Findings

What do systematic reviews say?

44 questions · 144 findings · 4 reviews · Oral Health

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No studies found 2 · 1.4%GRADE not reported 140 · 97.2%Very low 0 · 0%Low 2 · 1.4%Moderate 0 · 0%High 0 · 0%

Radiographic caries detection vs Reference standard (often histological; also invasive opening)

Advanced proximal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled sensitivity for radiographic detection of advanced proximal lesions was 0.444 (95% CI 0.38 to 0.51).

8 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
All included studies · Conventional meta-analysis (all studies)
Sensitivity 44.4 [38, 51]
22 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
All included studies · Conventional meta-analysis (all studies)
Negative LR 0.58 [0.52, 0.65]
22 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
All included studies · Conventional meta-analysis (all studies)
Positive LR 9.82 [7.3, 13.3]
22 studies
GRADE not reported

Show 5 more findings

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Egypt public health clinic · Tailored meta-analysis (Egypt)
Specificity 95.5 [94, 97]
22 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Egypt public health clinic · Tailored meta-analysis (Egypt)
Negative LR 0.58 [0.52, 0.65]
22 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
All included studies · Conventional meta-analysis (all studies)
Specificity 95.5 [94, 97]
22 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Egypt public health clinic · Tailored meta-analysis (Egypt)
Sensitivity 44.4 [38, 51]
22 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Egypt public health clinic · Tailored meta-analysis (Egypt)
Positive LR 9.82 [7.3, 13.3]
22 studies
GRADE not reported

Radiographic caries detection vs Reference standard (often histological; also invasive opening)

All proximal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled specificity for radiographic detection of all proximal lesions was 0.900 (95% CI 0.87 to 0.92).

1 finding from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
All included studies · Conventional meta-analysis (all studies)
Specificity 90.0 [87, 92]
38 studies
GRADE not reported

AI systems for caries detection/segmentation on dental X-ray images (predominantly convolutional neural networks; also ANNs, DNNs, DCNN, FCNN, SVMs, decision trees, random forests; e.g. EfficientNet, ResNet, AlexNet) vs Human dentists / trained dental professionals or traditional radiographic interpretation (reference standard / reference models)

Specificity · Patients undergoing dental X-ray (radiographic) imaging for caries detection

Across 7 studies, AI showed high weighted-mean specificity (~87.9%) for caries detection, with very high heterogeneity (I2=96%); ungraded.

1 finding from 1 review

Accuracy of artificial intelligence in caries detection: a systematic review and meta-analysis. 2025 All outcomes
Dental radiography (digital periapical, bitewing, panoramic; OCT/micro-CT in one study); studies 2017-2023 across China, South Korea, Brazil, Turkey, France, USA, UK, Taiwan, Germany, India, Netherlands · Overall (all studies pooled)
Proportion (weighted mean specificity, %) 87.90
7 studies
GRADE not reported

AI systems for caries detection/segmentation on dental X-ray images (predominantly convolutional neural networks; also ANNs, DNNs, DCNN, FCNN, SVMs, decision trees, random forests; e.g. EfficientNet, ResNet, AlexNet) vs Human dentists / trained dental professionals or traditional radiographic interpretation (reference standard / reference models)

Diagnostic accuracy (prevalence of accuracy) · Patients undergoing dental X-ray (radiographic) imaging for caries detection

On digital bitewing X-rays, AI accuracy was around 80% (single study, narrow CI; ungraded subgroup, numeric estimate not precisely readable).

4 findings from 1 review

Accuracy of artificial intelligence in caries detection: a systematic review and meta-analysis. 2025 All outcomes
Dental radiography (digital periapical, bitewing, panoramic; OCT/micro-CT in one study); studies 2017-2023 across China, South Korea, Brazil, Turkey, France, USA, UK, Taiwan, Germany, India, Netherlands · Digital bitewing X-rays (Fig 4a)
~80
1 study
GRADE not reported
Accuracy of artificial intelligence in caries detection: a systematic review and meta-analysis. 2025 All outcomes
Dental radiography (digital periapical, bitewing, panoramic; OCT/micro-CT in one study); studies 2017-2023 across China, South Korea, Brazil, Turkey, France, USA, UK, Taiwan, Germany, India, Netherlands · Periapical X-rays (Fig 4c)
~76
Studies not reported
GRADE not reported
Accuracy of artificial intelligence in caries detection: a systematic review and meta-analysis. 2025 All outcomes
Dental radiography (digital periapical, bitewing, panoramic; OCT/micro-CT in one study); studies 2017-2023 across China, South Korea, Brazil, Turkey, France, USA, UK, Taiwan, Germany, India, Netherlands · Digital panoramic X-rays (Fig 4b)
~70
1 study
GRADE not reported

Show 1 more finding

Accuracy of artificial intelligence in caries detection: a systematic review and meta-analysis. 2025 All outcomes
Dental radiography (digital periapical, bitewing, panoramic; OCT/micro-CT in one study); studies 2017-2023 across China, South Korea, Brazil, Turkey, France, USA, UK, Taiwan, Germany, India, Netherlands · Overall (all X-ray types pooled)
OR 2.72 [14.65, 14.65]
14 studies
GRADE not reported

AI systems for caries detection/segmentation on dental X-ray images (predominantly convolutional neural networks; also ANNs, DNNs, DCNN, FCNN, SVMs, decision trees, random forests; e.g. EfficientNet, ResNet, AlexNet) vs Human dentists / trained dental professionals or traditional radiographic interpretation (reference standard / reference models)

Sensitivity · Patients undergoing dental X-ray (radiographic) imaging for caries detection

Pooling 9 studies (17,190 participants), AI sensitivity for caries detection showed no significant association (pooled OR 1.258, 95% CI 0.493-2.540) with high heterogeneity (I2=86%); ungraded.

1 finding from 1 review

Accuracy of artificial intelligence in caries detection: a systematic review and meta-analysis. 2025 All outcomes
Dental radiography (digital periapical, bitewing, panoramic; OCT/micro-CT in one study); studies 2017-2023 across China, South Korea, Brazil, Turkey, France, USA, UK, Taiwan, Germany, India, Netherlands · Overall (all studies pooled)
OR 1.258 [0.493, 2.540]
9 studies · 17190 participants
GRADE not reported

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms compared with one another / against the reference caries diagnosis

Diagnostic accuracy for root caries detection · Dental radiographic/intraoral images of human teeth (X-ray and photographic)

One study reported machine-learning accuracy for root caries detection (97.1%, support vector machine); not pooled and not graded.

1 finding from 1 review

Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. 2022 All outcomes
Dental image datasets (X-ray/intraoral photographs), multiple countries, 2008-2022 · Root caries
Accuracy 97.1
1 study
GRADE not reported

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

Sensitivity 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…

17 findings from 1 review

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

Show 14 more findings

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 low <15% (non-CBCT)
Sensitivity 0.36 [0.25, 0.47]
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) · Reference standard: excavation (non-CBCT)
Sensitivity 0.51 [0.27, 0.74]
5 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 and digital combined (non-CBCT); 97 datasets
Sensitivity 0.46 [0.40, 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 high >=35% or unreported (non-CBCT)
Sensitivity 0.50 [0.40, 0.59]
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
Sensitivity 0.51 [0.43, 0.61]
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: excluding high/unclear risk of bias reference standard
Sensitivity 0.51 [0.45, 0.57]
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) · Setting: in vivo / clinical (non-CBCT)
Sensitivity 0.56 [0.43, 0.69]
17 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) · Setting: in vitro (non-CBCT)
Sensitivity 0.44 [0.37, 0.50]
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 dentine-caries prevalence <15%
Sensitivity 0.34 [0.25, 0.45]
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) · Reference standard: histology (non-CBCT)
Sensitivity 0.46 [0.39, 0.53]
64 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)
Sensitivity 0.47 [0.40, 0.53]
77 studies
Low
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 (non-CBCT)
Sensitivity 0.45 [0.35, 0.54]
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) · Primary dentition (non-CBCT)
Sensitivity 0.52 [0.40, 0.63]
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) · Proximal surfaces (non-CBCT)
Sensitivity 0.47 [0.39, 0.55]
Studies not reported
GRADE not reported

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

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…

17 findings from 1 review

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

Show 14 more findings

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) · Setting: in vitro (non-CBCT)
Specificity 0.89 [0.84, 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) · Proximal surfaces (non-CBCT)
Specificity 0.89 [0.84, 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) · Primary dentition (non-CBCT)
Specificity 0.87 [0.77, 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) · Occlusal surfaces (non-CBCT)
Specificity 0.88 [0.80, 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: excluding high/unclear risk of bias reference standard
Specificity 0.87 [0.83, 0.90]
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) · Reference standard: excavation (non-CBCT)
Specificity 0.96 [0.80, 0.99]
5 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) · Dentine-caries (D3) prevalence medium 15-34% (non-CBCT)
Specificity 0.87 [0.78, 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)
Specificity 0.88 [0.84, 0.92]
77 studies
Low
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 and digital combined (non-CBCT); 97 datasets
Specificity 0.89 [0.86, 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) · Sensitivity analysis: low dentine-caries prevalence <15%
Specificity 0.91 [0.87, 0.94]
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 low <15% (non-CBCT)
Specificity 0.91 [0.85, 0.95]
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) · Setting: in vivo / clinical (non-CBCT)
Specificity 0.89 [0.78, 0.95]
17 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) · Reference standard: enhanced visual (non-CBCT)
Specificity 0.91 [0.77, 0.97]
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) · Reference standard: histology (non-CBCT)
Specificity 0.88 [0.83, 0.92]
64 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, pooled specificity of visual detection for all (initial and advanced) occlusal caries was 75.3% (95% CI 70 to 80) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Specificity 75.3 [70, 80]
67 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Specificity 91.2 [88, 94]
12 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Specificity 77.0 [73, 81]
51 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

PPV for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the positive predictive value of visual detection for advanced occlusal caries was 77.9% at an assumed prevalence of 22.0% (ungraded).

2 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
PPV 77.9
50 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
PPV 30.6
55 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled sensitivity of visual detection for all (initial and advanced) occlusal caries was 49.1% (95% CI 40 to 58) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Sensitivity 49.1 [40, 58]
12 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Sensitivity 85.5 [81, 89]
67 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Sensitivity 85.8 [82, 89]
51 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of visual detection for all (initial and advanced) occlusal caries was 0.19 (95% CI 0.15 to 0.25) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Negative LR 0.19 [0.15, 0.25]
67 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Negative LR 0.18 [0.14, 0.24]
51 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Negative LR 0.56 [0.46, 0.68]
12 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the positive lr of visual detection for advanced occlusal caries was 7.09 (95% CI 5.6 to 8.9) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Positive LR 7.09 [5.6, 8.9]
94 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Positive LR 5.0 [4.3, 5.8]
55 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Positive LR 12.5 [9.2, 16.9]
50 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the negative lr of visual detection for advanced occlusal caries was 0.58 (95% CI 0.5 to 0.7) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Negative LR 0.58 [0.5, 0.7]
50 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Negative LR 0.39 [0.3, 0.5]
94 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Negative LR 0.29 [0.2, 0.4]
55 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

NPV for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the Egyptian public health clinic setting, the negative predictive value of visual detection for all (initial and advanced) occlusal caries was 97.4% at an assumed prevalence of 12.9% (ungraded).

2 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
NPV 97.4
51 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
NPV 68.6
12 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled specificity of visual detection for advanced occlusal caries was 96.5% (95% CI 95 to 97) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Specificity 96.5 [95, 97]
50 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Specificity 90.9 [88, 93]
94 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Specificity 84.9 [82, 89]
55 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

NPV for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the negative predictive value of visual detection for advanced occlusal caries was 85.9% at an assumed prevalence of 22.0% (ungraded).

2 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
NPV 85.9
50 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
NPV 97.5
55 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, the positive lr of visual detection for all (initial and advanced) occlusal caries was 3.73 (95% CI 3.1 to 4.4) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Positive LR 3.73 [3.1, 4.4]
51 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Positive LR 5.56 [3.7, 8.5]
12 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Positive LR 3.46 [2.8, 4.3]
67 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

PPV for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the positive predictive value of visual detection for all (initial and advanced) occlusal caries was 82.0% at an assumed prevalence of 45.0% (ungraded).

2 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
PPV 82.0
12 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
PPV 35.6
51 studies
GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled sensitivity of visual detection for advanced occlusal caries was 43.7% (95% CI 37 to 51) (ungraded).

3 findings from 1 review

Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Private practice, rural northern Germany · Tailored to Germany
Sensitivity 43.7 [37, 51]
50 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Conventional meta-analysis (all studies)
Sensitivity 64.6 [57, 71]
94 studies
GRADE not reported
Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. 2018 All outcomes
Public health clinic, Giza (Cairo), Egypt · Tailored to Egypt
Sensitivity 75.1 [70, 81]
55 studies
GRADE not reported