What do systematic reviews say?

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

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Permanent and primary dentition
  Cost-effectiveness reported narratively: SE found more cost-effective than SW in permanent (Labib 2019) and primary teeth (Elhennawy 2021); not GRADE-rated.
  2 studies
  GRADE not reported

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

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

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-60 months · Deep lesions, permanent dentition
  OR 2.25 [1.33, 3.82]
  3 studies · 371 participants
  Moderate
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-24 months · Deep lesions, primary dentition
  OR 2.05 [0.49, 8.62]
  2 studies · 126 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Selective carious tissue removal (selective excavation, SE)

It is very uncertain whether non-selective carious tissue removal and conventional restoration (CR) changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12 months · Cavitated but not deep lesions, primary dentition
  OR 0.62 [0.21, 1.88]
  2 studies · 204 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-18 months · Deep lesions, permanent dentition
  OR 11.32 [1.97, 65.02]
  2 studies · 179 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  6-36 months · Deep lesions, primary dentition
  OR 4.43 [1.04, 18.77]
  4 studies · 265 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Stepwise carious tissue removal (SW)

Non-selective carious tissue removal and conventional restoration (CR) probably leads to higher failure of therapy compared with stepwise carious tissue removal (SW) (moderate certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  6-60 months · Deep lesions, permanent dentition
  OR 2.06 [1.34, 3.17]
  3 studies · 398 participants
  Moderate
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12 months · Deep lesions, primary dentition
  OR 2.43 [0.65, 9.12]
  1 study · 63 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Selective carious tissue removal (selective excavation, SE)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Cavitated but not deep lesions, primary dentition
  Lesion progression reported narratively: Ribeiro 1999 found 6/24 lesions progressed after 12 months; not pooled and not GRADE-rated.
  1 study
  GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Hall Technique (sealing with a preformed metal crown)

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).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  24-36 months · Deep lesions, primary dentition
  OR 1.95 [0.57, 6.63]
  1 study · 72 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  24 months · Cavitated but not deep lesions, primary dentition
  OR 8.94 [0.57, 139.67]
  2 studies · 586 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Hall Technique (sealing with a preformed metal crown)

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).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  30-60 months · Cavitated (not deep) lesions, primary dentition
  OR 8.35 [3.73, 18.68]
  2 studies · 249 participants
  Low

Non-selective carious tissue removal and conventional restoration (CR) vs Hall Technique (sealing with a preformed metal crown)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Primary dentition
  Cost-effectiveness reported narratively: HT found more cost-effective than CR in primary teeth (Innes 2011; Santamaria 2018); not GRADE-rated.
  2 studies
  GRADE not reported

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

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).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  30 months · Cavitated lesions, primary dentition
  OR 1.16 [0.5, 2.71]
  1 study · 102 participants
  Very low

Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  18-24 months · Cavitated lesions, primary dentition
  OR 3.11 [0.11, 85.52]
  2 studies · 82 participants
  Very low

Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Cavitated lesions, primary dentition
  Lesion progression reported narratively: Dias 2018 1/27 sealed vs 1/21 SE at 24 months; Hesse 2014 0/17 sealed vs 0/17 SE at 18 months; not pooled and not GRADE-rated.
  2 studies
  GRADE not reported

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

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Non-cavitated lesions, primary dentition
  Lesion progression reported narratively: Borges 2012a found 3/26 sealed lesions progressed after 1 year (split-mouth); not pooled and not GRADE-rated.
  1 study
  GRADE not reported

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

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).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  48 months · Cavitated lesions, permanent dentition
  OR 5.0 [0.51, 49.27]
  1 study · 41 participants
  Very low

Resin-modified glass ionomer fissure sealant vs Fluoride varnish

Resin-modified glass ionomer fissure sealant showed no clear difference in progression of dentinal carious lesions into enamel or dentine compared with fluoride varnish; GRADE not reported.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes

  1 year
  OR 0.18 [0.01, 4.27]
  1 study · 21 participants
  GRADE not reported

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

The review found no eligible studies for this question.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  The study (Splieth 2001) did not report progression of dentinal carious lesions into enamel or dentine.
  0 studies
  No studies found

Resin-based fissure sealant (visible-light-polymerized) vs Fluoride varnish

It is very uncertain whether resin-based fissure sealant (visible-light-polymerized) changes incidence of dentinal carious lesion on treated occlusal surfaces of… compared with fluoride varnish (very low certainty).

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes

  9 years
  RR 0.48 [0.29, 0.79]
  1 study · 75 participants
  Very low
• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes

  4 years
  RR 0.42 [0.21, 0.84]
  1 study · 75 participants
  Very low

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

The review found no eligible studies for this question.

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
  None of the studies reported adverse effects.
  0 studies
  No studies found

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

The review found no eligible studies for this question.

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
  We found no studies reporting subjective evaluation of the treatments by participants.
  0 studies
  No studies found

Hall technique vs Non-restorative cavity control (NRCC)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Primary dentition
  Cost-effectiveness reported narratively: HT found more cost-effective than NRCC in primary teeth (Santamaria 2018); not GRADE-rated.
  1 study
  GRADE not reported

Sealing using sealant materials vs no treatment

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Non-cavitated lesions, permanent dentition
  Lesion progression reported narratively: da Silveira 2012 found 3/27 lesions progressed after 1 year; not pooled and not GRADE-rated.
  1 study
  GRADE not reported