Gap finder

Search review questions

Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.

Limit to evidence status or GRADE (optional)

18 questions in 5 reviews · cluster CL0091

current versions
No studies 0 · 0%Ungraded 13 · 72.2%Very low 0 · 0%Low 1 · 5.6%Moderate 4 · 22.2%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Intervention categories, outcome domains and clusters are a proposed key pending human validation. Clear all filters

QuestionEffectEvidenceStatus / GRADE
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro) · 24 h (immediate), Self-Etch + chemical ACAD
Biomimetic Remineralization Strategies for Dentin Bond Stability-Systematic Review and Network Meta-Analysis. (2025)
MD 2.140 [-1.506, 5.787]1 studyModerate
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Calcium-based agent
Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro) · 24 h (immediate), Etch-and-Rinse + chemical ACAD
Biomimetic Remineralization Strategies for Dentin Bond Stability-Systematic Review and Network Meta-Analysis. (2025)
MD 0.596 [-7.289, 8.482]7 studiesLow
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Calcium-based agent
Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro) · 24 h (immediate), Self-Etch + chemical ACAD
Biomimetic Remineralization Strategies for Dentin Bond Stability-Systematic Review and Network Meta-Analysis. (2025)
MD 2.663 [-2.395, 7.722]4 studiesModerate
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs No biomimetic remineralization (control)
Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro) · 24 h (immediate), Self-Etch + chemical ACAD
Biomimetic Remineralization Strategies for Dentin Bond Stability-Systematic Review and Network Meta-Analysis. (2025)
MD 1.539 [-1.738, 4.817]1 studyModerate
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro) · 24 h (immediate), Etch-and-Rinse + biological ACAD
Biomimetic Remineralization Strategies for Dentin Bond Stability-Systematic Review and Network Meta-Analysis. (2025)
MD 17.012 [11.920, 22.103]2 studiesModerate
CPP-ACP enamel pre-treatment for prevention of white spot lesions before bonding metallic orthodontic brackets vs No enamel pre-treatment before bonding, or treatment with another material
Shear bond strength (SBS) of metallic orthodontic brackets · Sound enamel of extracted permanent human teeth · Before bonding, Prevention of WSLs (sound enamel)
Shear bond strength of metallic brackets bonded to enamel pretreated with CPP-ACP: a systematic review and… (2023)
MD 1.009 [-0.723, 2.740]7 studiesUngraded
CPP-ACP enamel pre-treatment for remineralization of white spot lesions before bonding metallic orthodontic brackets vs No enamel pre-treatment before bonding, or treatment with another material
Shear bond strength (SBS) of metallic orthodontic brackets · Demineralized enamel of extracted permanent human teeth · Before bonding, Remineralization of WSLs (demineralized enamel)
Shear bond strength of metallic brackets bonded to enamel pretreated with CPP-ACP: a systematic review and… (2023)
MD 1.501 [-0.630, 3.632]9 studiesUngraded
Enamel pre-treatment with CPP-ACP before bonding metallic orthodontic brackets vs No enamel pre-treatment before bonding, or treatment with another material
Shear bond strength (SBS) of metallic orthodontic brackets · Extracted permanent human teeth (enamel); sound or demineralized · Before bonding
Shear bond strength of metallic brackets bonded to enamel pretreated with CPP-ACP: a systematic review and… (2023)
MD 1.163 [-0.321, 2.648]15 studies · 1379 participantsUngraded
Bleaching gel with added remineralising agent (fluoride, calcium, or CPP-ACP) vs Bleaching alone (no remineralising agent)
Whitening (bleaching) efficacy · Demineralised / white-spot-lesion enamel (in vitro specimens)
Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. (2020)
Low-quality in vitro data indicated that the presence of fluoride or any other remineralising agent did not impair the whitening effect.3 studiesUngraded
Bleaching gel with added remineralising agent (fluoride, calcium, or CPP-ACP) vs Bleaching alone (no remineralising agent)
Enamel mineral loss / remineralisation · Demineralised / white-spot-lesion enamel (in vitro specimens)
Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. (2020)
Inconclusive: F/Ca/CPP-ACP additives reduced mineral loss on SOUND enamel (refs 8,10,16) but not verified for artificial caries lesions (ref 35)4 studiesUngraded
CPP-ACP agent (e.g., GC Tooth Mousse) vs Control (no treatment / negative control)
Average enamel surface roughness · Extracted human teeth with early/artificial enamel lesions (in vitro) · 24 hours to 28 days
Evaluation of the efficacy of casein phosphopeptide-amorphous calcium phosphate on remineralization of white… (2019)
SMD -8.21 [-10.37, -6.04]3 studies · 56 participantsUngraded
CPP-ACP paste (casein phosphopeptide-amorphous calcium phosphate) vs Baseline (same subjects, pre-treatment)
Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients with white spot lesions (children/adolescents) · 4 weeks to 1 year, CPP-ACP vs baseline
Evaluation of the efficacy of casein phosphopeptide-amorphous calcium phosphate on remineralization of white… (2019)
SMD -0.43 [-0.79, -0.07]2 studies · 62 participantsUngraded
CPP-ACP paste (casein phosphopeptide-amorphous calcium phosphate; e.g., Tooth Mousse/MI Paste) vs Placebo paste without CPP-ACP (fluoride toothpaste control)
Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients with early enamel white spot lesions (children/adolescents, ages 2.5-18 years) · 4 weeks to 1 year
Evaluation of the efficacy of casein phosphopeptide-amorphous calcium phosphate on remineralization of white… (2019)
MD 0.08 [-0.91, 1.08]2 studies · 129 participantsUngraded
Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)
Quantitative light-induced fluorescence (QLF) change · Patients with early caries lesions in permanent teeth (non-fluoridated water area) · Post-treatment (4-12 weeks), Location of lesions: smooth surfaces
Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: A systematic review and… (2018)
MD 0.26 [-0.50, 1.01]2 studiesUngraded
Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)
Visual inspection scores · Patients with early caries lesions in permanent teeth (non-fluoridated water area) · Post-treatment (4-24 weeks)
Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: A systematic review and… (2018)
Not pooled (2 trials, different scoring criteria, standard deviations not reported). Brochner 2011: no significant difference; Andersson 2007: more lesions became invisible with fluorides + CPP-ACP.2 studiesUngraded
Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)
Laser fluorescence (LF) change · Patients with early caries lesions in permanent teeth (non-fluoridated water area) · Post-treatment (3-12 weeks), Location of lesions: occlusal surfaces
Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: A systematic review and… (2018)
MD -21.02 [-27.94, -14.10]3 studiesUngraded
Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)
Laser fluorescence (LF) change · Patients with early caries lesions in permanent teeth (non-fluoridated water area) · Post-treatment (12-24 weeks), Location of lesions: smooth surfaces
Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: A systematic review and… (2018)
MD -13.90 [-39.25, 11.46]4 studiesUngraded
Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)
Total lesion area divided by total surface area (visual) · Patients with early caries lesions in permanent teeth (non-fluoridated water area) · Post-treatment (8-24 weeks), Location of lesions: smooth surfaces
Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: A systematic review and… (2018)
MD 4.37 [-0.51, 9.26]2 studiesUngraded