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Evidence found and GRADE certainty

79 questions · 121 findings · 11 reviews

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No studies found 1 · 0.8%GRADE not reported 113 · 93.4%Very low 6 · 5%Low 0 · 0%Moderate 1 · 0.8%High 0 · 0%

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Fluoride-releasing coating materials do not appear to reduce WSL initiation more than non-fluoride coatings (RR 0.84, not significant); certainty of evidence is very low.

1 finding from 1 review

Fluoride-releasing resin-based bonding agent vs Non-fluoride resin-based bonding agent

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For resin-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.97); subgroup not separately GRADE-rated.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Sensitivity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled sensitivity (0.85) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%) and evidence of publication bias.

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative post-test probability · Dental images or diagnostic tests for dental caries detection

The negative post-test probability was 6%; certainty was not graded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Specificity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled specificity (0.90) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%).

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Area under the summary ROC curve · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

The area under the summary ROC curve for AI caries detection is 0.86, indicating high overall diagnostic accuracy; ungraded.

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive post-test probability · Dental images or diagnostic tests for dental caries detection

The positive post-test probability was 79%; certainty was not graded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A positive AI test raises caries probability substantially (LR+ 10.44; positive post-test probability 79%); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Log diagnostic odds ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms show strong pooled discriminative accuracy for dental caries (log DOR 4.37; DOR 70.9); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A negative AI test lowers caries probability substantially (LR- 0.17; negative post-test probability 6%); ungraded.

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Diagnostic odds ratio · Dental images or diagnostic tests for dental caries detection

The pooled diagnostic odds ratio was 70.9 (95% CI 44.9 to 111.9) across 20 studies; certainty was not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Intra-examiner reliability ranged from kappa 0.52 to 1.00 across 6 studies; certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Overall diagnostic accuracy (agreement) · Children and adults with primary or permanent dentition undergoing dental caries assessment

Where reported (about 5 studies, Table 2), overall diagnostic accuracy was high (about 93% to 97.6%); no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Specificity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the specificity of teledentistry caries diagnosis ranged from 83% to 100%; no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Sensitivity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Inter-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Inter-examiner reliability ranged from kappa 0.44 to 0.91 across 13 studies (moderate to almost perfect agreement); certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Negative predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Negative predictive value was reported in 10 studies and ranged widely across studies (about 31% to 99.5%); no pooled estimate and certainty not graded.

1 finding from 1 review