IADR Abstract Archives
The Impact of ICDAS on Caries Management Recommendations
Objectives: To assess the impact of ICDAS on dentists' caries management decisions.
Methods: Five investigators examined 270 extracted posterior teeth. In the first part, examiners were asked to evaluate the occlusal surface of the teeth and chose from a list of options their management recommendation for each tooth for at high risk for developing caries child. The list of management recommendations included the following: a. no action, b. non-operative care and c. operative care. Four weeks later, all examiners were trained and calibrated for the ICDAS scoring system. After one week, all investigators examined the same 270 teeth independently. For the occlusal surfaces of all teeth, investigators were instructed to record their management recommendation. At the end of the study, teeth were sectioned through specific points of interest. To determine the caries detection performance of the examinations, sensitivity, specificity, area under the Receiver Operating Characteristic (ROC) curve and Spearman’s correlation coefficients for ICDAS mode scores of all examiners were calculated. ICDAS D1, D2 and D3 thresholds were compared against histological dentine caries (Ekstrand et al. (1997) histological classification system code 2). Wilcoxon 2 related sample Rank Test was used to:1. test for differences between management recommendations made before and after ICDAS training.
Results: The scores for interexaminer reproducibility were not always comparable, suggesting a bias in using the ICDAS system among the examiners. When studying the correlation between mode ICDAS score for all examiners with the histological findings at dentine caries level (code 2-4), ICDAS D2 cutoff point demonstrated the strongest correlation. Management recommendations among different examiners prior to ICDAS training and post ICDAS training demonstrated a statistically significantly increased percentages of operative recommendations for two examiners. In relation to histologic dentine caries, ICDAS training increased the percentage of over treatment recommendation for the general and pediatric dentists (p<0.05).
Conclusions: ICDAS training resulted in differences in the impact among the different dental specialists.
Methods: Five investigators examined 270 extracted posterior teeth. In the first part, examiners were asked to evaluate the occlusal surface of the teeth and chose from a list of options their management recommendation for each tooth for at high risk for developing caries child. The list of management recommendations included the following: a. no action, b. non-operative care and c. operative care. Four weeks later, all examiners were trained and calibrated for the ICDAS scoring system. After one week, all investigators examined the same 270 teeth independently. For the occlusal surfaces of all teeth, investigators were instructed to record their management recommendation. At the end of the study, teeth were sectioned through specific points of interest. To determine the caries detection performance of the examinations, sensitivity, specificity, area under the Receiver Operating Characteristic (ROC) curve and Spearman’s correlation coefficients for ICDAS mode scores of all examiners were calculated. ICDAS D1, D2 and D3 thresholds were compared against histological dentine caries (Ekstrand et al. (1997) histological classification system code 2). Wilcoxon 2 related sample Rank Test was used to:1. test for differences between management recommendations made before and after ICDAS training.
Results: The scores for interexaminer reproducibility were not always comparable, suggesting a bias in using the ICDAS system among the examiners. When studying the correlation between mode ICDAS score for all examiners with the histological findings at dentine caries level (code 2-4), ICDAS D2 cutoff point demonstrated the strongest correlation. Management recommendations among different examiners prior to ICDAS training and post ICDAS training demonstrated a statistically significantly increased percentages of operative recommendations for two examiners. In relation to histologic dentine caries, ICDAS training increased the percentage of over treatment recommendation for the general and pediatric dentists (p<0.05).
Conclusions: ICDAS training resulted in differences in the impact among the different dental specialists.