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Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions.

ABSTRACT: Introduction:Operative dentistry addresses the surgical management of caries, a significant portion of dental practice. Dental students, who typically develop their skill sets in this important discipline by creating idealized preparations in plastic teeth, are often confused by the wide variety of tooth anatomy and caries presentation they see when they subsequently treat patients. To address this significant clinical transition issue, we developed this resource on preparing the moderate carious lesion using a stepwise, structured technique. Methods:This resource consists of a flipped-classroom learning module and associated laboratory activity with an algorithm worksheet to practice critical thinking skills. Prior to the exercise, an interactive tutorial introduces the didactic background. The 4-hour class session starts with a short quiz and review, then learners use the worksheet to prepare and restore their tooth specimens. Results:Learner response has been very positive. Moreover, faculty note that learners' skills in treating patients in clinic are noticeably higher and require less faculty intervention than was previously the case. Discussion:Since new national curriculum standards for caries are currently being introduced, in addition to providing instruction to dental students, this resource presents an excellent opportunity to calibrate faculty members, who are a secondary learner group in this exercise, on a standard clinical protocol.

SUBMITTER: Mitchell J

PROVIDER: S-EPMC6338171 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions.

Mitchell Jan J Brackett Martha M Brackett William W

MedEdPORTAL : the journal of teaching and learning resources 20170718

<h4>Introduction</h4>Operative dentistry addresses the surgical management of caries, a significant portion of dental practice. Dental students, who typically develop their skill sets in this important discipline by creating idealized preparations in plastic teeth, are often confused by the wide variety of tooth anatomy and caries presentation they see when they subsequently treat patients. To address this significant clinical transition issue, we developed this resource on preparing the moderat ...[more]

PMID: 30800804

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Project description:AimThe present investigation aimed at assessing the diagnostic accuracy of DIAGNOdent compared to the International Caries Detection and Assessment System-II (ICDAS-II) in the detection of facial, smooth surface noncavitated carious lesions.Settings and designSixty patients were enrolled in the current study according to the eligibility criteria. There were 161 teeth with noncavitated, white spot carious lesions and 32 sound teeth.Materials and methodsBefore examination, teeth were cleaned and polished and all patients were assessed under standardized operating conditions: preset dental unit position, operating light, and prolonged air drying (approximately 5 s). All teeth were assessed by two calibrated examiners individually without any contact using ICDAS-II and DIAGNOdent.Statistical analysisThe diagnostic accuracy of DIAGNOdent device was determined, including sensitivity, specificity, overall accuracy, positive and negative predictive values, and receiver operating characteristic curve analysis. Chi-square test was conducted to compare the distribution of ICDAS-II and DIAGNOdent scores. Inter-observer agreement between assessors was evaluated using Cohen's kappa test.ResultsIn the current study, DIAGNOdent had an overall accuracy of 84.45% with sensitivity and specificity of 87.58% and 96.87%, respectively, and +PV and -PV of 97.7% and 83.9%, respectively, when score 0 represented sound tooth surface, while scores 1 and 2 were considered clinically noncavitated carious lesions. Moreover, when only ICDAS score 1 was considered representing first visual change in enamel, DIAGNOdent had an accuracy of 74.15% with sensitivity and specificity of 83.53% and 90.62%, respectively, and +PV and -PV of 93% and 78.6%, respectively. In the present study, when only ICDAS score 2 was considered representing distinct visual change in enamel, DIAGNOdent had an accuracy of 100% with sensitivity and specificity of 100% and 100%, respectively, and +PV and -PV of 100% and 100%, respectively.ConclusionsThe overall performance of DIAGNOdent was equivalent to the visual inspection using ICDAS-II. DIAGNOdent might be considered a useful adjunctive device for detection and monitoring development of noncavitated carious lesions on facial smooth surfaces.

Dataset Information

Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions.

Publications

Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions.

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