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Evidence found and GRADE certainty

377 questions · 736 findings · 60 reviews · Dental caries

No studies found 17 · 2.3%GRADE not reported 563 · 76.5%Very low 39 · 5.3%Low 47 · 6.4%Moderate 50 · 6.8%High 20 · 2.7%

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: sensitivity from 0.61 to 0.98 ... CarieScan Pro: sensitivity from 0.55 to 0.91'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites…
    7 studies
    Very low

Analogue (conventional) radiographs vs Cone beam computed tomography (CBCT) (direct within-person / paired comparison); reference standard: histology

Diagnostic accuracy: analogue versus CBCT (within-person, not pooled) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Direct comparison analogue vs CBCT (within-person): 6 datasets from 3 studies (737 tooth sites or surfaces) provided data, but the results could not be pooled; only individual study results are shown (Figure 21). No…
    3 studies
    GRADE not reported

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    ECM (4 studies, 475 tooth surfaces): sensitivity ranged from 0.61 to 0.98 (0.61-0.65 in three studies; 0.98 in the most recent ECM IV study). No evidence of a difference in accuracy by device type (Chi2=0.05, df=1,…
    4 studies
    GRADE not reported

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 teeth of children or…
3 findings from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
    7 studies
    Very low

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (overall test accuracy) · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review

Cone beam computed tomography (CBCT) vs Digital radiographs (direct within-person / paired comparison); reference standard: histology

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

Cone beam computed tomography (CBCT) vs Digital radiographs (direct within-person / paired comparison); reference standard: histology

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

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 teeth of children or…
2 findings from 1 review

CarieScan Pro device vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review

Digital radiographs 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 teeth of children or…
1 finding from 1 review

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 teeth of children or…
1 finding from 1 review

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 not reported · Children/adolescents/adults or extracted teeth; target condition = non-cavitated enamel caries on PROXIMAL (approximal) tooth surfaces.

The review found no eligible studies for this question.

1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    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 found

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy in previously restored teeth (secondary caries) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

1 finding from 1 review
  • Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies) · Restorations (secondary caries)
    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 found

Radiographic examination (bitewing radiographs) vs Reference standard: histology

Sensitivity · Extracted molar teeth of adults with resin composite approximal restorations (in vitro; secondary root caries; Switzerland)
1 finding from 1 review
  • 2 in vitro studies (59 root surfaces) using extracted, restored teeth and a histological reference standard investigated the accuracy of radiographs. Reported estimates of sensitivity ranged from 0.40 to 0.63 and…
    2 studies
    Very low

Radiographic examination (bitewing radiographs) vs Reference standard: histology

Specificity · Extracted molar teeth of adults with resin composite approximal restorations (in vitro; secondary root caries; Switzerland)
1 finding from 1 review
  • 2 in vitro studies (59 root surfaces) using extracted, restored teeth and a histological reference standard investigated the accuracy of radiographs. Reported estimates of sensitivity ranged from 0.40 to 0.63 and…
    2 studies
    Very low

Sealant (any type) vs no treatment

Arrest or reversal of noncavitated approximal carious lesions · Children and adults with noncavitated carious lesions on approximal surfaces (primary and permanent teeth)

Sealant may be more effective than no treatment for arrest or reversal of approximal carious lesions (RR 2.41, 95% CI 1.26 to 4.58; low certainty).

1 finding from 1 review

38% silver diamine fluoride vs Fluoride varnish

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 5% NaF varnish for arrest or reversal of root carious lesions (RR 0.64, 95% CI 0.04 to 9.66; very low certainty).

1 finding from 1 review

0.2% NaF mouthrinse + supervised toothbrushing vs Sealant

Arrest or reversal of noncavitated occlusal carious lesions · Children and adults with noncavitated carious lesions on occlusal surfaces (primary and permanent teeth)

0.2% NaF mouthrinse + supervised toothbrushing may not differ from Sealant for arrest or reversal of occlusal carious lesions (RR 0.98, 95% CI 0.84 to 1.14; low certainty).

1 finding from 1 review