{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:24:58Z","timestamp":1792171498133,"version":"4.4.0"},"reference-count":60,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007397","name":"Charles University","doi-asserted-by":"publisher","award":["GA UK No. 52220"],"award-info":[{"award-number":["GA UK No. 52220"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007397","name":"Charles University","doi-asserted-by":"publisher","award":["Cooperatio 207030 Dental Medicine\/LF1"],"award-info":[{"award-number":["Cooperatio 207030 Dental Medicine\/LF1"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>This in vitro study aimed to compare outcomes of dental caries detection using visual inspection classified according to the International Caries Detection and Assessment System (ICDAS) with objective assessments using a well-established laser fluorescence system (Diagnodent pen) and a novel diffuse reflectance spectroscopy (DRS) device. One hundred extracted permanent premolars and molars were utilized, including sound teeth, teeth with non-cavitated caries, or teeth with small cavitated lesions. A total of 300 regions of interest (ROIs) were assessed using each detection method. Visual inspection, being a subjective method, was performed by two independent examiners. The presence and extent of caries were histologically verified according to Downer\u2019s criteria, serving as a reference for other detection methods. Histological results revealed 180 sound ROIs and 120 carious ROIs, categorized into three different extents of caries. Overall, there was no significant difference between the detection methods in sensitivity (0.90\u20130.93) and false negative rate (0.05\u20130.07). However, DRS exhibited superior performance in specificity (0.98), accuracy (0.95), and false positive rate (0.04) compared to other detection methods. Although the tested DRS prototype device exhibited limited penetration depth, it shows promise as a method, particularly for the detection of incipient caries.<\/jats:p>","DOI":"10.3390\/diagnostics13111878","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:16:04Z","timestamp":1685204164000},"page":"1878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diffuse Reflectance Spectroscopy as a Novel Method of Caries Detection\u2014An In Vitro Comparative Study in Permanent Teeth"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3361-7165","authenticated-orcid":false,"given":"Jindrich","family":"Charvat","sequence":"first","affiliation":[{"name":"Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-1738","authenticated-orcid":false,"given":"Ales","family":"Prochazka","sequence":"additional","affiliation":[{"name":"Department of Computing and Control Engineering, University of Chemistry and Technology in Prague, 166 28 Prague, Czech Republic"},{"name":"Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, 166 36 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Kucera","sequence":"additional","affiliation":[{"name":"Institute of Histology and Embryology, First Faculty of Medicine, Charles University in Prague, 128 01 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-9992","authenticated-orcid":false,"given":"Antonin","family":"Tichy","sequence":"additional","affiliation":[{"name":"Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maksim","family":"Yurchenko","sequence":"additional","affiliation":[{"name":"Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Himmlova","sequence":"additional","affiliation":[{"name":"Institute of Dental Medicine, First Faculty of Medicine of the Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Marinho, V.C., Chong, L.-Y., Worthington, H.V., and Walsh, T. (2016). Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst. Rev., CD002284.","DOI":"10.1002\/14651858.CD002284.pub2"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.cden.2017.11.003","article-title":"Fluorides and Other Preventive Strategies for Tooth Decay","volume":"62","author":"Horst","year":"2018","journal-title":"Dent. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s10103-020-03021-2","article-title":"Clinical performance of clinical-visual examination, digital bitewing radiography, laser fluorescence, and near-infrared light transillumination for detection of non-cavitated proximal enamel and dentin caries","volume":"35","author":"Kocak","year":"2020","journal-title":"Lasers Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1177\/0022034515586763","article-title":"Visual Inspection for Caries Detection: A systematic review and meta-analysis","volume":"94","author":"Gimenez","year":"2015","journal-title":"J. Dent. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5005\/jp-journals-10005-1089","article-title":"International Caries Detection and Assessment System (ICDAS): A New Concept","volume":"4","author":"Gugnani","year":"2011","journal-title":"Int. J. Clin. Pediatr. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.17096\/jiufd.38691","article-title":"ICDAS II criteria (international caries detection and assessment system)","volume":"49","author":"Dikmen","year":"2015","journal-title":"J. Istanb. Univ. Fac. Dent."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1159\/000486429","article-title":"The International Caries Detection and Assessment System\u2014ICDAS: A Systematic Review","volume":"52","author":"Ekstrand","year":"2018","journal-title":"Caries Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2761","DOI":"10.1007\/s00784-017-2078-2","article-title":"Radiographic diagnosis of proximal caries\u2014Influence of experience and gender of the dental staff","volume":"21","author":"Geibel","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/ipd.12463","article-title":"Do undergraduate dental students perform well detecting and staging caries and assessing activity by visual examination? A systematic review and meta-analysis","volume":"29","author":"Turchiello","year":"2019","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"358","DOI":"10.3897\/folmed.62.e47534","article-title":"In Vitro Comparison of Several Methods for Initial Proximal Caries Detection","volume":"62","author":"Todorova","year":"2020","journal-title":"Folia Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jdent.2006.06.001","article-title":"Caries detection and diagnosis: Novel technologies","volume":"34","author":"Pretty","year":"2006","journal-title":"J. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"315","DOI":"10.2334\/josnusd.16-0595","article-title":"Alternative methods to visual and radiographic examinations for approximal caries detection","volume":"59","author":"Abogazalah","year":"2017","journal-title":"J. Oral Sci."},{"key":"ref_13","first-page":"533","article-title":"Comparative evaluation of the effectiveness of five methods for early diagnosis of occlusal caries lesions\u2014In vitro study","volume":"20","author":"Anastasova","year":"2014","journal-title":"J. IMAB\u2014Annu. Proceeding Sci. Pap."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"468","DOI":"10.17219\/dmp\/64382","article-title":"Comparison of the detection of proximal caries in children and youth using DIAGNOcam and bitewing radiovisiography","volume":"53","author":"Blazejewska","year":"2016","journal-title":"Dent. Med. Probl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.4103\/njcp.njcp_237_19","article-title":"Accuracy of the DIAGNOcam and bitewing radiographs in the diagnosis of cavitated proximal carious lesions in primary molars","volume":"22","author":"Alamoudi","year":"2019","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_16","first-page":"445","article-title":"An in vitro evaluation of the effect of sealant characteristics on laser fluorescence for caries detection","volume":"28","author":"Gostanian","year":"2006","journal-title":"Pediatr. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1159\/000262404","article-title":"Reproducibility and Accuracy of Three Methods for Assessment of Demineralization Depth on the Occlusal Surface: An in vitro Examination","volume":"31","author":"Ekstrand","year":"1997","journal-title":"Caries Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/j.1875-595X.1997.tb00786.x","article-title":"Hidden caries: What is it? Does it exist? Does it matter?","volume":"47","author":"Ricketts","year":"1997","journal-title":"Int. Dent. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1089\/10445470152612008","article-title":"Detection of Occlusal Caries under Sealants by Use of a Laser Fluorescence System","volume":"19","author":"Takamori","year":"2001","journal-title":"J. Clin. Laser Med. Surg."},{"key":"ref_20","first-page":"127","article-title":"Clinical evaluation of visual, radiographic, and laser fluorescence methods for detection of occlusal caries","volume":"69","author":"Weerheijm","year":"2002","journal-title":"ASDC J. Dent. Child."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1159\/000068227","article-title":"Clinical Study of the Use of the Laser Fluorescence Device DIAGNOdent for Detection of Occlusal Caries in Children","volume":"37","author":"Anttonen","year":"2003","journal-title":"Caries Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.jdent.2005.11.002","article-title":"Performance of a new laser fluorescence device for the detection of occlusal caries in vitro","volume":"34","author":"Lussi","year":"2006","journal-title":"J. Dent."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1159\/000148162","article-title":"Performance of Fluorescence Methods, Radiographic Examination and ICDAS II on Occlusal Surfaces in vitro","volume":"42","author":"Rodrigues","year":"2008","journal-title":"Caries Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s10103-007-0486-2","article-title":"In vivo comparison of laser fluorescence measurements with conventional methods for occlusal caries detection","volume":"23","author":"Alkurt","year":"2007","journal-title":"Lasers Med. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1159\/000501257","article-title":"Occlusal Caries Detection and Diagnosis Using Visual ICDAS Criteria, Laser Fluorescence Measurements, and Near-Infrared Light Transillumination Images","volume":"29","author":"Tassoker","year":"2020","journal-title":"Med. Princ. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4103\/0970-4388.55333","article-title":"An in-vitro comparison of visual inspection, bite-wing radiography, and laser fluorescence methods for the diagnosis of occlusal caries","volume":"27","author":"Pourhashemi","year":"2009","journal-title":"J. Indian Soc. Pedod. Prev. Dent."},{"key":"ref_27","first-page":"159","article-title":"Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods","volume":"4","author":"Nokhbatolfoghahaie","year":"2013","journal-title":"J. Lasers Med. Sci."},{"key":"ref_28","first-page":"99","article-title":"In vivo and in vitro comparison of ICDAS II, DIAGNOdent pen, CarieScan PRO and SoproLife camera for occlusal caries detection in primary molar teeth","volume":"18","author":"Kockanat","year":"2017","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/eos.12257","article-title":"Validation of DIAGNOdent laser fluorescence and the International Caries Detection and Assessment System (ICDAS) in diagnosis of occlusal caries in permanent teeth: An in vivo study","volume":"124","author":"Castilho","year":"2016","journal-title":"Eur. J. Oral Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1366\/0003702001950409","article-title":"Caries Detection by Diode Laser Raman Spectroscopy","volume":"54","author":"Hill","year":"2000","journal-title":"Appl. Spectrosc."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Samek, O., Telle, H.H., and Beddows, D.C. (2001). Laser-induced breakdown spectroscopy: A tool for real-time, in vitro and in vivo identification of carious teeth. BMC Oral Health, 1.","DOI":"10.1186\/1472-6831-1-1"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/154405910408301s16","article-title":"DIAGNOdent: An Optical Method for Caries Detection","volume":"83","author":"Lussi","year":"2004","journal-title":"J. Dent. Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Izawa, T., and Wakaki, M. (2005, January 22\u201327). Application of Laser Raman Spectroscopy to Dental Diagnosis. Proceedings of the SPIE BiOS, San Jose, CA, USA.","DOI":"10.1117\/12.590211"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Liu, L., Tang, J., and Li, S.Z. (2009, January 17\u201319). A new method for caries diagnosis by characteristic spectrum. Proceedings of the 2009 2nd Inter-national Conference on Biomedical Engineering and Informatics, Tianjin, China.","DOI":"10.1109\/BMEI.2009.5305603"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"161090","DOI":"10.1155\/2013\/161090","article-title":"Spectroscopic Detection of Caries Lesions","volume":"2013","author":"Ruohonen","year":"2013","journal-title":"J. Med. Eng."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"7081","DOI":"10.1007\/s00521-021-06842-6","article-title":"Incremental deep learning for reflectivity data recognition in stomatology","volume":"34","author":"Mandic","year":"2022","journal-title":"Neural Comput. Appl."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s11760-020-01640-4","article-title":"Diffuse reflectance spectroscopy in dental caries detection and classification","volume":"14","year":"2020","journal-title":"Signal Image Video Process."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1364\/AO.47.000825","article-title":"Autofluorescence and diffuse reflectance spectroscopy of oral epithelial tissue using a depth-sensitive fiber-optic probe","volume":"47","author":"Schwarz","year":"2008","journal-title":"Appl. Opt."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1159\/000068226","article-title":"Performance of Conventional and New Methods for the Detection of Occlusal Caries in Deciduous Teeth","volume":"37","author":"Lussi","year":"2003","journal-title":"Caries Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1007\/s10103-019-02762-z","article-title":"Diagnostic validity of the use of ICDAS II and DIAGNOdent pen verified by micro-computed tomography for the detection of occlusal caries lesions\u2014An in vitro evaluation","volume":"34","author":"Obidzinska","year":"2019","journal-title":"Lasers Med. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1078\/1615-1615-00024","article-title":"Detection of Occlusal Caries by Laser Fluorescence: Basic and Clinical Investigations","volume":"16","author":"Hibst","year":"2001","journal-title":"Med. Laser Appl."},{"key":"ref_42","unstructured":"Fri\u010dl, M. (2020). Analysis of Spectroscopic Images of Hard Dental Tissues, University of Chemistry and Technology."},{"key":"ref_43","unstructured":"Martynek, D. (2022). Diffuse Reflectance Spectroscopy in Dental Tissue Analysis, University of Chemistry and Technology."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1159\/000260160","article-title":"Concurrent Validity of an Epidemiological Diagnostic System for Caries with the Histological Appearance of Extracted Teeth as Validating Criterion","volume":"9","author":"Downer","year":"1975","journal-title":"Caries Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1038\/sj.bdj.4800998a","article-title":"Occlusal caries detection in primary teeth: A comparison of DIAGNOdent with conventional methods","volume":"190","author":"Attrill","year":"2001","journal-title":"Br. Dent. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/ipd.12478","article-title":"In vivo validity of proximal caries detection in primary teeth, with histological validation","volume":"29","author":"Subka","year":"2019","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/j.jdent.2008.08.013","article-title":"Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars","volume":"36","author":"Huth","year":"2008","journal-title":"J. Dent."},{"key":"ref_48","first-page":"238","article-title":"Influence of examiner\u2019s clinical experience in detecting occlusal caries lesions in primary teeth","volume":"27","author":"Bengtson","year":"2005","journal-title":"Pediatr. Dent."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jdent.2005.04.002","article-title":"Performance of methods of occlusal caries detection in permanent teeth under clinical and laboratory conditions","volume":"34","author":"Reis","year":"2006","journal-title":"J. Dent."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1159\/000113160","article-title":"Reproducibility and Accuracy of the ICDAS-II for Detection of Occlusal Caries in vitro","volume":"42","author":"Stachniss","year":"2008","journal-title":"Caries Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.jdent.2010.07.005","article-title":"Diagnostic performance of the visual caries classification system ICDAS II versus radiography and micro-computed tomography for proximal caries detection: An in vitro study","volume":"38","author":"Mitropoulos","year":"2010","journal-title":"J. Dent."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jdent.2011.09.002","article-title":"Validity of MicroCT for in vitro detection of proximal carious lesions in primary molars","volume":"40","author":"Soviero","year":"2012","journal-title":"J. Dent."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1002\/j.0022-0337.2001.65.10.tb03470.x","article-title":"Systematic Reviews of Selected Dental Caries Diagnostic and Management Methods","volume":"65","author":"Bader","year":"2001","journal-title":"J. Dent. Educ."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1159\/000516084","article-title":"Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis","volume":"55","author":"Foros","year":"2021","journal-title":"Caries Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.14219\/jada.archive.2004.0051","article-title":"A systematic review of the performance of a laser fluorescence device for detecting caries","volume":"135","author":"Bader","year":"2004","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_56","unstructured":"Walsh, L.J. (2018). Dental Caries, InTech Open."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"150","DOI":"10.2341\/10-179-L","article-title":"The Effect of Distance and Tooth Structure on Laser Fluorescence Caries Detection","volume":"37","author":"Markowitz","year":"2012","journal-title":"Oper. Dent."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4684","DOI":"10.1364\/BOE.10.004684","article-title":"Approach to optimize 3-dimensional brain functional activation image with high resolution: A study on functional near-infrared spectroscopy","volume":"10","author":"Shoaib","year":"2019","journal-title":"Biomed. Opt. Express"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1255\/jnirs.351","article-title":"Investigation on deep layer meas-urements in the cerebral cortex within the adult head by near infrared spectroscopy using an absorbance difference technique","volume":"11","author":"Ohnishi","year":"2003","journal-title":"J. Near Infrared Spectrosc."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Si, W., Xiong, J., Huang, Y., Jiang, X., and Hu, D. (2022). Quality Assessment of Fruits and Vegetables Based on Spatially Resolved Spectroscopy: A Review. Foods, 11.","DOI":"10.3390\/foods11091198"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/11\/1878\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:43:28Z","timestamp":1760125408000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/11\/1878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,27]]},"references-count":60,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["diagnostics13111878"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13111878","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,27]]}}}