Effect of mechanical polishing and 35% hydrogen peroxide application on DIAGNOdent measurements in stained occlusal fissures: A randomized split-mouth clinical study

Abstract

Background DIAGNOdent laser fluorescence measurements may be confounded by extrinsic staining in occlusal fissures, and the effect of common surface-preparation protocols on these readings remains unclear. The aim of this study was to compare the effects of mechanical polishing and 35% hydrogen peroxide application on DIAGNOdent Pen measurements in stained occlusal fissures. Methods In this randomized split-mouth clinical study, 126 posterior teeth from 24 participants were evaluated. Opposing jaws received either mechanical polishing with a fluoride-free prophylaxis paste for 30 s or 35% hydrogen peroxide gel for 15 min. DIAGNOdent scores were recorded at baseline, after air–water spray cleaning and drying, and after the assigned procedure. Digital bite-wing radiographs obtained at baseline as a complementary diagnostic assessment. Data were analyzed using linear mixed-effects models and Wilcoxon signed-rank tests. Results Air–water spray cleaning and drying did not significantly change DIAGNOdent values in either group (bleaching: p = 0.355; polishing: p = 0.516). Post-procedure scores increased significantly after bleaching (p = 0.023) and polishing (p < 0.001). The mean score change was significantly greater after polishing than bleaching (18.4 ± 26.0 vs. 4.6 ± 19.3; p < 0.001).Conclusions Surface-preparation protocols significantly influence DIAGNOdent readings in stained occlusal fissures. Post-polishing readings should be interpreted with caution due to potential paste retention and measurement artifacts, whereas 35% hydrogen peroxide application induces a more limited change without mechanical surface alteration. Standardized surface-preparation protocols and interpretation alongside clinical and radiographic findings are recommended.