Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

550 questions · 606 findings · 25 reviews · Oral medicine and oral cancer

No studies found 62 · 10.2%GRADE not reported 428 · 70.6%Very low 69 · 11.4%Low 30 · 5%Moderate 16 · 2.6%High 1 · 0.2%

Blood and saliva analysis (biomarker tests) vs Surgical or punch biopsy with histological assessment

Outcome not reported · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions

The review found no eligible studies for this question.

1 finding from 1 review

Light-based detection and/or oral spectroscopy (e.g. ViziLite, VELscope, Microlux DL, Identafi 3000) vs Surgical or punch biopsy with histological assessment

Specificity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

Specificity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

Sensitivity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Light-based detection and/or oral spectroscopy (e.g. ViziLite, VELscope, Microlux DL, Identafi 3000) vs Surgical or punch biopsy with histological assessment

Sensitivity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs placebo

Amount of analgesia · Patients being treated for cancer (predominantly haematological malignancies)

The review found no eligible studies for this question.

1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs placebo

Patient quality of life · Patients being treated for cancer (predominantly haematological malignancies)

The review found no eligible studies for this question.

1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs placebo

Viral isolates (HSV isolates identified, with or without clinical symptoms) · Patients being treated for cancer (predominantly haematological malignancies)

Prophylactic aciclovir (oral or intravenous) led to lower viral isolates (HSV isolates identified, with or without clinical… compared with placebo; GRADE not reported.

1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs placebo

Length of hospital stay · Patients being treated for cancer (predominantly haematological malignancies)

The review found no eligible studies for this question.

1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs placebo

Recurrence of lesions · Patients being treated for cancer (predominantly haematological malignancies)

The review found no eligible studies for this question.

1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs Prophylactic valaciclovir (oral)

Cost of oral care · Patients being treated for cancer (predominantly haematological malignancies)
1 finding from 1 review

Prophylactic aciclovir (oral or intravenous) vs placebo

Adverse effects · Patients being treated for cancer (predominantly haematological malignancies)
1 finding from 1 review

Surgery plus Heister jaw opener vs Surgery plus wooden tongue depressors

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

It is very uncertain whether surgery plus Heister jaw opener changes maximal mouth opening (interincisal distance) compared with surgery plus wooden tongue depressors (very low certainty).

2 findings from 1 review

Surgery plus Heister jaw opener vs Surgery plus wooden tongue depressors

Burning sensation (VAS 0-100) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)
1 finding from 1 review
  • Vadepally 2019 measured burning sensation on a VAS but did not fully report results, stating there was no significant difference between the 2 groups (p=0.617).
    1 study · 50 participants
    GRADE not reported

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).

6 findings from 1 review
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Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

White spot lesion incidence · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

Most studies reported a lower incidence of white spot lesions with clear aligners than fixed appliances, but heterogeneous assessment methods precluded meta-analysis (ungraded).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).

1 finding from 1 review