Dental Systematic Review Research Articles

Saudi Arabia’s contribution to systematic reviews in dentistry: A bibliometric analysis

Background/objectivesBibliometric is a quantitative assessment method to identify prevailing trends and patterns of publications in a particular field of study. Systematic Reviews (SRs) give an in-depth study of the literature and the most comprehensive overview of the desired research subject. This study aimed to review the bibliometric properties of SRs published by the dentists of Saudi Arabia. Materials and methodsRelevant dataset of SRs on dentistry with at least one author affiliated with Saudi Arabia from PubMed database was obtained. Each document of the retrieved data was screened based on the inclusion and exclusion criteria. The citation metric was collected from Google Scholar. ResultsA total of 625 SRs published from the year 2007 to 2023 were included. The average number of citations for each of these SRs is 25.54. Though a low productivity was observed until 2017, the number of SRs published has increased in the previous three years. SRs in Prosthodontics were the most prevalent. The SRs with the first author from Saudi Arabia and internationally collaborated gained a higher citation impact. Most of the SRs were published in the Saudi Dental Journal. Authors from King Saud University contributed to more than a quarter of the SRs. The two nations that collaborated the most SRs were found to be United States and India. ConclusionOver the last three years, there has been significant progress in the publishing of SRs from Saudi Arabia.The bibliometric parameters identified in this study support researchers in understanding the current status of SRs publication. There is a need to increase awareness about the importance of high-evidence research in dentistry and enhance the training opportunities as well as research incentives for this kind of scientific production.

Therapeutic methods for burning mouth syndrome: an umbrella review

Background: An umbrella review on the treatment of burning mouth syndrome (BMS) may aid clinicians in selecting the most effective treatment modality to improve patients’ symptoms based on the best available evidence. Aim: The aim of the study was to perform an umbrella review of available systematic reviews on therapeutic methods used to alleviate BMS symptoms. Methods: This study was conducted following the Preferred Reporting for Systematic Reviews and Meta-analyses and is registered with the Prospective Register of Systematic Reviews (registration number CRD42021268587). The following databases were searched: PubMed, the Cochrane Library, Scopus, Embase, and Web of Science. The PICOT question was “For the relief of symptomatology, discomfort, and burning sensation caused by BMS, what is the best strategy?” A total of 197 articles were retrieved. After eliminating duplicates, 101 studies were evaluated for inclusion. Finally, eight articles were included in the study.Results: The most indicated pharmacological measure was clonazepam with short- and longterm effects on symptomatology relief. However, a standardized BMS treatment protocol is not described in the literature, since non-pharmacological therapeutic measures, such as psychotherapy and placebos, reduce the symptomatology of the pathology. The quality of the studies was analyzed through the evaluation of systematic reviews in dentistry (Glenny scale) and the Assessment of the Methodological Quality of Systematic Reviews (AMSTAR 2). According to the Glenny scale, the included studies are of moderate-to-high quality. However, according to AMSTAR 2, only two studies are of a high-quality level, while the others are classified as critically low. Conclusion: The use of pharmacological (clonazepam) and non-pharmacological (psychotherapy and placebo) measures reduces BMS symptoms. Relevance for Patients: This review on BMS treatment may aid clinicians in making better-informed decisions regarding treatment modality based on the best available evidence.

Publication Delay of Systematic Reviews in Dentistry: Findings, Implications, and Potential Solutions.

Clinicians, researchers, and policymakers often rely on the available scientific evidence to make strategic decisions. Systematic reviews (SRs) occupy an influential position in the hierarchy of scientific evidence. The findings of wellconducted SRs may provide valuable information to answer specific research questions1,2 and identify existing gaps for future research.3 Therefore, it is of supreme importance that SRs are published promptly, reducing as much as possible the time elapsed between the last date of the search for primary studies and the actual publication date. A study published in 2014 assessed the publication delay of SRs in orthodontics, revealing that the median time interval from the last search to publication was more than 1 year (13.2 months).4 Delays in the publication of SRs or original research articles may depend on author-related factors (eg, timing of resubmission after receiving feedback from reviewers) or journal-related factors (eg, time taken to process a submission).5-7 Regardless of the reasons, clinical recommendations and translation of SR findings may be affected by publication delay. We assessed the extent of publication delay of systematic reviews in dentistry with the purpose of addressing its implications and presenting potential solutions.

Cochrane systematic reviews in dentistry: an Altmetric and network analysis.

Introduction Cochrane systematic reviews (CSRs) play an important role in evidence-based decision-making. Therefore, the present study aimed to determine the social impact of CSRs in dentistry and the inclusivity and diversity of researchers contributing to one of the largest databases in health care research.Methodology The Altmetric and bibliometric data for CSRs in dentistry were obtained through Altmetric Explorer and the Dimensions database and were analysed to determine the trends. Furthermore, the correlation between the number of citations and the Altmetric Attention Score (AAS) was identified using Spearman's correlation co-efficient.Results Mendeley was found to be the most active Altmetric resource, followed by Twitter. The tweets were more popular among the members of the public (65.5%) and had a diverse geographic spread. The co-authorship network analysis revealed an overall dense network of researchers. In the co-citation network analysis, the Journal of Community Dentistry had the greatest influence. Moreover, a weaker correlation was noticed between the citation counts and AAS (rs=0.325; p <0.01).Conclusion CSRs had a modest social impact in terms of AAS; however, the social network of contributing researchers was diverse and the researchers affiliated with the University of Manchester, UK were found to have the strongest link.

Methodological quality of systematic reviews in dentistry including animal studies: a cross-sectional study

BackgroundThe overall confidence in the results of systematic reviews including animal models can be heterogeneous. We assessed the methodological quality of systematic reviews including animal models in dentistry as well as the overall confidence in the results of those systematic reviews.Material & methodsPubMed, Web of Science and Scopus were searched for systematic reviews including animal studies in dentistry published later than January 2010 until 18th of July 2022. Overall confidence in the results was assessed using a modified version of the A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) checklist. Checklist items were rated as yes, partial yes, no and not applicable. Linear regression analysis was used to investigate associations between systematic review characteristics and the overall adherence to the AMSTAR-2 checklist. The overall confidence in the results was calculated based on the number of critical and non-critical weaknesses presented in the AMSTAR-2 items and rated as high, moderate, low and critical low.ResultsOf initially 951 retrieved systematic reviews, 190 were included in the study. The overall confidence in the results was low in 43 (22.6%) and critically low in 133 (70.0%) systematic reviews. While some AMSTAR-2 items were regularly reported (e.g. conflict of interest, selection in duplicate), others were not (e.g. funding: n = 1; 0.5%). Multivariable linear regression analysis showed that the adherence scores of AMSTAR-2 was significantly associated with publication year, journal impact factor (IF), topic, and the use of tools to assess risk of bias (RoB) of the systematic reviews.ConclusionAlthough the methodological quality of dental systematic reviews of animal models improved over the years, it is still suboptimal. The overall confidence in the results was mostly low or critically low. Systematic reviews, which were published later, published in a journal with a higher IF, focused on non-surgery topics, and used at least one tool to assess RoB correlated with greater adherence to the AMSTAR-2 guidelines.

THERAPEUTIC METHODS FOR BURNING MOUTH SYNDROME: AN OVERVIEW

Objective To perform an overview of available systematic reviews (SR) on therapeutic methods used to alleviate Burning Mouth Syndrome (BMS) symptomatology. Study Design The study was conducted following the PRISMA and is registered with PROSPERO under number (CRD42021268587). The databases searched were PubMed, The Cochrane Library, Scopus, Embase, and Web of Science. The PICO question was "For the relief of symptomatology, discomfort, and burning sensation caused by BMS, what is the best strategy?". 212 articles were retrieved, 113 studies were evaluated for inclusion, and eight SR were included. The quality of SR was analyzed through the evaluation of SR in dentistry (Glenny Scale) and the Assessment of the Methodological Quality of SR (AMSTAR2). Results The most indicated pharmacological measure was clonazepam with short- and long-term effects on symptomatology relief. However, a standardized BMS treatment protocol is not described in the literature. According to Glenny scale, the studies had moderate to high quality, but according to AMSTAR 2, only two studies showed a high-quality level, while the others were classified as critically low. Conclusion The use of pharmacological and non-pharmacological measures reduces the symptomatology of BMS, but new randomized clinical trials are suggested to investigate treatment protocols for BMS. To perform an overview of available systematic reviews (SR) on therapeutic methods used to alleviate Burning Mouth Syndrome (BMS) symptomatology. The study was conducted following the PRISMA and is registered with PROSPERO under number (CRD42021268587). The databases searched were PubMed, The Cochrane Library, Scopus, Embase, and Web of Science. The PICO question was "For the relief of symptomatology, discomfort, and burning sensation caused by BMS, what is the best strategy?". 212 articles were retrieved, 113 studies were evaluated for inclusion, and eight SR were included. The quality of SR was analyzed through the evaluation of SR in dentistry (Glenny Scale) and the Assessment of the Methodological Quality of SR (AMSTAR2). The most indicated pharmacological measure was clonazepam with short- and long-term effects on symptomatology relief. However, a standardized BMS treatment protocol is not described in the literature. According to Glenny scale, the studies had moderate to high quality, but according to AMSTAR 2, only two studies showed a high-quality level, while the others were classified as critically low. The use of pharmacological and non-pharmacological measures reduces the symptomatology of BMS, but new randomized clinical trials are suggested to investigate treatment protocols for BMS.

Critical appraisal of systematic reviews of intervention in dentistry published between 2019-2020 using the AMSTAR 2 tool.

Introduction The number of systematic reviews (SRs) in dentistry published each year has grown considerably, and they have been essential in clinical decision-making and health policy.Objective The objective is to critically appraise SRs of intervention in dentistry using the 'A Measurement Tool to Assess Systematic Reviews 2' (AMSTAR 2) tool published within one year.Methods A search in the Medline/PubMed database was performed. The SRs were identified in two phases. The first phase identified SRs of interventions in dentistry by title and abstract. In the second phase, the full text was read, applying the eligibility criteria. Three calibrated reviewers methodologically assessed all SRs identified using the AMSTAR 2 tool. Data were analysed descriptively, and SRs were grouped according to methodological quality as moderate/high and low/critically low. A logistic regression model was applied to explore the associations between methodological quality and the study's characteristics.Results Two hundred and twenty-two SRs were included. The methodological quality of the SRs included in this study were: critically low (56.8%), low (27.9%), moderate (14.4%) and high (0.9%), according to AMSTAR 2. There were no statistical differences between moderate/high and low/critically low methodological quality and publication year, continent, journal Impact Factor and dental speciality.Conclusion Less than 1% of recently published SRs in dentistry were classified with high methodological quality. We hope that this study will alert researchers about the need to improve the methodological quality of SRs.

THE STRUCTURE FORMAT OF ABSTRACTS: A SURVEY OF LEADING DENTAL JOURNALS AND THEIR EDITORS.

To present the actual usage of different structure formats in abstracts of randomized controlled trials (RCTs) and systematic reviews (SRs) published in SCIE-indexed dental journals, and to assess the awareness, knowledge, as well as attitudes towards the structured formats of RCT and SR abstracts among editors-in-chief (EICs) of dental journals. In the first part of this study, we selected SCIE-indexed dental journals and assessed their eligibility according to pre-determined criteria. All RCTs and SRs published in the included journals during January-June 2020 were identified through a hand-search. The actual usage of different structure formats and headings, as well as relevant editorial policies were extracted. In the second part, an anonymous online survey among the EICs of included dental journals was conducted. A total of 88 journals were included, from which 364 RCT abstracts and 130 SR abstracts were identified. For RCT abstracts, 86% were structured, with 83% in IMRaD format (Introduction, Methods, Results, and Discussion) and 3% in highly structured (HS) format. For SR abstracts, 80% were structured, including 73% in IMRaD and 7% in HS format. According to the "instructions to authors", most journals required either IMRaD (68%) or HS (5%) for RCTs, while less than half required either IMRaD (36%) or HS (9%) for SRs. Twenty-one (24%) EICs participated in our survey, among which 18 agreed that structured formats could improve the reporting quality of RCT abstracts, while only 12 of them thought HS format should be widely recommended in the dental field. Compared with the HS format, IMRaD was more frequently used and required among RCT and SR abstracts in dentistry. Structured formats held a relatively high degree of recognition among EICs of dental journals. Joint efforts are needed for improving the awareness and usage of HS format.

Systematic Reviews in Dental Research: A Bibliometric Analysis of Contribution from Indian Dentists During 1948-2022.

Although systematic reviews (SRs) are the backbone of evidence-based dentistry, they have appeared infrequently in dental literature and their importance may not be recognized by dentists. So, this study aimed to identify SRs in dental research contributed by Indian dentists to the PubMed database during 1948-2022 and describes their epidemiological and descriptive characteristics. An electronic search of the PubMed database was performed from 1948 through September 2022. SRs were considered for inclusion if they were related to oral health and published by Indian dentists as the first author. From this collection, the following characteristics of SRs were described: name of the journal, type of journal (e.g., general dentistry, specialty dentistry, non-dental), year of publication, author's affiliation, and focus of the SR. The search identified 439 SRs in dentistry indexed in the PubMed database during 1948-2022. There were only 5 SRs published from 2007 to 2010 with maximum publications during the year 2021 (n = 114; 25.97%). About 32.35% of the SRs (n = 142) were published in 10 journals with the maximum contribution from the Journal of Conservative Dentistry (n = 22; 5.01%). The majority of the SRs were published in the field of Pedodontics and Preventive Dentistry (n = 72; 16.40%), followed by Conservative Dentistry and Endodontics (n = 63; 14.35%). The contribution of SRs in dental research from India is small but growing. There is a clear need to improve SRs in dental research qualitatively and quantitatively.

Protocol registration improves reporting quality of systematic reviews in dentistry

BackgroundThe aims of this study were to assess whether the previous registration of a systematic review (SR) is associated with the improvement of the quality of the report of SRs and whether SR registration reduced outcome reporting bias.MethodsWe performed a search in PubMed for SRs in dentistry indexed in 2017. Data related to SR registration and reporting characteristics were extracted. We analyzed if the reporting of 21 characteristics of included SRs was associated with the prospective registration of protocols or reporting of a previously established protocol. The association between prospective registering of protocols, reporting of funding and number of included studies versus outcome reporting bias was tested via multivariable logistic regression.ResultsWe included 495 SRs. One hundred and 62 (32.7%) SRs reported registering the SR protocol or working from a previously established protocol. Thirteen reporting characteristics were described statistically significant in SRs registered versus SRs that were not. Publication bias assessment and Report the number of participants showed the highest effects favoring the register (RR 1.59, CI 95% 1.19–2.12; RR 1.58, CI 95% 1.31–1.92 respectively). Moreover, Registration was not significantly linked with the articles’ reporting statistical significance (OR 0.96, CI 95% 0.49–1.90).ConclusionThere is a positive influence of previously registering a protocol in the final report quality of SRs in dentistry. However, we did not observe an association between protocol registration and reduction in outcome reporting bias.

Influence of Diabetes on the Survival Rate and Marginal Bone Loss of Dental Implants: An Overview of Systematic Reviews.

We aimed to conduct an analysis of the systematic reviews (SRs) in literature about the implant survival rate (ISR) and marginal bone loss (MBL) in diabetic and nondiabetic patients. This work was registered in The International Prospective Register of Systematic Reviews (CRD42018095314) and was developed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Library Handbook. A search was performed on PubMed, Cochrane, Scopus, Embase, and LILACS. The PICO (problem/patient/population, intervention/indicator, comparison, outcome) question was "Do the survival rates of dental implants and marginal bone loss differ between diabetic and nondiabetic patients?" A total of 130 articles were retrieved. After eliminating repetitions, 118 were reviewed. Finally, 6 SRs were included. All the reviews indicated that there is no effect of diabetes on the ISR; however, a negative effect of the disease can be observed in MBL. Analysis of the quality of the studies was performed using the assessment of SRs in dentistry (Glenny Scale) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2). Glenny Scale showed a moderate to high quality of the included studies. In contrast, AMSTAR 2 pointed out a critically low level for 4 studies, with no study fulfilling the criteria for high quality. It may be concluded that there is no effect of diabetes on the ISR; however, a negative effect of the disease can be observed on MBL.

Systematic reviews in restorative dentistry: discussing relevant aspects.

This article aims to discuss key aspects of systematic reviews (SR) focusing on the improvement of the conduct and reporting. Important aspects of SRs, such as prospective registration of the review protocol, basic structure, inclusion criteria, use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, confidence in the results and future directions are discussed. To determine relevant aspects, a search was conducted without date limitations in PubMed (October 15th, 2017) to identify SRs written in English evaluating clinical performance of direct composite resin restoration in permanent posterior teeth or comparing direct composite resin with other material/techniques. The quality of SRs included was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 tool. Fifteen SRs were included. The overall confidence in the results of SRs was classified as critically low. Some aspects should be highlighted: SRs of in vitro studies are an important tool in restorative dentistry, and initiatives such as the PRISMA Statement and PROSPERO should be considered a standard code of practice. The compliance with and awareness of the discussed aspects may be a significant feature of the improvement of SR quality in the dentistry. Initiatives such as the PRISMA Statement and PROSPERO should be taken in account by systematic reviewers in dentistry to improve the conduct and reporting of SRs, and to make their reviews are more clinically helpful.

Training Module for Capacity Building to Conduct Systematic Reviews in Dentistry

Training Module for Capacity Building to Conduct Systematic Reviews in Dentistry

Systematic reviews in dentistry: Current status, epidemiological and reporting characteristics

ObjectiveThis study aimed to evaluate the epidemiological and reporting characteristics of systematic reviews (SRs) in dentistry indexed within PubMed during the year 2017. MethodsWe searched for SRs in dentistry indexed within PubMed in 2017. Study selection was undertaken by two reviewers independently. Data related to epidemiological and reporting characteristics were extracted by one of three reviewers. A descriptive analysis of the data was performed. Characteristics of SRs were analyzed considering all SRs included and subgrouped by dental specialties. In addition, we explored if the reporting of 24 characteristics of treatment/therapeutic SRs was associated with the self-reported use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement calculating the risk ratio (RR) with a 95% confidence interval for each characteristic. Results495 articles fulfilled the eligibility criteria. The main specialty considered was Oral Surgery numbering 75 articles. Brazil presented the highest contribution with 117 SRs (23.6%). The reporting quality was variable. Items such as, use of the term “systematic review”, or “meta-analysis” in the title or abstract was well reported. In contrast, the study risk of bias/quality assessment method was not reported in 40.5% of SRs. In addition, only four reporting characteristics were described more often in those SR that reported using the PRISMA Statement. ConclusionA large number of SRs were published in dentistry in 2017 and the reporting and epidemiological characteristics varied among dental specialties. There is a mandatory need to improve the quality of reporting and conduct of SRs in dentistry. Clinical significancePoor reporting and conduction of SRs could generate SRs with imprecise and biased results.

A Quality Analysis of Systematic Reviews in Dentistry, Part 1: Meta-Analyses of Randomized Controlled Trials

ObjectivesAs the volume of publications in dentistry continues to increase, clinicians are becoming increasingly reliant on systematic reviews and meta-analyses as their primary source of evidence. With an increase in the dependence on dental metaanalyses, it is important to ensure that they are being conducted with as little bias as possible. The objective of this systematic review is to assess the quality of therapeutic meta-analyses of randomized controlled trials (RCTs) on dental-related topics and to analyze how quality has changed over time. MethodsAll relevant studies were searched for through MEDLINE, Embase, PsycINFO, and the Cochrane Library. Title, abstract, and full-text review, as well as data extraction and quality assessment, were all conducted in duplicate. All reviewers used a pilot-tested extraction form that included the AMSTAR checklist to assess quality of systematic reviews. A logit link function ordinal regression was conducted to evaluate quality improvement trends over time. ResultsOf the 3832 studies identified, 208 studies were selected for review. Of these, 13% provided an a priori design, 53% screened and extracted data in duplicate, 29% included gray literature, 63% assessed the quality of included studies, and 39% assessed publication bias. As was indicated by the ordinal regression, the quality of meta-analyses, as per the AMSTAR criteria, has increased significantly with time (P < .001). ConclusionsThis investigation illustrates that although the quality of meta-analyses of RCTs has been increasing since the start of the millennium, there remains substantial room for improvement within all aspects of systematic review reporting and methodology. Therefore, it is critical for clinicians to take caution when reading systematic reviews and meta-analyses, ensuring that the principals of critical appraisal are applied when interpreting meta-analyses of RCTs.

Systematic reviews in oral health: a quality imperative.

Systematic reviews must be conducted responsibly, eliminating any scope for error and bias. The reporting quality of a systematic review should follow and conform to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. AMSTAR (Assessment of Multiple Systematic Reviews) is an assessment tool, which has been developed specifically to assess the quality of the process used in conducting the review. There has been a significant increase in the number of systematic reviews in oral health and several reports have been published stating low AMSTAR ratings of systematic reviews in dentistry. Systematic reviews answer key clinical questions objectively, and are often used to underpin clinical guidelines in oral health. If the quality of these reviews is compromised, this can result in inadequate or inappropriate clinical guidelines. Consequently, ensuring consistent high quality is a key imperative for systematic reviews in oral health.

Don't shoot the messenger!

In this issue, in addition to our usual commentaries on published papers, we have a paper examining the quality of systematic reviews in dentistry (see page 66). This is not the first study to address this subject1,2, 3 but it does adopt a different approach, comparing quality across the different dental specialities.

Conclusive support for mechanical nonsurgical pocket therapy in the treatment of periodontal disease

Sources of studies were the Cochrane Oral Health Group List of Systematic Reviews in Dentistry, Database of Abstracts of Reviews of Effectiveness, Medline, Embase, and Scisearch. No date or language restriction was imposed. Reference lists of located reviews were checked for additional references. Twelve reviews addressing the question were included. A narrative appraisal of the reviews was conducted. A number of implications for clinical practice were identified. These are as follows:Initial therapy: In people who have periodontitis, mechanical nonsurgical pocket therapy reduces inflammation and pocket depth and increases clinical attachment level. The magnitude of pocket depth reduction correlates with greater pocket depth before treatment. Nonsurgical mechanical debridement may cause loss of attachment in shallow pockets (</=3 mm). There is no evidence of any difference in efficacy between machine-driven (ultrasonic and sonic) and hand instruments in single-rooted teeth. Machine-driven instruments may be faster than hand instruments. Adjunctive therapies have been developed and investigated but, to date, no therapy exists as a stand alone replacement for mechanical nonsurgical pocket therapy.Maintenance therapy: In periodontal maintenance patients, mechanical debridement reduces inflammation and disturbs the bacterial biofilm, which is thought critical to disease control including prevention of progression. The effect of mechanical nonsurgical pocket therapy on pocket depth reduction and clinical attachment gain in maintenance patients is unclear; maintenance or stability of pocket probing depth and clinical attachment level, however, has been demonstrated and meets the goal of maintenance therapy. There is not clear evidence to form recommendations over time taken, thoroughness and frequency of mechanical debridement for periodontal maintenance care. Existing evidence in the form of systematic reviews - the highest level of evidence for evaluating a therapy - provides conclusive support for the beneficial effect and efficacy of mechanical nonsurgical pocket therapy in the treatment of periodontal diseases.

Survey of systematic reviews in dentistry

Although systematic reviews are the backbone of evidence-based dentistry, they have appeared infrequently in the clinical dental literature and their importance may not be recognized by dentists. The authors describe the steps taken in systematic reviews and perform a literature survey to identify published systematic reviews of topics relevant to clinical dentistry. The authors searched MEDLINE and the Cochrane databases of systematic reviews and abstracts of reviews of effectiveness, as well as identified reviews that were known to the authors but not found in the searches. Systematic reviews included in this survey stated the intention to identify all relevant articles within predefined limitations, applied defined exclusion and inclusion criteria, and presented complete raw or synthesized data from included studies. This literature survey identified 131 systematic reviews, 96 of which had direct clinical relevance. During the past 14 years, clinically relevant systematic reviews have been published with increasing frequency. These reviews vary in the types of studies included and the assessment of those studies. The results of the reviews also varied in their definitiveness, with 17 percent finding the evidence to be insufficient to answer the key question. An additional 50 percent of the 96 reviews hedged in answering the key question, by noting that the supporting evidence was weak in quality or limited in quantity. The number of systematic reviews that address clinical topics in dentistry is small but growing. However, the authors of more than one-half of these reviews believed that the evidence available to answer the key question was not strong. As systematic reviews continue to grow, dentistry will become better informed about the adequacy and congruence of the scientific evidence underpinning clinical practice.

The assessment of systematic reviews in dentistry

The assessment of systematic reviews in dentistry