Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

310 questions · 590 findings · 34 reviews · Oral Health

No studies found 12 · 2%GRADE not reported 470 · 79.7%Very low 23 · 3.9%Low 34 · 5.8%Moderate 51 · 8.6%High 0 · 0%

Dentinal caries in primary dentition (at 5 years) vs Caries-free primary dentition

Dentinal caries in permanent (newly erupted) teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Dentinal caries in the primary dentition is associated with about 3.2 times higher odds of dentinal caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Stepwise excavation reduced the reported risk of pulp exposure by 69% versus complete caries removal (RR 0.31; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs Active dentine caries at baseline (single-arm before vs after proportion)

Arrest of dentine caries · Children with dentine caries in primary and permanent teeth

Professionally applied 38% silver diamine fluoride arrested about two-thirds of active dentine caries surfaces in children (pooled proportion 65.9%, 95% CI 41.2% to 90.7%; 5 studies); certainty was not GRADE-rated and heterogeneity was very high (I2=96%).

1 finding from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence (proportion of enrolled children developing dentin caries, ICDAS 4-6) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

Fluoride varnish and fissure sealant did not differ significantly in the proportion of children developing caries at 2 to 3 years (RR 1.12, 95% CI 0.60 to 2.09; 2 RCTs; ungraded).

1 finding from 1 review

Enamel caries in primary dentition (at 5 years) vs Caries-free primary dentition

Dentinal caries in permanent (newly erupted) teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Enamel caries in the primary dentition is associated with about 1.6 times higher odds of dentinal caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

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

Caries assessment at dentine threshold (cavitation into dentine) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries prevalence · European adolescents aged 12–19 years

Caries prevalence at the dentine threshold was about 56% (pooled 0.56, 95% CI 0.43 to 0.68; 15 studies; not GRADE-rated).

7 findings from 1 review
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Laser fluorescence (DIAGNOdent 2095) 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 (DIAGNOdent 2095) pooled summary ROC AUC was 0.79 for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (E-speed film) 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, conventional bitewing radiography (E-speed) pooled sensitivity was 0.48 (95% CI 0.21 to 0.77) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Visual examination (VE) 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, visual examination pooled sensitivity was 0.46 (95% CI 0.20 to 0.73) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Fibre-optic transillumination (FOTI) 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, fibre-optic transillumination pooled specificity was 0.97 (95% CI 0.89 to 0.994) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Laser fluorescence (DIAGNOdent 2095) vs Cavity preparation or biopsy (operative validation)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

In in vivo, laser fluorescence (DIAGNOdent 2095) pooled summary ROC AUC was 0.92 for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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Conventional bitewing radiography (D-speed film) vs Cavity preparation or biopsy (operative validation)

Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

In in vivo, conventional bitewing radiography (D-speed) pooled sensitivity was 0.79 (95% CI 0.41 to 0.96) for occlusal caries at the dentin detection level; ungraded.

4 findings from 1 review
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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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