Validity of the ICDAS-II for detection of fissure caries – an in-vitro study

Aim: The aim of this study was to validate the International Caries Detection and Assessment System [ICDAS-II) for the detection of occlusal caries. For this purpose, reproducibility, sensitivity, specificity and the correlation to histology were assessed. Material and Method: The occlusal surfaces of 100 teeth [181 investigation sites) were examined using the ICDAS-II graded scores of 0-6. Thereafter, the teeth were serially sectioned and the depth of the lesions assessed microscopically. Results: Weighted kappa values for inter- and intra-examiner reproducibility were 0.61-0.86 in the visual and histological examinations. The Spearman correlation coefficient between the visual and histological findings was 0.7. At the 01 diagnostic threshold (enamel and dentine lesions), specificity was 0.54% and sensitivity was 90.7%. At the 03 diagnostic threshold [dentine lesions) for the ICDAS cut-off 1/2 specificity was 69.6% and sensitivity was 86.6%. For the ICDAS cutoff 2/3, specificity was 91.1% and sensitivity was 70.1%. Conclusion: The ICDAS-II showed good reproducibility after a short training period. The ICDAS-II can be used in clinical studies with the acquired data on specificity and sensitivity.