MATERIALS AND METHODS: Dental students (n = 122) in their clinical years, year 3 (n = 37), year 4 (n = 44), and year 5 (n = 41) received training (two-hour introductory lecture on ICDAS, followed by a 90 min e-learning video, and practice sessions using extracted teeth and photographs) from a calibrated expert. After training, the students examined a prevalidated set of extracted teeth and assigned scores in two sessions. The intra- and inter-examiner agreement between students was analyzed using weighted kappa statistics and a focus group discussion was conducted for qualitative feedback.
RESULTS: The range of kappa values for intra-examiner agreement among the year 3, 4, and 5 students for ICDAS caries code (0.611-0.879, 0.633-0.848, and 0.645-1.000) and restoration code (0.615-0.942, 0.612-0.923, 0.653-1.000), respectively. The range of kappa values for inter-examiner agreement for year 3, 4, and 5 students with a trained expert for ICDAS caries code (0.526-0.713, 0.467-0.810, and 0.525-0.842) and restoration code (0.531-0.816, 0.682-0.842, and 0.645-0.928), respectively.
CONCLUSION: The ICDAS system is a promising tool for caries detection and its implementation in the curriculum was perceived by dental students as an effective method. In general, there was moderate to substantial agreement for ICDAS caries and restoration code between students of different academic year groups and with a trained ICDAS expert.
CLINICAL SIGNIFICANCE: ICDAS is a simple, logical, and evidence-based system for the detection and classification of caries. Introducing ICDAS to dental students enables them to detect caries in a reliable and reproducible manner irrespective of their past clinical experience and also significantly improves their caries detection skills.
Materials and Methods: A ross-sectional study was conducted involving the screening of patients that reported to the oral medicine clinics over a 2-year period. Age, gender, ethnicity, morphological variations in shape and size, number, and location of tori were recorded in all positive cases.
Results: Fourteen percent of individuals (n = 624) among the total 4443 who were screened were found to have either palatine tori, mandibular tori, or both. The prevalence of PT and MT was 10.8% and 0.9%, respectively. Tori were found in people in the age range of 5-85 years, with the maximum in the age range of 20-29 years (24.7%). The male-to-female ratio for PT and MT was 1:1.4 and 1:0.68, respectively. The morphologic shapes of palatine tori that were observed were flat (10%), spindle (10%), linear (15%), and nodular (59%) with up to six lobules. Mandibular tori were located either unilaterally or bilaterally; they were nodular in shape (89%) and/or band like (15%), with the band-like shape being described for the first time. Size variations ranging from 0.5 to 5 cm were observed.
Conclusion: The relatively high prevalence of tori among major ethnic groups of this region supports the probable hypothesis of the role of environmental factors. A wide variation in the morphology was also noted, along with a new morphologic variant of band-like TM, which may be due to the influence of diet or an unknown environmental factor.