Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

60 questions · 69 findings · 11 reviews · Dental caries

No studies found 14 · 20.3%GRADE not reported 25 · 36.2%Very low 30 · 43.5%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Recurrent oral ulcerations (WHO clinical stage 2) · Children or adolescents

CLWH on ART had significantly higher prevalence of recurrent oral ulcerations than healthy controls (pooled OR 6.83, 95% CI 1.18 to 39.53).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between ART regimens (very low certainty).

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Ulcerative stomatitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Ulcerative stomatitis was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Acute necrotizing ulcerative gingivitis/periodontitis (WHO clinical stage 3) · Children or adolescents

No eligible studies reported acute necrotizing ulcerative gingivitis/periodontitis.

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Acute necrotising ulcerative periodontitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in acute necrotising ulcerative periodontitis between ART regimens (very low certainty).

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between CLWH with and without ART (very low certainty).

1 finding from 1 review

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Oral ulcerations · Children and adolescents with juvenile idiopathic arthritis (JIA)

A single study reported more oral ulcerations in children with JIA (5/41) than without JIA (1/41); evidence is limited to one study (ungraded).

1 finding from 1 review

Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional ceramic brackets

Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Adhesive precoated flash-free brackets showed no demineralization difference, with certainty not graded.

1 finding from 1 review

Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional brackets

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

Two studies found adhesive flash-free brackets did not clinically reduce enamel demineralization or white spot lesions versus conventional brackets, though they reduced pathogenic bacteria (ungraded).

1 finding from 1 review

Inflammatory bowel disease (IBD) vs Healthy controls without IBD

DMFT/DMFS index (dental caries experience) · Patients with IBD (Crohn's disease and ulcerative colitis) and controls without IBD

Most included studies reported higher dental caries indices (DMF-t/DMF-s) in IBD patients (especially ulcerative colitis), but findings were inconsistent across studies and were not meta-analyzed or GRADE-rated.

1 finding from 1 review
  • Oral Health Status in Patients with Inflammatory Bowel Diseases: A Systematic Review. 2021 All outcomes
    Hospital/clinic-based case-control and cross-sectional studies in 11 countries; 15 studies total (1748 participants: 1104 Crohn's disease, 534 ulcerative colitis, 110 IBD-form unspecified)
    Not meta-analyzed (heterogeneity of caries indices). Abstract: "in most studies, patients with IBD were characterized by higher values of caries indices." Table 3 examples (IBD/subtype vs control): Zhang 2020 DMF-t…
    Studies not reported
    GRADE not reported

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs

Plaque · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) showed no clear difference in plaque index (PI) compared with metal-ceramic cantilevered FDPs; GRADE not reported.

1 finding from 1 review

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs

Cantilevered bridge failure · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis
1 finding from 1 review

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs

Gingival index (GI) · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) showed no clear difference in gingival index (GI) compared with metal-ceramic cantilevered FDPs; GRADE not reported.

1 finding from 1 review

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs

Cantilevered bridge complications · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis

It is very uncertain whether metal-free cantilevered FDPs (feldspathic-veneered zirconia) changes cantilevered bridge complications compared with metal-ceramic cantilevered FDPs (very low certainty).

2 findings from 1 review

Metal-free FDPs (lithium disilicate) vs Metal-ceramic FDPs

Bridge failure · Adults (18 years or older) needing a three-unit fixed dental prosthesis (FDP)

It is very uncertain whether metal-free FDPs (lithium disilicate) changes bridge failure compared with metal-ceramic FDPs (very low certainty).

2 findings from 1 review

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs

Aesthetics evaluated by the patient · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis

It is very uncertain whether metal-free cantilevered FDPs (feldspathic-veneered zirconia) changes aesthetic evaluation (patient VAS) compared with metal-ceramic cantilevered FDPs (very low certainty).

1 finding from 1 review

Direct composite resin restoration vs Full-coverage metal-ceramic crown

Clinical failure (post dislodgement) · Participants with endodontically-treated permanent premolars restored with a carbon-fibre post (Category III)

Direct composite restoration (final restoration) showed no clear difference in clinical failure (post dislodgement) compared with full-coverage metal-ceramic crown; GRADE not reported.

1 finding from 1 review