Mapping the Evidence: Efficiency of Systematic Reviews, Meta-Analyses, and Network MetaAnalyses in Contemporary Dentistry

Evidence-based dentistry relies on rigorous synthesis methods to inform clinical decision-making. Systematic reviews (SRs), meta-analyses (MAs), and network meta-analyses (NMAs) sit atop the evidence hierarchy, yet their methodological efficiency and practical impact in dental research warrant critical appraisal. SRs employ a structured, transparent process to identify, appraise, and synthesize all relevant studies addressing a focused question; MAs statistically pool comparable outcomes to generate summary effect estimates; NMAs extend conventional MAs by comparing multiple interventions simultaneously, even when head-to-head trials are lacking. Recent audits of high-impact dental journals reveal exponential growth in SR output, but only 15–25% meet Cochrane risk-of-bias and PRISMA adherence criteria, raising concerns about redundancy and variable quality. Well-conducted MAs have demonstrably influenced clinical guidelines, reducing unwarranted practice variation—for example, clarifying the superiority of powered over manual toothbrushes and the caries-preventive benefit of resin infiltrants. NMAs, though fewer, efficiently rank competing restorative materials, endodontic irrigants, and periodontal adjuncts, guiding cost-effective care where direct evidence is sparse. However, heterogeneity, publication bias, and inconsistent outcome reporting constrain their certainty. Strengthening protocol registration, core outcome sets, and advanced bias-adjustment methods will further enhance the efficiency and credibility of evidence syntheses in dentistry