Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

211 questions · 428 findings · 24 reviews

No studies found 1 · 0.2%GRADE not reported 346 · 80.8%Very low 14 · 3.3%Low 24 · 5.6%Moderate 43 · 10%High 0 · 0%

Calcium-based agent vs No biomimetic remineralization (control)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Calcium vs Control showed no significant difference in 24 h bond strength (MD -1.124, 95% CI -5.917 to 3.670; Moderate certainty).

1 finding from 1 review

Flavonoids (e.g., quercetin, proanthocyanidin) vs Mesoporous silica (SiO2)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Silica showed no significant difference in 24 h bond strength (MD 3.764, 95% CI -5.241 to 12.769; Moderate certainty).

1 finding from 1 review

SDF applied biannually (every 6 months) vs Other non/minimally-invasive treatment (ART or 5% NaF varnish)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

Biannual SDF application significantly arrested caries (pooled ES 0.39, 95% CI 0.19-0.60; ungraded).

1 finding from 1 review

38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs Atraumatic restorative treatment (ART)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF was not significantly better than ART at arresting caries (pooled ES 0.05, 95% CI -0.42 to 0.51; ungraded).

1 finding from 1 review

SDF applied once (single application, no re-application) vs Other non/minimally-invasive treatment (ART or silver-fluoride varnish)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

A single (one-time) SDF application did not significantly arrest caries (pooled ES -0.09, 95% CI -0.48 to 0.29; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF >=30%, i.e. 30% or 38%), applied annually or biannually vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

The pooled caries arrest rate with SDF (>=30%, applied annually/biannually) was 51.62% (622/1205 lesions arrested) at >=12 months follow-up.

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 fluorescence (DIAGNOdent 2190/pen) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, laser fluorescence (DIAGNOdent 2190) had a summary ROC AUC of 0.83 for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (E-speed film) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, conventional E-speed bitewing radiography had a pooled diagnostic odds ratio of 31.40 (95% CI 14.31, 68.93) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Digital bitewing radiography, phosphor plate (PSP) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, phosphor-plate digital bitewing radiography had a pooled specificity of 0.60 (95% CI 0.20, 0.90) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Laser fluorescence (DIAGNOdent 2190/pen) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, laser fluorescence (DIAGNOdent 2190) had a pooled specificity of 0.60 (95% CI 0.15, 0.93) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, conventional F-speed bitewing radiography had a pooled diagnostic odds ratio of 8.7 (95% CI 4.2, 18.1) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (D-speed film) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, conventional D-speed bitewing radiography had a pooled specificity of 0.99 (95% CI 0.96, 0.999) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Digital bitewing radiography, sensor-based (CCD/CMOS) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, sensor-based digital bitewing radiography had a pooled diagnostic odds ratio of 12.84 (95% CI 6.56, 25.13) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (E-speed film) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, conventional E-speed bitewing radiography had a pooled specificity of 0.91 (95% CI 0.80, 0.96) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (1/3 dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, conventional F-speed bitewing radiography had a summary ROC AUC of 0.98 for proximal caries detection at the 1/3 dentin detection level; ungraded.

4 findings from 1 review
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Visual examination (VE) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (1/3 dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, visual examination had a pooled specificity of 0.84 (95% CI 0.76, 0.89) for proximal caries detection at the 1/3 dentin detection level; ungraded.

4 findings from 1 review
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Digital bitewing radiography, phosphor plate (PSP) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, phosphor-plate digital bitewing radiography had a summary ROC AUC of 0.92 for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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