VALIDITY AND RELIABILITY OF DIGITAL PHOTOS AS A DIAGNOSTIC TOOL FOR DETERMINATION OF CARIES Objectives: The impact of COVID-19 on dental care and the adoption of tele-dentistry for caries detection needs investigating. The pandemic led to the use of digital photography, including DSLR cameras and smartphones, for remote dental operations. Literature suggests that use of digital images was found to enhance caries detection sensitivity compared to visual examination. The study aims were 1) to compare the reliability of visual inspection and digital photographs for caries diagnosis among dental clinicians and 2) to compare diagnostic tools of determination of caries between full ICDAS codes and modified ICDAS codes utilization. Methods: The research involved 45 postgraduate dental students examining 45 extracted permanent teeth using full ICDAS scores and modified ICDAS scores in three phases (Full Visual ICDAS, Digital ICDAS and Combination of Visual and Digital ICDAS). Kappa scores, sensitivity, specificity and Area Under the Curve (AUC) readings between participants answers and benchmark answers were determined. Results: Statistical analysis revealed that introducing digital images reduced inter-rater agreement, however modified ICDAS codes utilization showed comparable results between visual and digital methods. Intra-rater agreement for visual and modified ICDAS was high, while digital images showed moderate agreement. Sensitivity for caries detection was around 93% for visual and digital methods, and specificity ranged from 67% to 80%. The AUC values indicated good performance (0.89) for both full and modified ICDAS with visual examination and lower values for digital examination (0.81-0.82). Discussion: Results were consistent with prior studies however this research highlights video/image efficacy, emphasizing validity, reliability, and improved clinician planning using modified ICDAS. Conclusion: Use of digital photographs for caries diagnosis were promising and the use of modified ICDAS codes were comparable to conventional use of full ICDAS codes. Overall, the study demonstrated the potential benefits of digital methods in dental caries diagnosis and tele-dentistry practices.

EVALUATING THE PERSPECTIVES OF MALAYSIAN GENERAL DENTAL PRACTITIONERS ON DENTAL IMPRESSION TECHNIQUES FOR INDIRECT RESTORATION: QUESTIONNAIRE VALIDATION AND PILOT STUDY Accurate impressions with high dimensional stability for indirect restoration fabrications are crucial. The conventional impressions technique has multiple steps and requires material manipulation, which has an inevitable degree of error. On the other hand, intraoral scanners (IOS) are currently used as digital impression techniques and have better acquisition, precision, cost and time efficiency. Malaysian GDPs have varying demographic backgrounds, exposure, experience, and preference for dental impression techniques. This study aims to validate and assess the reliability of the twenty-item questionnaire regarding the ‘Malaysian General Dental Practitioners’ (GDP’s) perspective on dental impression techniques for indirect restoration. A twenty-item questionnaire is categorised into four sections: (1) Demographic Characteristics of General Dental Practitioners, (2) Questions for Conventional Impression technique users, (3) Questions for Digital Impression technique users, and (4) Questions for both Digital and Conventional Impression Technique users. The questionnaire is assessed by three experts measured for its Content Validity Index (CVI) prior to distribution. A cross-sectional pilot study is then carried out with a sample size of 30 participants. The descriptive data are compared using a Chi-square test based on the type of impression techniques and preference variables. Fifteen items in the questionnaire had an I-CVI score of 1, while five items had a score of 0.67. The S-CVI/Ave value was 0.92, while the S-CVI/UA value was 0.76. Thirty responses were collected in the pilot study. There were seven respondents who are digital technique users and 23 who are conventional technique users. All respondents are interested in learning or improving their knowledge and skills in IOS (100%). 15 out of 20 items in the questionnaire have good content validity with I-CVI values of 1. The S-CVI/Ave also reflected acceptable content validity with a value of 0.92. Five items from the questionnaire yielded I-CVI = 0.67, and the S-CVI/UA value showed 0.76, indicating unsatisfactory content validity levels. All questions were retained for the pilot study. The questionnaire can be improved for content validity by removing or modifying questions to make them fit, correlate more to the study, and achieve a higher S-CVI value. On the other hand, the pilot study concluded that most respondents use conventional impression techniques but favour using intraoral scanners when fabricating indirect restoration.