Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

270 questions · 565 findings · 37 reviews

No studies found 4 · 0.7%GRADE not reported 463 · 81.9%Very low 27 · 4.8%Low 23 · 4.1%Moderate 29 · 5.1%High 19 · 3.4%

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the negative lr of visual detection for advanced occlusal caries was 0.58 (95% CI 0.5 to 0.7) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled specificity of radiographic detection for all (initial and advanced) occlusal caries was 84.8% (95% CI 77 to 90) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting all (initial and advanced) proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled specificity of radiographic detection for all (initial and advanced) proximal caries was 91.7% (95% CI 90 to 93) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the positive lr of radiographic detection for advanced occlusal caries was 5.87 (95% CI 4.3 to 8.0) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (often histological; also invasive opening)

Advanced occlusal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled specificity for visual detection of advanced occlusal lesions was 0.849 (95% CI 0.82 to 0.89).

2 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting all (initial and advanced) proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the positive lr of radiographic detection for all (initial and advanced) proximal caries was 4.3 (95% CI 3.4 to 5.5) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

NPV for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the Egyptian public health clinic setting, the negative predictive value of visual detection for all (initial and advanced) occlusal caries was 97.4% at an assumed prevalence of 12.9% (ungraded).

2 findings from 1 review

Hall technique vs Other network treatments

Treatment success rate · Primary teeth with dentin caries lesions on occlusoproximal surfaces

The Hall technique ranked first for treatment success in the occlusoproximal-surface network (low certainty).

1 finding from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, pooled sensitivity of radiographic detection for advanced occlusal caries was 54.2% (95% CI 47 to 61) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting all (initial and advanced) proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, pooled sensitivity of radiographic detection for all (initial and advanced) proximal caries was 43.2% (95% CI 36 to 51) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

NPV for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the Egyptian public health clinic setting, the negative predictive value of radiographic detection for advanced occlusal caries was 89.3% at an assumed prevalence of 19.0% (ungraded).

2 findings from 1 review

Conventional restorative treatment with resin composite (CRT-RC) vs Sealing

Treatment success (caries lesion arrest or restoration survival) · Children with dentin caries lesions in the outer half of dentin on occlusal surfaces of primary teeth

Conventional restorative treatment with resin composite gave a higher treatment success rate than resin sealing for outer-half occlusal dentin caries in primary teeth (2 studies; low certainty).

1 finding from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled specificity of visual detection for advanced occlusal caries was 96.5% (95% CI 95 to 97) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

PPV for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the positive predictive value of radiographic detection for all (initial and advanced) occlusal caries was 22.6% at an assumed prevalence of 11.0% (ungraded).

2 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

NPV for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the negative predictive value of visual detection for advanced occlusal caries was 85.9% at an assumed prevalence of 22.0% (ungraded).

2 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, the positive lr of visual detection for all (initial and advanced) occlusal caries was 3.73 (95% CI 3.1 to 4.4) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

PPV for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the Egyptian public health clinic setting, the positive predictive value of radiographic detection for advanced occlusal caries was 58.3% at an assumed prevalence of 19.0% (ungraded).

2 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

PPV for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the positive predictive value of visual detection for all (initial and advanced) occlusal caries was 82.0% at an assumed prevalence of 45.0% (ungraded).

2 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled sensitivity of radiographic detection for all (initial and advanced) occlusal caries was 36.0% (95% CI 20 to 56) (ungraded).

3 findings from 1 review

Radiographic caries detection vs Reference standard (often histological; also invasive opening)

All proximal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled specificity for radiographic detection of all proximal lesions was 0.900 (95% CI 0.87 to 0.92).

1 finding from 1 review