Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

416 questions · 471 findings · 75 reviews

No studies found 54 · 11.5%GRADE not reported 133 · 28.2%Very low 125 · 26.5%Low 103 · 21.9%Moderate 40 · 8.5%High 16 · 3.4%

Resin infiltration vs Self-assembling peptide P11-4

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration did not differ significantly from P11-4 alone (SMD -0.39, 95% CI -0.97 to 0.20); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Self-assembling peptide P11-4 vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Self-assembling peptide P11-4 significantly improved remineralization versus control (SMD -0.56, 95% CI -0.96 to -0.15); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish was significantly better than fluoride varnish alone (SMD -0.71, 95% CI -1.13 to -0.29); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration was significantly better than CPP-ACP (SMD -0.77, 95% CI -1.31 to -0.23); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration significantly improved remineralization versus control (SMD -0.94, 95% CI -1.46 to -0.43), ranking second of seven therapies by SUCRA (88.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish did not differ significantly from CPP-ACP (SMD -0.07, 95% CI -0.44 to 0.29); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Combined self-assembling peptide P11-4 plus fluoride varnish significantly improved white spot lesion remineralization versus control (SMD -0.96, 95% CI -1.44 to -0.48) and ranked highest of seven therapies by SUCRA (89.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Fluoride varnish vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish did not differ significantly from CPP-ACFP (SMD 0.18, 95% CI -0.29 to 0.64); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish did not differ significantly from CPP-ACFP (SMD -0.54, 95% CI -1.15 to 0.08; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish vs Self-assembling peptide P11-4

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish did not differ significantly from P11-4 alone (SMD -0.40, 95% CI -0.97 to 0.17; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Fluoride varnish vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish (gold standard) did not differ significantly from control (SMD -0.25, 95% CI -0.51 to 0.02); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Self-assembling peptide P11-4 vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Self-assembling peptide P11-4 did not differ significantly from fluoride varnish (SMD -0.31, 95% CI -0.71 to 0.09); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Self-assembling peptide P11-4 vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Self-assembling peptide P11-4 did not differ significantly from CPP-ACP (SMD -0.38, 95% CI -0.87 to 0.11; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

CPP-ACP vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

CPP-ACP did not differ significantly from CPP-ACFP (SMD 0.25, 95% CI -0.24 to 0.73); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

CPP-ACP vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

CPP-ACP did not differ significantly from control (SMD -0.18, 95% CI -0.49 to 0.14); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

CPP-ACFP vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

CPP-ACFP versus control gave SMD -0.42 (95% CI -0.84 to 0.00); the review classed CPP-ACFP as statistically significant versus control although the reported CI upper limit is at the null (0.00); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Self-assembling peptide P11-4 vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Self-assembling peptide P11-4 did not differ significantly from CPP-ACFP (SMD -0.13, 95% CI -0.68 to 0.42); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

CPP-ACP vs No active treatment (control)

Enamel surface microhardness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP increased Vickers microhardness versus control (SMD 1.19, 95% CI 0.72 to 1.66; ungraded).

3 findings from 1 review

CPP-ACP vs No active treatment (control)

Average enamel surface roughness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP markedly reduced enamel surface roughness versus control (SMD -8.21, 95% CI -10.37 to -6.04; ungraded).

1 finding from 1 review