Fluorescence-aided caries excavation in minimally invasive dentistry: a scoping review

The aim of this scoping review was to systematically map the available evidence on fluorescence-aided caries excavation (FACE) and related fluorescence-based technologies used to guide dentin caries removal in operative dentistry.

A comprehensive literature search was conducted in PubMed/MEDLINE, Embase, CINAHL, LIVIVO, the Cochrane Library, Web of Science Core Collection, and BIOSIS Citation Index for studies published between January 1, 2000 and June 1, 2026.

Studies investigating fluorescence-based technologies used intraoperatively to guide dentin caries excavation were included. In vitro, ex vivo, and clinical studies were considered eligible. Studies focusing exclusively on fluorescence-based caries detection without an excavation component were excluded. Two reviewers independently screened titles, abstracts, and full texts according to predefined eligibility criteria.

A total of 16 studies were included, predominantly laboratory-based (12 in vitro, 1 ex vivo), with only three clinical studies. Across the included studies, fluorescence-guided excavation generally demonstrated enhanced selectivity, enabling preservation of less mineralized dentin while maintaining effective removal of bacterially infected tissue, although these advantages were not observed uniformly across all studies. Microbiological analyses showed reduced residual bacterial contamination following FACE compared with conventional excavation and dye-assisted methods. In addition, fluorescence signals were found to correlate with bacterial presence and diversity, supporting their biological relevance. Clinical studies indicated improved intraoperative detection of residual caries and provided biologically relevant information on bacterial contamination. However, the evidence base was heterogeneous and primarily focused on surrogate outcomes, with limited data on long-term clinical performance.

Fluorescence-guided caries excavation represents a promising adjunctive approach that provides qualitative intraoperative visualization of fluorescence characteristics associated with bacterial contamination, rather than a validated quantitative threshold for tissue removal. While the available evidence suggests improved excavation selectivity and microbiological outcomes, robust clinical data remain limited. Further well-designed clinical studies are required to determine the impact of FACE on patient-centered outcomes and its role in routine operative dentistry.

Fluorescence-guided technologies may assist clinicians in identifying bacterially infected dentin during cavity preparation and facilitate selective caries removal, potentially improving intraoperative decision-making.