Abstract
Objective: To use the International Caries Detection and Assessment System (ICDAS-II) to evaluate the scores of different stages of caries lesion development in cleft lip and palate children. Material and Methods: Fifty cleft lip and palate children aged6-10 years at mixed dentition were selected. Two examiners, one after the other, performed the visual examination of dental surfaces. Firstly, the teeth were cleaned with the aid of pumice and water paste. The examination was carried out under the dental chair reflector, after air drying for 5 seconds with air-water syringe, and with the aid of a WHO probe. The sites comprising the sample were classified according to criteria proposed by ICDAS-II. Results: Ten children met the inclusion criteria. Twenty-five anterior teeth at the cleft area and 93 posterior teeth were assessed, totalizing 590 surfaces classified by ICDAS-II. Four hundred and ninety-four surfaces were scored as sound (code 0-0) regarding the Caries Lesion Condition. Only one surface was scored as partial sealant (code 1), according to the Tooth Surface Condition, but classified as sound regarding the Caries Lesion Condition (code 1-0). No surface exhibited stainless steel; porcelain, gold or porcelain fused to metal crowner veneer; lost or broken restoration; and temporary restoration (codes 5, 6, 7, and 8, respectively). Conclusion: ICDAS-II shows good performance in analyzing caries lesions through more specific assessment and more accurate examination, enabling the detection of caries lesion development at several stages.
Highlights
Caries lesion detection at initial developmental stages is essential to adopt minimally invasive therapies favoring remineralization, which leads to better caries treatment prognosis [1]
One hundred and eighteen children were examined including 25 anterior teeth at the cleft area and 93 posterior teeth, resulting in590 tooth surfaces classified by International Caries Detection and Assessment System (ICDAS)-II system
494 surfaces were classified as sound according to the Caries Lesion Condition, 19 surfaces as first visual change in enamel; 17 surfaces as distinct visual change in enamel; one surface as localized enamel breakdown; one surface underlying dentin shadow; 5 surfaces as distinct cavity with visible dentine;and14 surfaces as extensive cavity within visible dentine
Summary
Caries lesion detection at initial developmental stages is essential to adopt minimally invasive therapies favoring remineralization, which leads to better caries treatment prognosis [1]. Dental caries development is a continuous process and whenever possible one should assess caries stages representing the moment of dental structure loss. Occlusal and approximal caries lesions have been detected through conventional visual-tactile and radiographic examinations. Notwithstanding, radiographic examination allows detecting alterations on dental surfaces at advanced stages. Visualtactile examination must be carried out under good light after tooth surface drying to better visualize caries lesions. Since visual-tactile examination is a subjective method and depends on the dentist’s clinical expertise, it has low reproducibility [2]. Difficulties in the early detection and caries lesion depth assessment have motivated the development of new methods to aid this process
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