scholarly journals Do combinations of clinical parameters related to caries activity status predict progression more accurately than individual parameters?

2019 ◽  
Author(s):  
I Floriano ◽  
R Matos ◽  
J Mattos-Silveira ◽  
ES Rocha ◽  
KR Ekstrand ◽  
...  
Keyword(s):  
Predictive Power ◽  
Assessment System ◽  
Caries Detection ◽  
Clinical Parameters ◽  
Caries Lesion ◽  
Occlusal Surfaces ◽  
Risk Of Progression ◽  
Caries Progression ◽  
Cavitated Lesions

AbstractFew studies have addressed the predictive power of the clinical parameters used in assessing caries lesion activity. This study assessed the predictive validity of evaluating clinical parameters that are related to caries lesion activity status, individually and combined, in a long-term analysis. The occlusal surfaces of primary molars (1361 surfaces) were examined in 205 children according to the following clinical features: potential for plaque stagnation, colour, luster, cavitation, texture, and clinical depth. Cavities with frankly exposed dentine were excluded from this sample. After 1 year, 148 children (828 surfaces) were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as an outcome to verify the predictive power of the initially assessed clinical parameters. Different combinations of two or more parameters were also tested to check for any association with caries progression. Multilevel Poisson regression analyses were performed and the relative risk for each parameter/combination tested was calculated by considering a confidence interval of 95%. Forty percent of the reassessed surfaces presented caries progression after 1 year. Despite their surface integrity, dentine caries lesions were approximately 10-fold more likely and enamel lesions were approximately three-fold more likely to progress than sound surfaces. Similarly, cavitated lesions showed the highest risk of progression compared to sound/non-cavitated lesions. When only non-cavitated surfaces were considered, roughness proved to be a risk factor for caries progression. In conclusion, the lesions presenting clinical involvement of the dentine and even those cavitations clinically involving only the enamel had a higher risk of progression compared to sound or non-cavitated surfaces. For these lesions, the evaluation of other conjoint parameters seems unnecessary. Nevertheless, surface roughness can be a useful feature in predicting the risk of non-cavitated caries lesion progression.

scholarly journals How combining different caries lesions characteristics may be helpful in short-term caries progression prediction: model development on occlusal surfaces of primary teeth

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabela Floriano ◽  
Elizabeth Souza Rocha ◽  
Ronilza Matos ◽  
Juliana Mattos-Silveira ◽  
Kim Rud Ekstrand ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Primary Teeth ◽  
Clinical Parameters ◽  
Short Term ◽  
Caries Lesion ◽  
Occlusal Surfaces ◽  
Caries Progression ◽  
One Year ◽  
Caries Lesions ◽  
Cavitated Lesions

Abstract Background Few studies have addressed the clinical parameters' predictive power related to caries lesion associated with their progression. This study assessed the predictive validity and proposed simplified models to predict short-term caries progression using clinical parameters related to caries lesion activity status. Methods The occlusal surfaces of primary molars, presenting no frank cavitation, were examined according to the following clinical predictors: colour, luster, cavitation, texture, and clinical depth. After one year, children were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as the outcome to be predicted. Univariate multilevel Poisson models were fitted to test each of the independent variables (clinical features) as predictors of short-term caries progression. The multimodel inference was made based on the Akaike Information Criteria and C statistic. Afterwards, plausible interactions among some of the variables were tested in the models to evaluate the benefit of combining these variables when assessing caries lesions. Results 205 children (750 surfaces) presented no frank cavitations at the baseline. After one year, 147 children were reassessed (70%). Finally, 128 children (733 surfaces) presented complete baseline data and had included primary teeth to be reassessed. Approximately 9% of the reassessed surfaces showed caries progression. Among the univariate models created with each one of these variables, the model containing the surface integrity as a predictor had the lowest AIC (364.5). Univariate predictive models tended to present better goodness-of-fit (AICs < 388) and discrimination (C:0.959–0.966) than those combining parameters (AIC:365–393, C:0.958–0.961). When only non-cavitated surfaces were considered, roughness compounded the model that better predicted the lesions' progression (AIC = 217.7, C:0.91). Conclusions Univariate model fitted considering the presence of cavitation show the best predictive goodness-of-fit and discrimination. For non-cavitated lesions, the simplest way to predict those lesions that tend to progress is by assessing enamel roughness. In general, the evaluation of other conjoint parameters seems unnecessary for all non-frankly cavitated lesions.

scholarly journals Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

2014 ◽  
Vol 93 (11) ◽  
pp. 1070-1075 ◽  
Author(s):  
M. Fontana ◽  
J.A. Platt ◽  
G.J. Eckert ◽  
C. González-Cabezas ◽  
K. Yoder ◽  
...  
Keyword(s):  
Assessment System ◽  
Retention Rates ◽  
Caries Detection ◽  
Major Barrier ◽  
Occlusal Surfaces ◽  
Before And After ◽  
Permanent Molars ◽  
Caries Lesions ◽  
Sealant Retention ◽  
Lesion Severity

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.

scholarly journals Caries severity and socioeconomic inequalities in a nationwide setting: data from the Italian National pathfinder in 12-years children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Guglielmo Campus ◽  
Fabio Cocco ◽  
Laura Strohmenger ◽  
Maria Grazia Cagetti
Keyword(s):  
Oral Health ◽  
Unemployment Rate ◽  
Gini Index ◽  
Negative Binomial ◽  
Smoking Habit ◽  
Socioeconomic Inequalities ◽  
Assessment System ◽  
Caries Detection ◽  
Per Capita ◽  
Cavitated Lesions

Abstract This study presents the result of the second National pathfinder conducted in Italy on children’s oral health, reporting the prevalence and severity of caries in 12-year old children and describing the caries figure related to the socioeconomic inequalities, both at individual level and macroeconomic level. The two-digit codes related to ICDAS (International Caries Detection and Assessment System) for each tooth and the gingival bleeding score were recorded at school on 7,064 children (48.97% males and 51.03% females). The Gross National Product (GNP) per capita, the Gini Index and Unemployment rate in each Italian section, parents’ educational levels, working status, smoking habit and their ethnic background were recorded. Zero-inflated-negative-binomial (ZINB) models were run, using caries-free teeth, teeth with enamel lesions, cavitated lesions and restorations as functions of socioeconomic explanatory variables, to evaluate the effects of justifiable economic factors of geographical distribution. The mean number of enamel lesions, cavitated lesions and filled per teeth were statistically significant (p < 0.01) dissimilar among the Italian section. GNP per capita, Gini Index and Unemployment rate were significantly correlated to ICDAS scores and filled teeth. Important differences in ICDAS score values remain among children from different socioeconomic backgrounds. Efforts should be made to improve awareness and knowledge regarding oral health practice and to implement preventive programs and access to dental services in Southern Italy where the disease is still unresolved.

Development of a Fluorescence-Based Caries Scoring System for an Intraoral Scanner: An in vitro Study

2020 ◽  
Vol 54 (4) ◽  
pp. 324-335
Author(s):  
Stavroula Michou ◽  
Ana Raquel Benetti ◽  
Christoph Vannahme ◽  
Pétur Gordon Hermannsson ◽  
Azam Bakhshandeh ◽  
...  
Keyword(s):  
Scoring System ◽  
State Of The Art ◽  
Assessment System ◽  
Detection Methods ◽  
Caries Detection ◽  
Fluorescence Signal ◽  
Radiographic Assessment ◽  
Intraoral Scanner ◽  
Posterior Teeth ◽  
Occlusal Surfaces

<b><i>Objectives:</i></b> To develop an automated fluorescence-based caries scoring system for an intraoral scanner and to<i></i>test the performance of the system compared to state-of-the-art methods. <b><i>Methods:</i></b> Seventy-three permanent posterior teeth were scanned with a three-dimensional (3D) intraoral scanner prototype which emitted light at 415 nm. An overlay representing the fluorescence signal from the tissue was mapped onto 3D models of the teeth. Multiple examination sites (<i>n</i> = 139) on the occlusal surfaces were chosen, and their red and green fluorescence signal components were extracted. These components were used to calculate 4 mathematical functions upon which a caries scoring system for the scanner prototype could be based. Visual-tactile (International Caries Detection and Assessment System, ICDAS), radiographic (ICDAS), and histological assessments were conducted on the same examination sites. <b><i>Results:</i></b> Most index tests showed significant correlation with histology. The strongest correlation was observed for the visual-tactile examination (<i>r</i><sub>s</sub> = 0.80) followed by the scanner supported by the caries classification function that quantifies the overall fluorescence compared to sound surfaces (<i>r</i><sub>s</sub> = 0.78). Additionally, this function resulted in the highest intra-examiner reliability (κ = 0.964), and the highest sum of sensitivity (SE) and specificity (SP) (sum SE-SP: 1.60–1.84) at the 2 histological levels where the comparison with visual-tactile assessment was possible (κ = 0.886, sum SE-SP = 1.57–1.81) and at the 3 out of 4 histological levels where the comparison with radiographic assessment was possible (κ = 0.911, sum SE-SP = 1.37–1.78); the only exception was for the lesions in the outer third of dentin, where the radiographic assessment showed the highest sum SE-SP (1.78). <b><i>Conclusion:</i></b> A fluorescence-based caries scoring system was developed for the intraoral scanner showing promising performance compared to state-of-the-art caries detection methods. The intraoral scanner accompanied by an automated caries scoring system may improve objective caries detection and increase the efficiency and effectiveness of oral examinations. Furthermore, this device has the potential to support reliable monitoring of early caries lesions.

scholarly journals Impact of Different Illumination Conditions on Visual Caries Detection with ICDAS

2015 ◽  
Vol 49 (6) ◽  
pp. 633-636 ◽  
Author(s):  
Klaus W. Neuhaus ◽  
Edi Jasarevic ◽  
Adrian Lussi
Keyword(s):  
Gold Standard ◽  
Area Under The Curve ◽  
Assessment System ◽  
Caries Detection ◽  
Lower Sensitivity ◽  
Pooled Data ◽  
Standard Operation ◽  
Occlusal Surfaces ◽  
Additional Illumination ◽  
Permanent Molars

The aim of this study was to test the influence of different degrees of additional illumination on visual caries detection using the International Caries Detection and Assessment System (ICDAS). Two calibrated examiners assessed 139 occlusal surfaces of extracted permanent molars using a standard operation lamp with or without an additional headlamp providing three default brightness intensities. Histology served as the gold standard. Pooled data showed no differences in sensitivities. Specificities were not influenced by additional light. The area under the curve for the Marthaler classification D3 threshold was significantly lower when an additional strong headlamp was used (0.59 compared to 0.69-0.72 when reduced illumination intensities were used). One of the two examiners also had a significantly lower sensitivity for the D1 threshold when an additional headlamp was used. The use of additional white light led to a reduced detection of dentine lesions.

The International Caries Detection and Assessment System – ICDAS: A Systematic Review

2018 ◽  
Vol 52 (5) ◽  
pp. 406-419 ◽  
Author(s):  
Kim Rud Ekstrand ◽  
Thais Gimenez ◽  
Fernanda R. Ferreira ◽  
Fausto M. Mendes ◽  
Mariana M. Braga
Keyword(s):  
Roc Curves ◽  
Diagnostic Odds Ratio ◽  
Assessment System ◽  
Caries Detection ◽  
Activity Assessment ◽  
Caries Progression ◽  
Overall Performance ◽  
Meta Analyses ◽  
Caries Lesions ◽  
Specific Search

The aims of this study were: (1) to evaluate the overall reproducibility and accuracy of the International Caries Detection and Assessment System (ICDAS) for assessing coronal caries lesions, and (2) to investigate the use of systems associated with the ICDAS for activity assessment of coronal caries lesions. Specific search strategies were adopted to identify studies published up to 2016. For the first objective, we selected studies that assessed primary coronal caries lesions using the ICDAS as a reference standard. A total of 54 studies were included. Meta-analyses summarized the results concerning reproducibility and accuracy (correlation with histology, summary ROC curves [SROC], and diagnostic odds ratio [DOR]). The latter 2 were expressed at D1/D3 levels. The heterogeneity of the studies was also assessed. Reproducibility values (pooled) were > 0.65. The ICDAS mostly presented a good overall performance as most areas under SROC were > 0.75 at D1 and > 0.90 at D3; DOR ≥6. For the second objective, we selected studies investigating activity assessment associated with the ICDAS. The meta-analyses pooled results based on the same methodology and parameters as above. Longitudinal findings regarding caries progression were described to estimate the validity of these systems. On average, the systems for activity assessment of caries lesions showed moderate values concerning reproducibility and overall performance. Active caries lesions were more prone to progress than inactive ones after 2 years. In conclusion, the ICDAS presented a substantial level of reproducibility and accuracy for assessing primary coronal caries lesions. Additional systems associated with the ICDAS that classify caries lesion activity can be useful as they are moderately reproducible and accurate.

scholarly journals Automated caries detection with smartphone color photography using machine learning

2021 ◽  
Vol 27 (2) ◽  
pp. 146045822110075
Author(s):  
Duc Long Duong ◽  
Malitha Humayun Kabir ◽  
Rong Fu Kuo
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Clinical Diagnostics ◽  
Assessment System ◽  
Caries Detection ◽  
Support Vector ◽  
Detection Scheme ◽  
Occlusal Surfaces ◽  
Icdas Ii ◽  
Untreated Caries

Untreated caries is significant problem that affected billion people over the world. Therefore, the appropriate method and accuracy of caries detection in clinical decision-making in dental practices as well as in oral epidemiology or caries research, are required urgently. The aim of this study was to introduce a computational algorithm that can automate recognize carious lesions on tooth occlusal surfaces in smartphone images according to International Caries Detection and Assessment System (ICDAS). From a group of extracted teeth, 620 unrestored molars/premolars were photographed using smartphone. The obtained images were evaluated for caries diagnosis with the ICDAS II codes, and were labeled into three classes: “No Surface Change” ( NSC); “Visually Non-Cavitated” ( VNC); “Cavitated” ( C). Then, a two steps detection scheme using Support Vector Machine (SVM) has been proposed: “ C versus (VNC  +  NSC)” classification, and “ VNC versus NSC” classification. The accuracy, sensitivity, and specificity of best model were 92.37%, 88.1%, and 96.6% for “ C versus (VNC  +  NSC),” whereas they were 83.33%, 82.2%, and 66.7% for “ VNC versus NSC.” Although the proposed SVM system required further improvement and verification, with the data only imaged from the smartphone, it performed an auspicious potential for clinical diagnostics with reasonable accuracy and minimal cost.

scholarly journals Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial

2021 ◽  
pp. 1-11
Author(s):  
Phoebe Pui Ying Lam ◽  
Divesh Sardana ◽  
Weijia Luo ◽  
Manikandan Ekambaram ◽  
Gillian Hiu Man Lee ◽  
...  
Keyword(s):  
Preschool Children ◽  
Assessment System ◽  
Fluoride Varnish ◽  
Caries Detection ◽  
Caries Experience ◽  
Primary Molars ◽  
Glass Ionomer ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Significant Difference

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3–4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0–1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group – application of 5% NaFV at 3-monthly intervals or GIS group – 1 single placement of GIS. A parental questionnaire was used to collect information on the children’s sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (<i>p</i> = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.

scholarly journals Clinical effectiveness of fluorescence, digital images and ICDAS for detecting occlusal caries

2017 ◽  
Vol 46 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Cristina Dupim PRESOTO ◽  
Tamara Carolina TREVISAN ◽  
Maria Costa de ANDRADE ◽  
Andrea Abi-Rached DANTAS ◽  
Juliana Alvares Duarte Bonini CAMPOS ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Roc Curve ◽  
Digital Images ◽  
Assessment System ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Occlusal Surfaces ◽  
Discrimination Capacity ◽  
Caries Lesions

Abstract Introduction The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited an acceptable discrimination capacity (AUROC=0.78), although it was lower than the others. The positive likelihood ratio for the fluorescence was only 2.32, compared to 20.58 for the intraoral image and 58.11 for the ICDAS. Conclusion Both methods and the ICDAS exhibited an adequate clinical performance, although the ICDAS and intraoral image were more effective than the fluorescence.

Tooth Surface Level Caries Progression in the Primary Dentition among Preschool Children

2015 ◽  
Vol 49 (4) ◽  
pp. 442-448 ◽  
Author(s):  
Amid I. Ismail ◽  
Sungwoo Lim ◽  
Marisol Tellez
Keyword(s):  
Preschool Children ◽  
Low Income ◽  
Assessment System ◽  
Caries Detection ◽  
Tooth Surface ◽  
Surface Level ◽  
Initial Caries ◽  
Tooth Surfaces ◽  
Caries Progression ◽  
Soda Consumption

The objective of this paper is to describe primary tooth surface level caries progression, over 2 years, based on the severity of the caries lesions. Data were collected from 790 low-income African-American preschool children in Detroit, Mich., USA. The caregivers of the children (aged 0-5 years) completed interviews and the dyad of child-caregiver completed dental examinations in 2002-2004 (baseline) and in 2004-2005 (follow-up). Caries were measured using the International Caries Detection and Assessment System (ICDAS). The caries status of tooth surfaces was classified into initial (ICDAS 1-2), moderate (ICDAS 3-4) and extensive (ICDAS 5-6) stages. Counts of tooth surfaces with progression, by baseline caries severity level, were used to compute rate ratios (RRs) relative to sound stages. RRs were also computed for type of tooth surfaces and frequency of intake of soda consumption at baseline. After adjusting for confounders, caries progression was more likely to occur in tooth surfaces with any baseline caries relative to sound surfaces. For surfaces with initial caries, the rate of progression to moderate caries was 9.6 times higher than that of sound surfaces. Surfaces with initial and moderate caries progressed to extensive caries 6.1 and 20.6 times, respectively, relative to sound surfaces. Baseline soda consumption was not associated with the RR of caries progression. In conclusion, the staging of caries identifies different progression risks and significant emphasis should be placed on secondary prevention of initial lesions as well as on primary prevention.

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