Early detection of proximal caries is vital for preventing structural loss and enabling conservative treatment. This clinical study assessed the diagnostic performance of two emerging technologies—laser fluorescence (LF) using the DIAGNOdent Pen and near-infrared reflection (NIRR) via the VistaCam iX Proxi head—in identifying early cavitated lesions in permanent posterior teeth. The investigation included 43 proximal surfaces from 15 female participants who exhibited limited radiolucent areas on bitewing radiographs, suggesting initial enamel or superficial dentin demineralization.
Each participant underwent a standardized diagnostic sequence. Prior to evaluation, proximal surfaces were cleaned with dental floss and cotton rolls and thoroughly air-dried to minimize interference from plaque or moisture. For LF assessment, the DIAGNOdent Pen was used with its specialized tip A probe, which allows angled access into tight interproximal contacts. The device emits 655 nm laser light that excites fluorescent compounds produced by cariogenic bacteria in decayed tissues. Readings were recorded per contact area, and values below 16 were classified as non-cavitated (score 0), while readings of 16 or higher indicated potential cavity formation (score 1). This threshold was selected based on manufacturer guidelines and previous clinical validation studies.
For NIRR imaging, the Proxi interchangeable head of the VistaCam iX intraoral camera system was employed. It uses two infrared LEDs emitting at 850 nm to illuminate adjacent teeth, with a semiconductor sensor capturing reflected light. Images were processed through DBSWIN software and displayed in grayscale: healthy enamel appears dark due to high translucency, while carious or demineralized dentin appears brighter due to increased light scattering. Lesions were categorized as score 0 if they showed no structural breakdown or only mild discoloration within enamel; score 1 was assigned when visual or tactile examination revealed enamel discontinuity.
To establish a reliable reference standard, orthodontic separators were placed between adjacent teeth to create sufficient space for direct visualization and exploration. After at least 48 hours, the separators were removed, and the proximal surfaces were examined using a dental mirror and explorer without pressure. This method provided definitive confirmation of cavitation status.
The results showed that 9 out of 43 surfaces (20.9%) were confirmed as cavitated by the reference standard. The DIAGNOdent Pen demonstrated a sensitivity of 44.4% and specificity of 61.8%, resulting in an overall accuracy of 58%. In contrast, the VistaCam iX Proxi achieved a sensitivity of 88.9% but a remarkably low specificity of 14.7%, yielding only 30% accuracy. Positive predictive values were 23.PBS Buffer medchemexpress 5% for LF and 21.Cephalosporin C manufacturer 6% for NIRR, while negative predictive values were high—80.PMID:34618287 8% and 83.3%, respectively.
These findings indicate that while NIRR is highly sensitive in detecting suspicious changes, it lacks specificity, often misidentifying non-cavitated lesions as pathological. The DIAGNOdent Pen, though less sensitive, provides greater confidence in ruling out cavitation, making it more suitable for guiding preventive care. However, neither device meets the clinical thresholds required for standalone use—sensitivity ≥75% and specificity >85%. Therefore, both tools should be integrated into a multimodal diagnostic approach rather than used independently. Future research should explore improved image interpretation algorithms and validate these devices across diverse populations with varying caries susceptibility.MedChemExpress (MCE) offers a wide range of high-quality research chemicals and biochemicals (novel life-science reagents, reference compounds and natural compounds) for scientific use. We have professionally experienced and friendly staff to meet your needs. We are a competent and trustworthy partner for your research and scientific projects.Related websites: https://www.medchemexpress.com