Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

602 questions · 963 findings · 90 reviews

No studies found 118 · 12.3%GRADE not reported 578 · 60%Very low 93 · 9.7%Low 92 · 9.6%Moderate 59 · 6.1%High 23 · 2.4%

Radiographic caries detection (bitewing radiography) 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) proximal caries · Proximal 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 sensitivity of radiographic detection for all (initial and advanced) proximal caries was 43.2% (95% CI 36 to 51) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) 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 Egyptian public health clinic setting, the negative predictive value of radiographic detection for advanced occlusal caries was 89.3% at an assumed prevalence of 19.0% (ungraded).

2 findings from 1 review

Conventional restorative treatment with resin composite (CRT-RC) vs Sealing

Treatment success (caries lesion arrest or restoration survival) · Children with dentin caries lesions in the outer half of dentin on occlusal surfaces of primary teeth

Conventional restorative treatment with resin composite gave a higher treatment success rate than resin sealing for outer-half occlusal dentin caries in primary teeth (2 studies; low certainty).

1 finding from 1 review

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

Radiographic caries detection (bitewing radiography) 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 radiographic detection for all (initial and advanced) occlusal caries was 22.6% at an assumed prevalence of 11.0% (ungraded).

2 findings from 1 review

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 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

Radiographic caries detection (bitewing radiography) 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 Egyptian public health clinic setting, the positive predictive value of radiographic detection for advanced occlusal caries was 58.3% at an assumed prevalence of 19.0% (ungraded).

2 findings from 1 review

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

Radiographic caries detection (bitewing radiography) 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 radiographic detection for all (initial and advanced) occlusal caries was 36.0% (95% CI 20 to 56) (ungraded).

3 findings from 1 review

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 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

Conventional restorative treatment with resin composite (CRT-RC) vs Sealing

Caries lesion arrestment · Children with dentin caries lesions in the outer half of dentin on occlusal surfaces of primary teeth

Resin sealing and conventional restorative treatment (resin composite) did not differ significantly for caries lesion arrestment in outer-half occlusal dentin caries of primary teeth (2 studies; low certainty).

1 finding from 1 review

Fluorescence camera (FC) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by setting (FC, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant setting difference for FC (RDOR 2.96, 0.36 to 24.45).

2 findings from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… probably leads to lower pulp exposure during caries removal compared with complete caries removal (moderate certainty).

1 finding from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard

More advanced caries lesion detection · Primary teeth with approximal surfaces

Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=89%; no GRADE rating was reported.

2 findings from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Restoration failure · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

It is very uncertain whether partial caries removal (single stage; residual dentinal caries… changes failure of restorations compared with complete caries removal (very low certainty).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Progression of caries · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

The review found no eligible studies for this question.

1 finding from 1 review

Fluorescence camera (FC) vs Reference standard

Initial caries lesion detection · Primary teeth with occlusal surfaces

Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported.

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions

Pen-type laser fluorescence on occlusal surfaces of permanent teeth (more advanced-lesion threshold): pooled DOR for LFpen lower than for LF and FC; heterogeneity I2=73%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review