• Logo
  • SBMUPublishing

Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods

Hanieh Nokhbatolfoghahaie, Marzieh AliKhasi, Nasim Chiniforush, Farzaneh Khoei, Nassimeh Safavi, Behnoush Yaghoub Zadeh




Introduction: Today the prevalence of teeth decays has considerably decreased. Related organizations and institutions mention several reasons for it such as improvement of decay diagnostic equipment and tools which are even capable of detecting caries in their initial stages. This resulted in reduction of costs for patients and remarkable increase in teeth life span. There are many methods for decay diagnostic, like: visual and radiographic methods, devices with fluorescence such as Quantitative light-induced fluorescence (QLF), Vista proof, Laser fluorescence (LF or DIAGNOdent), Fluorescence Camera (FC) and Digital radiography. Although DIAGNOdent is considered a valuable device for decay diagnostic, there are concerns regarding its efficacy and accuracy. Considering the sensitivity of decay diagnosis and the exorbitant annual expenses supported by government and people for caries treatment, finding the best method for early caries detection is of the most importance. Numerous studies were performed to compare different diagnostic methods with conflicting results. The objective of this study is a comparative review of the efficiency of DIAGNOdent in comparison to visual methods and radiographic methods in the diagnostic of teeth occlusal surfaces.

Methods: Search of PubMed, Google Scholar electronic resources was performed in order to find clinical trials in English in the period between 1998 and 2013. Full texts of only 35 articles were available.

Conclusion: Considering the sensitivity and specificity reported in the different studies, it seems that DIAGNOdent is an appropriate modality for caries detection as a complementary method beside other methods and its use alone to obtain treatment plan is not enough.


laser; fluorescence; dental caries


Silva BB, Severo NB, Maltz M. Validity of diode laser to monitor carious lesions in pits and fissures. J Dent. 2007;35(8):679-82.

Petersson GH, Bratthall D. The caries decline: a review of reviews. Eur J Oral Sci. 1996;104(4 ( Pt 2)):436-43.

Bratthall D, Hansel-Petersson G, Sundberg H. Reasons for the caries decline: what do the experts believe? Eur J Oral Sci. 1996;104(4 ( Pt 2)):416-22; discussion 23-5, 30-2.

Lussi A, Hellwig E. Performance of a new laser fluorescence device for the detection of occlusal caries in vitro. J Dent. 2006;34(7):467-71.

Baseren NM, Gokalp S. Validity of a laser fluorescence system (DIAGNOdent) for detection of occlusal caries in third molars: an in vitro study. J Oral Rehabil. 2003;30(12):1190-4.

Ingram GS, Edgar WM. Interaction of fluoride and non-fluoride agents with the caries process. Adv Dent Res. 1994 ;8:158–65.

Tam LE, McComb D. Diagnosis of occlusal caries: Part II. Recent diagnostic technologies. J Can Dent Assoc. 2001;67(8):459-63.

Hamilton JC, Gregory WA, Valentine JB. DIAGNOdent measurements and correlation with the depth and volume of minimally invasive cavity preparations. Oper Dent. 2006 May-;31(3):291-6.

Achilleos EE, Rahiotis C, Kakaboura A, Vougiouklakis G. Evaluation of a new fluorescence-based device in the detection of incipient occlusal caries lesions. Lasers Med Sci. 2013;28(1):193-201.

Ando M, Gonzalez-Cabezas C, Isaacs RL, Eckert GJ, Stookey GK. Evaluation of several techniques for the detection of secondary caries adjacent to amalgam restorations. Caries Res. 2004;38(4):350-6.

Chong MJ, Seow WK, Purdie DM, Cheng E, Wan V. Visual-tactile examination compared with conventional radiography, digital radiography, and DIAGNOdent in the diagnosis of occlusal occult caries in extracted premolars. Pediatr Dent. 2003;25(4):341-9.

Bamzahim M, Shi XQ, Angmar-Mansson B. Secondary caries detection by DIAGNOdent and radiography: a comparative in vitro study. Acta Odontol Scand. 2004;62(1):61-4.

Angnes G, Angnes V, Grande RH, Battistella M, Loguercio AD, Reis A. Occlusal caries diagnosis in permanent teeth: an in vitro study. Braz Oral Res. 2005;19(4):243-8.

Wenzle A FE, Hintze H. Patient discomfort and cross-infection control in bitewing examination with a storage phosphor plate and a CCD-based sensor. J Dent. 1999.

Kuhnisch J, Berger S, Goddon I, Senkel H, Pitts N, Heinrich-Weltzien R. Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements. Community Dent Oral Epidemiol. 2008;36(6):475-84.

de Paula AB, Campos JA, Diniz MB, Hebling J, Rodrigues JA. In situ and in vitro comparison of laser fluorescence with visual inspection in detecting occlusal caries lesions. Lasers Med Sci. 2011;26(1):1-5.

Jablonski-Momeni A, Ricketts DN, Rolfsen S, Stoll R, Heinzel-Gutenbrunner M, Stachniss V, et al. Performance of laser fluorescence at tooth surface and histological section. Lasers Med Sci. 2011;26(2):171-8.

De Benedetto MS, Morais CC, Novaes TF, de Almeida Rodrigues J, Braga MM, Mendes FM. Comparing the reliability of a new fluorescence camera with conventional laser fluorescence devices in detecting caries lesions in occlusal and smooth surfaces of primary teeth. Lasers Med Sci. 2011;26(2):157-62.

Lussi A, Imwinkelried S, Pitts N, Longbottom C, Reich E. Performance and reproducibility of a laser fluorescence system for detection of occlusal caries in vitro. Caries Research 1999;33:261–6.

Shi XQ, Welander U, Angmar-Mansson B. Occlusal caries detection with KaVo DIAGNOdent and radiography: an in vitro comparison. Caries Res. 2000;34(2):151-8.

Chu CH, Lo EC, You DS. Clinical diagnosis of fissure caries with conventional and laser-induced fluorescence techniques. Lasers Med Sci. 2010;25(3):355-62.

Pourhashemi SJ, Jafari A, Motahhari P, Panjnoosh M, Kharrazi Fard MJ, Sanati I, et al. An in-vitro comparison of visual inspection, bite-wing radiography, and laser fluorescence methods for the diagnosis of occlusal caries. J Indian Soc Pedod Prev Dent. 2009;27(2):90-3.

Sridhar N, Tandon S, Rao N. A comparative evaluation of DIAGNOdent with visual and radiography for detection of occlusal caries: an in vitro study. Indian J Dent Res. 2009;20(3):326-31.

Costa AM, Paula LM, Bezerra AC. Use of DIAGNOdent for diagnosis of non-cavitated occlusal dentin caries. J Appl Oral Sci. 2008;16(1):18-23.

Huth KC, Neuhaus KW, Gygax M, Bucher K, Crispin A, Paschos E, et al. Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars. J Dent. 2008;36(12):1033-40.

Toraman Alkurt M, Peker I, Deniz Arisu H, Bala O, Altunkaynak B. In vivo comparison of laser fluorescence measurements with conventional methods for occlusal caries detection. Lasers Med Sci. 2008;23(3):307-12.

Reis A, Mendes FM, Angnes V, Angnes G, Grande RH, Loguercio AD. Performance of methods of occlusal caries detection in permanent teeth under clinical and laboratory conditions. J Dent. 2006;34(2):89-96.

Tomasik M, Weyna E, Tomasik E, Lipski M, Woźniak K, H R. Comparison of visual and laser examination of first permanent molars in patients aged 6-7 years. Durham Anthropology Journal. 2005;12(2-3).

Anttonen V, Seppa L, Hausen H. A follow-up study of the use of DIAGNOdent for monitoring fissure caries in children. Community Dent Oral Epidemiol. 2004;32(4):312-8.

Fung L, Smales R, Ngo H, Moun G. Diagnostic comparison of three groups of examiners using visual and laser fluorescence methods to detect occlusal caries in vitro. Aust Dent J. 2004;49(2):67-71; quiz 101.

Lussi A, Megert B, Longbottom C, Reich E, Francescut P. Clinical performance of a laser fluorescence device for detection of occlusal caries lesions. Eur J Oral Sci. 2001;109(1):14-9.

Souza J F Bt, Diniz M B,Rodrigues J A, Lussi A,Cordeiro R C L. Traditional and novel methods for occlusal caries detection:performance on primary teeth. Lasers Med Sci. 2013;28:287-95.

Neuhaus KW, Rodrigues JA, Seemann R, Lussi A. Detection of proximal secondary caries at cervical class II-amalgam restoration margins in vitro. J Dent. 2012;40(6):493-9.

Celiberti P, Leamari VM, Imparato JC, Braga MM, Mendes FM. In vitro ability of a laser fluorescence device in quantifying approximal caries lesions in primary molars. J Dent. 2010;38(8):666-70.

Goel A, Chawla HS, Gauba K, Goyal A. Comparison of validity of DIAGNOdent with conventional methods for detection of occlusal caries in primary molars using the histological gold standard: an in vivo study. J Indian Soc Pedod Prev Dent. 2009;27(4):227-34.

Braga MM, Morais CC, Nakama RC, Leamari VM, Siqueira WL, Mendes FM. In vitro performance of methods of approximal caries detection in primary molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(4):e35-41.

Kavvadia K, Lagouvardos P. Clinical performance of a diode laser fluorescence device for the detection of occlusal caries in primary teeth. Int J Paediatr Dent. 2008;18(3):197-204.

Virajsilp V, Thearmontree A, Aryatawong S, Paiboonwarachat D. Comparison of proximal caries detection in primary teeth between laser fluorescence and bitewing radiography. Pediatr Dent. 2005;27(6):493-9.

Attrill DC, Ashley PF. Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods. Br Dent J. 2001 28;190(8):440-3.

Kositbowornchai S, Sukanya C, Tidarat T, Chanoggarn T. Caries detection under composite restorations by laser fluorescence and digital radiography. Clin Oral Investig. 2012 Dec 16.

Rodrigues JA, Neuhaus KW, Hug I, Stich H, Seemann R, Lussi A. In vitro detection of secondary caries associated with composite restorations on approximal surfaces using laser fluorescence. Oper Dent. 2010;35(5):564-71.

Bamzahim M, Aljehani A, Shi XQ. Clinical performance of DIAGNOdent in the detection of secondary carious lesions. Acta Odontol Scand. 2005;63(1):26-30.

Boston DW. Initial in vitro evaluation of DIAGNOdent for detecting secondary carious lesions associated with resin composite restorations. Quintessence Int. 2003;34(2):109-16.

Braga MM, Chiarotti AP, Imparato JC, Mendes FM. Validity and reliability of methods for the detection of secondary caries around amalgam restorations in primary teeth. Braz Oral Res. 2010;24(1):102-7.

Pinheiro I MM, Ferreira M, Lima K. Use of laser fluorescence(DIAGNOdent)for in vivo diagnosis of occlusal caries :A systematic review. J Appl Oral Sci. 2004;12:177-81.

Bader JD, Shugars DA. A systematic review of the performance of a laser fluorescence device for detecting caries. J Am Dent Assoc. 2004;135(10):1413-26.

Hitij T, Fidler A. Effect of dental material fluorescence on DIAGNOdent readings. Acta Odontol Scand. 2008;66(1):13-7.

Francescut P, Zimmerli B, Lussi A. Influence of different storage methods on laser fluorescence values: a two-year study. Caries Res. 2006;40(3):181-5.

Krause F, Braun A, Eberhard J, Jepsen S. Laser fluorescence measurements compared to electrical resistance of residual dentine in excavated cavities in vivo. Caries Res. 2007;41(2):135-40.

DOI: http://dx.doi.org/10.22037/2010.v4i4.5042