Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

129 questions · 295 findings · 29 reviews · Dental caries

No studies found 11 · 3.7%GRADE not reported 254 · 86.1%Very low 26 · 8.8%Low 3 · 1%Moderate 1 · 0.3%High 0 · 0%

Access to dental care / health services vs Not applicable (single-group prevalence)

Access to/visited dental services prevalence · Children (deciduous and/or permanent dentition) in low- and middle-income countries

About 44% of children in LMICs had access to or had visited dental services (pooled prevalence 0.444, 95% CI 0.277 to 0.618; 5 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

Middle SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 35% of children with caries in LMICs were of middle SES (pooled prevalence 0.353, 95% CI 0.180 to 0.550; 7 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

High SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 25% of children with caries in LMICs were of high SES (pooled prevalence 0.245, 95% CI 0.162 to 0.339; 5 studies; not GRADE-rated).

1 finding from 1 review

Pulpotomy (full or partial) vs None (single-arm pooled success proportion)

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

In symptomatic irreversible pulpitis, pooled pulpotomy success was 84% (95% CI 72-92%); not significantly different from asymptomatic (z=-1.34, p=0.18); ungraded.

1 finding from 1 review

Tooth-coloured direct restorative materials (composite, compomer, giomer, RMGIC, HVGIC, open-sandwich) vs No comparator

Retention success rate · Children with primary molars requiring proximal (Class II) restorations

For the Rubber dam isolation: Yes subgroup, the 24-month retention success rate was 0.931 (95% CI 0.834-0.973; ungraded).

28 findings from 1 review
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Tooth-coloured direct restorative materials (composite, compomer, giomer, RMGIC, HVGIC, open-sandwich) vs No comparator

Marginal integrity success rate · Children with primary molars requiring proximal (Class II) restorations

After trim-and-fill adjustment the marginal integrity success rate was 0.881 (95% CI 0.832-0.916; ungraded), a negligible change.

2 findings from 1 review

Tooth-coloured direct restorative materials (composite, compomer, giomer, RMGIC, HVGIC, open-sandwich) vs No comparator

Anatomic form success rate · Children with primary molars requiring proximal (Class II) restorations

The pooled 24-month anatomic form success rate was 0.901 (95% CI 0.845-0.938; ungraded).

2 findings from 1 review

Tooth-coloured direct restorative materials (composite, compomer, giomer, RMGIC, HVGIC, open-sandwich) vs No comparator

Absence of recurrent caries success rate · Children with primary molars requiring proximal (Class II) restorations

After trim-and-fill adjustment the absence-of-recurrent-caries success rate was 0.878 (95% CI 0.828-0.915; ungraded), a negligible change.

2 findings from 1 review

Silver diamine fluoride (SDF) vs Not applicable (single-arm safety outcome)

Serious adverse events · Children and older adults treated with SDF for carious lesions

No serious adverse events (e.g., allergic reactions or toxicity) were reported for SDF across the reviews (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Not applicable (single-arm safety outcome)

Adverse events: black staining of arrested lesions · Children and older adults treated with SDF for carious lesions

Black staining of arrested lesions was the main adverse event of SDF (reported by seven reviews); it was generally acceptable to patients (ungraded).

1 finding from 1 review

Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)

Marginal bone level change · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown

Metal-free implant abutments (zirconia) showed no clear difference in marginal bone level change (MBLC) compared with metal implant abutments (titanium); GRADE not reported.

2 findings from 1 review

Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)

Periodontal or peri-implant status: gingival recession (REC) · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown

Metal-free implant abutments (zirconia) showed no clear difference in gingival/mucosal recession (REC) compared with metal implant abutments (titanium); GRADE not reported.

1 finding from 1 review

Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)

Abutment failure · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown

It is very uncertain whether metal-free implant abutments (zirconia) changes abutment failure compared with metal implant abutments (titanium) (very low certainty).

1 finding from 1 review

Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)

Implant probing pocket depth (PPD) · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown

Metal-free implant abutments (zirconia) showed no clear difference in implant probing pocket depth (PPD) compared with metal implant abutments (titanium); GRADE not reported.

1 finding from 1 review

Metal-free implant abutments (zirconia) vs Metal implant abutments (titanium)

Aesthetics · Adults (18 years or older) with one missing tooth in the aesthetic zone needing an implant-supported single crown
1 finding from 1 review
  • Primary outcome aesthetic evaluation data were reported as the frequency of distribution of the Implant Crown Aesthetic Index (ICAI); no comparative summary estimate was presented.
    2 studies · 47 participants
    Very low

Fluoride varnish vs Untreated lesions (single-arm before vs after proportion)

Remineralisation of early enamel caries · Patients (mainly children) with white spot lesions (WSL)

Professionally applied 5% sodium fluoride varnish remineralised about two-thirds of early enamel caries lesions in children (pooled proportion 63.6%, 95% CI 36.0% to 91.2%; 4 studies); certainty was not GRADE-rated and heterogeneity was very high (I2=96%).

1 finding from 1 review

38% silver diamine fluoride vs Active dentine caries at baseline (single-arm before vs after proportion)

Arrest of dentine caries · Children with dentine caries in primary and permanent teeth

Professionally applied 38% silver diamine fluoride arrested about two-thirds of active dentine caries surfaces in children (pooled proportion 65.9%, 95% CI 41.2% to 90.7%; 5 studies); certainty was not GRADE-rated and heterogeneity was very high (I2=96%).

1 finding from 1 review

ART sealant using high-viscosity glass ionomer (press-finger technique) vs No comparator

Retention of sealant (complete or partial retention) · Pits and fissures of permanent (posterior) teeth

High-viscosity glass-ionomer ART sealants showed 4-year retention of 68% (95% CI 61-75%); evidence ungraded.

6 findings from 1 review
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High-viscosity glass-ionomer ART restorations vs No comparator

Restoration survival · Permanent posterior teeth with single-surface cavities

The pooled survival rate was 93% at 2 years.

6 findings from 1 review
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