The use of advanced medical devices as primary screening for diagnosis of caries aimed at improving oral health

Occlusal dental decay is still the most widespread disease in the world today. The aim of this in vivo study was to validate two different electronic laser fluorescence medical devices for caries diagnosis (Vistaproof and DIAGNOdent pen) in comparison with the gold standard traditional visit with digital x-ray Bite-Wings and the ICDAS II scores. Three expert clinicians, more than 10 years of experience, performed all visits using all three diagnostic methods. A total of 180 patients were enrolled for the study and data were collected from 2044 teeth. The statistical analysis found significative differences between the ICDAS values and the DIAGNOdent values, and between the ICDAS values and the Vistaproof, while there were no significative statistical differences between DIAGNOdent and Vistaproof values. Vistaproof values demonstrated a tendency to overestimate the presence and extension of carious lesions while DIAGNOdent pen gave a slight underestimation in caries detection. From a general point of view and relatively to ease of use and patient comfort, DIAGNOdent was judged better than Vistaproof. The DIAGNOdent pen cannot be a diagnostic substitute for an expert clinician diagnostic evaluation but can be considered an additional help and a valid device improve traditional visit consistency and accuracy. While both tested devices gave under or overestimated results, both are unable by themselves to determine whether or not treatment is required.