What do systematic reviews say?

13 questions · 13 findings · 1 reviews · Oral Health

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No studies found 0 · 0%GRADE not reported 10 · 76.9%Very low 3 · 23.1%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Fluoride-releasing glass ionomer-based bonding agent vs Non-fluoride glass ionomer-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

For a glass-ionomer-based bonding agent (single study), fluoride release significantly reduced WSL initiation (RR 0.64); subgroup not separately GRADE-rated.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Glass ionomer-based bonding agent
RR 0.64 [0.41, 0.99]
1 study · 144 participants
GRADE not reported

Sealant/coating agent WITH fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Among fluoride-releasing sealants, the reduction in WSL initiation versus no sealant was not statistically significant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
3-27 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Sealant with fluoride release
RR 0.69 [0.46, 1.05]
3 studies · 1467 participants
GRADE not reported

Glass ionomer cement (for bracket bonding) vs Resin adhesive

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

There is no clear difference in WSL initiation between glass ionomer cement and resin adhesive for bracket bonding (RR 0.72, not significant); certainty of evidence is very low.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
12-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level
RR 0.72 [0.34, 1.54]
3 studies · 394 participants
Very low

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For compomer-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.71); subgroup not separately GRADE-rated.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Compomer-based bonding agents
RR 0.71 [0.46, 1.11]
2 studies · 400 participants
GRADE not reported

Sealant/coating agent WITHOUT fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Among non-fluoride sealants, WSL initiation was significantly reduced versus no sealant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
3-27 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Sealant without fluoride release
RR 0.69 [0.49, 0.97]
3 studies · 847 participants
GRADE not reported

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
Sensitivity (glass ionomer cement vs resin adhesive, excluding high risk-of-bias studies)
RR 1.02 [0.82, 1.27]
Studies not reported
GRADE not reported

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
Sensitivity (coating with vs without fluoride release, excluding parallel-arm studies)
RR 0.82 [0.66, 1.02]
Studies not reported
GRADE not reported

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
Sensitivity (sealant vs no sealant, excluding high risk-of-bias studies)
RR 0.85 [0.66, 1.10]
Studies not reported
GRADE not reported

Fluoride-releasing resin-based sealant vs Non-fluoride resin-based sealant

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For resin-based sealants, fluoride release did not significantly change WSL initiation (RR 0.71, wide CI); subgroup not separately GRADE-rated.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Resin-based sealants
RR 0.71 [0.35, 1.43]
2 studies · 644 participants
GRADE not reported

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

The additional use of a sealant probably reduces the initiation of white spot lesions during fixed orthodontic treatment compared with no sealant (RR 0.70), but the certainty of evidence is very low.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
3-27 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level
RR 0.70 [0.53, 0.93]
6 studies · 2314 participants
Very low

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
Sensitivity (coating with vs without fluoride release, excluding high risk-of-bias studies)
RR 0.83 [0.67, 1.04]
Studies not reported
GRADE not reported

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Fluoride-releasing coating materials do not appear to reduce WSL initiation more than non-fluoride coatings (RR 0.84, not significant); certainty of evidence is very low.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level
RR 0.84 [0.70, 1.01]
10 studies · 4705 participants
Very low

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

For resin-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.97); subgroup not separately GRADE-rated.

1 finding from 1 review

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes
1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Resin-based bonding agents
RR 0.97 [0.79, 1.19]
5 studies · 3517 participants
GRADE not reported