Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,171 questions · 1,373 findings · 60 reviews · Dental caries

No studies found 282 · 20.5%GRADE not reported 606 · 44.1%Very low 257 · 18.7%Low 160 · 11.7%Moderate 66 · 4.8%High 2 · 0.1%

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Enhanced visual examination reference standard (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

Time taken to apply pit and fissure sealant or fluoride varnish · Children and adolescents (general population, aged under 20 years)
1 finding from 1 review

Blue fluorescence devices (VistaProof, SoproLife, Spectra; wavelength 400-450 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Analysed as a separate index test (coupled forest plot and SROC plot, Figure 24 / Figure 25; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 3 datasets, 1027 tooth sites.
    3 studies
    GRADE not reported

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

Changes in decayed, missing and filled (DMF) figures at whole-mouth level · Children and adolescents (general population, aged under 20 years)
1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity at fixed median specificity 0.78 (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Radiographic examination (bitewing radiographs) vs Reference standard: histology

Sensitivity · Extracted molar teeth of adults with resin composite approximal restorations (in vitro; secondary root caries; Switzerland)
1 finding from 1 review
  • 2 in vitro studies (59 root surfaces) using extracted, restored teeth and a histological reference standard investigated the accuracy of radiographs. Reported estimates of sensitivity ranged from 0.40 to 0.63 and…
    2 studies
    Very low

Combined index test: visual examination + radiograph + DIAGNOdent (Alomari 2015) vs Reference standard: histology

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Radiographic examination (bitewing radiographs) vs Reference standard: histology

Specificity · Extracted molar teeth of adults with resin composite approximal restorations (in vitro; secondary root caries; Switzerland)
1 finding from 1 review
  • 2 in vitro studies (59 root surfaces) using extracted, restored teeth and a histological reference standard investigated the accuracy of radiographs. Reported estimates of sensitivity ranged from 0.40 to 0.63 and…
    2 studies
    Very low

Resin-based fissure sealant (visible-light-polymerized) vs Fluoride varnish

Incidence of dentinal carious lesion on treated occlusal surfaces of molars or premolars (yes/no) · Children and adolescents (general population, aged under 20 years)

It is very uncertain whether resin-based fissure sealant (visible-light-polymerized) changes incidence of dentinal carious lesion on treated occlusal surfaces of… compared with fluoride varnish (very low certainty).

2 findings from 1 review

Resin-modified glass ionomer fissure sealant plus oral health education vs Fluoride varnish plus oral health education

Change in DMF increment on occlusal surfaces of first permanent molars · Children and adolescents (general population, aged under 20 years)

Resin-modified glass ionomer fissure sealant plus oral health… showed no clear difference in change in DMF increment on occlusal surfaces of first permanent molars compared with fluoride varnish plus oral health education; GRADE not reported.

2 findings from 1 review

Resin-based fissure sealant vs Fluoride varnish

Change in DMFT (decayed, missing and filled permanent teeth) increment · Children and adolescents (general population, aged under 20 years)

Resin-based fissure sealant led to lower change in DMFT (decayed, missing and filled permanent teeth) increment compared with fluoride varnish; GRADE not reported.

1 finding from 1 review

Resin-based fissure sealant vs Fluoride varnish

Number of visits to the dentist for repair of sealant or fluoride varnish application · Children and adolescents (general population, aged under 20 years)

Resin-based fissure sealant led to higher number of visits to the dentist for repair of sealant or fluoride… compared with fluoride varnish; GRADE not reported.

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

Change in DMFS (decayed, missing and filled permanent surfaces) increment · Children and adolescents (general population, aged under 20 years)

Resin-based fissure sealant led to lower change in DMFS (decayed, missing and filled permanent surfaces)… compared with fluoride varnish; GRADE not reported.

1 finding from 1 review

Blue fluorescence devices (VistaProof, SoproLife, Spectra; wavelength 400-450 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: High dentine-caries prevalence (>=35%) (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Primary dentition (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review