Standardized DIAGNOdent Protocol for Early Caries Detection: Technical Description and Clinical Implementation.

Objective: This technical note aims to describe and validate a standardized clinical protocol for using the DIAGNOdent laser fluorescence device to detect and quantify early caries lesions, facilitating consistent decisionmaking in minimally invasive dentistry. Methods: A detailed, step-by-step protocol is presented, encompassing device calibration, systematic surface preparation (cleaning and drying), zero baseline measurement on sound enamel, and sequential examination of tooth surfaces. The interpretation of numerical scores follows manufacturer-recommended thresholds to guide clinical management. The practical application and added diagnostic value of this protocol are demonstrated through three clinical cases. Results: Application of the standardized protocol in clinical practice enabled the detection and quantification of early demineralization, with device scores ranging from 13 to 24. These lesions, some not yet visible on radiographs or classified as early-stage (ICDAS 1), were managed with non-operative interventions. The protocol provided objective, quantitative data that directly informed therapeutic decisions, leading to treatments such as intensive fluoride prophylaxis, fissure sealing, and resin infiltration, thereby avoiding unnecessary restorative procedures. Conclusion: The implementation of a standardized DIAGNOdent protocol provides a reliable, reproducible, and quantitative method for the early detection of caries. Its ability to objectify the diagnosis of precavitated lesions makes it a valuable tool for adhering to the principles of minimally invasive dentistry, allowing for interventions that preserve tooth structure.