Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

582 questions · 664 findings · 25 reviews · Endodontics and dental trauma

No studies found 111 · 16.7%GRADE not reported 417 · 62.8%Very low 69 · 10.4%Low 50 · 7.5%Moderate 16 · 2.4%High 1 · 0.2%

Restorative materials placed by atraumatic restorative treatment (ART); mostly high-viscosity/conventional GIC, also RMGIC, glass carbomer, compomer, composite resin vs Different ART materials or application techniques (e.g., bilayer vs single-step, with vs without cavity conditioner/disinfectant), or composite resin

Treatment failure (annual failure rate) · Children with carious primary teeth treated by atraumatic restorative treatment (hand-instrument caries removal), no pulp therapy

ART restorations (mainly GIC) had a wide annual failure rate (1.2-37.1%) across 10 RCTs, with technique affecting survival; low to unclear quality of evidence (ungraded).

1 finding from 1 review

High-viscosity glass-ionomer cement (HVGIC) restoration (conventional restorative approach) vs Resin composite restoration

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; composite resin outperformed HVGIC in the review narrative.

1 finding from 1 review

Preformed metal crown (PMC) vs Resin-modified glass-ionomer cement + composite resin (modified open-sandwich restoration)

Treatment failure (annual failure rate) · Children with carious primary molars treated by pulpotomy (vital pulp therapy)

Preformed metal crowns had a low annual failure rate (2.5%) in primary molars after pulpotomy, but the evidence is of low quality (single high-risk-of-bias split-mouth RCT; not GRADE-rated).

2 findings from 1 review

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Pain at two weeks (postobturation) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

Single-visit root canal treatment showed no clear difference in pain at two weeks (postobturation) compared with multiple-visit root canal treatment (two or more visits); GRADE not reported.

1 finding from 1 review

HVGIC with chlorhexidine cavity disinfectant vs HVGIC without cavity disinfectant

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; cavity disinfectant did not affect success in the review narrative.

1 finding from 1 review

Amalgam vs Light-cured compomer (polyacid-modified composite resin)

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; the review described similar clinical performance.

1 finding from 1 review

Compomer (Dyract) vs HVGIC Equia Forte and Chemfil Rock

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; compomer had more favorable retention in the review narrative.

1 finding from 1 review

Bulk-fill composite resin with 7-second dentine etching vs Bulk-fill composite resin with 15-second dentine etching

Treatment failure (annual failure rate) · Children (aged 5-8 years) with Class-II caries in primary molars, no pulp therapy

Etching dentine for 7 s rather than 15 s lowered bulk-fill composite failure (5.8% vs 16.9% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Bio-active restorative materials vs Any conventional restorative material

Treatment failure (planned; no eligible studies) · Children with carious primary teeth after vital or non-vital pulp therapy

No eligible studies were found evaluating bio-active restorative materials for restoring carious primary teeth after pulp therapy.

1 finding from 1 review

Metal-reinforced glass-ionomer cement (MRGIC) restoration vs Conventional GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Metal-reinforced GIC had a high annual failure rate (29.9%) in a single RCT; low quality of evidence (ungraded).

1 finding from 1 review

Resin-modified glass ionomer cement for bonding orthodontic brackets vs Compomer and composite resin

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; failure rates were tabulated by arm.

1 finding from 1 review

Compomer (C) vs Amalgam, RMGIC, HVGIC, composite resin, bulk-fill composite resin, another compomer, or alternative caries management

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Compomer had an annual failure rate of 0-14.7% (7 RCTs), comparable to amalgam/RMGIC/composite and better than high-viscosity GIC; low quality of evidence (ungraded).

1 finding from 1 review

Flowable bulk-fill composite resin vs Light-cured compomer (polyacid-modified composite resin)

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; both arms had 0% failure.

1 finding from 1 review

Conventional GIC vs Amalgam or metal-reinforced GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Conventional GIC had an annual failure rate of 7.6-16.6% (2 RCTs) and failed more than amalgam in one trial; low quality of evidence (ungraded).

1 finding from 1 review

Class-I (single-surface) cavity restoration vs Class-II (proximal/multi-surface) cavity restoration

Treatment failure (annual failure rate) by cavity class · Children with carious primary teeth restored in Class-I versus Class-II cavities, no pulp therapy

Class-II restorations failed more than Class-I (annual failure 5-28.9% vs 1.2-14.7% in ART studies); low quality of evidence (ungraded).

1 finding from 1 review