What do systematic reviews say?

Near-infrared (NIR) transillumination vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Sensitivity 0.58 [0.46, 0.68]
  5 studies
  GRADE not reported

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Permanent dentition
  Permanent dentition (4 studies): sensitivity ranged from 0.55 to 0.65.
  4 studies
  GRADE not reported
• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Primary dentition
  Primary dentition (3 studies): sensitivity ranged from 0.91 to 0.93. No evidence of a difference in accuracy by dentition (removing accuracy covariate: Chi2=3.15, df=1, P=0.08).
  3 studies
  GRADE not reported

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Permanent dentition (non-CBCT)
  Specificity 0.90 [0.85, 0.93]
  Studies not reported
  GRADE not reported
• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Sensitivity analysis: low risk of bias for index test
  Specificity 0.88 [0.82, 0.92]
  Studies not reported
  GRADE not reported
• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Dentine-caries (D3) prevalence high >=35% or unreported (non-CBCT)
  Specificity 0.89 [0.82, 0.93]
  Studies not reported
  GRADE not reported

CarieScan Pro device vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  CarieScan Pro (3 studies, 244 tooth surfaces): sensitivity ranged from 0.55 to 0.91. No evidence of a difference in accuracy by device type (Chi2=0.05, df=1, P=0.82).
  3 studies
  GRADE not reported

Analogue (conventional) radiographs vs Digital radiographs (direct within-person / paired comparison); reference standard: histology, excavation, or enhanced visual examination

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Analogue
  Specificity 0.91 [0.86, 0.94]
  15 studies
  GRADE not reported
• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Digital
  Specificity 0.88 [0.83, 0.92]
  15 studies
  GRADE not reported

Analogue (conventional) radiographs vs Reference standard (histology, excavation, or enhanced visual examination)

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Specificity 0.90 [0.86, 0.93]
  51 studies
  GRADE not reported

Fibre-optic transillumination (FOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Sensitivity 0.47 [0.35, 0.59]
  8 studies
  GRADE not reported

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs)

The review found no eligible studies for this question.

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  No eligible studies. All included studies assessed occlusal surfaces only; smooth surfaces were a planned surface subgroup with no data.
  0 studies
  No studies found

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Permanent dentition
  Permanent dentition (4 studies): specificity ranged from 0.73 to 1.00.
  4 studies
  GRADE not reported
• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Primary dentition
  Primary dentition (3 studies): specificity ranged from 0 to 0.92.
  3 studies
  GRADE not reported

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  SoF findings (HSROC; no summary operating point reported): 'ECM: sensitivity from 0.61 to 0.98 ... CarieScan Pro: sensitivity from 0.55 to 0.91'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites…
  7 studies
  Very low

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  ECM (4 studies, 475 tooth surfaces): sensitivity ranged from 0.61 to 0.98 (0.61-0.65 in three studies; 0.98 in the most recent ECM IV study). No evidence of a difference in accuracy by device type (Chi2=0.05, df=1,…
  4 studies
  GRADE not reported

Transillumination and optical coherence tomography devices (all illumination devices combined: NIR, OCT, and FOTI/DIFOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Specificity 0.87 [0.82, 0.92]
  23 studies
  Low

Cone beam computed tomography (CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Sensitivity 0.60 [0.51, 0.68]
  7 studies
  GRADE not reported
• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Proximal surfaces (CBCT)
  Sensitivity 0.68 [0.42, 0.86]
  Studies not reported
  GRADE not reported
• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Occlusal surfaces (CBCT)
  Sensitivity 0.76 [0.55, 0.89]
  Studies not reported
  GRADE not reported

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  SoF findings (HSROC; no summary operating point reported): 'ECM: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
  7 studies
  Very low

Fibre-optic transillumination (FOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Specificity 0.92 [0.86, 0.96]
  8 studies
  GRADE not reported

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  ECM (4 studies, 475 tooth surfaces): specificity ranged from 0.73 to 0.96.
  4 studies
  GRADE not reported

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Diagnostic odds ratio (DOR) 15.65 [1.43, 171.15]
  7 studies
  Very low

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs)

The review found no eligible studies for this question.

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  No eligible studies. 'No included studies reported inclusion criteria of previously applied restorations or pit and fissure sealants' (a planned subgroup).
  0 studies
  No studies found

Transillumination/OCT device used as an adjunct to a conventional visual examination vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography)

The review found no eligible studies for this question.

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  No studies formally reported the use of the illumination devices as an adjunct to a conventional visual examination, and therefore it has not been possible to make an assessment.
  0 studies
  No studies found

Analogue (conventional) radiographs vs Digital radiographs (direct within-person / paired comparison); reference standard: histology, excavation, or enhanced visual examination

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Digital
  Sensitivity 0.47 [0.36, 0.59]
  15 studies
  GRADE not reported
• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Analogue
  Sensitivity 0.41 [0.30, 0.53]
  15 studies
  GRADE not reported