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
White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances
White spot lesions were also measured by laser fluorescence in 3 fluoride-vs-non-fluoride studies, but no meta-analysis was possible due to incompatible reporting.
1 finding from 1 review
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
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
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
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
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
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
Enamel demineralization (QLF ΔF) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Flash-free brackets showed no clinical WSL reduction, with certainty not graded.
1 finding from 1 review
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
Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).
6 findings from 1 review
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White spot lesion incidence · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
Most studies reported a lower incidence of white spot lesions with clear aligners than fixed appliances, but heterogeneous assessment methods precluded meta-analysis (ungraded).
1 finding from 1 review
Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).
1 finding from 1 review
Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded).
1 finding from 1 review
Lightness/brightness change of white spot lesion (luminosity L*, T0 to T1) · Patients with post-orthodontic white spot lesions and permanent dentition
ICON resin infiltration showed no statistically significant change in lightness/brightness of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD -0.001, 95% CI -0.23 to 0.23; 3 studies, 330 teeth; I2=97%); not GRADE-rated.
1 finding from 1 review
Color change of white spot lesion (color difference, T0 to T1) · Patients with post-orthodontic white spot lesions and permanent dentition
ICON resin infiltration significantly improved the color of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD 1.36, 95% CI 1.14 to 1.59; 4 studies, 458 teeth), although heterogeneity was very high (I2=98%) with a heavy outlier (Kannan); not GRADE-rated.
1 finding from 1 review
Size of the lower jaw (arch length) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
Lacebacks with fixed appliances showed no clear difference in size of the lower jaw (arch length) compared with fixed appliances only (control); GRADE not reported.
1 finding from 1 review
Size of the lower jaw (arch length, change) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
Schwarz appliance showed no clear difference in size of the lower jaw (mandibular arch length, change) at 9 months compared with no active treatment (control); GRADE not reported.
1 finding from 1 review
Amount of crowding · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
It is very uncertain whether nitinol archwire changes amount of crowding (change) up to 37 weeks compared with titinol archwire (very low certainty).
1 finding from 1 review
Time to alignment · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
Active self-ligating brackets showed no clear difference in time to alignment (days) compared with passive self-ligating brackets; GRADE not reported.
1 finding from 1 review