Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

310 questions · 590 findings · 34 reviews

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%

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

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

The evidence is very uncertain about the effect of cavity liners on treatment failure; no significant difference between lined and unlined (or differently lined) restorations was found (very low certainty).

1 finding 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

Postoperative hypersensitivity (POH), patient-reported (VAS score) · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

The evidence is very uncertain whether cavity liners reduce postoperative hypersensitivity; no significant difference was found overall (very low certainty).

1 finding 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

Tooth survival · 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 tooth survival (99.4% survival across groups; low certainty).

1 finding 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

Oral health-related quality of life · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

No included study reported oral health-related quality of life (a planned outcome), so no evidence is available.

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Radiographic hard-tissue (dentine) barrier formation · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Radiographic hard-tissue barrier formation did not differ significantly between partial and full pulpotomy (single RCT; ungraded).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to caries-affected dentin (in vitro)

SDF pretreatment without a rinsing step does not affect glass-ionomer cement bond strength to caries-affected dentin (MD 0.26 MPa, 95% CI -0.30 to 0.82; ungraded).

1 finding from 1 review

Prior application of silver diamine fluoride (SDF), with or without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives/resin composite bonded to dentin (in vitro), sound or caries-affected

Prior SDF application significantly reduces the immediate bond strength of adhesives to dentin overall (MD 7.12 MPa favoring untreated dentin, 95% CI 1.38 to 12.85; ungraded), with very high heterogeneity (I2=98%).

1 finding from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to caries-affected dentin (in vitro)

SDF pretreatment with a rinsing step does not affect glass-ionomer cement bond strength to caries-affected dentin (MD -0.36 MPa, 95% CI -1.07 to 0.35; ungraded).

1 finding from 1 review

Prior application of silver diamine fluoride (SDF), with or without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to dentin (in vitro), sound or caries-affected

Prior SDF application does not influence the immediate bond strength of glass-ionomer cement to dentin (MD -0.11 MPa, 95% CI -0.54 to 0.31; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs No treatment / other preventive agents (GIC, 5% NaF varnish)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

A second meta-analysis reported odds ratios of 2.44 to 3.63 favouring 38% SDF over fluoride varnish/water for caries arrest (ungraded).

2 findings from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to caries-affected dentin (in vitro)

Prior SDF followed by a rinsing step significantly increases adhesive bond strength to caries-affected dentin (MD -4.79 MPa favoring SDF, 95% CI -9.19 to -0.40; ungraded).

1 finding from 1 review

38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

Twice-yearly 38% SDF was reported to arrest more caries than once-yearly application (24-month rates 91% vs 79%; ungraded).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to caries-affected dentin (in vitro)

Only one study assessed SDF without a rinsing step on adhesive bonding to caries-affected dentin (Kucukyilmaz 2016, which reported impaired bond strength); no meta-analysis was possible, so no pooled estimate is available.

1 finding from 1 review

color contrast: black vs dark brown/light brown/yellow vs hardness contrast: soft vs medium/hard

total microbial load (log10 CFU) · humans with open primary dentine caries

In one study, hardness category differences exceeded color category differences; no meta-analysis was conducted.

1 finding from 1 review

Conventional restorative treatment with compomer vs Other network treatments

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

CRT with compomer ranked first for treatment success in the occlusal-surface network (low certainty).

1 finding 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

Hall technique vs Compomer restoration or non-restorative caries treatment

Treatment failure (annual failure rate) · Children (aged 3-8 years) with 2-surface occluso-proximal dentine caries in primary molars, no pulp therapy

Preformed metal (Hall) crowns had a low reported annual failure rate (3.1%) versus compomer (14.7%) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Nano-hydroxyapatite (nHA) dentifrice/paste (fluoride-free or fluoridated) vs nHA-free / fluoride-free (negative) control

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under remineralizing conditions, nHA produced significantly more remineralization than the negative control (MD 350, 95% CI 179 to 521; very low certainty).

2 findings from 1 review

Atraumatic restorative treatment with GIC vs Conventional restoration

Restoration failure · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement

ART with GIC was reported to increase the odds of restoration failure versus conventional restoration (OR 1.60; ungraded).

1 finding from 1 review