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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
515 questions in 19 reviews · cluster CL0076
current versionsNo studies 19 · 3.7%Ungraded 449 · 87.2%Very low 17 · 3.3%Low 23 · 4.5%Moderate 7 · 1.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Intervention categories, outcome domains and clusters are a proposed key pending human validation. Clear all filters
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fluorescence-based devices vs Visual classification Difference in sensitivity · Children or adults asymptomatic or suspected of enamel caries; extracted teeth · Analysis 1: fully within-person comparison Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2021) | Difference in sensitivity -0.11 [-0.25, 0.03] | 19 studies · 2849 participants | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Diagnostic accuracy on surfaces with pit and fissure sealants · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Pit and fissure sealants Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Pre-specified heterogeneity investigation of surfaces with pit and fissure sealants: no study reported the inclusion of sealants that would allow evaluation of early caries lesions. | 0 studies | No studies |
Visual examination (VE) vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | AUC 0.53 | 2 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or 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… · Up to 3 months between index test and reference standard (in vivo studies), Setting: in vivo / clinical (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.56 [0.43, 0.69] | 17 studies | Ungraded |
Analogue (conventional) radiographs vs Digital radiographs (direct within-person / paired comparison); 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… · Up to 3 months between index test and reference standard (in vivo studies), Analogue Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.41 [0.30, 0.53] | 15 studies | Ungraded |
Conventional bitewing radiography, D-speed film 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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.17 [0.07, 0.40] | 1 study | Ungraded |
Near-infrared (NIR) transillumination vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography) Specificity for detection of enamel/early caries · Children or adults presenting asymptomatically or suspected of having enamel caries (clinical/in vivo studies);… · Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately) Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries (2021) · Cochrane | Specificity 0.86 [0.80, 0.91] | 5 studies | Ungraded |
Digital radiographs vs Reference standard (histology, excavation, or enhanced visual examination) Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Specificity 0.87 [0.82, 0.91] | 40 studies | Ungraded |
Fibre-optic transillumination (FOTI) 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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | AUC 0.92 | 1 study | Ungraded |
Conventional bitewing radiography (D-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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | AUC 0.77 | 2 studies | Ungraded |
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… · Up to 3 months between index test and reference standard (in vivo studies), Occlusal surfaces (CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.76 [0.55, 0.89] | NR | Ungraded |
Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 5.34 [2.55, 11.17] | 8 studies | Ungraded |
Conventional bitewing radiography, F-speed film 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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Specificity 0.92 [0.86, 0.96] | 3 studies | Ungraded |
Digital bitewing radiography, phosphor plate (PSP) vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Specificity 0.89 [0.83, 0.93] | 11 studies | Ungraded |
Conventional bitewing radiography, E-speed film 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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.67 [0.19, 0.95] | 5 studies | Ungraded |
Digital bitewing radiography, sensor-based (CCD/CMOS) vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | AUC 0.89 | 1 study | Ungraded |
Visual classification: ERK (Ekstrand-Ricketts-Kidd system) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation) Specificity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies) Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Specificity 0.72 [0.61, 0.81] | 15 studies | Ungraded |
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) Sensitivity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), Permanent dentition Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Sensitivity 0.85 [0.77, 0.90] | NR | Ungraded |
Visual examination (VE) 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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | Sensitivity 0.70 [0.59, 0.80] | 2 studies | Ungraded |
COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Conventional oral examination (COE) alone Outcome NR · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | No eligible studies; planned comparative analysis (COE vs COE with light-based detection) not populated in this version. | 0 studies | No studies |
Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.43 [0.31, 0.57] | 8 studies | Ungraded |
Conventional bitewing radiography, D-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | AUC 0.55 | 2 studies | Ungraded |
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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.86 [0.03, 0.99] | 2 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Analogue and digital combined (non-CBCT); 97 datasets Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Specificity 0.89 [0.86, 0.92] | NR | Ungraded |
Visual examination (VE) 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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | AUC 0.79 | 8 studies | Ungraded |
Optical coherence tomography (OCT) vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography) Sensitivity for detection of enamel/early caries · Children or adults presenting asymptomatically or suspected of having enamel caries (clinical/in vivo studies);… · Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately) Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries (2021) · Cochrane | Sensitivity 0.94 [0.88, 0.97] | 10 studies | Ungraded |
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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | DOR 5.55 [1.88, 16.38] | 3 studies | Ungraded |
Conventional bitewing radiography, D-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.19 [0.13, 0.28] | 2 studies | Ungraded |
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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | AUC 0.90 | 2 studies | Ungraded |
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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 26.06 [7.29, 93.21] | 2 studies | Ungraded |
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) Specificity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), Approximal surface Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Specificity 0.83 [0.74, 0.89] | NR | Ungraded |
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 on surfaces with pit and fissure sealants · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), Pit and fissure sealants Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Pre-specified heterogeneity investigation of surfaces with previously applied pit and fissure sealants: no studies reported the inclusion of sealants. | 0 studies | No studies |
Digital bitewing radiography, sensor-based (CCD/CMOS) vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 24.4 [0.44, 1359.98] | 1 study | Ungraded |
Digital bitewing radiography, sensor-based (CCD/CMOS) vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (caries detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | AUC 0.82 | 1 study | Ungraded |
COE with vital rinsing (toluidine blue/tolonium chloride) 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 NR · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | No eligible study evaluated COE with vital rinse as a stand-alone screen against the reference standard in this version. | 0 studies | No studies |
Conventional bitewing radiography (D-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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | DOR 11.79 [2.43, 57.24] | 2 studies | Ungraded |
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) Sensitivity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), Non-histology reference standard (excavation, radiographs, separation) Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Sensitivity 0.78 [0.48, 0.93] | NR | Ungraded |
Fluorescence-based devices vs Dental imaging (analog or digital radiographs) Difference in specificity · Children or adults asymptomatic or suspected of enamel caries; extracted teeth · Analysis 1: fully within-person comparison Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2021) | Difference in specificity -0.03 [-0.14, 0.06] | 19 studies · 2849 participants | Ungraded |
Digital bitewing radiography, sensor-based (CCD/CMOS) 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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | AUC 0.90 | 4 studies | Ungraded |
Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs) Outcome NR · Children/adolescents/adults or extracted teeth; target condition = non-cavitated enamel caries on PROXIMAL… · Up to 3 months between index test and reference standard (in vivo studies) Electrical conductance for the detection of dental caries (2021) · Cochrane | No eligible studies. All included studies assessed occlusal surfaces only ('All studies assessed the use of the electrical conductance devices on occlusal surfaces.'); proximal surfaces were a planned surface subgroup… | 0 studies | No studies |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or 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… · Up to 3 months between index test and reference standard (in vivo studies), Setting: in vitro (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.44 [0.37, 0.50] | NR | Ungraded |
Conventional bitewing radiography (E-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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | Specificity 0.95 [0.53, 0.997] | 2 studies | Ungraded |
Optical coherence tomography (OCT) vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography) Specificity for detection of enamel/early caries · Children or adults presenting asymptomatically or suspected of having enamel caries (clinical/in vivo studies);… · Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately) Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries (2021) · Cochrane | Specificity 0.83 [0.68, 0.91] | 10 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Sensitivity analysis: low dentine-caries prevalence <15% Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Specificity 0.91 [0.87, 0.94] | NR | Ungraded |
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 Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | AUC 0.77 | 3 studies | Ungraded |
Digital bitewing radiography, sensor-based (CCD/CMOS) 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) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.36 [0.30, 0.42] | 4 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Dentine-caries (D3) prevalence low <15% (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Specificity 0.91 [0.85, 0.95] | NR | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Diagnostic accuracy on restored teeth (secondary caries) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Restorations (secondary caries) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Pre-specified heterogeneity investigation of teeth with previously applied restorations (secondary caries): no study intentionally included restored teeth in its sample. Studies evaluating secondary caries were… | 0 studies | No studies |
Conventional bitewing radiography, E-speed film vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 4.8 [1.48, 15.48] | 1 study | Ungraded |
COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone Specificity (COE alone arm) · OSCC or OPMD symptom-free individuals with tobacco habits Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Specificity 0.92 [0.91, 0.93] | 1 study · 3895 participants | Moderate |