Enamel remineralization extent · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, a nano-CaF2-containing orthodontic cement showed significant enamel remineralization versus control in a single study (ungraded).
1 finding from 1 review
Ion release · Human teeth with early enamel lesions surrounding orthodontic brackets
No meta-analysis was conducted; most studies reported increased ion release over time, but few reported peak values.
1 finding from 1 review
no estimate extracted
8 studies
GRADE not reported
White spot lesion incidence · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
The self-etch primer system had higher WSL incidence than the conventional system, with certainty not graded.
1 finding from 1 review
White spot lesion rate and volume · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Opal Seal showed no significant difference in WSL rate or volume, with certainty not graded.
1 finding from 1 review
The WSL volume was lower in the Opal Seal group than in the Clearfil and Transbond XT groups, but there was no significant difference among the groups (p > 0.05).
1 study · 15 participants
GRADE not reported
Enamel demineralization / white spot lesion prevention (DIAGNOdent, enamel mineral content) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
Two small RCTs gave inconsistent results for TiO2-modified adhesives/composites on enamel demineralization (one favorable on DIAGNOdent, one no difference in mineral content); ungraded.
1 finding from 1 review
White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
A single small split-mouth RCT found the nCaF2-containing primer reduced demineralization (DIAGNOdent) but showed no significant clinical white spot lesion difference at debonding (ungraded).
1 finding from 1 review
Photographic white spot lesion score · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
nCaF2 primer showed no clinical photographic WSL difference at debonding, with certainty not graded.
1 finding from 1 review
Enamel remineralization extent and color change · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, an n-AFCP-containing orthodontic primer showed significant enamel remineralization and less color change versus control in a single study (ungraded).
1 finding from 1 review
Intervention not reported
Pathogenic bacteria / plaque composition around brackets (fewer pathogenic bacteria with flash-free vs APC; comparable plaque quantity)
1 finding from 1 review
no estimate extracted
1 study
GRADE not reported
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
Ion release (fluoride, calcium, phosphate) · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, among the 5 BAG ion-release studies only Ga-doped BAG (GaMBN, Song [31]) reported a significant increase (phosphate, up to 14 days); a general significant fluoride/calcium/phosphate increase across all 5 is not supported (ungraded).
1 finding from 1 review
Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
nCaF2 primer differed in S. mutans count only at T1, with certainty not graded.
1 finding from 1 review
White spot lesion formation (QLF: fluorescence loss, lesion area) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Indirect bonding with a flowable adhesive favored less QLF-measured demineralization, with certainty not graded.
1 finding from 1 review
The DB group exhibited significantly higher loss of fluorescence and degree of demineralization compared to the IB group between T0 and T1, with notable differences in specific quadrants (p <0.05 for ΔF and ΔF max).
1 study · 51 participants
GRADE not reported
White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
Two studies found adhesive flash-free brackets did not clinically reduce enamel demineralization or white spot lesions versus conventional brackets, though they reduced pathogenic bacteria (ungraded).
1 finding from 1 review
Intervention not reported
Fluoride ion release
1 finding from 1 review
no estimate extracted
1 study
GRADE not reported
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
White spot lesion rate and volume · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Clearfil Protect Bond showed no WSL-rate difference versus conventional adhesive, with certainty not graded.
1 finding from 1 review
There was no significant difference among the WSL rates of the Clearfil, Opal Seal, and Transbond XT adhesives (p > 0.05).
1 study · 15 participants
GRADE not reported
Enamel mineral content · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Chitosan and TiO2 adhesive showed no enamel mineral-content difference, with certainty not graded.
1 finding from 1 review
Enamel remineralization / carious lesion development · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, an ammonium-based methacrylate-containing adhesive showed significant remineralization/anti-demineralization versus control in a single study (ungraded).
1 finding from 1 review
White spot lesion formation (QLF: fluorescence loss, lesion area) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
A single RCT found indirect bonding with flowable composite reduced white spot lesion formation versus direct bonding (ungraded).
1 finding from 1 review