What do systematic reviews say?

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Concomitant (concurrent) chemoradiotherapy probably leads to lower overall survival, concurrent chemoradiotherapy vs radiotherapy alone… compared with radiotherapy alone (non-resectable tumours) (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.74 [0.67, 0.83]
  24 studies · 2852 participants
  Moderate

Sealing using sealant materials vs no treatment

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Non-cavitated lesions, permanent dentition
  Lesion progression reported narratively: da Silveira 2012 found 3/27 lesions progressed after 1 year; not pooled and not GRADE-rated.
  1 study
  GRADE not reported

Hall technique vs Non-restorative cavity control (NRCC)

It is very uncertain whether hall Technique (sealing with a preformed metal crown) changes failure of therapy compared with non-restorative cavity control (NRCC) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  30 months · Cavitated lesions, primary dentition
  OR 0.19 [0.05, 0.74]
  1 study · 84 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Non-restorative cavity control (NRCC)

It is very uncertain whether non-selective carious tissue removal and conventional restoration (CR) changes failure of therapy compared with non-restorative cavity control (NRCC) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  30 months · Cavitated lesions, primary dentition
  OR 1.16 [0.5, 2.71]
  1 study · 102 participants
  Very low

Sealing using sealant materials vs Non-selective carious tissue removal and conventional restoration (CR)

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with non-selective carious tissue removal and conventional restoration (CR) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  48 months · Cavitated lesions, permanent dentition
  OR 5.0 [0.51, 49.27]
  1 study · 41 participants
  Very low

Sealing using sealant materials vs no treatment

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with no treatment (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12 months · Non-cavitated lesions, permanent dentition
  OR 0.05 [0.0, 2.71]
  2 studies · 103 participants
  Very low

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

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.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Glass ionomer sealant
  OR 0.13 [0.01, 2.52]
  1 study
  GRADE not reported

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

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  None of the studies reported on participant or operator perception
  0 studies
  No studies found

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

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.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Sealant patch
  OR 1.00 [0.14, 7.23]
  1 study
  GRADE not reported

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

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  None of the studies reported on costs for micro-invasive treatment or non-invasive control
  0 studies
  No studies found

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

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).

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  18 to 36 months (radiographic follow-up)
  OR 0.31 [0.18, 0.53]
  4 studies
  Moderate
• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up)
  OR 0.24 [0.14, 0.41]
  7 studies · 365 participants
  Moderate
• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 18 months (radiographic follow-up)
  OR 0.18 [0.06, 0.50]
  3 studies
  Moderate

Resin sealant (one micro-invasive treatment) vs Resin infiltration alone

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  up to 3 years
  Only one study (Martignon 2012) directly compared resin sealant versus resin infiltration; the review could not determine which technique is more advantageous and reported no direct effect estimate for this comparison.
  1 study
  GRADE not reported

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

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  1 to 3 years
  The four studies that measured adverse events reported no adverse events after micro-invasive treatment (no events in either arm)
  4 studies
  GRADE not reported

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

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  No studies reported on caries measured as change in decayed, missing and filled (DMF/dmf) figures at surface, tooth or whole mouth level
  0 studies
  No studies found

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

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

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Resin sealant
  OR 0.33 [0.18, 0.59]
  2 studies
  GRADE not reported

Micro-invasive treatment (proximal sealing or resin infiltration) vs Conventional invasive treatment (restoration / drill and fill)

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  No studies compared micro-invasive treatments with invasive treatment (fillings)
  0 studies
  No studies found

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

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

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Resin infiltration
  OR 0.19 [0.08, 0.46]
  2 studies
  GRADE not reported

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

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  3 years
  One study (Alkilzy 2011, sealant patch) reported material deficiency: 10% total and 23% partial loss of proximal sealants after three years; 53% maintained perfect margins and none had open margins. No studies reported…
  1 study
  GRADE not reported

PDHA program with robust prevention vs PDHA program or PDHA program with intensive staffing

The robust prevention PDHA model was projected to yield more than 50% tooth decay-free children versus 8% with other PDHA models, without a GRADE rating.

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  20 years · Alaska
  Percentage tooth decay-free >50% vs 8%
  1 study
  GRADE not reported

DHAT-delivered dental care vs Dentist-delivered dental care

DHATs had a lower amalgam restoration deficiency rate than dentists (12% vs 22%; certainty not graded).

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Cross-sectional (DHATs practising ~9 months to several years) · Alaska Native communities (Alaska Dental Health Aide Therapist program) · Amalgam restorations
  Deficient restorations (%), DHAT vs dentist 12 vs 22 (DHAT vs dentist)
  2 studies
  GRADE not reported
• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Cross-sectional (DHATs practising ~9 months to several years) · Alaska Native communities (Alaska Dental Health Aide Therapist program) · Composite restorations
  Deficient restorations (%), DHAT vs dentist 15 vs 12 (DHAT vs dentist)
  2 studies
  GRADE not reported
• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  Cross-sectional (DHATs practising ~9 months to several years) · Alaska Native communities (Alaska Dental Health Aide Therapist program) · Stainless steel crowns
  Deficient placements (%), DHAT vs dentist 3 vs 9 (DHAT vs dentist)
  2 studies
  GRADE not reported