Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

35 questions · 46 findings · 8 reviews

No studies found 0 · 0%GRADE not reported 26 · 56.5%Very low 0 · 0%Low 8 · 17.4%Moderate 12 · 26.1%High 0 · 0%

Bleaching gel with added remineralising agent (fluoride, calcium, or CPP-ACP) vs Bleaching alone (no remineralising agent)

Whitening (bleaching) efficacy · Demineralised / white-spot-lesion enamel (in vitro specimens)

Low-quality in vitro evidence indicates that adding fluoride or other remineralising agents does not impair the whitening/bleaching effect (ungraded).

1 finding from 1 review

Bleaching gel with added remineralising agent (fluoride, calcium, or CPP-ACP) vs Bleaching alone (no remineralising agent)

Enamel mineral loss / remineralisation · Demineralised / white-spot-lesion enamel (in vitro specimens)

Low-quality in vitro evidence indicates that adding fluoride, calcium or CPP-ACP to bleaching agents can reduce enamel mineral loss (ungraded).

1 finding from 1 review

Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD -0.009, 95% CI -4.076 to 4.058; Low certainty).

3 findings from 1 review

Flavonoids (e.g., quercetin, proanthocyanidin) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Etch-and-Rinse adhesive + biological ACAD protocol network, Flavonoids showed 12.771 MPa lower 24 h bond strength than Calcium Phosphate (MD -12.771, 95% CI -20.538 to -5.003; Moderate certainty).

2 findings from 1 review

HEMA/EGDMA-based desensitizer vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, HEMA vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD 0.360, 95% CI -5.589 to 6.309; Moderate certainty).

1 finding from 1 review

Hydroxyapatite (e.g., nano-HAp) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, HAp showed 4.455 MPa lower 24 h bond strength than Calcium Phosphate (MD -4.455, 95% CI -8.857 to -0.053; Moderate certainty).

2 findings from 1 review

Mesoporous silica (SiO2) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD -0.699, 95% CI -7.633 to 6.234; Moderate certainty).

1 finding from 1 review

P11-4 + 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…

P11-4 plus fluoride varnish was significantly better than CPP-ACP (SMD -0.78, 95% CI -1.33 to -0.24; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

SDF plus potassium iodide vs Split into two contrasts: (1) TCS paste (arrest 100%); (2) CPP-ACP (arrest 100%); SDF+KI arrest 54.8% at 24 months, p<.001

Caries arrest · Patients with early enamel carious lesions on permanent molars

SDF plus potassium iodide arrested 54.8% of early enamel lesions at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

P11-4 + fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · People or specimens with white spot lesions or early caries lesions

The NMA estimated an SMD of -0.78 for P11-4 + fluoride varnish versus CPP-ACP (95% CI -1.33 to -0.28).

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

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

38% SDF + potassium iodide solution (applied annually) vs CPP-ACP

Remineralization/arrest of early enamel carious lesions · Patients with early enamel carious lesions on permanent molars

For early enamel lesions, annual SDF+KI was significantly less effective than twice-daily CPP-ACP (54.8% vs 100% arrested; p<0.001; ungraded).

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

1.23% APF gel vs CPP-ACP

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel was probably more effective than 10% CPP-ACP paste for arrest or reversal of any-coronal carious lesions (RR 2.19, 95% CI 1.83 to 2.61; moderate certainty).

1 finding from 1 review