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Evidence found and GRADE certainty

3,323 questions · 5,762 findings · 263 reviews · Dental caries

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No studies found 321 · 5.6%GRADE not reported 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%

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Visual examination (VE) vs Cavity preparation or biopsy (operative validation)

Diagnostic accuracy for occlusal caries detection at the 1/3 dentin caries detection level (Ekstrand; D0-2 versus D3-4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

In in vivo, visual examination pooled specificity was 0.77 (95% CI 0.67 to 0.85) for occlusal caries at the 1/3 dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (E-speed film) vs Cavity preparation or biopsy (operative validation)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

In in vivo, conventional bitewing radiography (E-speed) pooled diagnostic odds ratio was 127.56 (95% CI 7.38 to 2203.70) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (D-speed film) vs Cavity preparation or biopsy (operative validation)

Diagnostic accuracy for occlusal caries detection at the caries detection level (D0 versus D1-D4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

In in vivo, conventional bitewing radiography (D-speed) pooled sensitivity was 0.65 (95% CI 0.57 to 0.73) for occlusal caries at the caries detection level; ungraded.

4 findings from 1 review
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Cesarean section delivery vs Vaginal delivery

Caries prevalence (early childhood caries) · Toddlers and preschool children, 2 to 6 years of age (primary dentition)

Caesarean section delivery may be associated with a modestly higher prevalence of early childhood caries than vaginal delivery (pooled OR 1.48), but the evidence is inconsistent and of very low certainty.

1 finding from 1 review

Transillumination and optical coherence tomography devices (all illumination devices combined: NIR, OCT, and FOTI/DIFOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Caries severity measurement (mean dmft for primary dentition; mean DMFT for permanent dentition) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Caries experience · Healthy children and adolescents (primary and permanent dentition) in the United Arab Emirates

Caries severity was substantial, with mean dmft 0.75-10.9 (primary dentition) and mean DMFT 1.48-3.19 (permanent dentition), and higher indices in Emirati than non-Emirati children (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Conventional bitewing radiography (E-speed film) vs Cavity preparation or biopsy (operative validation)

Diagnostic accuracy for occlusal caries detection at the caries detection level (D0 versus D1-D4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

In in vivo, conventional bitewing radiography (E-speed) pooled sensitivity was 0.80 (95% CI 0.71 to 0.87) for occlusal caries at the caries detection level; ungraded.

4 findings from 1 review
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Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy (sensitivity/specificity) for enamel caries, not meta-analyzed · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Visual examination (VE) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the 1/3 dentin caries detection level (Ekstrand; D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, visual examination pooled diagnostic odds ratio was 16.6 (95% CI 4.85 to 56.79) for occlusal caries at the 1/3 dentin detection level; ungraded.

4 findings from 1 review
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Cone beam computed tomography (CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
3 findings from 1 review

Digital bitewing radiography, phosphor plate (PSP) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, phosphor-plate digital bitewing radiography had a summary ROC AUC of 0.92 for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

White spot lesions (WSLs), tooth level · Adults undergoing orthodontic treatment

A single study reported a lower risk of white spot lesions (tooth level) with aligners versus fixed appliances in adults at 3 months (RR 0.72, 95% CI 0.60 to 0.86; ungraded).

1 finding from 1 review

0-19 remaining teeth vs 20-32 remaining teeth

Atherosclerotic cardiovascular disease (ACVD)-related events (morbidity and mortality) · Adults (any age) with a known number of remaining teeth, followed prospectively in cohort studies

In prospective cohorts, the crude HR for ACVD-related events in adults with 0-19 teeth vs adults with 20-32 teeth was 2.27 (95% CI 1.50 to 3.43; 1 study, I2 not applicable (single study)); GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

4 findings from 1 review
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Conventional bitewing radiography, F-speed film vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, conventional bitewing radiography (F-speed) pooled specificity was 0.97 (95% CI 0.71 to 0.998) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
    7 studies
    Very low

Conventional bitewing radiography (D-speed film) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, conventional bitewing radiography (D-speed) pooled specificity was 0.73 (95% CI 0.53 to 0.87) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Fibre-optic transillumination (FOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Visual examination (VE) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the caries detection level (D0 versus D1-D4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, visual examination pooled summary ROC AUC was 0.59 for occlusal caries at the caries detection level; ungraded.

4 findings from 1 review
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