Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

262 questions · 304 findings · 19 reviews · Dental caries

No studies found 28 · 9.2%GRADE not reported 200 · 65.8%Very low 61 · 20.1%Low 6 · 2%Moderate 9 · 3%High 0 · 0%

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

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

Selective carious tissue removal (selective excavation, SE) vs Stepwise carious tissue removal (SW)

Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

Selective carious tissue removal (selective excavation, SE) probably leads to higher failure of therapy compared with stepwise carious tissue removal (SW) (moderate certainty).

2 findings from 1 review

Hall technique vs Non-restorative cavity control (NRCC)

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 hall Technique (sealing with a preformed metal crown) changes failure of therapy compared with non-restorative cavity control (NRCC) (very low certainty).

1 finding from 1 review

Non-selective carious tissue removal and conventional restoration (CR) vs Non-restorative cavity control (NRCC)

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 non-selective carious tissue removal and conventional restoration (CR) changes failure of therapy compared with non-restorative cavity control (NRCC) (very low certainty).

1 finding from 1 review

Sealing using sealant materials vs Non-selective carious tissue removal and conventional restoration (CR)

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 sealing using sealant materials changes failure of therapy compared with non-selective carious tissue removal and conventional restoration (CR) (very low certainty).

1 finding from 1 review

Sealing using sealant materials vs no treatment

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 sealing using sealant materials changes failure of therapy compared with no treatment (very low certainty).

1 finding from 1 review

Resin-modified glass-ionomer cement (RMGIC) restoration vs Amalgam, compomer, composite resin, or glass carbomer

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

RMGIC had an annual failure rate of 1.9-16.9% (4 RCTs), lower than amalgam and similar to compomer/composite; low quality of evidence (ungraded).

1 finding from 1 review

Composite resin with etch-and-rinse (total-etch) adhesion vs Composite resin with self-etch adhesion (same universal adhesive)

Treatment failure (annual failure rate) · Children with moderately deep dentine caries in primary molars, no pulp therapy

Etch-and-rinse adhesion failed more than self-etch (19.5% vs 7.0% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Amalgam restoration vs Composite resin, compomer, conventional glass-ionomer cement, or resin-modified GIC (head-to-head RCT comparators)

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Amalgam restorations in primary teeth showed a wide annual failure rate (1-28%) across 4 RCTs; the evidence is of low quality (high risk of bias; ungraded).

1 finding from 1 review

High-viscosity glass-ionomer cement (HVGIC) restoration (conventional restorative approach) vs Compomer, composite resin, or another HVGIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

High-viscosity GIC had a wide annual failure rate (2.9-25.6%) and was outperformed by compomer/composite in some trials (3 RCTs); low quality of evidence (ungraded).

1 finding from 1 review

Composite resin with a beveled cavity margin vs Composite resin with no bevel (butt-joint margin)

Treatment failure (annual failure rate) · Children with Class-I carious lesions in primary molars, no pulp therapy

A beveled margin lowered composite resin failure (1.8% vs 3.5% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Restorative materials placed by atraumatic restorative treatment (ART); mostly high-viscosity/conventional GIC, also RMGIC, glass carbomer, compomer, composite resin vs Different ART materials or application techniques (e.g., bilayer vs single-step, with vs without cavity conditioner/disinfectant), or composite resin

Treatment failure (annual failure rate) · Children with carious primary teeth treated by atraumatic restorative treatment (hand-instrument caries removal), no pulp therapy

ART restorations (mainly GIC) had a wide annual failure rate (1.2-37.1%) across 10 RCTs, with technique affecting survival; low to unclear quality of evidence (ungraded).

1 finding from 1 review

Bulk-fill composite resin with 7-second dentine etching vs Bulk-fill composite resin with 15-second dentine etching

Treatment failure (annual failure rate) · Children (aged 5-8 years) with Class-II caries in primary molars, no pulp therapy

Etching dentine for 7 s rather than 15 s lowered bulk-fill composite failure (5.8% vs 16.9% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Metal-reinforced glass-ionomer cement (MRGIC) restoration vs Conventional GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Metal-reinforced GIC had a high annual failure rate (29.9%) in a single RCT; low quality of evidence (ungraded).

1 finding from 1 review

Compomer (C) vs Amalgam, RMGIC, HVGIC, composite resin, bulk-fill composite resin, another compomer, or alternative caries management

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Compomer had an annual failure rate of 0-14.7% (7 RCTs), comparable to amalgam/RMGIC/composite and better than high-viscosity GIC; low quality of evidence (ungraded).

1 finding from 1 review

Conventional GIC vs Amalgam or metal-reinforced GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Conventional GIC had an annual failure rate of 7.6-16.6% (2 RCTs) and failed more than amalgam in one trial; low quality of evidence (ungraded).

1 finding from 1 review

Class-I (single-surface) cavity restoration vs Class-II (proximal/multi-surface) cavity restoration

Treatment failure (annual failure rate) by cavity class · Children with carious primary teeth restored in Class-I versus Class-II cavities, no pulp therapy

Class-II restorations failed more than Class-I (annual failure 5-28.9% vs 1.2-14.7% in ART studies); low quality of evidence (ungraded).

1 finding from 1 review

Hall technique vs Compomer restoration or non-restorative caries treatment

Treatment failure (annual failure rate) · Children (aged 3-8 years) with 2-surface occluso-proximal dentine caries in primary molars, no pulp therapy

Preformed metal (Hall) crowns had a low reported annual failure rate (3.1%) versus compomer (14.7%) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review