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Evaluating Interfaculty Agreement in ICDAS Coding Between Restorative and Nonrestorative Dentists Using Photographic and Extracted Carious Samples: A Pilot Study

Parolia A, Toh CG, Seow LL, Bhatia S, Smales FC

European journal of dental education : official journal of the Association for Dental Education in Europe, 2026

Abstract

INTRODUCTION: The International Caries Detection and Assessment System (ICDAS) is a standardised method for recording caries severity. Effective training in ICDAS is essential for dental faculty and students. This pilot study aimed to compare the effectiveness of photographic images versus extracted teeth in ICDAS training and to assess whether restorative and nonrestorative dental faculty achieve similar accuracy in ICDAS coding.

METHODS: Following comprehensive ICDAS training, dental faculty participated in a rotation through diagnostic stations, where they assigned ICDAS codes to tooth surfaces. The specimens consisted of either extracted adult teeth or their corresponding photographic images, each was preassigned a gold standard ICDAS code. Faculty members were categorised as belonging to either restorative or nonrestorative disciplines. After each rotation, individual performance was assessed by calculating linearly weighted Kappa (kw) values comparing each participant's coding to the gold standard. Data were analysed using nonpaired, nonparametric, statistical methods. The study was completed over two end-of-training sessions, one of which included a repeat circuit of stations following a 1 h rest period.

RESULTS: With kw scores as measures of ability, dental faculty coded more accurately with extracted teeth carious surfaces than with photographic images (p = 0.0005). When grouped by specialities, there were nearly identical median kw scores (p = 0.482), with…

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