Classification Shifting of Carious Lesions Using International Caries Detection and Assessment System
Ade P. Dwisaptarini, Christopher Calvin, Indrayadi Gunardi, Melaniwati

Faculty of Dentistry, Universitas Trisakti

Abstract

Background. The objective of caries classification is to assess the severity and extent of carious lesions, with the International Caries Detection and Assessment System (ICDAS) organizing them into seven depth-based classes. Shifts in classification before and after cavity access preparation may affect treatment planning accuracy due to the obstruction of dentin visibility by enamel pre-preparation and the subsequent deepening of lesions post-preparation. Aim. to evaluate class shifts using ICDAS criteria pre- and post-preparation. Method. An observational cross-sectional design, 68 teeth were categorized into three groups (D3, D4, and D5) and assessed using visual clinical examination, caries detector dyes, and fluorescence light (FACE). Result. Data were analyzed using chi-square and Kappa tests, revealing inter-rater reliability of 0.737 before preparation and 0.962 after preparation. Progression from D3 to D5, D4 to D5, D4 to D6, and D5 to D6 was observed at rates of 100%, 84%, 16%, and 59.1%, respectively. No significant disparities were found in anterior and posterior teeth before (p=0.064) and after (p=0.435) preparation across all groups, while significant differences were noted in mandibular and maxillary teeth before (p=0.027) and after (p=0.004) preparation. Conclusion. This study highlights the dynamic nature of caries classification, revealing complexities in lesion progression and diagnostic challenges. The observed shifts underscore the importance of precise examination techniques and informed decision-making in treatment planning. The disparities between mandibular and maxillary teeth emphasize the need for tailored diagnostic approaches based on tooth location, emphasizing the complexity of dental caries management

Keywords: ICDAS, caries, treatment planning accuracy

Topic: Conservative Dentistry