Journal article
Impact of different magnification levels on visual caries detection with ICDAS.
- Neuhaus KW Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland. Electronic address: klaus.neuhaus@zmk.unibe.ch.
- Jost F Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland.
- Perrin P Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland.
- Lussi A Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland.
- 2015-09-15
Published in:
- Journal of dentistry. - 2015
Caries Diagnostics
Dental Loupes
Reliability
Sensitivity
Specificity
Bicuspid
Calibration
Dental Caries
Dental Caries Activity Tests
Dental Caries Susceptibility
Dental Enamel
Dentin
Dentists
Humans
Microscopy
Molar
Observer Variation
Physical Examination
Reproducibility of Results
Students, Dental
English
OBJECTIVES
The aim of this in vitro study was to examine the effect of different levels of magnification on the accuracy and reliability of visual caries detection using ICDAS criteria.
METHODS
Occlusal surfaces of 100 extracted molars were assessed by 14 examiners (3rd and the 4th year dental students and dentists) using no magnification aids, a 2.5× Galilean loupe, a 4.5× Keplerian loupe, or a surgical microscope with 10× magnification. The assessments were repeated on a different day. Sensitivity, specificity, AUC and reliabilities were calculated according to the gold standard of histology.
RESULTS
We found that with increasing magnification, the number of surfaces rated as "sound" (ICDAS code 0) decreased, while the number of surfaces with a localized enamel breakdown (ICDAS code 3) increased. While the sensitivities increased, the values of the specificities decreased to an unacceptably low level irrespective of the clinical experience of the examiners.
CONCLUSIONS
ICDAS seems to be optimized for natural vision up to 2.0× magnification and not for high magnifications. The use of powerful magnification in visual caries detection involves the risk of unnecessary and premature invasive treatment.
CLINICAL SIGNIFICANCE
This paper discusses when it does and does not make sense to use magnification devices for visual caries detection using ICDAS criteria. Strong magnifications should be refrained from for this purpose.
The aim of this in vitro study was to examine the effect of different levels of magnification on the accuracy and reliability of visual caries detection using ICDAS criteria.
METHODS
Occlusal surfaces of 100 extracted molars were assessed by 14 examiners (3rd and the 4th year dental students and dentists) using no magnification aids, a 2.5× Galilean loupe, a 4.5× Keplerian loupe, or a surgical microscope with 10× magnification. The assessments were repeated on a different day. Sensitivity, specificity, AUC and reliabilities were calculated according to the gold standard of histology.
RESULTS
We found that with increasing magnification, the number of surfaces rated as "sound" (ICDAS code 0) decreased, while the number of surfaces with a localized enamel breakdown (ICDAS code 3) increased. While the sensitivities increased, the values of the specificities decreased to an unacceptably low level irrespective of the clinical experience of the examiners.
CONCLUSIONS
ICDAS seems to be optimized for natural vision up to 2.0× magnification and not for high magnifications. The use of powerful magnification in visual caries detection involves the risk of unnecessary and premature invasive treatment.
CLINICAL SIGNIFICANCE
This paper discusses when it does and does not make sense to use magnification devices for visual caries detection using ICDAS criteria. Strong magnifications should be refrained from for this purpose.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jdent.2015.09.002
- PMID 26366524
- Persistent URL
- https://sonar.ch/global/documents/170047
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