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

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.

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

Two reviewers conducted a systematic search up to March 2024 in electronic databases. Any SR concerning the management of caries lesions in primary teeth was considered eligible.

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 registration protocol. The majority (67.9%) performed a meta-analysis, while a minority exclusively carried 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.

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.