Diagnostic Performance of QrayCam Pro Fluorescence Imaging with Full-Arch versus Quadrant Field-of-View for Dental Caries

Objectives: To compare the diagnostic performance of quadrant-focused (half-jaw) versus full-arch QLF imaging with QrayCam Pro for occlusal caries detection against a combined ICDAS+bitewing reference.Materials and Methods: Forty-five adults (mean age 25.1 years) each contributed one occlusal surface (sound or carious). Each surface was imaged under two protocols: quadrant-focused and full-arch. Q-ray Clinical software yielded ΔF_max (green fluorescence loss), ΔR_max (red fluorescence change), and QS scores. Diagnostic accuracy (sensitivity, specificity, area under the ROC curve [AUC]) was calculated versus the reference standard; protocol differences were assessed with MANOVA.Results: Both protocols showed high performance. For ΔR_max, both achieved AUC = 1.000 with 100% sensitivity and specificity. For ΔF_max, quadrant imaging achieved AUC = 1.000; full-arch had AUC = 0.993 (sensitivity 92.3%, specificity 94.7%). MANOVA found no significant overall difference between protocols (p = 0.790). Quadrant imaging tended to identify early enamel lesions more often.Conclusions: Quadrant-focused QLF imaging offers a small sensitivity advantage for incipient lesions while maintaining high specificity; full-arch imaging remains efficient for screening and documentation. Protocol choice can be tailored to early-lesion detection needs and AI-based analysis workflows.