The Performance of ICDAS-II Using Low-Powered Magnification with Light-Emitting Diode Headlight and Alternating Current Impedance Spectroscopy Device for Detection of Occlusal Caries on Primary Molars
Early detection of occlusal caries in children is challenging for the dentists, because of the morphology of pit and fissures. The aim of this study was to compare in vitro the diagnostic performance of low-powered magnification with light-emitting diode headlight (LPMLED) using ICDAS-II criteria and AC Impedance Spectroscopy (ACIS) device, on occlusal surfaces of primary molars. The occlusal surfaces of 18 extracted primary molars were examined blindly by two examiners. The teeth were sectioned and examined under light microscopy using Downer’s histological criteria as gold standard. Good to excellent inter- and intraexaminer reproducibility, higher sensitivity, specificity, and AUC values were achieved by LPMLED at D1 threshold. Also the relationship between histology and LPMLED was statistically significant. In conclusion visual aids have the potential to improve the performance of early caries detection and clinical diagnostics in children. Despite its potential, ACIS device should be considered as an adjunct method in detecting caries on primary teeth. 1. Introduction It is well established that caries levels in industrialized nations have decreased over the last few decades with the greatest reductions occurring on the smooth and approximal surfaces [1–4]. Because of the complex occlusal anatomy, more sensitive and reproducible diagnostic tools for precise caries detection in children are needed [5]. Visual examination still is the most commonly used method for detecting dental caries, but various studies showed problems for sensitivity and reproducibility problems [6–8]. A standardized scoring system, International Caries Detection and Assessment System (ICDAS-II), has been developed for clinical practice and research to overcome these problems [9]. A complimentary approach to visual examination is to use visual aids such as low-powered magnification (dental loupes) and special headlights mounted on them. These visual aids became popular among dentists to improve precision of visual examination and for ergonomic reasons [10, 11]. Advances in caries research led novel technologies to help dentists in the diagnosis of early lesions. ACIS device (CarieScan PRO, Dundee, Scotland) is one of the recent examples of the novel technologies. This device relies on the application of a small alternating electrical signal (undetectable by the patient) through the tooth while monitoring the response at the sensor. By changing frequency of the applied signal, a spectrum is captured which provides valuable insights into the physical and chemical properties of
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