Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,890 questions · 3,917 findings · 272 reviews · Oral Health

No studies found 429 · 11%GRADE not reported 2,657 · 67.8%Very low 512 · 13.1%Low 219 · 5.6%Moderate 80 · 2%High 20 · 0.5%

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

Vibrational appliance with fixed appliances vs Fixed appliances

Amount of crowding · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether vibrational appliance with fixed appliances changes amount of crowding (change in mandibular crowding) at 10 to 30 weeks compared with fixed appliances only / no vibrational appliance (control) (very 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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Lower lip bumper vs No active treatment (control)

Lower incisors to mandible (position, mm) at 9 months · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Lower lip bumper led to higher lower incisors to mandible at 6 months compared with no active treatment (control); GRADE not reported.

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)

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

Nickel-titanium archwire vs Stainless steel archwire

Amount of crowding (change in mandibular crowding) at 8 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether nickel-titanium archwire changes amount of crowding (change in mandibular crowding) at 8 weeks compared with stainless steel archwire (very low certainty).

1 finding from 1 review

Cervical pull headgear vs Minor interceptive procedures (control)

Size of the jaws (maxillary and mandibular arch length) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Cervical pull headgear led to higher size of the jaws (maxillary and mandibular arch length) compared with minor interceptive procedures (control); GRADE not reported.

1 finding from 1 review

Lower lip bumper vs No active treatment (control)

Size of the lower jaw (arch length) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Lower lip bumper led to higher size of the lower jaw (mandibular arch length) at 6 months compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

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

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy: in vitro versus in vivo comparison · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies) · Study setting (in vitro vs in vivo)
    Pre-specified in vitro versus in vivo comparison was not completed because 49 of the 60 histology studies were in vitro; a sensitivity analysis removing the in vivo studies confirmed a minimal change to summary…
    Studies not reported
    GRADE not reported

Laser fluorescence (DIAGNOdent 2190/pen) 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, laser fluorescence pen (2190) pooled specificity was 0.77 (95% CI 0.62 to 0.88) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Digital bitewing radiography, phosphor plate (PSP) 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, digital bitewing radiography (phosphor plates) pooled specificity was 0.95 (95% CI 0.59 to 0.995) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Nickel-titanium archwire vs Multistranded stainless steel archwire

Harms (pain) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
1 finding from 1 review
  • Orthodontic treatment for crowded teeth in children 2021 · Cochrane All outcomes
    first days
    No difference in overall pain, but more pain with nickel-titanium at 12 hours and day 1 (morning, afternoon, bedtime) vs multistranded stainless steel (Sandhu 2013). Narrative; no pooled estimate.
    1 study
    GRADE not reported