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Evidence found and GRADE certainty

1,692 questions · 2,586 findings · 180 reviews · Dental caries

No studies found 194 · 7.5%GRADE not reported 1,937 · 74.9%Very low 248 · 9.6%Low 136 · 5.3%Moderate 52 · 2%High 19 · 0.7%

Conventional bitewing radiography (E-speed film) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, conventional bitewing radiography (E-speed) pooled sensitivity was 0.48 (95% CI 0.21 to 0.77) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Visual examination (VE) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, visual examination pooled sensitivity was 0.46 (95% CI 0.20 to 0.73) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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CarieScan Pro device vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    CarieScan Pro (3 studies, 244 tooth surfaces): sensitivity ranged from 0.55 to 0.91. No evidence of a difference in accuracy by device type (Chi2=0.05, df=1, P=0.82).
    3 studies
    GRADE not reported

Conventional bitewing radiography (E-speed film) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, conventional E-speed bitewing radiography had a pooled specificity of 0.91 (95% CI 0.80, 0.96) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Laser fluorescence (DIAGNOdent 2190/pen) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (caries detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, laser fluorescence (DIAGNOdent 2190) had a summary ROC AUC of 0.96 for proximal caries detection at the caries detection level; ungraded.

4 findings from 1 review
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Analogue (conventional) radiographs vs Digital radiographs (direct within-person / paired comparison); reference standard: histology, excavation, or enhanced visual examination

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

Fibre-optic transillumination (FOTI) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, fibre-optic transillumination pooled specificity was 0.97 (95% CI 0.89 to 0.994) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Analogue (conventional) radiographs vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Selective carious tissue removal (selective excavation, SE) vs Hall Technique (sealing with a preformed metal crown)

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 selective carious tissue removal (selective excavation, SE) changes failure of therapy compared with hall Technique (sealing with a preformed metal crown) (very low certainty).

2 findings from 1 review

Fibre-optic transillumination (FOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Non-selective carious tissue removal and conventional restoration (CR) vs Hall Technique (sealing with a preformed metal crown)

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

Non-selective carious tissue removal and conventional restoration (CR) may leads to higher failure of therapy compared with hall Technique (sealing with a preformed metal crown) (low certainty).

1 finding from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
2 findings from 1 review

Digital bitewing radiography, sensor-based (CCD/CMOS) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (caries detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, sensor-based digital bitewing radiography had a pooled specificity of 0.93 (95% CI 0.77, 0.98) for proximal caries detection at the caries detection level; ungraded.

4 findings from 1 review
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Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: sensitivity from 0.61 to 0.98 ... CarieScan Pro: sensitivity from 0.55 to 0.91'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites…
    7 studies
    Very low

Analogue (conventional) radiographs vs Cone beam computed tomography (CBCT) (direct within-person / paired comparison); reference standard: histology

Diagnostic accuracy: analogue versus CBCT (within-person, not pooled) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Direct comparison analogue vs CBCT (within-person): 6 datasets from 3 studies (737 tooth sites or surfaces) provided data, but the results could not be pooled; only individual study results are shown (Figure 21). No…
    3 studies
    GRADE not reported