol 39:362–367PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Longbottom C, Huysmans MCDNJM (2004) Electrical measurements for use in caries clinical trials. J Dent Res 83(special issue):C76–C79PubMedCrossRefGoogle Scholar
  11. 11.
    Mendes FM, Novaes TF, Matos R, Bittar DG, Piovesan C, Gimenez T, Imparato JCP, Raggio DP, Braga MM (2012) Radiographic and laser fluorescence methods have no benefits for detecting caries in primary teeth. Caries Res 46:536–543PubMedCrossRefGoogle Scholar
  12. 12.
    Ashley P (2000) Diagnosis of occlusal caries in primary teeth. Int J Paediatric Dent 10:166–171CrossRefGoogle Scholar
  13. 13.
    Pitts NB, Longbottom C, Hall AF (2008) Diagnostic accuracy of an optimized ac impedance device to aid caries detection and monitoring. Caries Res 42(3):211Google Scholar
  14. 14.
    Carley S, Dosman S, Jones SR, Harrison M (2005) Simple nomograms to calculate sample size in diagnostic studies. Emerg Med J 22:80–181CrossRefGoogle Scholar
  15. 15.
    Downer MC (1975) Concurrent validity of an epidemiological diagnostic system for caries with the histological appearance of extracted teeth as validating criterion. Caries Res 9:231–246PubMedCrossRefGoogle Scholar
  16. 16.
    Lussi A, Hibst R, Paulus R (2004) DIAGNOdent: an optical method for caries detection. J Dent Res 83(special issue):C80–C83PubMedCrossRefGoogle Scholar
  17. 17.
    Anttonen V, Seppa L, Hausen H (2003) Clinical study of the use of the laser fluorescence device DIAGNOdent for detection of occlusal caries in children. Caries Res 37:17–23PubMedCrossRefGoogle Scholar
  18. 18.
    Khalife MA, Boynton JR, Dennison JB, Yaman P, Hamilton JC (2009) In vivo evaluation of DIAGNOdent for the quantification of occlusal dentine caries. Oper Dent 34(2):136–141PubMedCrossRefGoogle Scholar
  19. 19.
    Cohen JA (1960) Coefficient of agreement for nominal scales. Educ Psychol Measurement 20:37–46CrossRefGoogle Scholar
  20. 20.
    Huysmans M-CDNJM, Longbottom C (2004) The challenges of validating diagnostic methods and selecting appropriate gold standards. J Dent Res 83(Spec Iss C):C48–C52PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Terry Kuo-Yih Teo
    • 1
    Email author
  • Paul Francis Ashley
    • 2
  • Chris Louca
    • 3
  1. 1.Restorative DentistryNational Dental CentreSingaporeSingapore
  2. 2.Paediatric DentistryUCL Eastman Dental InstituteLondonUK
  3. 3.UCL Eastman Dental InstituteLondonUK

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