Diagnostic accuracy of quantitative light-induced fluorescence in detecting caries of various types and locations: a systematic review and meta-analysis

Abstract

This systematic review and meta-analysis aimed to assess the diagnostic accuracy of quantitative light-induced fluorescence (QLF) in detecting dental caries of varying lesion severities, surfaces, and dentition types, across both in vitro and in vivo studies. Data extracted included study characteristics, diagnostic outcomes (sensitivity, specificity, AUC), caries types, lesion thresholds (ICDAS), and QLF parameters (ΔF, ΔR). Enamel lesions were stratified into incipient (ICDAS 1–2) and advanced stages (ICDAS 3), with dentin caries defined as ICDAS 4 or greater. A comprehensive search of Ovid MEDLINE and EMBASE was conducted up to May 2023, without language restrictions. Manual reference screening was performed to identify additional relevant studies. Seventeen studies met the eligibility criteria, which included evaluating QLF against reference standards (ICDAS, radiography, histology) and reporting diagnostic measures. Risk of bias was assessed using QUADAS-2. Meta-analysis included studies with extractable or inferable 2 × 2 contingency data. QLF demonstrated excellent diagnostic accuracy in distinguishing sound surfaces from enamel and dentin lesions, with in vivo Area Under the Curve (AUC) values for incipient occlusal lesions ranging from 0.94 to 0.98. The technology showed high pooled sensitivity and specificity for both occlusal (in vivo: 0.86/0.82) and approximal caries (in vivo: 0.74/0.82), confirming its effectiveness for early-stage detection.