Comparison Between Visual and Radiographic Methods Using ICDAS Criteria in Permanent Molars for Detection of Occlusal and Proximal Caries – A Comparative Study

Comparison of Visual and Radiographic ICDAS Methods

Authors

  • Vijai Nand Department of Operative Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Mahwish Memon Department of Operative Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Ali Asghar Jafferi Department of Community and Preventive Dentistry, Dow University of Health Sciences, Karachi, Pakistan
  • Muhammad Ali Department of Operative Dentistry, Isra Dental College, Hyderabad, Pakistan
  • Sadia Memon Department of Oral Biology, Muhammad Dental College, Mirpurkhas, Pakistan
  • Shuja Aslam Department of Operative Dentistry, Muhammad Dental College, Mirpurkhas, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i9.3171

Keywords:

Visual, Radiographic, Caries, Permanent Molars

Abstract

Early detection of dental caries is critical for timely intervention and prevention of disease progression. The International Caries Detection and Assessment System (ICDAS) offers a standardized approach to evaluate caries through both visual and radiographic methods. Objectives: To compare between visual and radiographic methods using ICDAS criteria in permanent molars for detection of occlusal and proximal caries Methods: This comparative cross-sectional study was conducted at Liaquat University of Medical and Health Sciences (LUMHS) after ethical approval, using non-probability consecutive sampling to recruit 378 patients. Individuals aged 16–35 years with fully erupted, clinically intact permanent molars and no signs of periodontal disease were included. Participants were assigned to Group A (occlusal caries) or Group B (proximal caries), with 189 in each group. Caries were assessed visually and radiographically using ICDAS criteria, with scores 1–2 indicating initial and 3–6 indicating advanced lesions. Two calibrated examiners performed the evaluations. Results: There were no statistically significant differences in baseline demographics between the occlusal and proximal caries groups. The mean age was comparable (25.9 ± 6.5 vs. 26.1 ± 6.2 years, p=0.753), as was gender distribution (p=0.752). When comparing diagnostic methods, no statistically significant differences were observed between visual and radiographic ICDAS assessments for detecting initial or advanced caries in either group (all p>0.05), indicating comparable diagnostic performance. Conclusions: Visual and radiographic methods based on the ICDAS system were equally effective in identifying occlusal and proximal carious lesions in permanent molars.

 

References

Devadiga D, Shetty P, Hegde MN. Characterization of Dynamic Process of Carious and Erosive Demineralization – An Overview. Journal of Conservative Dentistry and Endodontics. 2022 Sep; 25(5): 454–62. doi: 10.4103/jcd.jcd_161_22. DOI: https://doi.org/10.4103/jcd.jcd_161_22

Usuga-Vacca M, Marin-Zuluaga DJ, Castellanos JE, Martignon S. Association between Root/Coronal Caries and Individual Factors in Institutionalised Elderly Using ICDAS Severity and Activity. BMC Oral Health. 2021 Mar; 21(1): 146. doi: 10.1186/s12903-021-01520-4. DOI: https://doi.org/10.1186/s12903-021-01520-4

Foros P, Oikonomou E, Koletsi D, Rahiotis C. Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis. Caries Research. 2021 Aug; 55(4): 247–59. doi: 10.1159/000516084. DOI: https://doi.org/10.1159/000516084

Abdelaziz M. Detection, Diagnosis, and Monitoring of Early Caries: The Future of Individualized Dental Care. Diagnostics. 2023 Dec; 13(24): 3649. doi: 10.3390/diagnostics13243649. DOI: https://doi.org/10.3390/diagnostics13243649

Azam I, Mathur VP, Tewari N, Morankar R, Bansal K, Rajwar A. Feasibility of the International Caries Classification and Management System (ICCMS) Protocol in a Hospital-Based Setting in India. Indian Journal of Dental Research. 2024 Jul; 35(3): 262–7. doi: 10.4103/ijdr.ijdr_46_24. DOI: https://doi.org/10.4103/ijdr.ijdr_46_24

Oh SH, Lee SR, Choi JY, Choi YS, Kim SH, Yoon HC, et al. Detection of Dental Caries and Cracks with Quantitative Light-Induced Fluorescence in Comparison to Radiographic and Visual Examination: A Retrospective Case Study. Sensors. 2021 Mar; 21(5): 1741. doi: 10.3390/s21051741. DOI: https://doi.org/10.3390/s21051741

Chen Y, Chen D, Lin H. Infiltration and Sealing for Managing Non-Cavitated Proximal Lesions: A Systematic Review and Meta-Analysis. BMC Oral Health. 2021 Jan; 21(1): 13. doi: 10.1186/s12903-020-01364-4. DOI: https://doi.org/10.1186/s12903-020-01364-4

Gudipaneni RK, Alkuwaykibi AS, Ganji KK, Bandela V, Karobari MI, Hsiao CY, et al. Assessment of Caries Diagnostic Thresholds of DMFT, ICDAS II and CAST in the Estimation of Caries Prevalence Rate in First Permanent Molars in Early Permanent Dentition – A Cross-Sectional Study. BMC Oral Health. 2022 Apr; 22(1): 133. doi: 10.1186/s12903-022-02134-0. DOI: https://doi.org/10.1186/s12903-022-02134-0

AbdELkader AR, Hafez Ibrahim S, Elsayed Hassanein O. Reliability of Impedance Spectroscopy versus Digital Radiograph and ICDAS-II in Occlusal Caries Detection: A Prospective Clinical Trial. Scientific Reports. 2024 Jul; 14(1): 16553. doi: 10.1038/s41598-024-66627-4. DOI: https://doi.org/10.1038/s41598-024-66627-4

Mitropoulos P, Rahiotis C, Stamatakis H, Kakaboura A. Diagnostic Performance of the Visual Caries Classification System ICDAS II versus Radiography and Micro-Computed Tomography for Proximal Caries Detection: An In Vitro Study. Journal of Dentistry. 2010 Nov; 38(11): 859–67. doi: 10.1016/j.jdent.2010.07.005. DOI: https://doi.org/10.1016/j.jdent.2010.07.005

Shugars DA, Elter JR, Jacks MT, White RP Jr, Phillips C, Haug RH, et al. Incidence of Occlusal Dental Caries in Asymptomatic Third Molars. Journal of Oral and Maxillofacial Surgery. 2005 Mar; 63(3): 341–6. doi: 10.1016/j.joms.2004.11.009. DOI: https://doi.org/10.1016/j.joms.2004.11.009

Gugnani N, Pandit IK, Srivastava N, Gupta M, Sharma M. International Caries Detection and Assessment System (ICDAS): A New Concept. International Journal of Clinical Pediatric Dentistry. 2010 Apr; 4(2): 93. doi: 10.5005/jp-journals-10005-1089. DOI: https://doi.org/10.5005/jp-journals-10005-1089

Carvalho RN, Letieri AD, Vieira TI, Santos TM, Lopes RT, Neves AD, et al. Accuracy of Visual and Image-Based ICDAS Criteria Compared with a Micro-CT Gold Standard for Caries Detection on Occlusal Surfaces. Brazilian Oral Research. 2018 Jul; 32: e60. doi: 10.1590/1807-3107bor-2018.vol32.0060. DOI: https://doi.org/10.1590/1807-3107bor-2018.vol32.0060

Ekstrand KR, Luna LE, Promisiero L, Cortes A, Cuevas S, Reyes JF, et al. The Reliability and Accuracy of Two Methods for Proximal Caries Detection and Depth on Directly Visible Proximal Surfaces: An In Vitro Study. Caries Research. 2011 May; 45(2): 93–9. doi: 10.1159/000324439. DOI: https://doi.org/10.1159/000324439

Thippanna RK, Ramu VC. Prevalence of Dental Attrition and Its Severity in Relation to Age and Gender: A Clinical Study. CODS Journal of Dentistry. 2018 Dec; 9(1): 16–21. doi: 10.5005/jp-journals-10063-0027. DOI: https://doi.org/10.5005/jp-journals-10063-0027

Mount GJ, Hume WR, Ngo HC, Wolff MS, editors. Preservation and Restoration of Tooth Structure. John Wiley and Sons. 2016 Jun 13.

He S, Yon MJ, Liu F, Lo EC, Yiu CK, Chu CH, et al. Prevalence of Caries Patterns in the 21st Century Preschool Children: A Systematic Review and Meta-Analysis. Journal of Evidence-Based Dental Practice. 2024 Sep; 24(3): 101992. doi: 10.1016/j.jebdp.2024.101992. DOI: https://doi.org/10.1016/j.jebdp.2024.101992

Mohapatra S, Mohandas R. Plaque Cleaning Efficacy of Waist-Shaped Interdental Brushes among Individuals with Open Interproximal Spaces: A Systematic Review. Evidence-Based Dentistry. 2024 Dec; 25(4): 214. doi: 10.1038/s41432-024-01036-0. DOI: https://doi.org/10.1038/s41432-024-01036-0

Stoica SN, Nimigean V, Vîrlan MJ, Nimigean VR. The Pathology of the First Permanent Molar during the Mixed Dentition Stage. Applied Sciences. 2022 Dec; 13(1): 483. doi: 10.3390/app13010483. DOI: https://doi.org/10.3390/app13010483

Bakhurji EA, El Tantawi MM, Gaffar BO, Al-Khalifa KS, Al-Ansari AA. Carious Lesions of Permanent Molars and Oral Health Practices of Parents and Peers in Saudi Male Adolescents. Saudi Medical Journal. 2017 Jul; 38(7): 748. doi: 10.15537/smj.2017.7.17601. DOI: https://doi.org/10.15537/smj.2017.7.17601

Downloads

Published

2025-09-30
CITATION
DOI: 10.54393/pjhs.v6i9.3171
Published: 2025-09-30

How to Cite

Nand, V., Memon, M., Jafferi, A. A., Ali, M., Memon, S., & Aslam, S. (2025). Comparison Between Visual and Radiographic Methods Using ICDAS Criteria in Permanent Molars for Detection of Occlusal and Proximal Caries – A Comparative Study: Comparison of Visual and Radiographic ICDAS Methods. Pakistan Journal of Health Sciences, 6(9), 139–143. https://doi.org/10.54393/pjhs.v6i9.3171

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)

1 2 > >>