What do systematic reviews say?

1,171 questions · 1,373 findings · 60 reviews · Dental caries

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No studies found 282 · 20.5%GRADE not reported 606 · 44.1%Very low 257 · 18.7%Low 160 · 11.7%Moderate 66 · 4.8%High 2 · 0.1%

Fibre-optic transillumination (FOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

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

Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes
Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
Sensitivity 0.47 [0.35, 0.59]
8 studies
GRADE not reported

Chemotherapy regimen A (+/- locoregional treatment) vs Chemotherapy regimen B (+/- locoregional treatment)

Overall survival (total mortality), chemotherapy regimen A vs regimen B · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
Eight of 11 induction-before-radiotherapy studies reported overall survival; not pooled (heterogeneity). Only Vermorken 2007 significant: cisplatin+5-FU+docetaxel induction HR 0.73 (95% CI 0.57 to 0.93, P = 0.01).…
8 studies
GRADE not reported

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 SMOOTH 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; smooth surfaces were a planned surface subgroup with no data.
0 studies
No studies found

Non-selective carious tissue removal and conventional restoration (CR) vs Hall Technique (sealing with a preformed metal crown)

Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

Non-selective carious tissue removal and conventional restoration (CR) may leads to higher failure of therapy compared with hall Technique (sealing with a preformed metal crown) (low certainty).

1 finding from 1 review

Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
30-60 months · Cavitated (not deep) lesions, primary dentition
OR 8.35 [3.73, 18.68]
2 studies · 249 participants
Low

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

2 findings 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) · Permanent dentition
Permanent dentition (4 studies): specificity ranged from 0.73 to 1.00.
4 studies
GRADE not reported
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) · Primary dentition
Primary dentition (3 studies): specificity ranged from 0 to 0.92.
3 studies
GRADE not reported

Direct composite resin restoration vs Amalgam restoration

Secondary caries · People with permanent or adult posterior teeth requiring restoration (parallel-group trials involved children aged 6 to 12 years)

Direct composite resin restoration showed no clear difference in secondary caries compared with amalgam restoration; GRADE not reported.

3 findings from 1 review

Direct composite resin fillings versus amalgam fillings for permanent posterior teeth 2021 · Cochrane All outcomes
Follow-up >= 3 years · Parallel-group and split-mouth trials combined
RR 1.93 [0.98, 3.80]
7 studies
GRADE not reported
Direct composite resin fillings versus amalgam fillings for permanent posterior teeth 2021 · Cochrane All outcomes
Follow-up >= 3 years · Split-mouth trials
RR 1.30 [0.34, 4.97]
5 studies
GRADE not reported
Direct composite resin fillings versus amalgam fillings for permanent posterior teeth 2021 · Cochrane All outcomes
Follow-up: 5 to 7 years
RR 2.14 [1.67, 2.74]
2 studies · 921 participants
Low

Chemotherapy vs Placebo

Outcome not reported · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
Types of studies: it was anticipated that there would be no studies comparing chemotherapy with placebo (none were identified).
0 studies
No studies found

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

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

Specificity · Oral cavity cancer or potentially malignant disorder symptom-free individuals with tobacco habits

2 findings from 1 review

Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
Specificity 0.91 [0.90, 0.91]
1 study · 4080 participants
Moderate
Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
Specificity 0.92 [0.91, 0.93]
1 study · 3895 participants
Moderate

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

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy: in vitro versus in vivo comparison · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

1 finding from 1 review

Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes
Up to 3 months between index test and reference standard (in vivo studies) · Study setting (in vitro vs in vivo)
Pre-specified in vitro versus in vivo comparison was not completed because 49 of the 60 histology studies were in vitro; a sensitivity analysis removing the in vivo studies confirmed a minimal change to summary…
Studies not reported
GRADE not reported

Rubber dam isolation and moisture control (alone or with saliva aspiration) vs Cotton rolls (with or without saliva aspiration)

Costs: direct cost of treatment · Dental patients undergoing direct or indirect restorative treatment (no age or gender restriction)

The review found no eligible studies for this question.

1 finding from 1 review

Rubber dam isolation for restorative treatment in dental patients 2021 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Adverse events (any type) and safety of sealant · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
None of the studies reported adverse effects.
0 studies
No studies found

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs COE with vital rinsing (toluidine blue/tolonium chloride)

Outcome not reported · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance programme, or screened…

The review found no eligible studies for this question.

1 finding from 1 review

Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
No eligible studies; planned comparative analysis (COE with vital rinse vs COE with light-based detection) not populated in this version.
0 studies
No studies found

Rubber dam vs Isolite system

Participant acceptance/satisfaction · Dental patients undergoing direct or indirect restorative treatment (no age or gender restriction)

1 finding from 1 review

Rubber dam isolation for restorative treatment in dental patients 2021 · Cochrane All outcomes
Pit and fissure sealing (permanent molars)
Rubber dam may be associated with significantly lower satisfaction than the Isolite system but evidence very uncertain, mainly worse comfort (31%, P=0.02) and less preference (26%, P=0.002) (Alhareky 2014).
1 study · 42 participants
Very low

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Overall survival, induction platinum + 5-fluorouracil prior to radiotherapy vs radiotherapy alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.85 [0.70, 1.04]
5 studies · 7427 participants
Moderate

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

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Disease-free survival · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Induction chemotherapy plus locoregional treatment (radiotherapy… led to lower disease-free survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone; GRADE not reported.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.78 [0.63, 0.97]
3 studies · 332 participants
GRADE not reported

Transillumination and optical coherence tomography devices (all illumination devices combined: NIR, OCT, and FOTI/DIFOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

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

Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes
Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
Specificity 0.87 [0.82, 0.92]
23 studies
Low

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy (sensitivity/specificity) for enamel caries, not meta-analyzed · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

1 finding from 1 review

Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes
Up to 3 months between index test and reference standard (in vivo studies) · Smooth surface
Smooth surfaces reported by 2 datasets (Nakagawa 2013; Shi 2000) but excluded from the surface meta-analysis owing to sparsity; no summary sensitivity or specificity estimated.
2 studies
GRADE not reported