Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

232 questions · 289 findings · 30 reviews · Oral Health

No studies found 26 · 9%GRADE not reported 199 · 68.9%Very low 33 · 11.4%Low 17 · 5.9%Moderate 12 · 4.2%High 2 · 0.7%

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

Most in vitro studies indicate e-cigarette aerosol/e-liquid (especially flavored/high-concentration) disrupts normal oral flora and favors cariogenic S. mutans growth and biofilm, plausibly increasing caries risk; not pooled (ungraded, narrative).

1 finding from 1 review

All exposure-OHRQoL estimates pooled for publication-bias correction (meta-trim sensitivity); specific exposure set not defined in source vs Not specified

Poor oral health-related quality of life (OHRQoL) · Children aged 3-12 years

A trim-and-fill sensitivity analysis pooling every exposure estimate gave an overall OR of 0.17 (95% CI 0.13-0.21) after correcting for significant publication bias (Fig. 13); this combined estimate spans heterogeneous exposures and is a publication-bias sensitivity result (ungraded).

1 finding from 1 review

Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal

Pulp exposure rate · Patients with deep carious lesions in permanent (mainly posterior) teeth

Minimally invasive caries removal was associated with a lower mean pulp exposure rate than conventional removal (1.2% vs 8.1%), but the difference was not statistically significant (Wilcoxon, p = 0.068); certainty of evidence was not graded.

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Stepwise excavation reduced the reported risk of pulp exposure by 69% versus complete caries removal (RR 0.31; ungraded).

1 finding from 1 review

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children with dentine caries in primary and permanent teeth

Partial caries removal was reported to reduce pulp-exposure risk by 77% versus complete caries removal (RR 0.23; ungraded).

1 finding from 1 review

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Partial caries removal reduced the reported risk of pulp exposure versus complete caries removal in primary teeth (RR 0.24; ungraded).

1 finding from 1 review

Fluoride-containing dental care products (mainly fluoride toothpaste) vs Dietary fluoride sources (drinking water, beverages, food)

Contribution of dental care products to total fluoride exposure · Pregnant and lactating women

No study has explored the contribution of dental care products to total fluoride exposure in pregnant and lactating women.

1 finding from 1 review

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Exposure of the plate (adverse effect) · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Up to 3 years postoperatively
    Both titanium and resorbable groups experienced two plate exposures which occurred between the third and ninth month, with plate exposure rates of 1.02% for the titanium group and 1.21% for the resorbable group. All…
    1 study · 60 participants
    GRADE not reported

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Adverse effects (composite: plate exposure, wound infection, sinus tract, wound dehiscence, plate removal) · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Up to 24 months postoperatively
    SoF row. Adverse effects; 60 participants (1 RCT); Quality of the evidence (GRADE): VERY LOW. Exposure of the plate: both titanium and resorbable groups experienced 2 plate exposures which occurred between the third…
    1 study · 60 participants
    Very low

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… probably leads to lower pulp exposure during caries removal compared with complete caries removal (moderate certainty).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Stepwise excavation (two-stage caries removal, re-entry after an… probably leads to lower pulp exposure during caries removal compared with one stage complete caries removal (moderate certainty).

3 findings from 1 review

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Adverse effects (insufficient fixation; re-operation/revision; plate exposure; superficial or deep wound infection; sinus tract; wound dehiscence; giant cell/foreign body or inflammatory reaction; post-traumatic dystrophy) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    Up to 3 years postoperatively
    Planned adverse-effects outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved…
    0 studies
    No studies found

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

Overall success (composite of clinical and radiographic success) · Permanent teeth with carious pulp exposure

In partial pulpotomy, MTA had significantly higher success than calcium hydroxide (OR 2.81; ungraded).

5 findings from 2 reviews · compare the 2 reviews
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Full pulpotomy vs Partial pulpotomy

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

The three-study meta-analysis found no significant difference between full and partial pulpotomy after 1 year.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Spine bone mineral density · Females (all ages)

Among females in low-to-moderate-risk-of-bias studies, the reported spine-BMD estimate above 2.35 mg/L water fluoride was MD 0.07 g/cm2 (95% CI 0.11 to 0.24; ungraded).

2 findings from 1 review

Partial pulpotomy with permanent restoration after 7-14 days vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Permanent restoration after 7-14 days was associated with a pooled success rate of 73.6%.

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Partial pulpotomy with MTA or Biodentine had a pooled success rate of 86.8%.

1 finding from 1 review

Partial pulpotomy with one additional day before permanent restoration vs Partial pulpotomy with one fewer day before permanent restoration

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Each additional day before permanent restoration was associated with a 0.088% decrease in success in meta-regression.

1 finding from 1 review

Partial pulpotomy with permanent restoration after more than 14 days vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Permanent restoration after more than 14 days was associated with a pooled success rate of 23.2%.

1 finding from 1 review

Partial pulpotomy with sodium hypochlorite (NaOCl) hemostatic agent vs Partial pulpotomy without NaOCl / alternative hemostatic agent

Overall success (composite of clinical and radiographic success) · Adults (>=18 y) with mature permanent teeth and deep carious pulp exposure

Using NaOCl during partial pulpotomy is associated with borderline-higher success, independent of concentration (ungraded, exploratory).

1 finding from 1 review