Diagnostic accuracy of QrayPen fluorescence scoring for secondary caries in repair-/replacement-indicated posterior composite restorations
Clinical Oral Investigations, cilt.30, sa.8, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 8
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00784-026-07038-9
- Dergi Adı: Clinical Oral Investigations
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Composite restoration, Diagnostic accuracy, QrayPen, Quantitative light-induced fluorescence, Secondary caries
- Marmara Üniversitesi Adresli: Evet
Özet
Objectives: To evaluate the adjunctive diagnostic performance of QrayPen C fluorescence-image severity scoring (QS) for identifying same-site secondary caries in posterior composite restorations already selected for repair or replacement. Materials and methods: In this single-centre prospectively conducted observational diagnostic-accuracy study, 102 patients were assessed; 14 declined participation and 5 were excluded because of non-interpretable QLF/clinical images. The final analysis included 83 adults and 120 repair-/replacement-indicated posterior composite restorations. Restorations were assessed using Nyvad criteria, bitewing ICCMS scoring, and QrayPen C imaging. QS was scored on a 0–3 scale and analysed at thresholds > 0, >1, and > 2. The reference standard was same-site dentin status after removal. Results: Secondary caries was confirmed in 80/120 restorations (66.7%). For QS > 0, sensitivity was 85.0%, specificity 90.0%, accuracy 86.7%, LR + 8.50, and LR- 0.17. Patient-level clustered bootstrap analysis gave similar but wider estimates: sensitivity 85.0% (clustered 95% CI 75.9–92.8) and specificity 90.0% (clustered 95% CI 80.0-97.7). Higher QS thresholds increased specificity but reduced sensitivity. Conclusions: In repair-/replacement-indicated restorations, QS > 0 may help localize suspicious areas and increase diagnostic confidence for same-site secondary caries, but the estimates apply to an enriched clinically problematic cohort. Clinical relevance: QrayPen QS should be interpreted as an adjunctive imaging-derived signal. QS positivity should not justify replacement in isolation, and QS = 0 should not be interpreted as evidence of sound dentin.