Diagnostic validity of ICDAS II, VistaProof and a combination of these two methods. An in vitro study in pre-cavitated lesions.

PURPOSE

In view of the present fall in advanced cavitation lesion prevalence, diagnostic methods have been developed to assist in assessing and measuring pre-cavitation lesions. The purpose of this study was to assess the VistaProof fluorescence-based system in vitro and compare the results with those of visual examination using the ICDAS II criteria.

METHODS

100 permanent teeth were collected and 65 were chosen at random for this study. Two separate examiners each examined them twice, 3 weeks apart, assessing them in accordance with ICDAS II. They were subsequently examined with the VistaProof system and the images were stored in the computer program. After obtaining all these data, the teeth were prepared for histological examination and the extent of the lesion was measured.

RESULTS

The sensitivity with VistaProof was 0.705 for examiner 1 and 0.818 for examiner 2. With ICDAS II it was 0.796 and 0.864, respectively. The specificity was 0.810 and 0.619, respectively, for VistaProof and 0.810 and 0.952 for ICDAS II. The agreement with the histology results was 0.757 and 0.719, respectively, for VistaProof and 0.802 and 0.908 for ICDAS II. The intra-examiner and inter-examiner reproducibility of both methods was also assessed. For VistaProof the values were 0.76 and 0.78 intra-examiner agreement and 0.65 inter-examiner. For ICDAS II they were 0.82 and 0.91 intra-examiner and 0.76 inter-examiner. The data showed that both ICDAS II and VistaProof presented very good sensitivity but moderate specificity, as well as strong agreement (fair to good) with the histology results, and the intra-examiner and inter-examiner reproducibility was significant for both methods.

CONCLUSIONS

ICDAS II criteria and the assistance provided by VistaProof increase the ability to diagnose incipient lesions and take early action to treat them. It is important to combine the two in order to obtain more significant results, considering non-opperative treatments for non-cavitated lesions diagnosed. Lasers Surg. Med. 50:166-173, 2018. © 2017 Wiley Periodicals, Inc.