Clinical Validity of ICDAS in the Detection of Interproximal Caries

Objectives: Background and Objectives: The ICDAS is a standardized system created for dental caries diagnosis that is becoming widely accepted by dental researchers and clinicians. This method has not been validated clinically for the detection of interproximal caries. No previous experimental research has been done to validate the ICDAS for the detection of interproximal caries clinically and to compare its validity to bite-wing radiography, which is the standard diagnostic tool used by dentists for the detection of these types of lesions. The objective of this study was to clinically evaluate clinically the validity of the ICDAS System in detecting interproximal caries using the bite-wing radiographs as the gold standard.

Methods: Methods: A group of 185 adult subjects were examined for dental caries by one calibrated examiner using the ICDAS clinical criteria as part of a larger study of caries risk factors. Digital bite-wing radiographs were taken. The radiographs were read by the same examiner using the ICDAS criteria for radiographs. The results of both methods were compared using pair-wise correlations, sensitivity, specificity, positive and negative predictive values and ROC curves. Only the mesial and distal surfaces of the premolar and molar teeth were used for the analysis (N= 5,315 surfaces).

Results: Results: The ICDAS clinical scores for interproximal caries correlated moderately with the x- ray scores (Spearman rho=0.43, P<0.001). When the radiographs were used as the “gold standard”, the validity measures of the ICDAS in the detection of interproximal caries in the dentine were: sensitivity 27.27%, specificity 99.52%, positive predictive value 64.29%, negative predictive value 97.74%, and AUC: 0.73 (95% CI 0.69, 0.77).


Conclusions: Conclusion: Under the conditions of the present study, the ICDAS was shown to have low sensitivity, but high specificity, but low sensitivity in the clinical detection of interproximal caries with dentinal involvement compared to the bite-wing radiographsy.