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What do systematic reviews say?

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Evidence found and GRADE certainty

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

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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Pulpotomy (full or partial) vs None (single-arm pooled success proportion)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with symptomatic irreversible pulpitis due to carious pulp exposure

In symptomatic irreversible pulpitis, pooled pulpotomy success was 84% (95% CI 72-92%); not significantly different from asymptomatic (z=-1.34, p=0.18); ungraded.

1 finding from 1 review

Enamel caries in primary dentition (at 5 years) vs Caries-free primary dentition

Dentinal caries in permanent (newly erupted) teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Enamel caries in the primary dentition is associated with about 1.6 times higher odds of dentinal caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs74470773 (3:33958083; nearest gene(s) PDCD6IP) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs74470773 near PDCD6IP showed suggestive (not genome-wide significant) association with ECC (Z = -4.589, p = 4.46e-6); genetic association, ungraded.

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Caries experience · Children and adolescents (<18 years) living with HIV (CLWH)

ART was not associated with a significant difference in dental caries experience among CLWH (very low certainty).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Persistent parotid enlargement prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in persistent parotid enlargement between ART regimens (very low certainty).

1 finding from 1 review

Sugary drinks/sweets consumption vs Children without dental caries

Dental caries (association with sugary drinks/sweets consumption) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Sugary drinks/sweets consumption was associated with about twice the odds of dental caries in LMIC children (OR 2.04, 95% CI 1.59 to 2.60; 7 studies; not GRADE-rated).

1 finding from 1 review

Amalgam vs Preformed metal crown (PMC)

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 (2.4%) in primary molars after pulpotomy, lower than amalgam in the same trial (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

HVGIC bilayer insertion and surface coating protocols vs Alternative HVGIC insertion and surface coating protocols

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; bilayer placement and nanofilled coating were described as improving survival.

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Dental caries (by severity) · Children or adolescents

One study reported higher median caries severity among CLWH under 12 years; no meta-analytic estimate was pooled.

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)

Restorative index (RI = f/[d+f]) in the primary dentition · Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable children without CL/P

The restorative index tended to be lower in children with CL/P (3 of 5 studies), indicating a lower proportion of restoratively managed carious teeth; not pooled (narrative; ungraded).

1 finding from 1 review
  • Caries in children with and without orofacial clefting: A systematic review and meta-analysis. 2022 All outcomes
    Children with CL/P and comparable non-CL/P children across 12 countries (India, Brazil, China, Sweden, UK, USA, Germany, Greece, Ireland, Netherlands, Jordan, Thailand); studies published 1989-2021
    Of the five studies for which the RI could be calculated, three of them (Dahllof 1989; Nagappan 2019; Veiga 2016) showed a lower RI for children with CL/P compared to children with no CL/P demonstrating a lower…
    5 studies
    GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulpal disease (signs/symptoms of pulp necrosis) · Children with dentine caries in primary and permanent teeth

The reported estimate did not show a clear difference in pulpal disease after partial versus complete caries removal (ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of CDH17 (chr8q22.1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of CDH17 was significantly associated with ECC in the TWAS (p = 3.32e-8); genetic association, ungraded.

1 finding from 1 review

Oral cytology (e.g. OralCDx brush biopsy, CytID) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

Outcome not reported · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance programme, or screened…

The review found no eligible studies for this question.

1 finding from 1 review