A comparison of treatment choices when dental caries lesions are diagnosed with two visual-tactile systems the Nyvad and ICDAS II+LAA
Bibliographic record
Abstract
Aim: The aim of this randomized cross-over study was to evaluate the reproducibility and differences in diagnostic and treatment outcomes by practicing dental clinicians previously inexperienced in using the Nyvad criteria and the ICDAS II criteria with Lesion Activity Assessment system (ICDAS II+LAA). Methods: Four volunteer dentists were randomly allocated to one of two groups. Both groups of dentists examined the same voluntary sample (n=140) of caries active young adults using the Nyvad and the ICDAS II+LAA criteria in different sequences. The first group used the Nyvad criteria during period I, followed by ICDAS II+LAA during period II; the second group did the examinations in the opposite sequence. Before the period 1 and 2 examinations, dentists from both groups were trained with the Nyvad or the ICDAS II+LAA criteria, depending on the group in which they were assigned. Results: Intra-examiner agreement for the severity diagnostic threshold was high for both diagnostic instruments (weighted Kappa 0.62-0.80). For the D1 (active) diagnostic threshold, the intra-examiner unweighted Kappa values were 0.31-0.61 for the ICDAS II+LAA and 0.36-0.51 for the Nyvad. The mean number of active non-cavitated carious lesions was significantly higher for the ICDAS II+LAA (6.14, SD±5.4) than for the Nyvad criteria (3.90, SD±3.9; p<0.0001). Active cavitated/dentinal carious lesions were significantly higher for the ICDAS II+LAA (4.14, SD±4.1) than for the Nyvad criteria (2.13, SD±3.1; p<0.0001). The mean number of operative treatment decisions per surface was 1.53 (95% CI 1.43-1.65) times higher for the ICDAS II+LAA than for the Nyvad. The mean number of non-operative treatment decisions was 1.59 (95% CI 1.51-1.68) times higher for the ICDAS II+LAA than for the Nyvad. Conclusion: Both the Nyvad and the ICDAS II+LAA diagnostic systems showed high reproducibility for the lesion severity assessment. The use of the ICDAS II+LAA diagnostic system may result in more treatment, both operative and non-operative in a high caries risk population. A long-term study is needed to determine the costs and health effects with both diagnostic systems. Trial registration: ISRCTN65592532.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".