Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

262 questions · 304 findings · 19 reviews · Dental caries

No studies found 28 · 9.2%GRADE not reported 200 · 65.8%Very low 61 · 20.1%Low 6 · 2%Moderate 9 · 3%High 0 · 0%

CPP-ACFP vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

CPP-ACFP versus control gave SMD -0.42 (95% CI -0.84 to 0.00); the review classed CPP-ACFP as statistically significant versus control although the reported CI upper limit is at the null (0.00); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Selective caries removal (SCR) + composite resin vs Complete caries removal (CCR) + composite resin

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, selective caries removal had a 3.44 higher probability of failure than complete caries removal.

1 finding from 1 review

Composite strip crowns with composite, fiber, or reverse metal posts vs Alternative post type

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, composite strip crowns with composite posts had an annual failure rate of 2.3% after 1 year.

1 finding from 1 review

Compomer (C) vs Resin composite restoration

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

Compomer restorations had an annual failure rate of 8.9% in primary molars after pulpotomy, higher than composite resin in the same trial (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

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

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, composite resin had an annual failure rate of 0% after 2 years.

1 finding from 1 review

Composite strip crown (CSC) with a post (microhybrid composite resin, Amelogen) vs Post type: composite post (CP) vs fibre post (FP) vs reverse metal post (RMP)

Treatment failure (annual failure rate) · Children with severely decayed maxillary primary incisors treated by pulpectomy (non-vital pulp therapy)

Composite strip crowns with composite posts had a low annual failure rate (2.3%) in maxillary primary incisors after pulpectomy (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

3 findings from 1 review

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

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, preformed metal crowns had an annual failure rate of 2.5% after 2 years.

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

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

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

Slow-release fluoride devices vs Alternative fluoride therapy (topical fluoride: toothpaste, mouthrinse, gel, or varnish)

Outcome not reported · Children or adults

The review found no eligible studies for this question.

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (mean number of new lesions per subject) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

Patients developed on average about 2.29 new ICLs during fixed orthodontic treatment (95% CI 1.12-3.46; very low certainty; very high heterogeneity).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (mean number of lesions per subject) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Patients had on average about 2.24 ICLs per subject during/after fixed orthodontic treatment (95% CI 1.79-2.70; very low certainty; very high heterogeneity).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of tooth surfaces developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 15% of tooth surfaces developed new ICLs during fixed orthodontic treatment (pooled 0.15, 95% CI 0.08-0.26; very low certainty; extreme heterogeneity).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs prevalence · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

ICLs prevalence increased with longer orthodontic treatment duration (meta-regression P=.01; ungraded).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between patient age and number of ICLs · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Patient age was not significantly associated with the number of ICLs (ungraded).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs incidence · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

ICLs incidence increased with longer orthodontic treatment duration (meta-regression P<.01; ungraded).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of subjects developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 48% of patients developed new ICLs during fixed orthodontic treatment (pooled incidence 0.48, 95% CI 0.33-0.63; very low certainty; very high heterogeneity).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (proportion of tooth surfaces affected) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

About 22% of tooth surfaces showed ICLs during/after fixed orthodontic treatment (pooled 0.22, 95% CI 0.14-0.33; very low certainty; extreme heterogeneity).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (proportion of subjects affected) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Around 57% of patients had ICLs during or after fixed orthodontic treatment (pooled prevalence 0.57, 95% CI 0.48-0.65; very low certainty; very high heterogeneity).

1 finding from 1 review