Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Secondary education vs University education

Prevalence of untreated decay (% DT > 0) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In United States, secondary versus university education differed by 10.4 percentage points in prevalence of untreated decay.

4 findings from 1 review
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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

Low polymerization shrinkage resin composite (silorane, ormocer, bulk-fill or other modified-monomer composite) vs Conventional methacrylate-based resin composite

Secondary caries · People with permanent posterior teeth restored with class I or II direct restorations

No secondary caries was reported at 24 months in any of seven studies, so no meta-analysis was possible (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)

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

Artesunate vs Quinine

Death · Patients with severe malaria

The fixed-effect NMR reported a difference between artesunate and quinine at every displayed average age; no GRADE assessment was reported.

2 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

Low polymerization shrinkage resin composite (silorane, ormocer, bulk-fill or other modified-monomer composite) vs Conventional methacrylate-based resin composite

Marginal discoloration · People with permanent posterior teeth restored with class I or II direct restorations

At 24 months, marginal discoloration did not differ significantly (7 groups; p = 0.77; ungraded).

4 findings from 1 review
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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

Fluoride varnish vs Fluoride in dentifrice

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in varnish versus fluoride in dentifrice across randomization year; the review did not state whether the difference was significant and certainty was not graded.

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 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

Older adults (population mean age >33.4 years) vs Not applicable

Dental caries · Adult participants in 25 meta-regression studies

The unadjusted meta-regression coefficient for older mean age was 4.324884.

2 findings from 1 review

Low polymerization shrinkage resin composite (silorane, ormocer, bulk-fill or other modified-monomer composite) vs Conventional methacrylate-based resin composite

Retention (restoration loss) · People with permanent posterior teeth restored with class I or II direct restorations

At 24 months, retention did not differ significantly between the composites (6 studies; ungraded).

2 findings from 1 review

Prenatal passive tobacco exposure (maternal smoking during pregnancy / in the womb) vs No passive tobacco exposure (non-exposed children)

Dental caries in permanent teeth · Children and adolescents with permanent dentition

No eligible studies examined prenatal tobacco exposure and caries in permanent dentition.

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)

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

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs Fluoride in rinse

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in gel versus fluoride in rinse across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review