What do systematic reviews say?

Microinvasive techniques (resin infiltration or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

In primary teeth (5 trials), microinvasive techniques reduced radiographic proximal caries progression versus non-invasive measures (OR 0.38; ungraded subgroup).

• Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomes

  Final follow-up (1 to 2 years across trials) · Multiple countries (Brazil, Saudi Arabia, Netherlands, USA, Turkey, Switzerland, Germany, New Zealand, Chile, Thailand); dental clinic/community settings · Primary teeth (Fig. 6, subgroup 2.1.2)
  OR 0.38 [0.25, 0.57]
  5 studies · 266 participants
  GRADE not reported

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Only three trials reported secondary/adverse outcomes; no adverse events were attributed to microinvasive treatment and periodontal findings were mixed and not pooled (ungraded).

• Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomes

  Baseline and follow-up · Multiple countries (Brazil, Saudi Arabia, Netherlands, USA, Turkey, Switzerland, Germany, New Zealand, Chile, Thailand); dental clinic/community settings
  Reported narratively by 3 trials (Arthur 2018, Sarti 2020, Jorge 2019). No adverse events were attributed to microinvasive treatment. Gingival bleeding index: no significant difference in Arthur 2018 and Jorge 2019 but…
  3 studies
  GRADE not reported

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Microinvasive techniques probably reduce radiographic progression of non-cavitated proximal caries lesions compared with non-invasive measures (moderate certainty).

• Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomes

  Final follow-up (1 to 7 years across trials) · Multiple countries (Brazil, Saudi Arabia, Netherlands, USA, Turkey, Switzerland, Germany, New Zealand, Chile, Thailand); dental clinic/community settings · Overall (all microinvasive vs non-invasive pooled)
  OR 0.27 [0.19, 0.38]
  13 studies · 623 participants
  Moderate

Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Pooling 10 trials, resin infiltration reduced radiographic proximal caries progression versus non-invasive measures (OR 0.23); this subgroup was not separately GRADE-rated.

• Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomes

  Final follow-up (1 to 7 years across trials) · Multiple countries (Brazil, Saudi Arabia, Netherlands, USA, Turkey, Switzerland, Germany, New Zealand, Chile, Thailand); dental clinic/community settings · Resin infiltration vs non-invasive (Fig. 5, subgroup 2.1.1)
  OR 0.23 [0.15, 0.35]
  10 studies · 459 participants
  GRADE not reported

Resin infiltration vs Fluoride varnish

Resin infiltration was significantly better than fluoride varnish (SMD -0.70, 95% CI -1.18 to -0.21); certainty of evidence not assessed (no GRADE).

• Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. 2023 All outcomes

  RCTs (clinical and in vitro); predominantly children and adolescents; orthodontic and non-orthodontic white spot lesions, early caries lesions, and artificial lesions
  SMD -0.70 [-1.18, -0.21]
  4 studies
  GRADE not reported

Resin infiltration vs P11-4 + fluoride varnish

Resin infiltration and P11-4 plus fluoride varnish did not differ significantly (SMD 0.01, 95% CI -0.62 to 0.65; indirect evidence only); certainty of evidence not assessed (no GRADE).

• Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. 2023 All outcomes

  RCTs (clinical and in vitro); predominantly children and adolescents; orthodontic and non-orthodontic white spot lesions, early caries lesions, and artificial lesions
  SMD 0.01 [-0.62, 0.65]
  Studies not reported
  GRADE not reported

Resin infiltration vs Fluoride varnish

Resin infiltration produced significantly greater optical improvement than fluoride varnish (MD 4.76, 95% CI 0.74 to 8.78; moderate certainty).

• Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a… 2021 All outcomes

  3 to 6 months
  MD 4.76 [0.74, 8.78]
  3 studies · 212 participants
  Moderate
• Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a… 2021 All outcomes

  3 to 6 months · Mild lesions, DIAGNOdent score <=14 (Ciftci et al. 2018; Giray et al. 2018)
  MD 3.65 [0.82, 6.48]
  2 studies · 172 participants
  GRADE not reported
• Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a… 2021 All outcomes

  3 to 6 months · Severe lesions, DIAGNOdent score >14 (Gozetici et al. 2019)
  MD 13.15 [3.98, 22.32]
  1 study · 40 participants
  GRADE not reported

Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Resin infiltration led to lower caries (lesion) progression (radiographic) compared with fluoride varnish, sham/placebo, or flossing advice (non-invasive…; GRADE not reported.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Resin infiltration
  OR 0.19 [0.08, 0.46]
  2 studies
  GRADE not reported

Microinvasive techniques (mostly resin infiltration; incl. resin sealant) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

In permanent teeth (7 trials), microinvasive techniques reduced radiographic proximal caries progression versus non-invasive measures (OR 0.18; ungraded subgroup).

• Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomes

  Final follow-up (1 to 7 years across trials) · Multiple countries (Brazil, Saudi Arabia, Netherlands, USA, Turkey, Switzerland, Germany, New Zealand, Chile, Thailand); dental clinic/community settings · Permanent teeth (Fig. 6, subgroup 2.1.1)
  OR 0.18 [0.10, 0.32]
  7 studies · 296 participants
  GRADE not reported

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  None of the studies reported on participant or operator perception
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  None of the studies reported on costs for micro-invasive treatment or non-invasive control
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Micro-invasive treatment (proximal sealing or resin infiltration):… probably leads to lower caries (lesion) progression measured by pairwise reading of… compared with non-invasive measures (e.g. fluoride varnish, flossing/oral hygiene… (moderate certainty).

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  18 to 36 months (radiographic follow-up)
  OR 0.31 [0.18, 0.53]
  4 studies
  Moderate
• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up)
  OR 0.24 [0.14, 0.41]
  7 studies · 365 participants
  Moderate
• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 18 months (radiographic follow-up)
  OR 0.18 [0.06, 0.50]
  3 studies
  Moderate

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  1 to 3 years
  The four studies that measured adverse events reported no adverse events after micro-invasive treatment (no events in either arm)
  4 studies
  GRADE not reported

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  No studies reported on caries measured as change in decayed, missing and filled (DMF/dmf) figures at surface, tooth or whole mouth level
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  3 years
  One study (Alkilzy 2011, sealant patch) reported material deficiency: 10% total and 23% partial loss of proximal sealants after three years; 53% maintained perfect margins and none had open margins. No studies reported…
  1 study
  GRADE not reported