Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

107 questions · 124 findings · 13 reviews

No studies found 3 · 2.4%GRADE not reported 68 · 54.8%Very low 43 · 34.7%Low 3 · 2.4%Moderate 7 · 5.6%High 0 · 0%

Calcium hydroxide (CH) vs Mineral trioxide aggregate (MTA)

Dentin bridge formation · Patients with carious pulp exposure in permanent teeth undergoing partial pulpotomy

Evidence on dentin bridge formation for calcium hydroxide versus MTA is weak and imprecise, with no material shown superior (4 RCTs, not pooled; ungraded).

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with Calcium Enriched Mixture (CEM)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure

Biodentine had a significantly higher pulpotomy success rate than CEM (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with calcium hydroxide (Ca(OH)2)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure

Biodentine had a significantly higher pulpotomy success rate than calcium hydroxide (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with mineral trioxide aggregate (MTA)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure

Biodentine had a significantly higher pulpotomy success rate than MTA (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Caries-associated bacterial biofilm vs Sound/control tissue (sound dentin, sound root, or enamel caries)

Bacterial collagenolytic protease gene expression · Human ex vivo carious lesions / caries-associated biofilm

Genes encoding bacterial collagenolytic proteases were detected/overexpressed in coronal and root caries (ungraded; GRADE not feasible).

1 finding from 1 review

Caries-associated bacterial biofilm vs Sound/control tissue (sound dentin, sound root, or enamel caries)

Bacterial collagenolytic enzymatic activity · Human ex vivo carious lesions / caries-associated biofilm

Bacterial collagenolytic enzymatic activity in caries biofilm is inconclusive across two small studies (ungraded; GRADE not feasible).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Stepwise excavation reduced the reported risk of pulp exposure by 69% versus complete caries removal (RR 0.31; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs No treatment / other preventive agents (GIC, 5% NaF varnish)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

A second meta-analysis reported odds ratios of 2.44 to 3.63 favouring 38% SDF over fluoride varnish/water for caries arrest (ungraded).

2 findings from 1 review

38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

Twice-yearly 38% SDF was reported to arrest more caries than once-yearly application (24-month rates 91% vs 79%; ungraded).

1 finding from 1 review

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Adverse events (any type) and safety of sealant · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Subjective evaluation of the treatments by participants · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review

Hall technique vs Non-restorative cavity control (NRCC)

Efficiency, costs or cost-effectiveness · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
1 finding from 1 review

Sealing using sealant materials vs no treatment

Lesion progression · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
1 finding from 1 review

Hall technique vs Non-restorative cavity control (NRCC)

Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

It is very uncertain whether hall Technique (sealing with a preformed metal crown) changes failure of therapy compared with non-restorative cavity control (NRCC) (very low certainty).

1 finding from 1 review

Sealing using sealant materials vs no treatment

Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with no treatment (very low certainty).

1 finding 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

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