title: Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen.
abstract: OBJECTIVE
  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-II) and the DIAGNOdent Pen, and to study the correlation between the two methods.
  
  
  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-II) showed a good correlation with the DIAGNOdent Pen.
authors.affiliation: a  Orthodontist and PhD student, Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Demonstrator, Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Naif A
authors.initials: NA
authors.lastname: Almosa
authors.forename: Ted
authors.initials: T
authors.lastname: Lundgren
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Aldrees
authors.forename: Dowen
authors.initials: D
authors.lastname: Birkhed
authors.forename: Heidrun
authors.initials: H
authors.lastname: Kjellberg
mesh_terms: D001641:Bicuspid / Q000473:pathology; D003430:Cross-Sectional Studies; D003481:Cuspid / Q000473:pathology; D003731:Dental Caries / Q000145:classification / Q000175:diagnosis*; D017005:Dental Debonding / Q000379:methods*; D003743:Dental Enamel / Q000473:pathology; D003804:Dentin / Q000473:pathology; D005260:Female; D006801:Humans; D007180:Incisor / Q000473:pathology; D007834:Lasers; D008297:Male; D009967:Orthodontic Appliances / Q000009:adverse effects*; D011331:Private Practice; D017150:Public Sector; D018570:Risk Assessment / Q000379:methods