Abstract
BackgroundSome studies have addressed the influence of optical magnification on the detection of caries lesions using a visual scoring system. However, there is a lack of research related to the use of the CAST and ADA-CCS visual scoring systems. In addition, the reliability and accuracy of ADA-CCS index in permanent teeth were not studied yet. So, the aim of this study was to evaluate, in vitro, the influence of different levels of optical magnification on the detection of occlusal caries lesions in permanent molars using three visual scoring systems. Material and MethodsOne occlusal site per tooth was analyzed in 120 extracted permanent molars. Two trained examiners inspected the teeth using ICDAS (International Caries Detection and Assessment System), CAST (Caries Assessment Spectrum and Treatment), and ADA-CCS (American Dental Association-Caries Classification System) visual criteria, twice with each scoring system, with a one-week interval between examinations. The study was conducted in three phases: (A) without optical magnification, (B) using a binocular lens (3.5× magnification), and (C) using an operating microscope (16× magnification). Then, the teeth were sectioned longitudinally through the center of the selected site and the section with the more severe lesion was histological evaluated considering the D1 (lesions in enamel and dentin) and D3 (dentin lesions) thresholds. ResultsKappa values for intra- and inter-examiner reproducibility were good to excellent for all systems. At the D1 threshold, sensitivity, accuracy, and area under the ROC curve were high for ICDAS and CAST in all phases. However, this was not the case for the ADA-CCS in phase C (<0.05). At the D3 diagnostic threshold, there was no significant difference between the visual scoring systems during the study phases (>0.05). ConclusionsThe magnification does not improve the accuracy of the visual scoring systems in the detection of occlusal caries lesions in permanent molars. Key words:Dental caries, caries detection, permanent teeth, visual examination, magnification.
Highlights
Visual examination is the most commonly used method for detecting caries lesions
ICDAS (International Caries Detection and Assessment System), CAST (Caries Assessment Spectrum and Treatment) and ADA-CCS (American Dental Association-Caries Classification System) are visual scoring systems that have been used in cariology studies [2,3,4,5,6]
This study examines the use of magnification in the caries diagnosis process and is the first to evaluate the influence of magnification on the use of CAST and ADA-CCS systems
Summary
Visual examination is the most commonly used method for detecting caries lesions. It is based on subjective criteria including color, translucency, and hardness of the dental structure. The aim of this study was to evaluate in vitro the influence of different levels of optical magnification (binocular lens, 3.5×; operating microscope, 16×) compared to no magnification on the detection of occlusal caries lesions in permanent teeth using three visual scoring systems (ICDAS, CAST and ADA-CCS). The aim of this study was to evaluate, in vitro, the influence of different levels of optical magnification on the detection of occlusal caries lesions in permanent molars using three visual scoring systems. Two trained examiners inspected the teeth using ICDAS (International Caries Detection and Assessment System), CAST (Caries Assessment Spectrum and Treatment), and ADA-CCS (American Dental Association-Caries Classification System) visual criteria, twice with each scoring system, with a one-week interval between examinations. Conclusions: The magnification does not improve the accuracy of the visual scoring systems in the detection of occlusal caries lesions in permanent molars
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