Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

310 questions · 590 findings · 34 reviews · Oral Health

No studies found 12 · 2%GRADE not reported 470 · 79.7%Very low 23 · 3.9%Low 34 · 5.8%Moderate 51 · 8.6%High 0 · 0%

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: mean difference in log10 CFU (microbial load) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

For yellow-vs-other colour compared with soft-vs-harder hardness, hardness was significantly the more discriminant test (pooled WMD -3.87, 95% CI -4.46 to -2.87; ungraded).

6 findings from 1 review
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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

Bulk-fill composite resin with 7-second dentine etching vs Bulk-fill composite resin with 15-second dentine etching

Treatment failure (annual failure rate) · Children (aged 5-8 years) with Class-II caries in primary molars, no pulp therapy

Etching dentine for 7 s rather than 15 s lowered bulk-fill composite failure (5.8% vs 16.9% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Glass ionomer or resin-modified glass ionomer fissure sealant vs Fluoride varnish

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)
1 finding from 1 review

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)

It is very uncertain whether resin-based fissure sealant plus fluoride varnish changes dentine caries in permanent molars (yes/no) compared with fluoride varnish alone (very low certainty).

1 finding from 1 review

Resin-based fissure sealant vs Fluoride varnish

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)

It is very uncertain whether resin-based fissure sealant changes dentine caries in permanent molars (yes/no) compared with fluoride varnish (very low certainty).

1 finding from 1 review

Glass ionomer-based sealant vs No sealant (control/no treatment)

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)
1 finding from 1 review
  • Inconclusive results: two studies slightly favoured glass ionomers (Liu 2014b OR 0.46 (0.23-0.91); Tagliaferro 2011) evaluating 426 children; one study (Songpaisan 1995) found no difference (MD DFS -0.18 (-0.39 to…
    3 studies · 830 participants
    Very low

Resin-based fissure sealant (2nd/3rd/4th generation) vs No sealant (control/no treatment)

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)

Resin-based fissure sealant (2nd/3rd/4th generation) probably leads to lower dentine caries in permanent molars (24 months) compared with no sealant (control/no treatment) (moderate certainty).

1 finding from 1 review

Glass ionomer-based sealant vs Resin-based sealant

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)
1 finding from 1 review

Glass ionomer sealant (with fluoride gel plus dentifrice) vs Fluoride gel plus fluoride toothpaste/dentifrice (non-invasive control)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Glass ionomer sealant (with fluoride gel plus dentifrice) showed no clear difference in caries (lesion) progression (radiographic) compared with fluoride gel plus fluoride toothpaste/dentifrice (non-invasive…; GRADE not reported.

1 finding from 1 review

Adhesive/polyurethane sealant patch vs No treatment (both arms received flossing plus fluoride toothpaste)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Adhesive/polyurethane sealant patch showed no clear difference in caries (lesion) progression (radiographic) compared with no treatment (both arms received flossing plus fluoride toothpaste); GRADE not reported.

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Micro-invasive treatment (proximal sealing or resin infiltration):… probably leads to lower caries (lesion) progression measured by pairwise reading of… compared with non-invasive measures (e.g. fluoride varnish, flossing/oral hygiene… (moderate certainty).

4 findings from 1 review
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Resin sealant (one micro-invasive treatment) vs Resin infiltration alone

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…
1 finding from 1 review

Resin sealant (with or without flossing advice) vs Flossing advice (non-invasive control)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Resin sealant (with or without flossing advice) led to lower caries (lesion) progression (radiographic) compared with flossing advice (non-invasive control); GRADE not reported.

1 finding from 1 review

Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Resin infiltration led to lower caries (lesion) progression (radiographic) compared with fluoride varnish, sham/placebo, or flossing advice (non-invasive…; GRADE not reported.

1 finding from 1 review

Hydraulic calcium silicate cements (HCSC; MTA or Biodentine) vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Vital permanent teeth (mature or immature) with deep or extremely deep caries and asymptomatic pulp or reversible pulpitis, undergoing…

At 36-month follow-up, HCSC show higher odds of clinical and radiographic success than CaOH (OR 2.34, 95% CI 1.43 to 3.84; ungraded subgroup).

3 findings from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Restoration longevity · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

Cavity liners may make little or no difference to restoration longevity (high success across groups; low certainty).

1 finding from 1 review