Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

762 questions · 830 findings · 43 reviews · Orthodontics

No studies found 186 · 22.4%GRADE not reported 410 · 49.4%Very low 122 · 14.7%Low 79 · 9.5%Moderate 30 · 3.6%High 3 · 0.4%

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Percentage of bleeding on probing (BOP) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly increased bleeding on probing versus healthy controls (MD 16.57%, 95% CI 12.89 to 20.25; low certainty).

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of initial caries around brackets, aesthetic-zone teeth only · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

When only aesthetic-zone teeth (incisors and canines) were considered, two studies reported a significant reduction in initial caries incidence favoring fluoride mouthrinse (ungraded, narrative; no pooled estimate).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary flow rate (stimulated) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Stimulated salivary flow rate was significantly lower in anorexia nervosa patients than controls, but only unstimulated flow was meta-analyzed; this outcome is ungraded.

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary pH · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly lower salivary pH than healthy controls (MD -0.39, 95% CI -0.54 to -0.24; low certainty).

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary alpha-amylase · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

There is no significant difference in salivary alpha-amylase between anorexia nervosa patients and healthy controls (MD 6.32 U/l, 95% CI -6.14 to 18.79; low certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary flow rate (unstimulated) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa probably reduces unstimulated salivary flow rate versus healthy controls (MD -0.27 ml/min, 95% CI -0.31 to -0.24; moderate certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Gingival (marginal) recession · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Gingival (marginal) recession was significantly higher in anorexia nervosa patients than controls in both reporting studies, but was not pooled or graded (ungraded).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Dental erosion · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Dental erosion was more prevalent in anorexia nervosa patients than controls (low erosive-wear severity), but was not pooled or graded (ungraded).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Plaque · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa patients tended to have higher plaque accumulation than healthy controls (significant in 2 of 3 studies), but results were not pooled or graded (ungraded).

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of initial enamel caries / white spot lesions adjacent to bracket base (subject level, dichotomized) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Adding a fluoride mouthrinse to daily fluoride toothpaste produced a small reduction in the incidence of initial caries/white spot lesions adjacent to brackets (pooled risk difference -0.07, 95% CI -0.14 to -0.01; 5 studies, 491 subjects), but the authors judged the overall evidence inconclusive (ungraded).

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Side effects or other adverse events · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

No adverse effects were reported in any of the seven included studies (ungraded).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Caries experience · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

1 finding from 1 review

Experimental orthodontic composite containing nano-hydroxyapatite (n-HAP) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel surface microhardness · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, a nano-hydroxyapatite-containing orthodontic composite showed significant enamel remineralization versus control in a single study (ungraded).

1 finding from 1 review

ACP light-cure adhesive vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

ACP adhesive had lower demineralization scores at 1 month, with certainty not graded.

2 findings from 1 review

Thermoelastic copper NiTi (CuNiTi) arch wire vs Conventional (stabilised) NiTi arch wire

Time to next/working arch wire · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Thermoelastic copper NiTi (CuNiTi) arch wire showed no clear difference in time to next/working arch wire compared with conventional NiTi arch wire; GRADE not reported.

1 finding from 1 review

Facemask (RME) or modified facemask vs Other non-surgical orthodontic treatments (mini maxillary protractor, Pushing Splints, modified tandem, Reverse Forsus, reverse Twin Block, reverse chin cup, tongue appliance, Frankel III)

Perceived need for surgery in adulthood · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

The review found no eligible studies for this question.

1 finding from 1 review

Bone-anchored intermaxillary traction (BAIMT) vs Removable mandibular retractor (RMR)

Overjet · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Bone-anchored intermaxillary traction (BAIMT) led to higher overjet compared with removable mandibular retractor (RMR); GRADE not reported.

1 finding from 1 review

Orthodontic removable traction appliance (ORTA) vs no intervention

Wits appraisal · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Orthodontic removable traction appliance (ORTA) led to higher wits appraisal compared with untreated control (no treatment); GRADE not reported.

1 finding from 1 review