Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,556 questions · 10,375 findings · 429 reviews · Oral Health

No studies found 1,344 · 13%GRADE not reported 6,832 · 65.9%Very low 1,228 · 11.8%Low 613 · 5.9%Moderate 290 · 2.8%High 68 · 0.7%

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Visual examination (VE) 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, visual examination had a summary ROC AUC of 0.85 for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
Show 1 more finding

Sealant/coating agent WITHOUT fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Among non-fluoride sealants, WSL initiation was significantly reduced versus no sealant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Fixed bonded Hyrax appliance followed by U-bow activator therapy vs no treatment

Canine expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed bonded Hyrax appliance followed by U-bow activator therapy showed no clear difference in canine expansion compared with no treatment; GRADE not reported.

1 finding from 1 review
  • Orthodontic treatment for posterior crossbites 2021 · Cochrane All outcomes
    12 months after start of treatment
    U-bow activator 3.6 mm vs untreated 1 mm; P<0.001 (no SD reported); significant in favour of treatment
    1 study · 66 participants
    GRADE not reported

Fixed tooth-borne expansion (quad-helix) vs Removable tooth-borne expansion (expansion plate)

Canine expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed tooth-borne expansion (quad-helix) may leads to higher canine expansion (inter-canine distance) compared with removable tooth-borne expansion (expansion plate) (low certainty).

1 finding from 1 review

Quad-helix plus multi-bracket appliance vs Expansion arch plus multi-bracket appliance

Molar expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Quad-helix plus multi-bracket appliance showed no clear difference in molar expansion compared with expansion arch plus multi-bracket appliance; GRADE not reported.

1 finding from 1 review

Intensive periodontal treatment (subgingival SRP with or without other periodontal treatment) vs No treatment (no periodontal treatment)

Adverse events (participants with adverse events or withdrawals due to adverse events) · Adults (any age/sex) with chronic periodontitis (>=5 teeth remaining; PPD >4 mm), with or without hypertension
1 finding from 1 review
  • SoF 1 (Adverse effects): Only 1 study reported that 1 participant in the treatment group experienced a myocardial infarction during the study period. 1 study reported no adverse effects. The remaining 2 studies did not…
    2 studies · 294 participants
    Low

Fixed tooth-borne expansion (quad-helix) vs Removable tooth-borne expansion (expansion plate)

Length of treatment · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed tooth-borne expansion (quad-helix) probably leads to lower length of treatment compared with removable tooth-borne expansion (expansion plate) (moderate certainty).

1 finding from 1 review

Mineral trioxide aggregate (MTA) vs Intermediate restorative material (IRM)

Success rate at 1 year · Patients needing retrograde filling in root canal therapy (orthograde root canal filling or retreatment not possible; periapical surgery…

It is very uncertain whether mineral trioxide aggregate (MTA) changes success rate at 1 year compared with intermediate restorative material (IRM) (very low certainty).

1 finding from 1 review

Other visual classification systems (unspecified or unique systems, e.g. Nyvad, Downer, Lussi, UniViSS) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection of 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

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Probing pocket depth (PPD/PD) · Adults undergoing orthodontic treatment

Aligners may reduce pocket depth compared with fixed appliances in adults at 6-12 weeks (MD -0.42 mm, 95% CI -0.71 to -0.12; very low certainty).

1 finding from 1 review

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

Detection rate of oral pre-malignant and malignant lesions after referral (COE+vital rinsing vs COE alone) · Oral cavity cancer or potentially malignant disorder symptom-free individuals with tobacco habits

COE with vital rinsing (toluidine blue/tolonium chloride) showed no clear difference in detection rate of oral pre-malignant and malignant lesions after… compared with conventional oral examination (COE) alone (moderate certainty).

1 finding from 1 review

Fixed tooth-borne expansion (quad-helix) vs Removable tooth-borne expansion (expansion plate)

Stability of crossbite correction (relapse of molar expansion) · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…
1 finding from 1 review
  • Orthodontic treatment for posterior crossbites 2021 · Cochrane All outcomes
    12 months after correction
    Relapse occurred in 9.1% of both quad-helix and expansion plate groups after one year of follow-up (Godoy 2011)
    1 study · 66 participants
    GRADE not reported

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

Specificity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

White spot lesions (WSLs), patient level · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in white spot lesion formation (patient level) between aligners and fixed appliances in adolescents at 9 months (RR 0.33, 95% CI 0.10 to 1.04; ungraded).

1 finding from 1 review

Gingivitis (assessed by gingival index or WHO criteria) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Gingival health at 6 months · Children and adolescents in the United Arab Emirates (Sharjah)

Gingivitis and high plaque levels were common among UAE children and adolescents, more likely in females and older children (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Inflammatory bowel disease (IBD) vs Healthy controls without IBD

DMFT/DMFS index (dental caries experience) · Patients with IBD (Crohn's disease and ulcerative colitis) and controls without IBD

Most included studies reported higher dental caries indices (DMF-t/DMF-s) in IBD patients (especially ulcerative colitis), but findings were inconsistent across studies and were not meta-analyzed or GRADE-rated.

1 finding from 1 review
  • Oral Health Status in Patients with Inflammatory Bowel Diseases: A Systematic Review. 2021 All outcomes
    Hospital/clinic-based case-control and cross-sectional studies in 11 countries; 15 studies total (1748 participants: 1104 Crohn's disease, 534 ulcerative colitis, 110 IBD-form unspecified)
    Not meta-analyzed (heterogeneity of caries indices). Abstract: "in most studies, patients with IBD were characterized by higher values of caries indices." Table 3 examples (IBD/subtype vs control): Zhang 2020 DMF-t…
    Studies not reported
    GRADE not reported

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Overall survival, post-surgery chemotherapy vs surgery alone (no radiotherapy) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Surgery +/- radiotherapy + (adjuvant) chemotherapy showed no clear difference in overall survival, adjuvant chemotherapy vs observation alone… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

1 finding from 1 review