Clinical failure · Children with extensive decay involving the dental pulp in primary teeth
Vitapex (calcium hydroxide/iodoform) showed no clear difference in clinical failure compared with sealapex (eugenol-free calcium hydroxide); GRADE not reported.
1 finding from 1 review
Radiological failure · Children with extensive decay involving the dental pulp in primary teeth
Zinc oxide and eugenol (ZOE) showed no clear difference in radiological failure compared with formocresol (FC); GRADE not reported.
1 finding from 1 review
Radiological failure · Children with extensive decay involving the dental pulp in primary teeth
Diode laser showed no clear difference in radiological failure compared with electrosurgery (low certainty).
1 finding from 1 review
Radiological failure · Children with extensive decay involving the dental pulp in primary teeth
It is very uncertain whether non-rinse conditioner + acetone-based total-etch adhesive changes radiological failure compared with acetone-based total-etch adhesive (very low certainty).
1 finding from 1 review
Clinical failure · Children with extensive decay involving the dental pulp in primary teeth
Sealapex (eugenol-free calcium hydroxide) showed no clear difference in clinical failure compared with zinc oxide and eugenol (ZOE); GRADE not reported.
1 finding from 1 review
Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
1 study · 275 participants
GRADE not reported
Clinical success (absence of periapical pathology, tenderness to pressure and fistula formation) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
Hodosh 2003 (Analysis 3.1): all 18 patients receiving KNO3/DMI/PCa responded favourably (0/18 developed clinical symptoms) versus 9/17 in the KNO3/PCa group; symptomatic teeth required endodontic therapy or extraction.…
1 study · 35 participants
GRADE not reported
Clinical symptoms at 12 months · Adults (aged 20 to 60 years, mean 27) with deep carious lesions in permanent teeth (indirect or direct pulp capping, or complete caries…
1 finding from 1 review
Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes12 months · Complete caries removal
Analysis 2.2 (clinical symptoms at 12 months following complete caries removal, Dycal vs Cavitec). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth…
1 study · 151 participants
GRADE not reported
Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
1 study · 275 participants
GRADE not reported
Clinical symptoms at 12 months · Adults (aged 20 to 60 years, mean 27) with deep carious lesions in permanent teeth (indirect or direct pulp capping, or complete caries…
1 finding from 1 review
Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes12 months · Complete caries removal
Analysis 2.2 (clinical symptoms at 12 months following complete caries removal, Life vs Cavitec). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth…
1 study · 151 participants
GRADE not reported
Clinical success (absence of periapical pathology, tenderness to pressure and fistula formation) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
Hodosh 2003 (Analysis 3.1): all 18 patients receiving KNO3/DMI/PCa responded favourably (0/18 developed clinical symptoms) versus 10/12 in the PCa group. "The results in groups two and three were statistically…
1 study · 30 participants
GRADE not reported
Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
1 study · 275 participants
GRADE not reported
Clinical success (absence of periapical pathology, tenderness to pressure and fistula formation) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
Hodosh 2003 (Analysis 3.1): 9/17 in the KNO3/PCa group and 10/12 in the PCa group developed clinical symptoms requiring endodontic therapy or extraction. No significance test reported for this specific contrast; no…
1 study · 29 participants
GRADE not reported
Restoration longevity · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis
Cavity liners may make little or no difference to restoration longevity (high success across groups; low certainty).
1 finding from 1 review
Fracture · general population
Non-linear positive dose-response: little change in overall fracture risk below ~1.5 mg/L drinking-water fluoride, with risk increasing above that threshold (RR 1.06, 1.19, 1.35 at 2.0, 3.0, 4.0 mg/L vs null); ungraded (4 studies).
4 findings from 1 review
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.2 mg/L vs null
RR 1.00 [0.80, 1.24]
4 studies
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 4.0 mg/L vs null
RR 1.35 [0.94, 1.95]
4 studies
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 3.0 mg/L vs null
RR 1.19 [0.87, 1.64]
4 studies
GRADE not reported
Show 1 more finding
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 2.0 mg/L vs null
RR 1.06 [0.80, 1.41]
4 studies
GRADE not reported
Percentage of bleeding on probing (BOP) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Anorexia nervosa is associated with significantly increased bleeding on probing versus healthy controls (MD 16.57%, 95% CI 12.89 to 20.25; low certainty).
1 finding from 1 review
Risk of femoral fractures · general population
Femoral-fracture risk was mildly U-shaped: RR 0.86 at 0.5 mg/L rising to 1.06 at 1.8 mg/L drinking-water fluoride vs null; risk mostly below null across the range; ungraded.
2 findings from 1 review
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.8 mg/L vs null
RR 1.06 [0.67, 1.69]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 0.5 mg/L vs null
RR 0.86 [0.71, 1.05]
Studies not reported
GRADE not reported
Risk of fragility fractures · general population
Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 mg/L drinking-water fluoride vs null; ungraded.
5 findings from 1 review
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride up to 0.9 mg/L vs null
RR 0.93 [0.84, 1.02]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.8 mg/L vs null
RR 1.05 [0.82, 1.35]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Sensitivity (excluding high risk-of-bias studies): 0.8-1.5 mg/L vs null
RR 0.93 [0.72, 1.21]
Studies not reported
GRADE not reported
Show 2 more findings
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.48 mg/L vs null
RR 1.00 [0.82, 1.21]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Sensitivity (excluding high risk-of-bias studies): 1.8 mg/L vs null
RR 0.95 [0.70, 1.29]
Studies not reported
GRADE not reported
Treatment failure · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis
The evidence is very uncertain about the effect of cavity liners on treatment failure; no significant difference between lined and unlined (or differently lined) restorations was found (very low certainty).
1 finding from 1 review
Postoperative hypersensitivity (POH), patient-reported (VAS score) · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis
The evidence is very uncertain whether cavity liners reduce postoperative hypersensitivity; no significant difference was found overall (very low certainty).
1 finding from 1 review