Plaque · Adults undergoing orthodontic treatment
Aligners may reduce plaque index compared with fixed appliances in adults at 6-12 weeks (MD -0.58, 95% CI -0.82 to -0.34; very low certainty).
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
Among fluoride-releasing sealants, the reduction in WSL initiation versus no sealant was not statistically significant (RR 0.69); subgroup not separately GRADE-rated.
1 finding from 1 review
Optical/esthetic improvement (visual-tactile assessment) · Patients with post-orthodontic white spot lesions (WSL)
Resin infiltration produced significantly greater optical improvement of white spot lesions than untreated (naturally remineralizing) controls (SMD 1.24, 95% CI 0.59 to 1.88; moderate certainty).
4 findings from 1 review
SMD 1.24 [0.59, 1.88]
3 studies · 949 participants
Moderate
SMD 2.34 [1.68, 3.01]
1 study · 66 participants
GRADE not reported
SMD 0.63 [0.26, 1.01]
1 study · 115 participants
GRADE not reported
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Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
Fluoride-releasing coating material did not show a statistically significant reduction in new white spot lesions versus non-fluoride coating (very low certainty).
1 finding from 1 review
Lactobacilli presence (CFU > 10^5) · Adults undergoing orthodontic treatment
Aligners probably lower the risk of high lactobacilli counts versus fixed appliances in adults at 3 months (RR 0.09, 95% CI 0.02 to 0.47; low certainty).
2 findings from 1 review
Average fluorescence loss (dF%) · Adults undergoing orthodontic treatment
A single study reported lower average fluorescence (mineral) loss with aligners versus fixed appliances in adults at 3 months (MD -1.40, 95% CI -2.15 to -0.65; ungraded).
1 finding from 1 review
MD -1.40 [-2.15, -0.65]
1 study
GRADE not reported
Plaque · Adolescents/teenagers undergoing orthodontic treatment
A single study reported a lower full-mouth plaque score with aligners versus fixed appliances in adolescents at 12 months (MD -43.48, 95% CI -47.65 to -39.31; ungraded).
3 findings from 1 review
MD -43.48 [-47.65, -39.31]
1 study
GRADE not reported
MD -0.40 [-0.77, -0.03]
1 study
GRADE not reported
MD -14.78 [-16.74, -12.82]
1 study
GRADE not reported
Gingival index (GI) · Adolescents/teenagers undergoing orthodontic treatment
A single study reported lower gingival index with aligners versus fixed appliances in adolescents at 18 months (MD -0.57, 95% CI -0.93 to -0.21; ungraded).
1 finding from 1 review
MD -0.57 [-0.93, -0.21]
1 study
GRADE not reported
Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
Glass ionomer cement did not show a statistically significant difference in new white spot lesions versus resin adhesive (very low certainty).
1 finding from 1 review
S. mutans presence (CFU > 10^5) · Adults undergoing orthodontic treatment
Aligners probably lower the risk of high S. mutans counts versus fixed appliances in adults at 3 months (RR 0.07, 95% CI 0.01 to 0.49; low certainty).
2 findings from 1 review
Patient/dentist satisfaction · Patients with dental fluorosis
Patient/dentist satisfaction did not differ between bleaching-then-infiltration and infiltration alone (SMD -1.53, 95% CI -4.75 to 1.70; ungraded).
1 finding from 1 review
SMD -1.53 [-4.75, 1.70]
2 studies
GRADE not reported
Gingival index (GI) · Adults undergoing orthodontic treatment
A single study found no significant difference in gingival index between aligners and fixed appliances in adults at 6-12 weeks (MD -0.10, 95% CI -0.35 to 0.15; ungraded).
1 finding from 1 review
MD -0.10 [-0.35, 0.15]
1 study
GRADE not reported
Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances
There is no clear difference in WSL initiation between glass ionomer cement and resin adhesive for bracket bonding (RR 0.72, not significant); certainty of evidence is very low.
1 finding from 1 review
White spot lesions (WSLs), tooth level · Adults undergoing orthodontic treatment
A single study reported a lower risk of white spot lesions (tooth level) with aligners versus fixed appliances in adults at 3 months (RR 0.72, 95% CI 0.60 to 0.86; ungraded).
1 finding from 1 review
RR 0.72 [0.60, 0.86]
1 study
GRADE not reported
Optical/esthetic improvement (DIAGNOdent reading) · Patients (mainly children) with white spot lesions (WSL)
Resin infiltration produced significantly greater optical improvement than fluoride varnish (MD 4.76, 95% CI 0.74 to 8.78; moderate certainty).
3 findings from 1 review
MD 4.76 [0.74, 8.78]
3 studies · 212 participants
Moderate
MD 3.65 [0.82, 6.48]
2 studies · 172 participants
GRADE not reported
MD 13.15 [3.98, 22.32]
1 study · 40 participants
GRADE not reported
Percentage of bleeding on probing (BOP) · Adults undergoing orthodontic treatment
No clear difference in bleeding on probing between aligners and fixed appliances in adults at 6-12 weeks (MD -0.26, 95% CI -0.77 to 0.26; very low certainty).
1 finding from 1 review
Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
Sealant use reduced the incidence of new white spot lesions versus no sealant (very low certainty).
1 finding from 1 review
Gingival inflammation-related index · Adolescents/teenagers undergoing orthodontic treatment
A single study reported lower simplified gingival index with aligners versus fixed appliances in adolescents at 1 month (MD -8.46, 95% CI -10.47 to -6.45; ungraded).
1 finding from 1 review
MD -8.46 [-10.47, -6.45]
1 study
GRADE not reported
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 compomer-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.71); subgroup not separately GRADE-rated.
1 finding from 1 review
Masking effect / color improvement · Patients with white spot lesions or developmental enamel defects
Two studies compared resin infiltration with microabrasion, but no pooled or comparative effect estimate was reported (ungraded).
1 finding from 1 review
no estimate extracted
2 studies
GRADE not reported