Mapping Systematic Reviews on the Management of Dental Caries in Primary Teeth: A Meta-Research.

Abstract

Background: Systematic reviews (SRs) represent the most robust source of evidence for informing decision-making. While there are rigorous protocols for properly conducting SRs, sometimes the methodological biases in the primary studies are accounted for in the conclusions of the SRs.

Objective: This study aimed to map the evidence regarding the management of caries lesions in primary teeth.

Methods: Two reviewers conducted a systematic search up to March 2024 in electronic data-bases. Any SR concerning the management of caries lesions in primary teeth was considered eli-gible.

Results: About 162 SRs were included. Among these, 80 focused on restorative treatments, 64 on endodontic treatments, and 18 on non-invasive treatments. Only 42.6% presented a study registra-tion protocol. The majority (67.9%) performed a meta-analysis, while a minority exclusively car-ried out qualitative data analysis. Despite 92.6% of the SRs evaluating the methodological quality or risk of bias of the primary studies using some tool, only 24% assessed the certainty of evidence using the GRADE approach, resulting in classifications ranging from very low to moderate.

Conclusion: There is a limited adherence to study registration protocols, indicating a need for improvements in this practice. Additionally, among the few SRs that used the GRADE approach, the majority demonstrated levels of very low to moderate certainty.