What do systematic reviews say?

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 studies reported the inclusion of a low prevalence (0% to 14%) of d3/D3 of tooth surfaces'; all included studies reported d3/D3 prevalence of 15% or above, so the planned low-prevalence…
  0 studies
  No studies found

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Non-histology reference standard (excavation, radiographs, separation)
  Specificity 0.86 [0.76, 0.92]
  Studies not reported
  GRADE not reported
• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · High prevalence of dentine caries (>= 35%)
  Specificity 0.75 [0.66, 0.82]
  Studies not reported
  GRADE not reported
• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Histology reference standard
  Specificity 0.76 [0.69, 0.81]
  Studies not reported
  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)
  Sensitivity 0.44 [0.38, 0.50]
  51 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) · Reference standard: enhanced visual (non-CBCT)
  Sensitivity 0.47 [0.29, 0.66]
  8 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) · Permanent dentition (non-CBCT)
  Sensitivity 0.44 [0.37, 0.51]
  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 medium 15-34% (non-CBCT)
  Sensitivity 0.51 [0.40, 0.61]
  Studies not reported
  GRADE not reported

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Primary/mixed dentition
  Sensitivity 0.87 [0.80, 0.92]
  Studies not reported
  GRADE not reported
• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Occlusal surface
  Sensitivity 0.87 [0.82, 0.90]
  Studies not reported
  GRADE not reported
• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Approximal surface
  Sensitivity 0.80 [0.60, 0.92]
  Studies not reported
  GRADE not reported

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) · Proximal surfaces (CBCT)
  Specificity 0.90 [0.77, 0.96]
  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)
  Specificity 0.81 [0.73, 0.88]
  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) · Occlusal surfaces (CBCT)
  Specificity 0.54 [0.31, 0.75]
  Studies not reported
  GRADE not reported

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

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

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

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

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Smooth surface
  Smooth surfaces reported by 2 datasets (Nakagawa 2013; Shi 2000) but excluded from the surface meta-analysis owing to sparsity; no summary sensitivity or specificity estimated.
  2 studies
  GRADE not reported

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

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

Other visual classification systems (unspecified or unique systems, e.g. Nyvad, Downer, Lussi, UniViSS) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Sensitivity 0.81 [0.65, 0.91]
  16 studies
  GRADE not reported

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Previously restored teeth (secondary caries)
  Only one study (Kim 2017) intentionally included restored teeth in its sample; the pre-specified secondary-caries subgroup analysis could not be performed, no summary estimate reported.
  1 study
  GRADE not reported

Cone beam computed tomography (CBCT) vs Digital radiographs (direct within-person / paired comparison); reference standard: histology

• 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 0.76 [0.43, 0.93]
  6 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) · CBCT
  Specificity 0.69 [0.35, 0.90]
  6 studies
  GRADE not reported

Cone beam computed tomography (CBCT) vs Digital radiographs (direct within-person / paired comparison); reference standard: histology

• 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) · CBCT
  Sensitivity 0.76 [0.65, 0.85]
  6 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
  Sensitivity 0.69 [0.57, 0.80]
  6 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) · 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