What do systematic reviews say?

9 questions · 9 findings · 1 reviews · Dental caries

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No studies found 0 · 0%GRADE not reported 3 · 33.3%Very low 6 · 66.7%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (mean number of new lesions per subject) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

Patients developed on average about 2.29 new ICLs during fixed orthodontic treatment (95% CI 1.12-3.46; very low certainty; very high heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During fixed orthodontic treatment (development of new lesions) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
MEAN 2.29 [1.12, 3.46]
5 studies · 208 participants
Very low

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (mean number of lesions per subject) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Patients had on average about 2.24 ICLs per subject during/after fixed orthodontic treatment (95% CI 1.79-2.70; very low certainty; very high heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment (cross-sectional/at debonding) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
MEAN 2.24 [1.79, 2.70]
6 studies · 484 participants
Very low

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of tooth surfaces developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 15% of tooth surfaces developed new ICLs during fixed orthodontic treatment (pooled 0.15, 95% CI 0.08-0.26; very low certainty; extreme heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During fixed orthodontic treatment (development of new lesions) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
Proportion 0.15 [0.08, 0.26]
4 studies · 1890 participants
Very low

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs prevalence · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

ICLs prevalence increased with longer orthodontic treatment duration (meta-regression P=.01; ungraded).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment · International (16 countries; studies published 2005-2022); orthodontic clinical settings · By orthodontic treatment duration (subgroup meta-analysis; positive association, P=.01)
Prevalence of ICLs positively associated with orthodontic treatment duration (meta-regression, P=.01); effect size/slope not available (Fig. 6a image not provided)
Studies not reported
GRADE not reported

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between patient age and number of ICLs · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Patient age was not significantly associated with the number of ICLs (ungraded).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment · International (16 countries; studies published 2005-2022); orthodontic clinical settings · By patient age (subgroup meta-analysis; no significant association)
No significant association found between patient age and the number of ICLs (meta-regression / subgroup analysis)
Studies not reported
GRADE not reported

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs incidence · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

ICLs incidence increased with longer orthodontic treatment duration (meta-regression P<.01; ungraded).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment · International (16 countries; studies published 2005-2022); orthodontic clinical settings · By orthodontic treatment duration (subgroup meta-analysis; positive association, P<.01)
Incidence of new ICLs positively associated with orthodontic treatment duration (meta-regression, P<.01); effect size/slope not available (Fig. 6b image not provided)
Studies not reported
GRADE not reported

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of subjects developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 48% of patients developed new ICLs during fixed orthodontic treatment (pooled incidence 0.48, 95% CI 0.33-0.63; very low certainty; very high heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During fixed orthodontic treatment (development of new lesions) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
Proportion 0.48 [0.33, 0.63]
7 studies · 533 participants
Very low

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (proportion of tooth surfaces affected) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

About 22% of tooth surfaces showed ICLs during/after fixed orthodontic treatment (pooled 0.22, 95% CI 0.14-0.33; very low certainty; extreme heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment (cross-sectional/at debonding) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
Proportion 0.22 [0.14, 0.33]
6 studies · 11583 participants
Very low

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (proportion of subjects affected) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Around 57% of patients had ICLs during or after fixed orthodontic treatment (pooled prevalence 0.57, 95% CI 0.48-0.65; very low certainty; very high heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment (cross-sectional/at debonding) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
Proportion 0.57 [0.48, 0.65]
13 studies · 1448 participants
Very low