Clinical performance of ICDAS II, radiovisiography, and alternating current impedance spectroscopy device for the detection and assessment of occlusal caries in primary molars

Objective: To investigate the clinical performance of International Caries Detection and Assessment System II (ICDAS II) (a ranked visual scale), radiovisiography (RVG) (a digital radiography device), and an alternating current impedance spectroscopy (ACIS) device for the detection and assessment of occlusal caries in primary teeth. Materials and Methods: Twenty-five molars were assessed using all three systems under standardized in vivo conditions. They were then extracted and also assessed by examiners in vitro . Downer's histological scoring criterion was the validation gold standard. Sensitivity, specificity, positive and negative likelihood ratios, and area under the receiver-operator curves were calculated for enamel caries and dentine caries. Repeatability was analyzed using intraclass correlation coefficient (ICC). The performances of the systems between in vivo and in vitro settings by the same examiner were also compared. Statistical Analysis: SPSS version 17.0 (SPSS Inc., Chicago, IL, USA) was used to analyze the data. Comparison of the performance of all three systems for all caries and dentine caries using receiver operating characteristic curves was calculated using a range of cutoffs. Reliability was assessed using ICC method. Results: ICDAS II system showed the highest validity and repeatability for assessing occlusal caries in the primary molars. RVG was less accurate than the ICDAS II for detecting caries lesions confined to enamel. However, when dentine was involved, RVG was found to be as effective as ICDAS II. Conclusion: Within the limitations of the study, the in vivo results of ICDAS II and RVG were satisfactory and comparable to those obtained in vitro , with ICDAS II performing better. The ACIS device was least accurate among the three systems for caries assessment.