Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

99 questions · 162 findings · 10 reviews · Oral Health

No studies found 11 · 6.8%GRADE not reported 124 · 76.5%Very low 9 · 5.6%Low 10 · 6.2%Moderate 8 · 4.9%High 0 · 0%

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… probably leads to lower pulp exposure during caries removal compared with complete caries removal (moderate certainty).

1 finding from 1 review

Spectra caries detection device (Air Techniques; blue fluorescence) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    The Spectra caries detection device fits into the blue fluorescence category but no studies provided data for inclusion in the meta-analysis (Markowitz 2015).
    1 study
    GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection of 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

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Sensitivity for detection of 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

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

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 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: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
    7 studies
    Very low

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Medium dentine-caries prevalence (15% to 34%) (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Low dentine-caries prevalence (<=14%) (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: High dentine-caries prevalence (>=35%) (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Restoration failure · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

It is very uncertain whether partial caries removal (single stage; residual dentinal caries… changes failure of restorations compared with complete caries removal (very low certainty).

1 finding from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… showed no clear difference in signs or symptoms of pulpal disease compared with complete caries removal (low certainty).

1 finding from 1 review

No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) vs Complete caries removal

Restoration failure · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

No dentinal caries removal (caries sealed under a preformed metal… probably leads to lower failure of restorations compared with complete caries removal (moderate certainty).

1 finding from 1 review

No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) vs Complete caries removal

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

No dentinal caries removal (caries sealed under a preformed metal… showed no clear difference in signs or symptoms of pulpal disease compared with complete caries removal (moderate certainty).

1 finding from 1 review

CarieScan Pro device vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · 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)
    CarieScan Pro (3 studies, 244 tooth surfaces): sensitivity ranged from 0.55 to 0.91. No evidence of a difference in accuracy by device type (Chi2=0.05, df=1, P=0.82).
    3 studies
    GRADE not reported

CarieScan Pro device 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…
1 finding from 1 review

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · 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)
    ECM (4 studies, 475 tooth surfaces): sensitivity ranged from 0.61 to 0.98 (0.61-0.65 in three studies; 0.98 in the most recent ECM IV study). No evidence of a difference in accuracy by device type (Chi2=0.05, df=1,…
    4 studies
    GRADE not reported

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) 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…
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 · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
2 findings 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) · Permanent dentition
    Permanent dentition (4 studies): sensitivity ranged from 0.55 to 0.65.
    4 studies
    GRADE not reported
  • 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) · Primary dentition
    Primary dentition (3 studies): sensitivity ranged from 0.91 to 0.93. No evidence of a difference in accuracy by dentition (removing accuracy covariate: Chi2=3.15, df=1, P=0.08).
    3 studies
    GRADE not reported

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

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)

Diagnostic odds ratio (overall test accuracy) · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review