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What do systematic reviews say?

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Evidence found and GRADE certainty

1,340 questions · 1,512 findings · 205 reviews

No studies found 317 · 21%GRADE not reported 358 · 23.7%Very low 356 · 23.5%Low 271 · 17.9%Moderate 173 · 11.4%High 37 · 2.4%

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Triple antibiotic paste (TAP)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single 3-arm RCT found no difference in pulpotomy success between MTA and triple antibiotic paste (both 100%; not pooled; ungraded).

1 finding from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (often histological; also invasive opening)

All occlusal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled specificity for visual detection of all occlusal lesions was 0.770 (95% CI 0.73 to 0.81).

2 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for advanced proximal caries was 0.58 (95% CI 0.52 to 0.65) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, pooled specificity of visual detection for all (initial and advanced) occlusal caries was 75.3% (95% CI 70 to 80) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

PPV for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the positive predictive value of visual detection for advanced occlusal caries was 77.9% at an assumed prevalence of 22.0% (ungraded).

2 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

NPV for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the German private-practice setting, the negative predictive value of radiographic detection for all (initial and advanced) occlusal caries was 91.4% at an assumed prevalence of 11.0% (ungraded).

2 findings from 1 review

Radiographic caries detection vs Reference standard (often histological; also invasive opening)

Advanced proximal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled sensitivity for radiographic detection of advanced proximal lesions was 0.444 (95% CI 0.38 to 0.51).

8 findings from 1 review
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Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for advanced occlusal caries was 0.53 (95% CI 0.46 to 0.62) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled sensitivity of visual detection for all (initial and advanced) occlusal caries was 49.1% (95% CI 40 to 58) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, the negative lr of radiographic detection for all (initial and advanced) proximal caries was 0.65 (95% CI 0.57 to 0.74) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the positive lr of radiographic detection for advanced proximal caries was 9.82 (95% CI 7.3 to 13.3) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, pooled specificity of radiographic detection for advanced proximal caries was 95.5% (95% CI 94 to 97) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of visual detection for all (initial and advanced) occlusal caries was 0.19 (95% CI 0.15 to 0.25) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the positive lr of radiographic detection for all (initial and advanced) occlusal caries was 1.74 (95% CI 1.3 to 2.4) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for all (initial and advanced) occlusal caries was 0.79 (95% CI 0.65 to 0.96) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, pooled sensitivity of radiographic detection for advanced proximal caries was 44.4% (95% CI 38 to 51) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the positive lr of visual detection for advanced occlusal caries was 7.09 (95% CI 5.6 to 8.9) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled specificity of radiographic detection for advanced occlusal caries was 91.4% (95% CI 88 to 94) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the negative lr of visual detection for advanced occlusal caries was 0.58 (95% CI 0.5 to 0.7) (ungraded).

3 findings from 1 review

Biofunctional Prosthetic System (BPS): closed-mouth two stage-two step final impression with addition silicone elastomer vs Conventional complete denture technique (CCD): open-mouth two stage-two step conventional technique using elastomer

Oral health-related quality of life · Completely edentulous people
1 finding from 1 review