Use of ICDAS-II, Visual, Radiography, Activity Assessments in Dental Caries Treatment Decision

Introduction: Of several methods used today for caries diagnosis, few studies report the using of visual/radiographic examination and caries activity assessment in treatment decision-making. Objectives: To calculate caries prevalence (caries activity, visual (ICDAS-II)/bitewing examinations) and caries treatment decision-making. Materials-Methods: Observational, cross-sectional trial, approved by Ethics Committee. Random sample: 45 individuals attended voluntarily FHS-UFP dentistry appointments (Set2013-Mar2014). Caries activity ICDAS-II visual and bitewing radiographs (collect from files) examinations were performed by five examiners trained/calibrated (ICC=0.970) to detect mesial/distal/oclusal carious lesions in 900 posterior teeth (2700 surfaces). Statistical analysis/inference by caries activity (active/inactive) and ICDAS (visual/bitewing examinations) for prevalence. Visual/bitewing records compared by Z-test and prevalence for treatment decision (surgical/non-Surgical treatments and/or therapeutic monitoring-TM) through 95%CI. Results: Sample: 57.8% male patients, 14-71 years old (age/gender; Mann-Whitney T., p=0.408); Prevalence of caries activity: 82.04% sound, 1.06% inactive and 16.90% active lesions. ICDAS (Visual and bitewing): enamel (7.07% and 2.67%), dentine (3.74% and 4.44%) and recurrent (3% and 2.41 %) caries. Visual/bitewing examination ICC=0.674(95%CI: 0.594-0.734). Caries treatment decisions: 82.23% surfaces for TM; 3.78% non-surgical treatments and TM; 10.11% surgical/non-surgical treatments or/and TM, and 3.88% surgical and therapeutic treatments. Conclusions: Use of ICDAS-II, by visual and radiography examinations and caries activity, enables a more accurate diagnosis and guidance in surgical/non-surgical/therapeutic decision-making. Correlation between visual/radiography examinations is reasonable to good. Clinical Implications: ICDAS-II may have high potential for caries detection and treatment planning, and other diagnosis devices can add more substantial information to visual examinations. Keywords: Intra-oral radiography, caries diagnosis, detection, prevalence, treatment-decision, activity, ICDAS-II