Do systematic reviews of non- and micro-invasive treatment for caries lesions in children and adolescents adhere to the PRISMA reporting guidelines? A meta-research.

Aim: To evaluate whether systematic reviews (SRs) with or without meta-analysis or network meta-analysis focusing on non- and micro-invasive treatment of caries lesions in children and adolescents adhere to the PRISMA reporting guidelines and the PRISMA checklist and their extensions for Abstracts and Network Meta-analysis (NMA).

Material and methods: We conducted a comprehensive literature search up to 1st of September 2025 in the following databases: PubMed/MEDLINE, Scopus, Web of Science, and EMBASE. Gray literature was assessed through ProQuest and Epistemonikos, with no language or publication date restrictions. We included SRs focused on non- and micro-invasive caries treatment and excluded study protocols of SRs and SRs focused on special populations. Two independent reviewers extracted data from the included systematic reviews and assessed the adherence to PRISMA and its extensions as a reporting guideline.

Results: We retrieved 1221 publications; after duplicate removal and eligibility process, 45 studies were considered for further data extraction and 36 SRs for the assessment of the adherence to the PRISMA checklists. Two independent reviewers assessed the adherence to the PRISMA checklist, and the mean overall adherence was 70.8%. Thirty-six SRs (80%) reported following PRISMA. The PRISMA item with the lowest adherence was protocol pre-registration (n = 2; 12.5%). In contrast, the SRs reported following the PRISMA-NMA extension showed higher adherence to the checklist items.

Conclusions: Despite the authors' declaration of adhering to PRISMA, several reporting items were not fully addressed in the systematic reviews on non- and micro-invasive caries treatments. Incomplete or inconsistent reporting limits clinicians' ability to interpret the sources of discordant findings across reviews and constrains the application of evidence-based judgments in pediatric caries management. Given the overall low reporting quality, not only is further improvement in these SRs essential, but some recommended management strategies should also be interpreted and implemented with caution until more robust and transparently reported evidence becomes available.