The assessment of systematic reviews in dentistry.

The aim of this study was to assess the quality of systematic reviews of effectiveness of interventions in dentistry. The Database of Abstracts of Reviews of Effectiveness and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews examining the effectiveness of interventions for oral, dental and craniofacial disorders and diseases. Sixty-five reviews were identified and assessed independently by two reviewers. The area most frequently evaluated within the reviews was pain relief/prevention (20/65, 31%) followed by caries and oral medicine. The quality assessment of the identified systematic reviews highlighted key areas where improvements could be made. One major weakness of the reviews was that the search strategies employed were not always adequate. Only 12 reviews (19%) demonstrated an attempt to identify all relevant studies. Other areas of weakness include the screening and quality assessment of primary studies, the pooling of data and examination of heterogeneity, and the interpretation of findings. This investigation shows that the quality of systematic reviews in dentistry could be improved. If future clinical decisions are to be based upon systematic reviews, it is imperative that the reviews address clinically relevant, focused questions and follow a 'transparent', well-designed protocol.

[1]  E Giedrys-Leeper,et al.  Guided tissue regeneration for periodontal infra-bony defects. , 2006, The Cochrane database of systematic reviews.

[2]  Mark Petticrew,et al.  Systematic reviews from astronomy to zoology: myths and misconceptions , 2001, BMJ : British Medical Journal.

[3]  S. Poulsen,et al.  Potassium nitrate toothpaste for dentine hypersensitivity. , 2000, The Cochrane database of systematic reviews.

[4]  H. Worthington,et al.  Potassium nitrate toothpaste for dentine hypersensitivity (Cochrane Review) , 2001 .

[5]  C. Kreulen,et al.  [Meta-analysis of anterior veneer restorations in clinical studies]. , 2001, Nederlands tijdschrift voor tandheelkunde.

[6]  J. Harrison,et al.  Orthodontic treatment for posterior crossbites. , 2001, The Cochrane database of systematic reviews.

[7]  I. Olkin,et al.  Meta-analysis of observational studies in epidemiology - A proposal for reporting , 2000 .

[8]  S. Schoem.  Oral appliances for the treatment of snoring and obstructive sleep apnea , 2000, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[9]  David Moher,et al.  Meta-analysis of Observational Studies in Epidemiology , 2000 .

[10]  H. Worthington,et al.  Prevention of oral mucositis or oral candidiasis for patients with cancer receiving chemotherapy (excluding head and neck cancer). , 2000, The Cochrane database of systematic reviews.

[11]  E. Kalso,et al.  Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials , 1999, PAIN®.

[12]  I. Olkin,et al.  Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement , 1999, The Lancet.

[13]  M. Egger,et al.  The hazards of scoring the quality of clinical trials for meta-analysis. , 1999, JAMA.

[14]  A. Ismail,et al.  A systematic review of clinical diagnostic criteria of early childhood caries. , 1999, Journal of public health dentistry.

[15]  S. Richmond,et al.  What type of filling? Best practice in dental restorations. , 1999, Quality in health care : QHC.

[16]  J H Kim,et al.  The effectiveness of protraction face mask therapy: a meta-analysis. , 1999, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[17]  P. Dijkstra,et al.  Therapeutic outcome assessment in permanent temporomandibular joint disc displacement. , 1999, Journal of oral rehabilitation.

[18]  J. Waksman,et al.  The Safety Profile of Nonprescription Ibuprofen in Multiple‐Dose Use: A Meta‐Analysis , 1999, Journal of clinical pharmacology.

[19]  R. Moore,et al.  Injected morphine in postoperative pain: a quantitative systematic review. , 1999, Journal of pain and symptom management.

[20]  E. Ernst,et al.  Acupuncture as a treatment for temporomandibular joint dysfunction: a systematic review of randomized trials. , 1999, Archives of otolaryngology--head & neck surgery.

[21]  N. Wilson,et al.  Glass-ionomer Restoratives: A Systematic Review of a Secondary Caries Treatment Effect , 1999, Journal of dental research.

[22]  A. Ismail,et al.  Fluoride supplements and fluorosis: a meta-analysis. , 1999, Community dentistry and oral epidemiology.

[23]  A. Glaros,et al.  A meta-analysis of EMG biofeedback treatment of temporomandibular disorders. , 1999, Journal of orofacial pain.

[24]  Dental Restoration: What Type of Filling? , 1999, Evidence-Based Dentistry.

[25]  P. Rosted.  The use of acupuncture in dentistry: a review of the scientific validity of published papers. , 2008, Oral diseases.

[26]  T. Einarson,et al.  Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies , 1998, BMJ.

[27]  D. Locker.  Patient-based assessment of the outcomes of implant therapy: a review of the literature. , 1998, The International journal of prosthodontics.

[28]  D. Fishbain,et al.  Do Antidepressants Have an Analgesic Effect in Psychogenic Pain and Somatoform Pain Disorder? A Meta-Analysis , 1998, Psychosomatic medicine.

[29]  B. Hodgkinson,et al.  The Effectiveness of Strategies for Preventing and Treating Chemotherapy and Radiation Induced Oral Mucositis in Patients with Cancer; A systematic Review , 1998 .

[30]  E. Ernst,et al.  The effectiveness of acupuncture in treating acute dental pain: a systematic review , 1998, British Dental Journal.

[31]  P. Rosted.  The Use of Acupuncture in Dentistry: A Systematic Review , 1998 .

[32]  J Gunne,et al.  A meta-analysis of implants in partial edentulism. , 1998, Clinical oral implants research.

[33]  J. Bader,et al.  Meta-analysis of fixed partial denture survival: prostheses and abutments. , 1998, The Journal of prosthetic dentistry.

[34]  M. Drangsholt,et al.  A review of survival rates for implants placed in grafted maxillary sinuses using meta-analysis. , 1998, The International journal of oral & maxillofacial implants.

[35]  K. Seers,et al.  Relaxation for the relief of chronic pain: a systematic review. , 1998, Journal of advanced nursing.

[36]  M. A. van 't Hof,et al.  A Meta-Analysis of Clinical Studies on the Caries-Inhibiting Effect of Fluoride Gel treatment , 1998, Caries Research.

[37]  C. Zaza,et al.  Critical review of 5 nonpharmacologic strategies for managing cancer pain. , 1998, Cancer prevention & control : CPC = Prevention & controle en cancerologie : PCC.

[38]  J. Ioannidis.  Effect of the statistical significance of results on the time to completion and publication of randomized efficacy trials. , 1998, JAMA.

[39]  P. Wiffen,et al.  Comparing analgesic efficacy of non‐steroidal anti‐inflammatory drugs given by different routes in acute and chronic pain: A qualitative systematic review , 1998, Acta anaesthesiologica Scandinavica.

[40]  K. Linde,et al.  Randomized controlled trials of individualized homeopathy: a state-of-the-art review. , 1998, Journal of alternative and complementary medicine.

[41]  A. Li Wan Po,et al.  Analgesic efficacy of ibuprofen alone and in combination with codeine or caffeine in post-surgical pain: a meta-analysis , 1998, European Journal of Clinical Pharmacology.

[42]  L. Kaban,et al.  Recommendations for management of trigeminal nerve defects based on a critical appraisal of the literature. , 1997, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[43]  Wayne B Jonas,et al.  Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials , 1997, The Lancet.

[44]  M. Tramèr,et al.  Analgesic efficacy of peripheral opioids (all except intra-articular): a qualitative systematic review of randomised controlled trials , 1997, Pain.

[45]  C. Lengeler,et al.  Language bias in randomised controlled trials published in English and German , 1997, The Lancet.

[46]  J. Beck,et al.  Meta-analysis of the effect of systemic metronidazole as an adjunct to scaling and root planing for adult periodontitis. , 1997, Journal of periodontal research.

[47]  J C van Houwelingen,et al.  Antimicrobial treatment in acute maxillary sinusitis: a meta-analysis. , 1997, Journal of clinical epidemiology.

[48]  B Trpkova,et al.  Cephalometric Landmarks Identification and Reproducibility: a Meta Analysis Materials and Methods Selection of Studies and Landmarks , 2022 .

[49]  R. Gibbons,et al.  The effect of treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia. A meta-analysis. , 1997, Archives of internal medicine.

[50]  D. Carroll,et al.  Paracetamol with and without codeine in acute pain: a quantitative systematic review , 1997, Pain.

[51]  W. Y. Zhang,et al.  Do codeine and caffeine enhance the analgesic effect of aspirin?—A systematic overview , 1997, Journal of clinical pharmacy and therapeutics.

[52]  R. Moore,et al.  Single-patient data meta-analysis of 3453 postoperative patients: oral tramadol versus placebo, codeine and combination analgesics , 1997, Pain.

[53]  R. Carrau,et al.  Osteosarcoma of the Head and Neck: Meta‐analysis of Nonrandomized Studies , 1997, The Laryngoscope.

[54]  G. Snow,et al.  Effect of chemotherapy on survival of craniofacial osteosarcoma: a systematic review of 201 patients. , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[55]  D. Locker,et al.  The efficacy of nonopioid analgesics for postoperative dental pain: a meta-analysis. , 1997, Anesthesia progress.

[56]  L. Hedges,et al.  Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. , 1997, Lancet.

[57]  H. J. McQuay,et al.  A systematic review of antidepressants in neuropathic pain , 1996, Pain.

[58]  I G Williamson,et al.  The clinical problem of Bell's palsy: is treatment with steroids effective? , 1996, The British journal of general practice : the journal of the Royal College of General Practitioners.

[59]  M. Quirynen,et al.  Microbiological response to mechanical treatment in combination with adjunctive therapy. A review of the literature. , 1996, Journal of periodontology.

[60]  J. Liedberg,et al.  Evidence-based evaluation of three imaging methods for the temporomandibular disc. , 1996, Dento maxillo facial radiology.

[61]  A. Po,et al.  Analgesic efficacy of paracetamol and its combination with codeine and caffeine in surgical pain–a meta‐analysis , 1996, Journal of clinical pharmacy and therapeutics.

[62]  D. Locker,et al.  Is dental health education effective? A systematic review of current evidence. , 1996, Community dentistry and oral epidemiology.

[63]  J. Piccirillo,et al.  The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. , 1996, Sleep.

[64]  G. Truin,et al.  A Meta-analysis of Clinical Studies on the Caries-inhibiting Effect of Chlorhexidine Treatment , 1996, Journal of dentistry research.

[65]  R. Anderson,et al.  Effective oral health promotion: literature review , 1996 .

[66]  Dawn Carroll,et al.  Anticonvulsant drugs for management of pain: a systematic review , 1995, BMJ.

[67]  W. Schmidt-Nowara,et al.  Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. , 1995, Sleep.

[68]  H. McQuay,et al.  Pre-emptive analgesia: a systematic review of clinical studies. , 1995, Annals of medicine.

[69]  E. Verdonschot,et al.  Factors involved in validity measurements of diagnostic tests for approximal caries--a meta-analysis. , 1995, Caries research.

[70]  J. Holcombe,et al.  A meta-analysis of intervention effectiveness for symptom management in oncology nursing research. , 1994, Oncology nursing forum.

[71]  K. Dickersin,et al.  Full publication of results initially presented in abstracts. A meta-analysis. , 1994 .

[72]  U. Helfenstein,et al.  Fluoride varnishes (Duraphat): a meta-analysis. , 1994, Community dentistry and oral epidemiology.

[73]  M. Paesmans,et al.  Value of antifungal prophylaxis with antifungal drugs against oropharyngeal candidiasis in cancer patients. , 1994, European journal of cancer. Part B, Oral oncology.

[74]  M. Delgado-Rodríguez,et al.  Factors influencing the effectiveness of sealants--a meta-analysis. , 1993, Community dentistry and oral epidemiology.

[75]  A Antczak-Bouckoms,et al.  Meta-analysis of surgical versus non-surgical methods of treatment for periodontal disease. , 1993, Journal of clinical periodontology.

[76]  E. Burdick,et al.  Quality assessment and meta-analysis of systemic tetracycline use in chronic adult periodontitis. , 1992, Journal of clinical periodontology.

[77]  W. Holzemer,et al.  Use of the McGill Pain Questionnaire To Measure Pain: A Meta‐Analysis , 1990, Nursing research.

[78]  C. Mulrow.  The medical review article: state of the science. , 1987, Annals of internal medicine.

[79]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.