Gap finder
Search review questions
Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
342 questions in 11 reviews · Pain control and patient management
current versionsNo studies 158 · 46.2%Ungraded 53 · 15.5%Very low 87 · 25.4%Low 30 · 8.8%Moderate 10 · 2.9%High 4 · 1.2%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine Duration of anaesthesia · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: paraesthesia following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
3% mepivacaine plain vs 2% lidocaine, 1:50,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.97 [0.88, 1.07] | 2 studies · 70 participants | Low |
4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Duration of anaesthesia (soft tissue, simulated) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -11.80 [-27.76, 4.16] | 2 studies · 533 participants | Very low |
4% articaine plain vs 4% articaine, 1:200,000 epinephrine Duration of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -28.36 [-42.06, -14.65] | 2 studies · 102 participants | Very low |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: pain following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Speed of onset of anaesthesia (soft tissue, simulated) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD 0.02 [-1.07, 1.10] | 3 studies · 79 participants | Very low |
4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine Adverse effects: pain following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia (soft tissue, self-reported) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 1.03 [0.99, 1.07] | 6 studies · 355 participants | Moderate |
Dexmedetomidine vs A different sedative agent Behaviour · Children and adolescents (0 to 16 years) needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | Any behavioural score - Dexmedetomidine versus (other sedatives): 120 (2); VERY LOW | 2 studies · 120 participants | Very low |
4% articaine, 1:200,000 epinephrine vs 4% prilocaine, 1:200,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 1.15 [0.93, 1.41] | 3 studies · 97 participants | Very low |
4% prilocaine, 1:200,000 epinephrine vs 4% prilocaine plain Duration of anaesthesia (soft tissue, simulated) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD 18.78 [9.02, 28.54] | 2 studies · 506 participants | Low |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine Adverse effects: paraesthesia following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia, absence of pain (clinical testing of healthy pulps, hard and soft tissues) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · 10 minutes post-injection to end of clinical procedure Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | OR 0.58 [0.07, 5.12] | 2 studies · 31 participants | Low |
2% lidocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.89 [0.63, 1.26] | 3 studies · 70 participants | Very low |
4% prilocaine plain vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: pain on injection (solution deposition) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
2% mepivacaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia, absence of pain (clinical testing of diseased pulps with irreversible pulpitis) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · 10-14 minutes post-injection to end of clinical procedure Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 1.16 [0.25, 5.45] | 2 studies · 68 participants | Low |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine Speed of onset of anaesthesia (soft tissue, simulated) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -0.78 [-1.04, -0.52] | 2 studies · 116 participants | Very low |
3% mepivacaine plain vs 2% lidocaine, 1:50,000 epinephrine Speed of onset of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -0.56 [-1.54, 0.42] | 2 studies · 58 participants | Low |
3% mepivacaine plain vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.92 [0.83, 1.02] | 6 studies · 208 participants | Low |
3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine Duration of anaesthesia · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Speed of onset of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -1.19 [-3.08, 0.70] | 2 studies · 39 participants | Low |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Speed of onset of anaesthesia · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: See comment, not estimable (orphan study; duration of follow-up not reported); 100 participants, 100 interventions (1 study). Not pooled/graded. | 1 study · 100 participants | Ungraded |
4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 1:100,000 epinephrine Success of local anaesthesia, absence of pain (clinical testing of healthy pulps, hard and soft tissues) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · 10-20 minutes Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | OR 3.82 [0.61, 23.82] | 2 studies · 110 participants | Low |
4% prilocaine plain vs 2% lidocaine, 1:100,000 epinephrine Speed of onset of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -0.96 [-2.87, 0.95] | 2 studies · 52 participants | Low |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: pain on injection (solution deposition) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: See comment (orphan study; unclear whether data relate to just solution deposition; SDs not reported); 18 participants, 36 interventions (1 study). Not pooled/graded. | 1 study · 18 participants | Ungraded |
2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine Success of local anaesthesia (soft tissue, self-reported; 100% success in all studies) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | '100% success': mandibular BI - Dagher 1997 30/30 vs 30/30; IANB - Yared 1997 30/30 vs 30/30. Both 100% successful; no meta-analysis. | 2 studies · 60 participants | Ungraded |
Nitrous oxide/oxygen vs Placebo (including no intervention) Behaviour (Houpt/behavioural score) · Children and adolescents (0 to 16 years) needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | SMD 0.69 [0.13, 1.26] | 1 study · 52 participants | Very low |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | OR 2.71 [1.74, 4.22] | 8 studies · 309 participants | Low |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Duration of anaesthesia · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
Chloral hydrate/promethazine vs A different sedative agent Behaviour · Children and adolescents (0 to 16 years) needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | Any behavioural score - Chloral hydrate/promethazine versus (other sedatives): 24 (1); VERY LOW | 1 study · 24 participants | Very low |
Chloral hydrate/hydroxyzine vs A different sedative agent Behaviour · Children and adolescents (0 to 16 years) needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | Any behavioural score - Chloral hydrate/hydroxyzine versus (other sedatives): 235 (6); VERY LOW | 6 studies · 235 participants | Very low |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine Success of local anaesthesia (clinical; orphan data) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | No data available for meta-analysis; orphan data summarized in Table 6. Not pooled/graded. | NR | Ungraded |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Duration of anaesthesia (soft tissue, simulated) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD 222.88 [135.99, 309.76] | 6 studies · 232 participants | Very low |
Ketamine vs A different sedative agent Behaviour · Children and adolescents (0 to 16 years) needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | Any behavioural score - Ketamine versus (other sedatives): 494 (8); VERY LOW | 8 studies · 494 participants | Very low |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Duration of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD 21.87 [-10.96, 54.71] | 3 studies · 52 participants | Very low |
3% mepivacaine plain vs 2% lidocaine, 1:100,000 epinephrine Speed of onset of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -1.23 [-2.31, -0.16] | 3 studies · 85 participants | Low |
Midazolam (any mode of delivery) vs Different dosage of the same sedative Behaviour · Children and adolescents (0 to 16 years) needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | Any behavioural score - Midazolam (any mode of delivery): 394 (10 studies); VERY LOW. Insufficient evidence to determine whether any specific dose of intranasal midazolam is effective; weak evidence oral midazolam… | 10 studies · 394 participants | Very low |
2% mepivacaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: pain following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine Adverse effects: paraesthesia following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
4% prilocaine plain vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: paraesthesia following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: See comment; 0 participants (0 studies); 1 case of prolonged anaesthesia recorded; no clinical studies met the outcome definition (unable to confirm whether prolonged anaesthesia = paraesthesia). | 0 studies | No studies |
4% articaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 1.33 [0.33, 5.36] | 2 studies · 28 participants | Very low |
2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.81 [0.65, 1.01] | 2 studies · 60 participants | Very low |
Sedation Outcome NR · Medically compromised children (ASA III+) or children with learning/behavioural difficulties needing dental treatment Sedation of children undergoing dental treatment (2018) · Cochrane | 'Some of the techniques described may be useful in the management of medically compromised patients, but at present there are no studies carried out in these groups.' (Discussion) Explicit evidence gap. | 0 studies | No studies |
2% lidocaine, 1:80,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 1.27 [1.01, 1.59] | 2 studies · 60 participants | Very low |
4% prilocaine plain vs 2% lidocaine, 1:100,000 epinephrine Success of local anaesthesia, absence of pain (clinical testing of healthy pulps, hard and soft tissues) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · 5-30 minutes Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.86 [0.75, 0.99] | 2 studies · 228 participants | Low |
4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine Success of local anaesthesia, absence of pain (clinical testing of healthy pulps, hard and soft tissues) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · 10 minutes post-injection to end of clinical procedure Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | OR 0.87 [0.27, 2.83] | 2 studies · 37 participants | Low |
3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: paraesthesia following injection · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | SoF: Not measured. | 0 studies | No studies |
4% articaine plain vs 4% articaine, 1:100,000 epinephrine Duration of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -37.08 [-60.95, -13.21] | 2 studies · 100 participants | Very low |
2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Speed of onset of anaesthesia (pulpal, electric pulp tester; healthy pulps) · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD -0.44 [-1.66, 0.79] | 4 studies · 92 participants | Very low |