Which management strategy has the highest success rate for occlusoproximal caries lesions in primary molars? A systematic review and network meta-analysis

This systematic review and network meta-analysis aimed to identify the most effective strategy for managing occlusoproximal caries in primary molars. A comprehensive literature search was conducted across five databases (MEDLINE/PubMed, Web of Science, Scopus, EMBASE, and ProQuest) up to February 2024. Eligible studies were randomized controlled trials with at least 12 months of follow-up, comparing different treatment approaches. Seven studies were included, covering five interventions: Hall Technique (HT), non-restorative cavity control (NRCC), conventional restorative treatment (CRT), silver diamine fluoride (SDF), and atraumatic restorative treatment (ART). The Hall Technique showed the highest success rate (80.8%), although no statistically significant differences were found among the remaining treatments. The risk of bias was high in most studies, mainly due to selective reporting. The certainty of evidence was rated from very low to moderate. These findings suggest HT may be the most effective option currently available, but further high-quality trials considering patient-centered outcomes are needed to support clinical decision-making.