Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen

Objectives: To clinically evaluate the prevalence of buccal caries and white spot lesions (WSLs) at debonding in governmental and private orthodontic patients, using the International Caries Detection and Assessment System (ICDAS-11) and the DIAGNOdent Pen, and to study the correlation between the two methods. Materials and Methods: A cross-sectional study was carried out on the nonextracted premolars and anterior teeth of 89 orthodontic patients. They were recruited into two groups based on the treatment center they attended: governmental group (G; n = 45) and private group (P; n = 44). Immediately after debonding, the examination of buccal caries and WSLs on premolars and anterior teeth was carried out using the ICDAS-II and the DIAGNOdent Pen. Cross-tabulation was applied to study the correlation between the ICDAS-II index and the DIAGNOdent Pen by calculating the Spearman correlation coefficient. Results: The G group showed a significantly higher (P < .0001) prevalence of WSLs and/or buccal caries compared to that of the P group based on evaluation by the two methods. Based on ICDAS-II, 43% of the patients in the P group and 9% in the G group were free from any WSLs. In the G group, 22% of the patients had >= 16 lesions, whereas there were none for the P group. The Spearman correlation coefficient between the two methods was .71. Conclusions: The prevalence of caries and/or WSLs at debonding was significantly higher in the G group compared to the P group. The clinical index (ICDAS-11) showed a good correlation with the DIAGNOdent Pen.