Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

408 questions · 640 findings · 55 reviews · Oral Health

No studies found 32 · 5%GRADE not reported 528 · 82.5%Very low 29 · 4.5%Low 44 · 6.9%Moderate 7 · 1.1%High 0 · 0%

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence of occlusal surfaces of first permanent molars · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

After excluding Bravo 1996, occlusal caries incidence slightly favored fluoride varnish but was not significant, with heterogeneity falling to 0% (RR 0.98, 95% CI 0.82 to 1.16; 3 RCTs; ungraded).

2 findings from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Increment of occlusal DMFS (decayed, missing, filled surfaces) of FPMs · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

Fluoride varnish and fissure sealant did not differ significantly in occlusal DMFS increment of FPMs (MD 0.13, 95% CI -0.09 to 0.34; 3 RCTs; ungraded).

2 findings from 1 review

Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from weakly contaminated areas, individual cross-sectional studies reported mostly higher but inconsistent DMFT/dmft in exposed vs non-exposed children; the review did not pool the data and drew no firm conclusion (ungraded).

4 findings from 1 review
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CPP-ACP vs No active treatment (control)

Enamel surface microhardness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP increased Vickers microhardness versus control (SMD 1.19, 95% CI 0.72 to 1.66; ungraded).

3 findings from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from heavily contaminated areas, individual studies gave conflicting DMFT/dmft differences (some favouring exposed, some non-exposed); the review did not pool them (ungraded).

4 findings from 1 review
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Residence in low-contamination area (approx. 5-15 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from a low-contamination area, one study reported higher DMFT/dmft in exposed than non-exposed children; the estimate was not pooled (ungraded).

1 finding from 1 review

CPP-ACP vs No active treatment (control)

Average enamel surface roughness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP markedly reduced enamel surface roughness versus control (SMD -8.21, 95% CI -10.37 to -6.04; ungraded).

1 finding from 1 review

CPP-ACP vs Placebo paste without CPP-ACP (fluoride toothpaste control)

Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients (mainly children) with white spot lesions (WSL)

CPP-ACP toothpaste did not differ significantly from placebo paste (fluoride control) for white spot lesion remineralization on QLF (MD 0.08, 95% CI -0.91 to 1.08; ungraded).

1 finding from 1 review

Antimicrobial photodynamic therapy (PDT) vs No photodynamic therapy (untreated negative control)

Microbial reduction (viable count, log CFU/mL) · Patients with dental caries (in vivo cariogenic microorganisms, including children with early childhood caries)

In randomized clinical trials, photodynamic therapy significantly reduced cariogenic microbial counts versus untreated control (SMD -1.16, 95% CI -2.02 to -0.30; 2 trials), but heterogeneity was high (I2=70%) and considered too high to rely on; certainty was not graded.

1 finding from 1 review

0.9% silicon tetrafluoride (SiF4) vs Not specified

Remineralisation of white spot lesions · Patients (mainly children) with white spot lesions (WSL)

One trial found professionally applied silicon tetrafluoride did not remineralise white spot lesions; ungraded.

1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs placebo or control

Aesthetics · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…

Enamel matrix derivative (EMD; Emdogain) showed no clear difference in aesthetics compared with placebo or control (same surgical or non-surgical intervention… (low certainty).

1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs Various bone grafting (BG) procedures (animal-derived or synthetic bone / bioactive ceramic filler)

Aesthetics · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…

The review found no eligible studies for this question.

1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs placebo or control

Change in gingival recession (REC) · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…

Enamel matrix derivative (EMD; Emdogain) showed no clear difference in change in gingival recession (REC) compared with placebo or control (same surgical or non-surgical intervention… (low certainty).

1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs placebo or control

Marginal bone level change · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…
1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs Various bone grafting (BG) procedures (animal-derived or synthetic bone / bioactive ceramic filler)

Change in probing attachment level (PAL) · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…
1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs Guided tissue regeneration (GTR) with barriers

Change in probing pocket depth (PPD) · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…

Enamel matrix derivative (EMD; Emdogain) showed no clear difference in change in probing pocket depth (PPD) compared with guided tissue regeneration (GTR) with barriers (low certainty).

1 finding from 1 review

Enamel matrix derivative (EMD; Emdogain) vs Guided tissue regeneration (GTR) with barriers

Change in gingival recession (REC) · Patients affected by chronic, aggressive, or early onset periodontitis, with intrabony defects having an intrabony component of at least 3…

Enamel matrix derivative (EMD; Emdogain) may leads to higher change in gingival recession (REC) compared with guided tissue regeneration (GTR) with barriers (low certainty).

1 finding from 1 review