Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

93 questions · 137 findings · 10 reviews · Dental caries

No studies found 10 · 7.3%GRADE not reported 109 · 79.6%Very low 5 · 3.6%Low 13 · 9.5%Moderate 0 · 0%High 0 · 0%

Resin-modified glass ionomer cement for bonding orthodontic brackets vs Composite resin for bonding brackets

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Resin-modified glass ionomer cement for bonding orthodontic brackets showed no clear difference in number of participants with new demineralised lesions (DLs) compared with light-cured composite resin for bonding brackets (low certainty).

1 finding from 1 review

Resin-modified glass ionomer cement for bonding orthodontic brackets vs Composite resin for bonding brackets

Number of participants with more severe DLs of aesthetic concern · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Resin-modified glass ionomer cement for bonding orthodontic brackets showed no clear difference in number of participants with more severe DLs of aesthetic concern compared with light-cured composite resin for bonding brackets (low certainty).

1 finding from 1 review

12,500 ppm F (NaF/olaflur/dectaflur) amine fluoride gel, professionally applied every 3 months plus home use vs Placebo gel

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

It is very uncertain whether 12,500 ppm F (NaF/olaflur/dectaflur) amine fluoride gel,… changes number of participants with new demineralised lesions (DLs) compared with 0 ppm F placebo gel (very low certainty).

1 finding from 1 review

Patient-used 250 ppm F mouthrinse (100 ppm amine F/150 ppm NaF), daily vs 0 ppm F placebo mouthrinse, daily

Number of participants with more severe DLs (severity of DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

The review found no eligible studies for this question.

1 finding from 1 review

Slow-release fluoride device (fluoride glass beads) vs Fluoride mouthrinse

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

It is very uncertain whether intraoral fluoride-releasing glass bead device attached to the brace changes number of participants with new demineralised lesions (DLs) compared with 250 ppm F (daily) fluoride mouthrinse (very low certainty).

1 finding from 1 review

Patient-used 250 ppm F mouthrinse (100 ppm amine F/150 ppm NaF), daily vs 0 ppm F placebo mouthrinse, daily

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

It is very uncertain whether patient-used 250 ppm F mouthrinse (100 ppm amine F/150 ppm NaF), daily changes number of participants with new demineralised lesions (DLs) compared with 0 ppm F placebo mouthrinse, daily (very low certainty).

1 finding from 1 review

Patient-used 5000 ppm F toothpaste, daily vs 1450 to 1500 ppm F toothpaste

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Patient-used 5000 ppm F toothpaste, daily throughout treatment showed no clear difference in number of participants with new demineralised lesions (DLs) compared with 1450 ppm F (conventional) toothpaste, daily (low certainty).

1 finding from 1 review

Professionally-applied 12,300 ppm F APF foam, every 2 months vs 0 ppm F placebo foam

Number of participants with more severe DLs (severity of DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

The review found no eligible studies for this question.

1 finding from 1 review

Professionally-applied 12,300 ppm F APF foam, every 2 months vs 0 ppm F placebo foam

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Professionally-applied 12,300 ppm F APF foam, every 2 months may leads to lower number of participants with new demineralised lesions (DLs) compared with 0 ppm F placebo foam (low certainty).

1 finding from 1 review

Resin infiltration 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…

Resin infiltration did not differ significantly from CPP-ACFP (SMD -0.52, 95% CI -1.16 to 0.12; indirect evidence only); certainty of evidence not assessed (no GRADE).

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

Resin infiltration 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…

Resin infiltration was significantly better than fluoride varnish (SMD -0.70, 95% CI -1.18 to -0.21); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs P11-4 + 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…

Resin infiltration and P11-4 plus fluoride varnish did not differ significantly (SMD 0.01, 95% CI -0.62 to 0.65; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

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