Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).

1 finding from 1 review

Fluoride-containing amalgam (FAAG) vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 2 or more years in permanent teeth, secondary caries did not differ significantly between fluoride-containing amalgam and GIC (RR 0.95, 95% CI 0.45-2.00; low certainty).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Adverse events (participants with >=1 adverse event) · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin showed a borderline, non-significant increase in adverse events versus placebo (RD 0.10, 95% CI 0.00 to 0.21; ungraded subgroup).

3 findings from 1 review

Dental fluorosis (assessed by TFI or WHO criteria) vs Individuals without dental fluorosis

Oral health-related quality of life · Indian children and young adults

Two studies found dental fluorosis significantly associated with poorer OHRQoL; narrative, ungraded.

1 finding from 1 review

Composite resin vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

Over 2 or more years in deciduous teeth, secondary caries did not differ significantly between resin composite and RMGIC (RR 1.60, 95% CI 0.85-3.00; low certainty).

1 finding from 1 review

Compomer (Dyract) vs Resin composite restoration

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

In deciduous teeth at 1 year, secondary caries did not differ significantly between compomer and resin composite, with high heterogeneity (RR 0.41, 95% CI 0.02-8.34; I2=83%; ungraded).

1 finding from 1 review

P11-4 + fluoride varnish vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Combined self-assembling peptide P11-4 plus fluoride varnish significantly improved white spot lesion remineralization versus control (SMD -0.96, 95% CI -1.44 to -0.48) and ranked highest of seven therapies by SUCRA (89.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Chlorhexidine mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce the Gingival Index versus blank control in the short term (WMD -0.54, 95% CI -0.96 to -0.13), but with very high heterogeneity the evidence is very uncertain (very low certainty).

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing pulpotomy

For pulpotomy, whether MTA improves success over calcium hydroxide is uncertain (OR 2.36, 95% CI 0.47-11.75; low certainty; CI includes no effect).

1 finding from 1 review

Calcium hydroxide (CH) vs Biodentine

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy

Biodentine appeared to perform better than calcium hydroxide for success, but the evidence was not pooled (2 RCTs; ungraded).

1 finding from 1 review

Polyether impression material vs Polyvinyl siloxane impression material

Pulp necrosis · Vital teeth

The pooled incidence with polyether impression material was 4.02%.

2 findings from 1 review

Herbal mouthwash vs placebo

Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced gingival inflammation-related indices versus placebo, but certainty is very low.

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in mature permanent teeth

In mature teeth, MTA probably achieves higher clinical and radiographic success than calcium hydroxide (OR 3.34, 95% CI 1.81-6.17; moderate certainty).

1 finding from 1 review

Fluoride varnish vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish did not differ significantly from CPP-ACFP (SMD 0.18, 95% CI -0.29 to 0.64); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing direct pulp capping

MTA increases clinical and radiographic success versus CH after direct pulp capping (moderate certainty).

1 finding from 1 review

Herbal mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Herbal mouthwash probably reduces the Gingival Index versus blank control in the short term (WMD -0.20, 95% CI -0.32 to -0.09; moderate certainty).

1 finding from 1 review

Chlorhexidine mouthwash vs placebo

Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy

MTA achieved higher clinical and radiographic success than calcium hydroxide overall (OR 2.94, 95% CI 1.96-4.49; low certainty), but this unadjusted estimate pools clinically heterogeneous DPC and pulpotomy studies.

1 finding from 1 review