Effect of chewing gum on orthodontic pain in patients receiving fixed orthodontic treatment: a systematic review and meta-analysis

Table 2 Summary of overall quality of evidence of studies included in each meta-analysis using GRADE

Certainty assessment
Outcome	Number of Studies	Study Design	Risk of Bias	Inconsistency	Indirectness	Imprecision	Certainty
Chewing gum group VS blank group	10	RCTs	Serious	Serious	Serious	Not serious
Chewing gum group VS analgesics group	9	RCTs	Serious	Very serious	Serious	Serious
GRADE Working Group grades of evidence
High certainty: we are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect
Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect

^aDowngraded due to unclear or absence of blinding of both patients and outcome assessors
^bDowngraded due to high heterogeneity
^cDue to some Included studies that included only female subjects
^dDowngraded due to credibility interval

ISSN: 2047-783X