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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 |
|---|---|---|---|
Sevoflurane 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 - Sevoflurane versus (other sedatives): 1140 (3); VERY LOW | 3 studies · 1140 participants | Very low |
2% mepivacaine, 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 |
2% mepivacaine, 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 |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 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: Not measured. | 0 studies | No studies |
2% mepivacaine, 1:100,000 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); 48 participants, 48 interventions (1 study). Not pooled/graded. | 1 study · 48 participants | Ungraded |
3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: allergy to local anaesthetic · 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 |
Ketamine/midazolam 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/midazolam versus (other sedatives): 27 (1); VERY LOW | 1 study · 27 participants | Very low |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: allergy to local anaesthetic · 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 (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 3.32 [0.27, 6.37] | 2 studies · 63 participants | Low |
4% articaine, 1:100,000 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: Not measured. | 0 studies | No studies |
Oral midazolam 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 - Oral midazolam versus (other sedatives): 654 (7); VERY LOW | 7 studies · 654 participants | Very low |
4% prilocaine, 1:200,000 epinephrine vs 4% articaine, 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 1.74 [1.16, 2.60] | 2 studies · 78 participants | Low |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 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 0.97 [0.87, 1.08] | 5 studies · 248 participants | Low |
4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 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 -0.85 [-1.26, -0.44] | 2 studies · 69 participants | Very low |
4% articaine, 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 0.19 [-2.06, 2.45] | 2 studies · 40 participants | Very low |
4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 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; 147 participants, 147 interventions (2 studies); unclear whether data relate to just solution deposition. Not pooled/graded. | 2 studies · 147 participants | Ungraded |
4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine Adverse effects: allergy to local anaesthetic · 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 |
Oral diazepam 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 0.62 [-0.28, 1.53] | 1 study · 20 participants | Very low |
0.5% bupivacaine, 1:200,000 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 |
4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 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 (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 0.80 [0.62, 1.05] | 3 studies · 90 participants | Low |
4% articaine, 1:100,000 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 -0.63 [-1.69, 0.42] | 6 studies · 202 participants | Very low |
0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 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 | 'Other comparisons with 100% success': IANB - Sampaio 2012 35/35 vs 35/35; Fernandez 2005 39/39 vs 39/39. Both formulations 100% successful; no meta-analysis (no difference). | 2 studies · 74 participants | Ungraded |
4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: pain on injection (solution deposition), Heft-Parker VAS 0-170 mm · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · 0-1 minute following needle insertion Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD 4.74 [-1.98, 11.46] | 3 studies · 157 participants | Moderate |
Intravenous midazolam 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 1.21 [0.24, 2.18] | 1 study · 20 participants | Very low |
0.5% bupivacaine, 1:200,000 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 |
4% articaine plain vs 4% articaine, 1:200,000 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 0.03 [-0.66, 0.71] | 2 studies · 102 participants | Very low |
3% prilocaine, 0.03 IU felypressin 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: Not measured. | 0 studies | No studies |
4% prilocaine, 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 1.14 [0.91, 1.43] | 2 studies · 48 participants | Low |
3% prilocaine, 0.03 IU felypressin 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… · Not reported (estimated < 2 hours) Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.86 [0.79, 0.95] | 2 studies · 907 participants | Moderate |
3% prilocaine, 0.03 IU felypressin 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, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: pain following injection, Heft-Parker VAS 0-170 mm · Participants of any age and gender undergoing dental procedures, and volunteers who took part in simulated scenario… · Measured at the time anaesthesia wore off Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | MD 6.41 [1.01, 11.8] | 3 studies · 156 participants | Moderate |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 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 minutes post-injection to end of clinical procedure Injectable local anaesthetic agents for dental anaesthesia (2018) · Cochrane | RR 0.85 [0.71, 1.02] | 3 studies · 930 participants | Very low |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine Adverse effects: allergy to local anaesthetic · 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; 63 participants, 187 interventions (1 study); 1 case of urticaria occurred (unclear which anaesthetic). Not pooled/graded. | 1 study · 63 participants | Ungraded |
2% mepivacaine, 1:20,000 levonordefrin vs 2% lidocaine, 1:100,000 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 clinical success data summarized in Table 6 (e.g. clinical anaesthesia success 2% lidocaine 1:100,000 64/110 vs 2% mepivacaine 1:20,000 levonordefrin 99/113). Not… | NR | Ungraded |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 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: See comment (orphan study; exact time of follow-up not reported); 86 participants, 172 interventions (1 study). Not pooled/graded. | 1 study · 86 participants | Ungraded |
4% articaine, 1:100,000 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 56.88 [44.08, 69.69] | 2 studies · 422 participants | Low |
2% mepivacaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine Adverse effects: allergy to local anaesthetic · 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 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 -172.61 [-239.69, -105.53] | 2 studies · 39 participants | Very low |
4% articaine, 1:200,000 epinephrine vs 4% articaine, 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 0.15 [-0.42, 0.73] | 5 studies · 162 participants | Very low |
4% prilocaine, 1:200,000 epinephrine vs 4% prilocaine plain Success of local anaesthesia (clinical/EPT; 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; data summarized in Table 5 (orphan). Not pooled/graded. | NR | Ungraded |
Oral midazolam 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 1.96 [1.59, 2.33] | 6 studies · 202 participants | Moderate |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Rescue analgesia · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | RR 0.8 [0.3, 1.9] | 2 studies · 41 participants | Ungraded |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 2 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -11.66 [-16.15, -7.17] | 10 studies · 685 participants | Moderate |
Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg) Time off school or work · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Quality of life or participant satisfaction · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | Reported narratively by 2 studies (Wang 2012: SF-36 and SAS - significant reduction in SF-36 bodily pain at 30 days vs baseline, no significant between-group differences; Minor 2009: STAI and PANAS - no significant… | 2 studies | Ungraded |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 24 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -9.74 [-47.88, 28.40] | 2 studies · 69 participants | Very low |
NSAID (systemic) vs Paracetamol Rescue analgesia · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | RR 1.5 [0.6, 3.6] | 1 study · 159 participants | Very low |
Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg) Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 24 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -21.19 [-28.31, -14.06] | 12 studies · 1012 participants | Moderate |