Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

678 questions · 854 findings · 51 reviews · Dental caries

No studies found 38 · 4.4%GRADE not reported 675 · 79%Very low 61 · 7.1%Low 47 · 5.5%Moderate 32 · 3.7%High 1 · 0.1%

Low level of schooling (>33.60% of the population) vs Not applicable

Dental caries · Adult participants in 25 meta-regression studies

The unadjusted meta-regression coefficient for low schooling was -2.301079.

2 findings from 1 review

Low socioeconomic status (>22.4% of the population) vs Not applicable

Dental caries · Adult participants in 25 meta-regression studies

The unadjusted meta-regression coefficient for low socioeconomic status was 10.49365.

2 findings from 1 review

Populations with a lower proportion of university-educated people (<33.78% with university level) vs Not applicable

Dental caries · Adult participants in 25 meta-regression studies

The Model 1 adjusted meta-regression coefficient for lower university education was -4.132903.

2 findings 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

TiO2-modified composite (1 wt.%) vs Control composite in contralateral quadrant

Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

TiO2-modified composite showed no S. mutans difference, with certainty 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

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs None (descriptive prevalence; random-effects pooled proportion)

Dental caries prevalence · Children (deciduous and/or permanent dentition) in low- and middle-income countries

About 39% of children in LMICs had dental caries (pooled prevalence 0.387, 95% CI 0.284 to 0.495; 11 studies; very high heterogeneity I2=99%; not GRADE-rated).

1 finding from 1 review

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

Pulpal disease (signs/symptoms of pulp necrosis) · Children with dentine caries in primary and permanent teeth

The reported estimate did not show a clear difference in pulpal disease after partial versus complete caries removal (ungraded).

1 finding from 1 review

Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)

Pulpal inflammation or necrosis · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years)

It is very uncertain whether laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) changes pulpal inflammation or necrosis compared with conventional mechanical caries removal (standard drill; handpiece… (very low certainty).

3 findings from 1 review

Repair of a defective resin composite restoration in a permanent molar or premolar tooth (with resin composite) vs Replacement of a defective resin composite restoration in a permanent molar or premolar tooth (with resin composite)

Presence of clinical symptoms (pain, swelling, diagnosis of pulpitis, abscess formation) · Adults (16 years or over) with one or more defective resin composite restoration(s) in a molar or premolar tooth/teeth

The review found no eligible studies for this question.

1 finding from 1 review

Repair of a defective amalgam restoration in a permanent molar or premolar tooth (with amalgam) vs Replacement of a defective amalgam restoration in a permanent molar or premolar tooth (with amalgam)

Presence of clinical symptoms (pain, swelling, diagnosis of pulpitis, abscess formation) · Adults (16 years or over) with one or more defective amalgam restoration(s) in a molar or premolar tooth/teeth

The review found no eligible studies for this question.

1 finding from 1 review

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

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

Signs or symptoms of pulpal disease · 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… showed no clear difference in signs or symptoms of pulpal disease compared with one stage complete caries removal (moderate certainty).

1 finding from 1 review

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

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… showed no clear difference in signs or symptoms of pulpal disease compared with complete caries removal (low certainty).

1 finding from 1 review

Resin composite restorations containing antibacterial agents vs Non-antibacterial containing composite restorations

Postoperative sensitivity, marginal adaptation, anatomic form and other clinical outcomes (USPHS restoration quality; includes tooth vitality and pulpitis) · Adults and adolescents in any age group with restorations in the permanent dentition and children with restorations in the primary dentition

The review found no eligible studies for this question.

1 finding from 1 review