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.
Highlights
The basic assumption of modern dentistry is the early detection of initial carious lesions
It has been used in laboratory research in the field of dentistry, for measuring the mineral density of enamel and dentin, evaluating cortical bone and the sealing ability of fillings of carious cavities and root canals [12, 13, 15, 16]. The use of this method in clinical practice has some limitations, such as high radiation doses, long scanning time, and image processing as well as the high cost of the device with software [16]. The aim of this in vitro study was to investigate the extent of occlusal early carious lesions in enamel and dentin using the International Caries Detection and Assessment System (ICDAS) II, DIAGNOdent pen compared with microcomputed tomography (microCT) examination
MicroCT examination revealed that of the 48 occlusal examination sites, 8 were sound (0), 4 had caries extending up to the outer half of the enamel (E1), 20 had caries extending into the inner half of the enamel (E2), 15 had caries in the dentin outer one third (D1), and 1 site had caries in the 1/3 middle dentin (D2)
Summary
The basic assumption of modern dentistry is the early detection of initial carious lesions. It is a modified version of computed tomography, enabling noninvasive 3-D imaging of tooth tissues In recent years, it has been used in laboratory research in the field of dentistry, for measuring the mineral density of enamel and dentin, evaluating cortical bone and the sealing ability of fillings of carious cavities and root canals [12, 13, 15, 16]. It has been used in laboratory research in the field of dentistry, for measuring the mineral density of enamel and dentin, evaluating cortical bone and the sealing ability of fillings of carious cavities and root canals [12, 13, 15, 16] The use of this method in clinical practice has some limitations, such as high radiation doses, long scanning time, and image processing as well as the high cost of the device with software [16]
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