In Vitro Evaluation of Reliability and Validity of International Caries Detection and Assessment System II Coding for...

To check the reliability and validity of International Caries Detection and Assessment System (ICDAS) II coding in occlusal caries detection under unaided visual and enhanced visual examination.

This study included 100 extracted premolars and molars. Two examiners independently scored occlusal caries using ICDAS II criteria without magnification and under 6x magnification in the dental operating microscope. The examination was repeated after one month to check the intraexaminer reliability. The examined samples were sectioned and the carious lesions were scored using Ekstrand-Ricketts-Kidd (ERK) histological criteria under 20x magnification in stereomicroscope. The ICDAS II scores given by the examiners were compared with the histological scores.

The κ values for interexaminer reproducibility of unaided and enhanced visual examinations were 0.695 and 0.626, respectively (substantial agreement), and 0.984 (almost perfect agreement) for histological examination. Intraexaminer reproducibility for unaided and enhanced visual examinations were 0.835 and 0.910, respectively (almost perfect agreement). Spearman's correlation coefficients of ICDAS II unaided visual and enhanced visual examinations to ERK histological scores were 0.724 and 0.689, respectively, which infers that there is a strong correlation between unaided visual and histological examination and a moderate correlation between enhanced visual and histological examination. For unaided visual examination, specificity is 100% and sensitivity is 92%, whereas for enhanced visual examination, specificity is 50%, and sensitivity is 100%.

Unaided visual examination demonstrated good reliability and validity for ICDAS II coding, whereas enhanced visual examination exhibited good reliability but relatively lower validity.

This study reveals that magnification did not have any added benefits in occlusal caries diagnosis using ICDAS II coding compared to unaided visual examination. The use of magnification did not improve the validity and led to a drop in the specificity, which indicates higher chances of false positive results.

SasiRekha G, Chandrasekhar R, Vinay C, et al.In Vitro Evaluation of Reliability and Validity of International Caries Detection and Assessment System II Coding for Occlusal Caries using Magnification. Int J Clin Pediatr Dent 2023;16(S-2):S138-S141.