Dental Students' Performance in Detecting In Vitro Occlusal Carious Lesions Using ICDAS with E-Learning and Digital Learning Strategies.

Abstract

The aim of this study was to assess the performance of dental students for detecting in vitro occlusal carious lesions using the International Caries Detection and Assessment System (ICDAS) with different learning strategies. A convenience sample of all 64 fourth-year dental students at a dental school in Brazil who had no previous experience with ICDAS was selected for the study in 2015. First, students performed the in vitro examination of the occlusal surfaces of 80 teeth according to ICDAS. Two weeks later, students were randomly allocated to three groups: G1 (n=21), ICDAS e-learning; G2 (n=22), ICDAS e-learning + digital learning tool (DLT); G3 (n=21), no training (control group). All students reexamined the 80 teeth according to ICDAS two weeks later. Sensitivity, specificity, and area under the ROC curve (AUC) were calculated according to three thresholds. Of the 64 students, 59 completed all study phases, for a 92.2% participation rate. The intra-group comparison found significantly higher sensitivity and specificity values for G1 and G2 students. G3 students showed an increased sensitivity at the D2 threshold. G2 was the only training strategy that resulted in significant improvement for the AUC. In the comparison of groups at the same threshold, G1 showed higher specificity at D3 threshold (0.78) than G2 (0.72) and G3 (0.73). Regarding sensitivity, G1 showed a lower value at D2 (0.91) threshold than G2 (0.94) and G3 (0.94). In this study, both training strategies (ICDAS e-learning and ICDAS e-learning + DLT) improved the performance of dental students for the in vitro detection of occlusal carious lesions, mainly when the association of methods was used.