Cochrane · intervention · CD013039

Interventions for treating cavitated or dentine carious lesions

Schwendicke, F, Walsh, T, Lamont, T, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library

Oral Health Dental caries2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 2 · 8.3%Ungraded 7 · 29.2%Very low 12 · 50%Low 1 · 4.2%Moderate 2 · 8.3%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Participants with permanent or primary teeth and vital pulps (i.e. not diagnosed as having irreversible pulpitis or pulp necrosis), and carious lesions conventionally considered in need of a restoration (i.e. cavitated lesions or, on occlusal surfaces, non‐cavitated or micro‐cavitated but radiographically extending into dentine)	In total, studies recruited 3350 participants (minimum 28; maximum 521; mean 77; median 68), with 4195 teeth/lesions treated. The minimum age of participants was three years old, while the oldest participants were 54 years old
Intervention	Non‐selective carious tissue removal; selective carious tissue removal; stepwise carious tissue removal; sealing of carious lesions using sealant materials or preformed metal crowns; non‐restorative cavity control (NRCC)	Non‐selective carious tissue removal (n=19); Selective carious tissue removal (n=16); Stepwise carious tissue removal (n=7); Sealing using sealant materials (n=8); Hall Technique (n=6); Non‐restorative cavity control (n=2)
Comparison	Placebo/No treatment/Each other	No treatment (n=2); Placebo (n=0)
Outcomes	Failure of therapy: a composite outcome, that is, complications including: signs or symptoms of irreversible pulp inflammation or death; endodontic therapy (pulp capping, pulp therapy or root‐canal treatment etc.); extraction of the tooth; restorative failure or retreatment (restoration replacement, repair, resealing of sealed lesions etc.), or both; or a combination of the above. Secondary outcomes: Lesion progression, if reported separately; Subjective evaluation of the treatments by participants, regardless of the outcome measure used; Efficiency (time needed for the intervention), costs or cost‐effectiveness (regardless of how effectiveness was defined); Any safety issues (e.g. allergies) that were related to the interventions (adverse events)	Failure of therapy (n=27); Lesion progression (n=5); Efficiency, costs or cost-effectiveness (n=7); Subjective evaluation of treatments by participants (n=0); Safety issues (n=0)
Study designs	Randomised controlled trials (RCTs) that compared any of the interventions. We included studies that were randomised at the level of the individual or by cluster. Split‐mouth studies were also eligible for inclusion. We excluded cross‐over trials	RCT (n=27; 24 parallel-group, 3 split-mouth)
Timing	Follow‐up times varied from a minimum of four to six months to 10 years	Follow‐up times varied from no follow‐up (1 study) to 10 years (1 study). Twelve months was the most common maximum follow‐up (9 studies)

Search date: 2020-07. Databases: Cochrane Oral Health's Trials Register; CENTRAL; MEDLINE Ovid; Embase Ovid; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov; World Health Organization International Clinical Trials Registry Platform