Yazici 2010.

Methods	Design: split‐mouth randomised controlled clinical trial Centres: 1 Date: not reported Setting: secondary care Operators: 1 single experienced dentist
Participants	Setting: University School of Dentistry Clinic Geographical area: Turkey Sample: 27 participants; 54 teeth; 108 cavities (54 in laser group versus 54 in drill group) Age: 19 to 21 years Sex: males 22% Baseline: participants with first and second permanent molars affected by non‐cavitated enamel caries. These lesions were assessed by visual inspection and a laser fluorescence device (DIAGNOdent) as well as by bitewing radiography. Visual inspections were performed with participants positioned in a dental chair, with reflector light, air/water spray and a plane buccal mirror Inclusion criteria: first and second permanent molars with at least 2 active occlusal non‐cavitated superficial carious lesions Exclusion criteria: frank occlusal cavitation, poor oral hygiene, serious systemic diseases and bruxism
Interventions	Intervention: Er,Cr:YSGG laser: wavelength: 2.780 μm pulse energy: 275 mJ (for enamel) pulse frequency: 20 Hz pulse duration: 140 μsec cooling method: air water Control: diamond bur in high‐speed handpiece
Outcomes	Primary outcomes Caries removal: not reported Episodes of pain: not reported Secondary outcomes Marginal integrity of restoration: assessed by 2 independent investigators not involved with the treatment procedures through objective and tactile (with a dental explorer) evaluation during 4 follow‐up visits at 6, 12, 18 and 24 months. A 3‐point rating scale (highly acceptable, acceptable, unacceptable) was used for this evaluation Durability of restoration: assessed by 2 independent investigators not involved with the treatment procedures through objective and tactile (with a dental explorer) evaluation during 4 follow‐up visits at 6, 12, 18 and 24 months. A 3‐point rating scale (highly acceptable, acceptable, unacceptable) was used for this evaluation Recurrent caries: assessed through a 2‐point scale (caries or no caries) after 2 years of follow‐up visits by 2 independent investigators not involved with the treatment procedures Pulpal inflammation or necrosis: not reported Participant discomfort: not reported Need for anaesthesia: not reported Operator preference/fatigue in operator: not reported Participant preference: not reported Duration of treatment: not reported
Notes	The cavities were restored with a nanofilled flowable resin composite, Grandio Flow, using an etch‐and‐rinse adhesive, Solobond M No reporting about use of anaesthesia Funding: unclear
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Distribution of the cavity preparation techniques per tooth was done using a table of random numbers
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgement of 'low risk' or 'high risk'
Blinding of participants and personnel (performance bias) All outcomes	High risk	The type of intervention does not allow the performance of blinding
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Evaluation was done by 2 other independent investigators not involved with the treatment procedures using a mirror, explorer and air stream. The investigators were calibrated to a predetermined level of inter‐ and intra‐examiner agreement at least 95% per single criterion. Any discrepancy between evaluators was resolved at chairside
Incomplete outcome data (attrition bias) All outcomes	Low risk	No apparent attrition
Selective reporting (reporting bias)	High risk	The study protocol was not available. The primary outcomes, caries removal and episodes of pain, were not reported
Other bias	Unclear risk	It was unclear whether the study was funded or not