What do systematic reviews say?

Capitation remuneration vs Fee-for-service remuneration

Capitation remuneration may leads to lower patient outcomes: mean percentage of 0- to 15-year-olds having one… compared with fee-for-service remuneration (low certainty).

• The effect of different methods of remuneration on the behaviour of primary care dentists 2013 · Cochrane All outcomes

  3 years · Rural community
  RR 0.70
  1 study · 2250 participants
  Low
• The effect of different methods of remuneration on the behaviour of primary care dentists 2013 · Cochrane All outcomes

  3 years · Commuter suburb community
  RR 1.00
  1 study · 2250 participants
  Low
• The effect of different methods of remuneration on the behaviour of primary care dentists 2013 · Cochrane All outcomes

  3 years · Northern urban community
  RR 0.72
  1 study · 2250 participants
  Low

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Stepwise excavation (two-stage caries removal, re-entry after an… probably leads to lower pulp exposure during caries removal compared with one stage complete caries removal (moderate certainty).

• Operative caries management in adults and children 2013 · Cochrane All outcomes

  During caries removal · Secondary dentition
  RR 0.51 [0.36, 0.72]
  3 studies · 454 participants
  Moderate
• Operative caries management in adults and children 2013 · Cochrane All outcomes

  During caries removal · Primary dentition
  RR 0.31 [0.17, 0.57]
  2 studies · 173 participants
  Moderate
• Operative caries management in adults and children 2013 · Cochrane All outcomes

  During caries removal
  RR 0.44 [0.33, 0.60]
  4 studies · 627 participants
  Moderate

DHAT-delivered dental care vs Dentist-delivered dental care

DHATs had a lower amalgam restoration deficiency rate than dentists (12% vs 22%; certainty not graded).

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Cross-sectional (DHATs practising ~9 months to several years) · Alaska Native communities (Alaska Dental Health Aide Therapist program) · Amalgam restorations
  Deficient restorations (%), DHAT vs dentist 12 vs 22 (DHAT vs dentist)
  2 studies
  GRADE not reported
• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Cross-sectional (DHATs practising ~9 months to several years) · Alaska Native communities (Alaska Dental Health Aide Therapist program) · Composite restorations
  Deficient restorations (%), DHAT vs dentist 15 vs 12 (DHAT vs dentist)
  2 studies
  GRADE not reported
• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Cross-sectional (DHATs practising ~9 months to several years) · Alaska Native communities (Alaska Dental Health Aide Therapist program) · Stainless steel crowns
  Deficient placements (%), DHAT vs dentist 3 vs 9 (DHAT vs dentist)
  2 studies
  GRADE not reported

DHAT-delivered dental care vs Not applicable (single-group prevalence)

Four newly trained DHATs met stated clinical care standards in a qualitative evaluation, without a GRADE rating.

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  9 months · Alaska
  Four practising DHATs met Indian Health Service guidelines for record keeping and standards of care for cavity preparation and restoration, patient management, and patient safety.
  1 study
  GRADE not reported

Capitation remuneration vs Fee-for-service remuneration

Capitation remuneration showed no clear difference in measures of health service utilisation: mean number of visits per 0-… compared with fee-for-service remuneration (low certainty).

• The effect of different methods of remuneration on the behaviour of primary care dentists 2013 · Cochrane All outcomes

  3 years · Commuter suburb community
  MD -0.4
  1 study · 2250 participants
  Low
• The effect of different methods of remuneration on the behaviour of primary care dentists 2013 · Cochrane All outcomes

  3 years · Scottish community
  MD -0.5
  1 study · 2250 participants
  Low
• The effect of different methods of remuneration on the behaviour of primary care dentists 2013 · Cochrane All outcomes

  3 years · Rural community
  MD -0.3
  1 study · 2250 participants
  Low

2 mm titanium plates vs 2.5 mm bioresorbable plates

2 mm titanium plates showed no clear difference in moderate soft tissue deformity compared with 2.5 mm bioresorbable plates; GRADE not reported.

• Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes

  1 month
  RR 6.4 [0.80, 51.3]
  1 study · 57 participants
  GRADE not reported

Hyperbaric oxygen vs No HBO therapy

It is very uncertain whether hyperbaric oxygen (HBO) therapy changes prosthetic failure compared with no HBO therapy (very low certainty).

• Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants 2013 · Cochrane All outcomes

  1 year after delivery of the prosthesis
  RR 3.00 [0.13, 67.06]
  1 study · 24 participants
  Very low

Immediate loading vs Early loading

It is very uncertain whether immediate loading changes prosthesis failure compared with early loading (very low certainty).

• Interventions for replacing missing teeth: different times for loading dental implants 2013 · Cochrane All outcomes

  1 year
  RR 0.69 [0.25, 1.87]
  4 studies · 408 participants
  Very low

Orthodontic distalising appliance (intraoral or extraoral) vs no intervention

The review found no eligible studies for this question.

• Orthodontic treatment for distalising upper first molars in children and adolescents 2013 · Cochrane All outcomes
  Duration of treatment was not reported in the studies of the appliance-versus-untreated-control comparison ("Duration of treatment, non-compliance, number of attendances required to complete treatment and adverse…
  0 studies
  No studies found

Pre-radiotherapy extraction of healthy molar teeth vs Conservative treatment (leaving the teeth in place during radiotherapy, with oral health education and disease prevention: oral hygiene, fluoride, diet advice)

The review found no eligible studies for this question.

• Dental extractions prior to radiotherapy to the jaws for reducing post‐radiotherapy dental complications 2013 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found

3-dimensional (3D) miniplates vs Standard (Champy) plates

• Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes
  All participants in both groups in Jain 2010 had "satisfactory post-operative occlusion"; it is unclear whether a validated tool was used.
  1 study
  GRADE not reported

PDHA program vs Baseline pre-intervention service-delivery scenario

The PDHA program was projected to increase clinic-based dental care utilization from 75% to 90%, without a GRADE rating.

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  20 years · Alaska
  Percentage-point increase 15
  1 study
  GRADE not reported

Self etching primer (one-step etchant-and-primer technique) vs Conventional etchants (two-step etch and prime method using 37% phosphoric acid)

Self etching primers (one-step etchant and primer system) showed no clear difference in bond failure rate compared with conventional etchants (two-step etch and prime method using 37%… (low certainty).

• Enamel etching for bonding fixed orthodontic braces 2013 · Cochrane All outcomes

  5 to 37 months
  RR 1.14 [0.75, 1.73]
  5 studies · 221 participants
  Low

Open (surgical) reduction and fixation vs Closed (non-surgical) treatment

The review found no eligible studies for this question.

• Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes
  "There were no studies comparing different types of closed interventions with one another or comparing open and closed interventions." "We found no studies that compared surgical with non-surgical treatments."
  0 studies
  No studies found

Orthodontic distalising appliance (intraoral or extraoral) vs no intervention

• Orthodontic treatment for distalising upper first molars in children and adolescents 2013 · Cochrane All outcomes
  SoF table 1. Assumed risk "Not estimated"; Corresponding risk "Not estimated"; Relative effect "Meta-analysis not appropriate". Comment: "No pooled estimate due to different types of appliances (First Class and…
  2 studies · 74 participants
  Low

DHAT-delivered dental care vs Dentist-delivered dental care

Amalgam restoration deficiency was 12% for DHATs versus 22% for dentists, without a GRADE rating.

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Alaska Native communities
  Proportion of deficient amalgam restorations 12% vs 22%
  2 studies
  GRADE not reported

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Stepwise excavation (two-stage caries removal, re-entry after an… showed no clear difference in signs or symptoms of pulpal disease compared with one stage complete caries removal (moderate certainty).

• Operative caries management in adults and children 2013 · Cochrane All outcomes

  1 year
  RR 0.78 [0.39, 1.58]
  2 studies · 278 participants
  Moderate

Transbuccal miniplate combined with intraoral approach vs Intraoral approach alone

• Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes

  3 months · Angle of mandible only
  Persistent malocclusion was minimal, reported in one participant in each group at the 3-month follow-up. Mean interincisor mouth opening at 3 months 37.68 mm (range 17 to 50) combined approach vs 38.19 mm (range 22 to…
  1 study
  GRADE not reported

Hyperbaric oxygen vs No HBO therapy

Hyperbaric oxygen (HBO) therapy showed no clear difference in patient satisfaction (overall denture satisfaction) compared with no HBO therapy; GRADE not reported.

• Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants 2013 · Cochrane All outcomes

  1 year after delivery of the prosthesis
  Analysis 1.2 (Overall denture satisfaction): Mean Difference (IV, Fixed, 95% CI), totals not selected (value not displayed).
  1 study · 17 participants
  GRADE not reported

Two lag screws vs One lag screw (with arch bars and IMF)

• Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes
  Average pain scores (scale 1 to 10): week 1, 6.6 (two lag screws) vs 6.4 (one lag screw); after 2 weeks, 2.5 vs 2.1. Confidence intervals were not reported.
  1 study
  GRADE not reported