Summary of findings for the main comparison. Preformed crowns compared to fillings for decayed primary molar teeth.
| Preformed crowns compared to fillings for decayed primary molar teeth | ||||||
| Patient or population: decayed primary molar teeth Settings: secondary care, UK and Germany Intervention: preformed crown Comparison: filling | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Filling | Preformed crown | |||||
| Major failure ‐ long term (12 months to 48 months) | Study population | RR 0.18 (0.06 to 0.56) | 346 (3 RCTs) | ⊕⊕⊕⊝ moderate 1,2 | ||
| 112 per 1000 | 20 per 1000 (7 to 63) | |||||
| Pain ‐ long term (12 months to 24 months) | Study population | RR 0.15 (0.04 to 0.67) | 312 (2 RCTs) | ⊕⊕⊕⊝ moderate 1 | This was based on patient and/or parent reports | |
| 83 per 1000 | 12 per 1000 (3 to 56) | |||||
| Satisfaction with treatment | ||||||
| Discomfort associated with the procedure | Study population | RR 0.56 (0.36 to 0.87) | 381 (2 RCTs) | ⊕⊕⊕⊝ moderate 1 | This was patient‐reported in one study, and dentist‐reported in another study. Outcomes were recorded using different 5‐point scales, but dichotomised for analyses, with all partients who scored 'moderate' or more severe levels of discomfort considered as having experienced discomfort | |
| 239 per 1000 | 134 per 1000 (86 to 208) | |||||
| Gingival bleeding ‐ long term (12 months) | Study population | RR 1.74 (0.99 to 3.06) | 195 (2 RCTs) | ⊕⊕⊝⊝ low 1,3 | ||
| 156 per 1000 | 272 per 1000 (155 to 478) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio, RCT: randomised controlled trial | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Intervention and comparison look different. Blinding of outcome assessor, patients and the person doing the procedures was not possible. Outcomes have subjective elements. Although pain was not measured using validated tools, there was no further downgrading for this.
2 One of the studies only had data from 87% of randomised participants from one country (from a multinational study of three countries); the study is still ongoing at the time of publication.
3 Small sample size; event rates were low. Confidence intervals were wide.