Gap finder

Search review questions

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.

Limit to evidence status or GRADE (optional)

5,762 questions in 263 reviews · Dental caries

current versions
No studies 321 · 5.6%Ungraded 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%

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.

QuestionEffectEvidenceStatus / GRADE
ART using high-viscosity glass ionomer cement (H-GIC), hand instruments vs Conventional treatment using H-GIC (rotary instruments)
Restoration failure (permanent dentition) · People with dental caries in primary teeth (mainly children)
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
No studies reported on restoration failure in permanent dentition for this comparison.0 studiesNo studies
ART using composite resin vs Conventional treatment using composite resin
Costs (direct and indirect) · Children with dental caries in primary teeth (mean age 7 years)
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
No studies reported on costs for this comparison.0 studiesNo studies
Metal-free FDPs (zirconia ceramic) vs Metal-ceramic FDPs
Aesthetic evaluation (patient aesthetic satisfaction changes) · Adults (18 years or older) needing a three-unit fixed dental prosthesis (FDP) · 36 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
OR 15.40 [0.78, 304.61]1 study · 34 participantsVery low
Glass ionomer-based sealant vs Resin-based sealant
Dentine caries in permanent molars · Children and adolescents (general population, aged under 20 years) · 12-72 months
Pit and fissure sealants for preventing dental decay in permanent teeth (2017) · Cochrane
Inconsistent effect (differences in products, comparisons, outcomes, outcome reporting times, background fluoride and age groups); 21 trials (3883 participants randomised); very low quality21 studies · 3883 participantsVery low
ART using high-viscosity glass ionomer cement (H-GIC), hand instruments vs Conventional treatment using H-GIC (rotary instruments)
Restoration failure (primary dentition) · People with dental caries in primary teeth (mainly children) · 12 to 24 months
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
OR 1.60 [1.13, 2.27]5 studies · 643 participantsLow
Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs
Cantilevered bridge complications · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis · 36 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
OR 2.00 [0.15, 26.73]1 study · 19 participantsVery low
Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)
Complications · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown on… · 12 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
At 12 months no complications were reported in either group.2 studies · 47 participantsVery low
Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs Placebo or no treatment
Decayed or filled primary tooth surfaces at 3 years · Pregnant women (for preventing dental caries in the primary teeth of their children) · 3 years
Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing… (2017) · Cochrane
MD 0.12 [-0.05, 0.29]1 study · 938 participantsVery low
Dementia (any type or severity) vs Older people without dementia
Number of teeth present (mean) · Older people (aged 60 years or older) with dementia
Oral health and orofacial pain in older people with dementia: a systematic review with focus on dental hard… (2017)
no estimate extracted16 studiesUngraded
ART using resin-modified glass ionomer cement (RM-GIC) vs Conventional treatment using RM-GIC
Adverse events · Older adults with root caries in permanent (mature) teeth (mean age 75 years)
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
Adverse events: Not measured.0 studiesNo studies
Metal-free tooth-supported FDPs (pressed veneering ceramic) vs Metal-free tooth-supported FDPs (layered veneering ceramic)
Bridge complications · Adults (18 years or older) needing a three-unit tooth-supported fixed dental prosthesis · 36 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
OR 2.80 [0.66, 11.92]1 study · 36 participantsVery low
ART using glass ionomer cement (GIC) vs Conventional treatment using amalgam
Participant experience (co-operation during procedure) · Children and adolescents with dental caries (primary teeth and permanent immature teeth)
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
Ling 2003 assessed participant co-operation during procedures, showing a co-operation rate in the ART group significantly higher than in the control group (no summary statistic reported).1 studyUngraded
Metal-free implant-supported single crowns (zirconia veneered with feldspathic ceramic) vs Metal-ceramic implant-supported single crowns
Implant crown complications · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown · 24 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
OR 6.33 [0.26, 152.86]1 study · 18 participantsVery low
Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs Placebo or no treatment
Decayed or filled primary tooth surfaces at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children) · 5 years
Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing… (2017) · Cochrane
MD -0.05 [-0.42, 0.32]1 study · 798 participantsVery low
Metal-free single crowns (full-contour zirconia) vs Cast gold (conventional metal) single crowns
Periodontal/peri-implant status and occlusal wear (secondary outcomes) · Adults (18 years or older) needing a single crown in the molar or premolar region
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
No data were presented for any of the pre-specified secondary outcomes.0 studiesNo studies
Ormocer-based sealant vs Low-viscosity glass ionomer sealant
Dentine caries in permanent molars · Children and adolescents (general population, aged under 20 years) · 24 months
Pit and fissure sealants for preventing dental decay in permanent teeth (2017) · Cochrane
Guler 2013 (N=50) compared ormocer-based sealant versus low-viscosity glass ionomer; not separately meta-analysed1 study · 50 participantsUngraded
Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs Placebo or no treatment
Decayed primary surfaces at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children) · 5 years
Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing… (2017) · Cochrane
MD -0.06 [-0.17, 0.05]1 study · 798 participantsUngraded
Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)
Aesthetic evaluation (Implant Crown Aesthetic Index, ICAI) · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown on… · 12 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
Primary outcome aesthetic evaluation data were reported as the frequency of distribution of the Implant Crown Aesthetic Index (ICAI); no comparative summary estimate was presented.2 studies · 47 participantsVery low
Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs
Aesthetic evaluation (patient VAS) · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis · 24 months
Metal‐free materials for fixed prosthodontic restorations (2017) · Cochrane
MD -0.34 [-0.85, 0.17]1 study · 19 participantsVery low
ART using H-GIC vs Conventional treatment using amalgam
Pain (primary dentition) · Children with dental caries in primary teeth · Single and multiple lesions
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
OR 1.44 [0.45, 4.60]1 studyUngraded
ART using resin-modified glass ionomer cement (RM-GIC) vs Conventional treatment using RM-GIC
Restoration failure (permanent, mature dentition; root surfaces) · Older adults with root caries in permanent (mature) teeth (mean age 75 years) · 6 months, Root caries
Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries (2017) · Cochrane
OR 2.71 [0.94, 7.81]1 study · 64 participantsVery low
Adhesively bonded amalgam restorations in conventional preparations utilising deliberate retention (all bonding agents) vs Traditional non‐bonded amalgam restorations
Marginal deterioration of the restoration and fracture of the remaining tooth tissue · Adults and adolescents with permanent posterior molar and premolar teeth suitable for Class I and II, but excluding… · Mean 24 months
Adhesively bonded versus non‐bonded amalgam restorations for dental caries (2016) · Cochrane
Marginal deterioration of the restoration and fracture of the remaining tooth tissue - Follow‐up: mean 24 months | Study population | Relative effect (95% CI): Not estimable | Number of participants (studies): 31 (1…1 study · 31 participantsLow
Job-related or family-related stress and pessimistic attitude to life vs Lower stress and no pessimistic attitude
Periodontal disease and serum IL-1β IL-6 and cortisol · Patients with aggressive or chronic periodontitis at a university periodontology department
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 study · 80 participantsUngraded
Adhesively bonded amalgam restorations in conventional preparations utilising deliberate retention (all bonding agents) vs Traditional non‐bonded amalgam restorations
Survival of the restoration · Adults and adolescents with permanent posterior molar and premolar teeth suitable for Class I and II, but excluding… · Mean 24 months
Adhesively bonded versus non‐bonded amalgam restorations for dental caries (2016) · Cochrane
Survival of the restoration - Follow‐up: mean 24 months | Illustrative comparative risks: Assumed risk (Control) See comment; Corresponding risk (Adhesive bonding) See comment | Relative effect (95% CI): Not estimable…1 study · 31 participantsLow
Selective or stepwise carious tissue removal vs Non-selective or complete carious tissue removal
Proportion of dentists selecting selective or stepwise removal · Dentists surveyed about deep carious lesions in permanent teeth · Oen 2007
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and… (2016)
Proportion (%) 18 [11, 27]1 study · 85 participantsUngraded
Selective or stepwise carious tissue removal vs Non-selective or complete carious tissue removal
Proportion of dentists selecting selective or stepwise removal · Dentists surveyed about deep carious lesions in permanent teeth · Weber 2013
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and… (2016)
Proportion (%) 21 [12, 34]1 study · 53 participantsUngraded
Perceived psychosocial stress vs No or lower perceived stress
GCF elastase activity and non-surgical periodontal treatment outcome (salivary cortisol, ICTP measured; no effect reported) · Adults with periodontitis needing non-surgical periodontal treatment · 6-month follow-up
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 study · 45 participantsUngraded
Perceived stress vs Lower perceived stress
Gingival inflammation and GCF IL-1β IL-6 and IL-8 · Adults with gingivitis or periodontitis from a private periodontics practice
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 study · 80 participantsUngraded
Job-stress-related depression vs Women without depression
Periodontitis and GCF IL-6 · Women on long-term sick leave for depression
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 study · 49 participantsUngraded
Selective or stepwise carious tissue removal vs Non-selective or complete carious tissue removal
Proportion of dentists selecting selective or stepwise removal · Dentists surveyed about deep carious lesions in permanent teeth · Chisini 2015
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and… (2016)
Proportion (%) 62 [55, 69]1 study · 171 participantsUngraded
Professionally applied 5% sodium fluoride (NaF) varnish vs Untreated lesions (single-arm before vs after proportion)
Remineralisation of early enamel caries (proportion of lesions remineralised) · Children with early enamel caries or white spot lesions
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
Proportion 0.636 [0.360, 0.912]4 studiesUngraded
Nano-silver fluoride vs Not specified
Arrest of dentine caries · Children with active dentine caries
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
A randomised trial using nano-silver fluoride found it was effective to arrest dentine caries without causing dark staining.1 studyUngraded
Adhesively bonded amalgam restorations in conventional preparations utilising deliberate retention (all bonding agents) vs Traditional non‐bonded amalgam restorations
Economic data: direct costs of materials and any reported associated indirect costs · Adults and adolescents with permanent posterior molar and premolar teeth suitable for Class I and II, but excluding…
Adhesively bonded versus non‐bonded amalgam restorations for dental caries (2016) · Cochrane
Economic data: direct costs of materials and any reported associated indirect costs - not measured | See comment | See comment | Not estimable | - | See comment | No study addressed this outcome0 studiesNo studies
Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)
Marginal integrity of restorations · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years) · 2 years follow-up
Lasers for caries removal in deciduous and permanent teeth (2016) · Cochrane
RR 1.00 [0.21, 4.74]1 studyUngraded
Intervention NR
Remineralisation of early enamel caries · NaF varnish plus chlorhexidine or calcium fluoride vs NaF varnish alone (no significant added benefit)
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
no estimate extracted3 studiesUngraded
Professionally applied sodium fluoride (NaF) varnish vs No fluoride treatment
Dimensional change (size) of early enamel caries lesions · Children with white spot lesions / early enamel caries
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
One clinical trial (Du 2012) evaluating dimensional change reported that the average size of early enamel caries in children receiving professional NaF therapy was significantly smaller than in those with no fluoride…1 studyUngraded
Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)
Participant discomfort (vibration, smell, noise) · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years) · during treatment
Lasers for caries removal in deciduous and permanent teeth (2016) · Cochrane
Five studies reported participant discomfort (Belcheva 2014; Evans 2000; Hadley 2000; Keller 1998; Liu 2006). Keller 1998 (90 adults): discomfort significantly lower with laser (Analysis 1.6). Hadley 2000 (66 adults):…5 studiesUngraded
Professionally applied 38% silver diamine fluoride (SDF) vs Active dentine caries at baseline (single-arm before vs after proportion)
Arrest of dentine caries (proportion of surfaces arrested) · Children with active dentine caries (primary and permanent teeth)
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
Proportion 0.659 [0.412, 0.907]5 studiesUngraded
Lower socioeconomic position measured by poverty income and education vs Higher socioeconomic position
Periodontitis and allostatic load · US adults in NHANES III
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 studyUngraded
Intervention NR
Arrest of dentine caries · 38% SDF vs 5% NaF varnish (SDF superior)
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
no estimate extracted2 studiesUngraded
Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)
Pulpal inflammation or necrosis · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years) · 6 months follow-up
Lasers for caries removal in deciduous and permanent teeth (2016) · Cochrane
RR 0.99 [0.10, 9.41]2 studies · 156 participantsVery low
Selective or stepwise carious tissue removal vs Non-selective or complete carious tissue removal
Proportion of dentists selecting selective or stepwise removal · Dentists surveyed about deep carious lesions in permanent teeth · Seale and Glickman 2007 (pedodontists)
Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and… (2016)
Proportion (%) 71 [65, 77]1 study · 252 participantsUngraded
Depression and social isolation (psychosocial strain) vs No depression or lower psychosocial strain
Antibody titres to periodontal pathogens · Adults with periodontitis · Baseline and 1-year follow-up
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 study · 148 participantsUngraded
Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)
Pulpal inflammation or necrosis · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years) · 1 week follow-up
Lasers for caries removal in deciduous and permanent teeth (2016) · Cochrane
RR 1.51 [0.26, 8.75]3 studies · 317 participantsVery low
Lower socioeconomic position measured by annual family income and poverty-income ratio vs Higher socioeconomic position
Periodontitis and allostatic load · US adults in NHANES 1999-2004 · Race/ethnicity
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
no estimate extracted1 studyUngraded
High-viscosity glass-ionomer cement (HVGIC) fissure sealant placed by press-finger technique vs Resin-based fissure sealant
Development of carious lesions on sealed occlusal pits and fissures · Children with fully erupted permanent first molar teeth (mean age about 6 to 8 years) · 48 months
Caries-Preventive Effect of High-Viscosity Glass Ionomer and Resin-Based Fissure Sealants on Permanent… (2016)
RR 0.62 [0.31, 1.21]2 studies · 1007 evaluated sealed teeth participantsUngraded
Intervention NR
Dental caries prevalence in primary teeth (cavitated lesions) · Children aged 5-6 years in Latin America and the Caribbean · Studies with data collected after 2000 (21st century), Other Latin American/Caribbean countries (non-Brazil)
Does the Decline in Caries Prevalence of Latin American and Caribbean Children Continue in the New Century?… (2016)
Prevalence 0.70 [0.59, 0.79]8 studies · 8593 participantsUngraded
Intervention NR
Dental caries prevalence in permanent teeth (cavitated lesions) · Children aged 11-13 years in Latin America and the Caribbean · Studies with data collected after 2000 (21st century), Other Latin American/Caribbean countries (non-Brazil)
Does the Decline in Caries Prevalence of Latin American and Caribbean Children Continue in the New Century?… (2016)
Prevalence 0.64 [0.45, 0.79]12 studies · 7227 participantsUngraded
Intervention NR
Serum inflammatory cytokines (IL-1b, IL-6) and cortisol in periodontitis · Registered job/family stress
Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. (2016)
Narrative (no effect size) No correlation between registered stress and serum IL-1b/IL-6/cortisol; untreated aggressive periodontitis showed pessimistic attitude and elevated serum IL-61 studyUngraded
1.23% acidulated phosphate fluoride (APF) gel vs Not specified
Remineralisation of early enamel caries · Children with incipient (early) enamel caries
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016)
One double-blind randomised trial found acidulated phosphate fluoride gel was not effective to remineralise early enamel caries.1 studyUngraded