## 4 Review Quality Assessment  
The assessment of each CERQual component was based on judgements by the review authors and these judgements were described and detailed in CERQual Qualitative Evidence Profile (Table 5). * **Methodological limitations**: The extent to which there are problems in the design or conduct of the primary studies that contributed evidence to a review finding. * **Relevance**: The extent to which the body of evidence from the primary studies supporting a review finding is applicable to the context (perspective or population, phenomenon of interest, setting) specified in the review question. * **Coherence**: The extent to which the review finding is well grounded in data from the contributing primary studies and provides a convincing explanation for the patterns found in these data. * **Adequacy of data**: An overall determination of the degree of richness and quantity of data supporting a review finding. **The CERQual approach--Definitions of levels of confidence in a review finding**
* **High confidence**: It is highly likely that the review finding is a reasonable representation of the phenomenon of interest. * **Moderate confidence**: It is likely that the review finding is a reasonable representation of the phenomenon of interest. * **Low confidence**: It is possible that the review finding is a reasonable representation of the phenomenon of interest. * **Very low confidence**: It is not clear whether the review finding is a reasonable representation of the phenomenon of interest. \begin{table}
\begin{tabular}{c c} \hline \hline  & **Interventional Reviews** \\ \hline
**Author** & **Result** \\ \hline  & Adjuvant therapies hyperbaric oxygen (HBO), low-intensity laser (LIL), and platelet-rich plasma (PRP) have positive effects on MRONJ treatment, being safe and well-tolerated. \\ [PERSON] et al. (2019) [62] & There was improvement in 75.6\% of the patients submitted to HBO. For LIL, 64.2\% of the patients/sites improved the symptoms and 39.8\% healed completely. \\  & For PRP, 17.3\% of the 81 patients treated, had significantly improved the symptoms and 80.2\% completely healed. \\ \hline  & Over suppression of bone turnover is probably the primary mechanism for the development of this condition, although there may be contributing comorbid factors. All sites of potential jaw infection should be eliminated before bisphosphonate therapy is initiated in these patients to reduce the necessity of subsequent dentoalveolar surgery. Conservative debridement of necrotic bone, pain control, infection management, use of antimicrobial oral rinses, and withdrawal of bisphosphonates are preferable to aggressive surgical measures for treating this condition. \\ \hline \hline \end{tabular}
\end{table} 
Table 4: _Cont._In summary the authors found that:
* There were minor concerns with respect to the relevance and coherence of the epidemiological type of reviews in all studies. Moderate concerns were noted regarding the methodological limitations in eight studies and serious concerns were highlighted for similar limitations in four studies. Serious concerns were also noted for the adequacy of data of their results in all of the included studies. Due to the high number of serious concerns, particularly regarding methodology and result data, the overall assessment was assessed as very low confidence (lack of clarity whether the review finding is a reasonable representation of the phenomenon of interest). * Minor concerns were highlighted with respect to the relevance and coherence of management types of reviews. Moderate concerns were raised regarding methodological limitations in three studies and serious concerns in methodological limitations in one study. Serious concerns were raised for one study regarding the adequacy of data in the results. Due to these concerns, the overall assessment regarding the management type was graded as very low confidence (lack of clarity whether the review finding is a reasonable representation of the phenomenon of interest).