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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.
29 questions in 6 reviews · cluster CL0295
current versionsNo studies 0 · 0%Ungraded 28 · 96.6%Very low 1 · 3.4%Low 0 · 0%Moderate 0 · 0%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
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
ACP light-cure adhesive vs Control Transbond XT adhesive Enamel demineralization score · Patients undergoing fixed orthodontic treatment · 1 month after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | At T1, the control group had an average demineralization score of 3.39 (±1.29), whereas the ACP group had a notably lower average score of 2.58 (±1.11) (p-value of 0.000). | 1 study · 26 participants | Ungraded |
One-step adhesive bonding system (GC Ortho Connect) vs Conventional three-step bonding system (3M Transbond XT) White spot lesion incidence, area, and depth · Patients undergoing fixed orthodontic treatment · 2 and 4 months after treatment start Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Group 3 (GC Ortho Connect) showed a significantly higher incidence than both groups (p < 0.001). Group 3 (GC Ortho Connect) also had larger lesion areas and deeper lesions compared to other groups (p < 0.001). | 1 study · 75 participants | Ungraded |
Opal Seal fluoride-releasing primer vs Conventional Transbond XT primer White spot lesion area · Patients undergoing fixed orthodontic treatment · During orthodontic treatment Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | There was no significant difference in the WSL area between the two groups, with the mean WSL area measuring 161.3 mm2 in the Opal Seal group and 1361.2 mm2 in the conventional group. | 1 study · 56 participants | Ungraded |
Adhesive precoated flash-free brackets vs Conventional ceramic brackets Enamel demineralization (DIAGNOdent score) · Patients undergoing fixed orthodontic treatment · Baseline, 1 month, and 6 months after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Intergroup evaluation showed that there were no statistically significant differences in demineralization measurements between all sides of the conventional and flash-free brackets at all the time intervals (p >0.05). | 1 study · 30 participants | Ungraded |
Opal Seal fluoride-releasing primer vs Conventional Transbond XT primer DIAGNOdent white spot lesion measurement · Patients undergoing fixed orthodontic treatment · During orthodontic treatment Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Opal Seal group showed fewer WSLs compared to the Transbond group, with initial demineralization rates of 1.3% and 3.9%, and caries lesion rates of 0.2% and 1.3%, respectively (p <0.03). | 1 study · 56 participants | Ungraded |
Opal Seal fluoride-releasing primer vs Conventional Transbond XT primer Photographic white spot lesion severity · Patients undergoing fixed orthodontic treatment · During orthodontic treatment Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | WSL severity in digital photographs: no significant difference between the two groups (p >0.05). | 1 study · 56 participants | Ungraded |
nCaF2 primer vs Control Transbond primer Enamel demineralization (DIAGNOdent score) · Patients undergoing fixed orthodontic treatment · 1, 3, and 6 months after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Statistically significant scores in favor of the nCaF2 primer at T1, T3, and T6 (p-value = 0.000). | 1 study · 31 participants | Ungraded |
Fluoride-releasing primers/adhesives (Opal Seal; Clearfil Protect Bond) vs Conventional primer/adhesive (Transbond XT) White spot lesions / enamel demineralization (photographic scoring, DIAGNOdent, micro-CT) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35) · 8 weeks to full treatment (to debonding) Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Three non-randomized studies (Comert 2020 n=56; Oz 2019 n=35; Oz 2017 n=15) showed no consistent clinical advantage. Comert: no significant difference in photographic WSL severity or area, although DIAGNOdent favored… | 3 studies · 106 participants | Ungraded |
ACP light-cure adhesive vs Control Transbond XT adhesive Enamel demineralization score · Patients undergoing fixed orthodontic treatment · 6 months after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | At T2, the control group had an average score of 4.32 (±2.32), while the ACP group continued to exhibit a lower average score of 3.41 (±1.11) (p-value of 0.000). | 1 study · 26 participants | Ungraded |
Self-etch primer bonding system (3M Transbond Plus) vs Conventional three-step bonding system (3M Transbond XT) White spot lesion incidence · Patients undergoing fixed orthodontic treatment · 2 and 4 months after treatment start Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Group 2 (3M Transbond Plus) had a significantly higher incidence of WSLs than Group 1 (3M Transbond XT) (p <0.05). | 1 study · 75 participants | Ungraded |
Opal Seal fluoride-releasing adhesive vs Transbond XT conventional adhesive White spot lesion rate and volume · Patients undergoing fixed orthodontic treatment · 8 weeks after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | The WSL volume was lower in the Opal Seal group than in the Clearfil and Transbond XT groups, but there was no significant difference among the groups (p > 0.05). | 1 study · 15 participants | Ungraded |
Farzanegan 2021 = Transbond XT + 1% chitosan + 1% TiO2 (co-intervention); Mollabashi 2022 = TiO2-only composite (1 wt%) vs Conventional adhesive/composite (Transbond XT) Enamel demineralization / white spot lesion prevention (DIAGNOdent, enamel mineral content) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35) · 1 day to 6 months Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Two RCTs (Farzanegan 2021 n=24; Mollabashi 2022 n=40): Mollabashi reported DIAGNOdent readings significantly lower on the TiO2 side than the control side (p<0.001); Farzanegan reported no significant difference in… | 2 studies · 64 participants | Ungraded |
nCaF2 primer vs Control Transbond primer Photographic white spot lesion score · Patients undergoing fixed orthodontic treatment · Before and after treatment Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | No significant differences in the WSLs photographic scores of the control group with the contralateral nCaF2 group before and after bonding. | 1 study · 31 participants | Ungraded |
Indirect bonding with flowable adhesive (Opal Bond MV) vs Direct bonding with Transbond XT White spot lesion formation measured by QLF · Patients undergoing fixed orthodontic treatment · Before and after treatment Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | The DB group exhibited significantly higher loss of fluorescence and degree of demineralization compared to the IB group between T0 and T1, with notable differences in specific quadrants (p <0.05 for ΔF and ΔF max). | 1 study · 51 participants | Ungraded |
Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional brackets (conventional adhesive-coated / ceramic brackets) Enamel demineralization / white spot lesions (DIAGNOdent, QLF) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35) · 1 to 6 months (to debonding) Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Two studies (Tan 2020 split-mouth, n=30; Yetkiner 2019 RCT, n=50): no statistically significant difference in demineralization between flash-free and conventional/APC brackets (Tan p>0.05; Yetkiner delta-F not… | 2 studies · 80 participants | Ungraded |
Adhesive flash-free ceramic brackets vs Adhesive precoated ceramic brackets Enamel demineralization (QLF ΔF) · Patients undergoing fixed orthodontic treatment · Baseline to debonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | ΔF values (T0-debonding) were not statistically significantly different between the groups. | 1 study · 50 participants | Ungraded |
Clearfil Protect Bond vs Transbond XT conventional adhesive White spot lesion rate and volume · Patients undergoing fixed orthodontic treatment · 8 weeks after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | There was no significant difference among the WSL rates of the Clearfil, Opal Seal, and Transbond XT adhesives (p > 0.05). | 1 study · 15 participants | Ungraded |
Indirect bonding using flowable composite adhesive (Opal Bond MV) vs Direct bonding (conventional, Transbond XT) White spot lesion formation (QLF: fluorescence loss, lesion area) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35) · Before and after treatment (T0 to T1) Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Atilla 2020 (1 single-blind parallel RCT, 51 patients): the direct-bonding group had significantly greater loss of fluorescence and demineralization and larger lesion areas than the indirect-bonding (flowable… | 1 study · 51 participants | Ungraded |
TiO2-modified composite (1 wt.%) vs Control composite in contralateral quadrant Enamel demineralization (DIAGNOdent score) · Patients undergoing fixed orthodontic treatment · 1 to 6 months after bonding Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Mean readings were significantly greater on the control side than on the experimental side (p < 0.001) at all time points except at baseline. | 1 study · 40 participants | Ungraded |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Incidence of white spot lesions (WSLs) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · End of orthodontic treatment (varying) White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | Not meta-analyzed (heterogeneous methods; tooth-based vs patient-based incidence). 4 studies assessed WSL incidence; 3 (Albhaisi 2020 [12]; Buschang 2019 [29]; Dallel 2020 [30]) reported a lower risk of developing WSLs… | 4 studies | Ungraded |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Baseline to end of treatment (varying) White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | Not meta-analyzed. 2 RCTs assessed WSL severity by lesion surface area (Albhaisi 2020 [12]; Alshatti 2017 [31]) and 1 (Albhaisi 2020 [12]) also by lesion depth; reported narratively with differing methods, generally… | 2 studies | Ungraded |
Fluoride-releasing coating material vs Coating material without fluoride release Incidence of new white spot lesions by visual-tactile assessment · Patients receiving comprehensive fixed orthodontic treatment · 1 to 24 months, Overall Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel… (2021) | RR 0.84 [0.70, 1.01] | 10 studies · 4705 participants | Very low |
Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances White spot lesions (WSLs), tooth level · Adults undergoing orthodontic treatment · 3 months, Adults Impact of Aligners and Fixed Appliances on Oral Health during Orthodontic Treatment: A Systematic Review and… (2021) | RR 0.72 [0.60, 0.86] | 1 study | Ungraded |
Fluoride-releasing compomer-based bonding agent vs Non-fluoride compomer-based bonding agent Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances · 1-24 months follow-up, Compomer-based bonding agents Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel… (2021) | RR 0.71 [0.46, 1.11] | 2 studies · 400 participants | Ungraded |
Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances White spot lesions (WSLs), patient level · Adolescents/teenagers undergoing orthodontic treatment · 9 months, Adolescents Impact of Aligners and Fixed Appliances on Oral Health during Orthodontic Treatment: A Systematic Review and… (2021) | RR 0.33 [0.10, 1.04] | 1 study | Ungraded |
Fluoride-releasing compomer bonding agent vs Compomer bonding agent without fluoride release Incidence of new white spot lesions by visual-tactile assessment · Patients receiving comprehensive fixed orthodontic treatment · 1 to 24 months, Compomer-based bonding agents Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel… (2021) | RR 0.71 [0.46, 1.11] | 2 studies · 400 participants | Ungraded |
Fluoride-releasing resin-based bonding agent vs Non-fluoride resin-based bonding agent Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances · 1-24 months follow-up, Resin-based bonding agents Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel… (2021) | RR 0.97 [0.79, 1.19] | 5 studies · 3517 participants | Ungraded |
Tooth bleaching (carbamide or hydrogen peroxide; home and/or in-office) vs No bleaching (untreated control) Colour change / camouflage of white spot lesions (reduction of colour disparity between carious and sound enamel) · Permanent teeth with post-orthodontic white spot lesions (orthodontic patients and in vitro enamel specimens) Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. (2020) | The results showed that bleaching of WSL can diminish colour disparities between carious and non-affected areas, but the certainty of the evidence was very low. | 3 studies | Ungraded |
0.9% silicon tetrafluoride (SiF4) vs Not specified Remineralisation of white spot lesions · Children with white spot lesions / early enamel caries Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a… (2016) | One study found that silicon tetrafluoride could not remineralise white spot lesions. | 1 study | Ungraded |