Evidence map›Paper›PMID 40349703›Full record

SynthesisCaries research2026

Dental Practitioners' Thresholds for Restorative Intervention in Carious Lesions: A Survey-Based Systematic Review Update.

Heather J Lundbeck, Vinay Pitchika, Paul Wilson, Daniela P Raggio, Jennifer Galloway, Waraf Al-Yaseen, Arindam Dutta, Rhiannon Jones, Shannu Bhatia, Glesni Guest-Rowlands and 3 more

Abstract readSystematic Review
In one paragraph

Synthesis in Caries research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Heather J LundbeckSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK, lundbeckh@cardiff.ac.uk.
Vinay PitchikaDepartment of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Munich, Germany.
Paul WilsonSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Daniela P RaggioFaculdade de Odontologia, Universidade de São Paulo, São Paulo, Brazil.
Jennifer GallowaySchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Waraf Al-YaseenSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Arindam DuttaSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Rhiannon JonesSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Shannu BhatiaSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Glesni Guest-RowlandsSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Kathryn RowlesSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Falk SchwendickeDepartment of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Munich, Germany.
Nicola InnesSchool of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: Despite evidence supporting the clinical and cost-effectiveness of minimally invasive dentistry (MID), its adoption by the dental profession has been slow. A systematic review in 2016 found the majority of dentists intervene invasively earlier than necessary. The aim was to update this review of the assessment of dental practitioners' thresholds for providing restorative treatment for carious lesions given changes in evidence, teaching, and guidelines since 2016. The primary outcome was dental practitioners' restorative thresholds (the extent of the lesion when they would decide to intervene restoratively). Secondary outcomes were changes over time, caries risk, regional differences, and primary/permanent dentition.

methodsThis updated review replicated the methodology for the initial review, following the PRISMA 2020 guidelines (PROSPERO; CRD42023431906). Embase, MEDLINE (via PubMed), and Web of Science databases were searched (2016-2023) for observational studies reporting on dental clinicians' thresholds for restorative interventions in adults and children without language, time, or quality restrictions. Screening, data extraction, and risk of bias assessment (Modified Newcastle-Ottawa Scale) were carried out independently and in duplicate. Meta-analyses were performed using a random-effects model. No funding sought.

resultsOverall, 47 publications (30 from original publication and 17 from updated search) met the inclusion criteria and 65 datasets were included in the meta-analyses: 19 for occlusal lesions (16 pre-2016 and 3 post-2016; n = 11,946) and 46 for proximal lesions (38 pre-2016 and 8 post 2016; n = 20,428). The meta-analyses found that for occlusal lesions confined to enamel, there were fewer practitioners intervening invasively: 5% (95% confidence interval [CI]; 1-20%) post-2016, compared with 15% (95% CI; 9-23%) pre-2016. The opposite was found for proximal lesions with increased intervention levels, 27% (95% CI; 18-40%) for lesions confined to enamel post-2016, compared with 19% (95% CI; 12-29%) pre-2016, and for lesions extending up to the enamel-dentine junction 61% (95% CI; 36-81%) post-2016, compared with 39% (95% CI; 29-51%) pre-2016. There was variance between regions but too few studies to draw conclusions on individual regions.

conclusionThere was a suggestion of less invasive treatment of occlusal lesions over time; however, this was not evident for proximal lesions. </p>.

Indexed as

Dental CariesDental Restoration, PermanentDentistsPractice Patterns, Dentists'HumansSurveys and QuestionnairesCariesEvidence-based dentistryMinimally invasive dentistryRestorative dentistryTreatment planning

Identifiers

PMID40349703
PMCPMC12180769

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.