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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.

Limit to evidence status or GRADE (optional)

830 questions in 43 reviews · Orthodontics

current versions
No studies 186 · 22.4%Ungraded 410 · 49.4%Very low 122 · 14.7%Low 79 · 9.5%Moderate 30 · 3.6%High 3 · 0.4%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

QuestionEffectEvidenceStatus / GRADE
Full-time clear plastic (removable) retainer vs Any type of fixed (bonded) retainer
Patient satisfaction: discomfort/pain (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
No studies measured or reported this outcome0 studiesNo studies
Part-time clear plastic (removable) retainer vs Any type of fixed (bonded) retainer
Patient satisfaction: discomfort/pain (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
RR 12.22 [1.69, 88.52]1 study · 57 participantsVery low
Fibre-reinforced composite fixed (bonded) retainer vs Multistrand / spiral wire fixed (bonded) retainer
Survival: mean survival time (lower arch, months) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
No RCTs at 12-month follow-up; 2 RCTs at 24 months: earlier failures with fibre-reinforced composite (MD -1.48, 95% CI -1.88 to -1.08; very low-certainty)0 studiesNo studies
Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment (placebo or no adjunct)
Rate of orthodontic tooth movement with removable orthodontic aligners · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances · Full aligner treatment duration
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
MD 0.2 [-1.51, 1.10]1 study · 27 participantsUngraded
Light-emitting diode (LED) photobiomodulation vs Conventional orthodontic appliance treatment
Rate of orthodontic tooth movement during space closure stage (maxillary canine distalisation), mm/day · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment · Space closure (canine retraction)
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
MD 0.006 [0, 0.02]1 study · 39 participantsVery low
Fluoride varnish applied periodically (at least quarterly) around the bracket bases during treatment vs Placebo varnish, resin sealant, or standard care (oral hygiene instructions)
White spot lesion clinical score (mean values), subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances · At debonding
Prevention of white spot lesions with fluoride varnish during orthodontic treatment with fixed appliances: a… (2023)
SMD -0.44 [-0.64, -0.24]2 studies · 258 participantsUngraded
Low level laser therapy (LLLT) vs Conventional orthodontic appliance treatment
Orthodontically-induced inflammatory root resorption (OIIRR) during molar intrusion · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
Abellan 2021 assessed OIIRR using CBCT after intrusion of maxillary molars; no evidence of significant increase or reduction with LLLT. Statistical test results not published.1 studyUngraded
Probiotic mouthwash (e.g., Lactobacillus-based) vs Blank control (no mouthwash; before-after comparison)
Cariogenic bacteria (Mutans streptococci colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term)
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
Colony count of MS was significantly reduced compared to blank control [53]. Colony count of MS was insignificantly increased compared to baseline [33].2 studiesVery low
Fluoride mouthwash vs Blank control
Plaque-related index · Orthodontic patients · ≤ 3 months
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
TI was significantly reduced compared to baseline [34]; PI was significantly reduced compared to baseline but similar to blank control [46].2 studiesVery low
Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment (placebo or no adjunct)
Orthodontic tooth movement (OTM) during alignment stage (reduction in Little's Irregularity Index, mm) · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances · Full alignment stage (also 4-6 weeks; 10-16 weeks)
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
MD -0.20 [-7.02, 6.62]1 study · 54 participantsLow
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF)
Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 3 months, Follow-up: 3 months
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023)
SMD -1.08 [-1.93, -0.24]5 studies · 211 participantsUngraded
Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment (placebo or no adjunct)
Harms: non-serious adverse effects (headache, discomfort, loosening of temporary anchorage devices) · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
RR 0.96 [0.32, 2.85]1 study · 45 participantsUngraded
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Placebo mouthwash
Gingival Index (GI, Loe & Silness 1963) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term)
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
WMD -0.45 [-0.70, -0.20]3 studies · 98 participantsLow
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF)
Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Maximum reported time-point per study (range 1-18 months)
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023)
SMD -1.58 [-2.57, -0.58]8 studies · 357 participantsUngraded
Fibre-reinforced composite fixed (bonded) retainer vs Multistrand / spiral wire fixed (bonded) retainer
Stability: Little's Irregularity Index (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
MD -0.70 [-1.17, -0.23]1 study · 52 participantsVery low
CAD/CAM nitinol fixed (bonded) retainer vs Conventional/analogue multistrand fixed (bonded) retainer
Stability: Little's Irregularity Index (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
MD -0.46 [-0.72, -0.21]1 study · 66 participantsVery low
Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment (placebo or no adjunct)
Duration of orthodontic treatment · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
MD -0.61 [-2.44, 1.22]2 studies · 77 participantsLow
Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment (placebo or no adjunct)
Total number of orthodontic appliance adjustment appointments during treatment · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
MD -0.32 [-1.69, 1.05]2 studies · 77 participantsLow
Full-time wear of removable retainer (any type) vs Part-time wear of removable retainer (any type)
Stability: Little's Irregularity Index (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
MD 0.20 [-0.28, 0.68]1 study · 52 participantsVery low
Malocclusion vs No malocclusion
Oral health-related quality of life (OHRQoL), impaired (qualitative synthesis) · Adolescents aged 10-19 years
Malocclusions and quality of life among adolescents: a systematic review and meta-analysis. (2023)
Impaired OHRQoL, qualitative synthesis: relative effect not estimable across the 13 studies (13,864 participants); moderate quality of evidence (GRADE).13 studies · 13864 participantsModerate
Full-time clear plastic (removable) retainer vs Any type of fixed (bonded) retainer
Adverse effects on oral health: gingival bleeding (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
RR 0.53 [0.31, 0.88]1 study · 84 participantsVery low
Herbal mouthwash vs Blank control
Plaque-related index · Orthodontic patients · ≤ 3 months
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
PI was significantly reduced compared to baseline [39; 48; 54; 58]; BBPI was significantly reduced compared to blank control [47]; TI and dental plaque amount were significantly reduced compared to baseline [45; 38].8 studiesVery low
Full-time clear plastic (removable) retainer vs Any type of fixed (bonded) retainer
Stability: Little's Irregularity Index (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
MD 0.60 [0.17, 1.03]1 study · 84 participantsVery low
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Blank control (no mouthwash; before-after comparison)
Total bacteria (colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term)
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
Colony count of total bacteria were significantly reduced compared to placebos according to two studies [34, 43].2 studiesVery low
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF)
Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 12 months, Follow-up: 12 months
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023)
SMD -2.14 [-3.64, -0.64]3 studies · 113 participantsUngraded
Fibre-reinforced composite fixed (bonded) retainer vs Multistrand / spiral wire fixed (bonded) retainer
Adverse effects on oral health: Gingival Index (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
No RCTs at 12-month follow-up; 1 RCT at 6 months: higher gingival inflammation with fibre-reinforced composite (MD 0.59, 95% CI 0.13 to 1.05; very low-certainty)0 studiesNo studies
Light-emitting diode (LED) photobiomodulation vs Conventional orthodontic appliance treatment
Harms and side effects arising during treatment · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
Harms and side effects | Not reported. None of the included studies assessed harms arising during the LED intervention.NRNo studies
Herbal mouthwash vs Blank control
Gingival inflammation-related index · Orthodontic patients · ≤ 3 months
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
CPI was significantly reduced compared to baseline [35]; SBI was significantly reduced while MGI was similar compared to baseline [45]; BOP was significantly reduced compared to blank control [39].3 studiesVery low
Light-emitting diode (LED) photobiomodulation vs Conventional orthodontic appliance treatment
Duration of orthodontic treatment: alignment stage (mandibular arch) · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment · Alignment stage
Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic… (2023) · Cochrane
MD -24.5 [-42.45, -6.55]1 study · 34 participantsVery low
Herbal mouthwash vs Blank control
Cariogenic bacteria (Mutans streptococci) · Orthodontic patients · ≤ 3 months
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
Colony count of MS was significantly reduced compared to baseline [48]; another study found an insignificant reduction compared to baseline [51].2 studiesVery low
Full-time clear plastic (removable) retainer vs Any type of fixed (bonded) retainer
Adverse effects on oral health: caries (lower arch) · People who had received fixed appliance orthodontic treatment · 12 months, lower arch
Retention procedures for stabilising tooth position after treatment with orthodontic braces (2023) · Cochrane
RD 0.00 [-0.05, 0.05]1 study · 84 participantsVery low
Icon resin infiltration vs Baseline before resin infiltration
Lightness change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d 0.71 [0.32, 1.09]1 studyUngraded
Icon resin infiltration vs Baseline before resin infiltration
Color change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d 0.40 [0.11, 0.65]1 studyUngraded
Icon resin infiltration vs Baseline before resin infiltration
Color change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d 0.82 [0.43, 1.20]1 studyUngraded
Icon resin infiltration vs Baseline before resin infiltration
Color change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d 6.80 [5.70, 7.82]1 studyUngraded
Resin infiltration (ICON, low-viscosity infiltrative resin; DMG) vs Pre-treatment baseline before infiltration (T0); pooled as a within-arm before/after change
Lightness/brightness change of white spot lesion (luminosity L*, T0 to T1) · Patients with post-orthodontic white spot lesions (permanent dentition, after removal of fixed multibracket… · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
SMD -0.001 [-0.23, 0.23]3 studies · 330 participantsUngraded
Icon resin infiltration vs Baseline before resin infiltration
Lightness change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d -1.76 [-2.22, -1.30]1 studyUngraded
Resin infiltration (ICON, low-viscosity infiltrative resin; DMG) vs Pre-treatment baseline before infiltration (T0); pooled as a within-arm before/after change
Color change of white spot lesion (color difference, T0 to T1) · Patients with post-orthodontic white spot lesions (permanent dentition, after removal of fixed multibracket… · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
SMD 1.36 [1.14, 1.59]4 studies · 458 participantsUngraded
Icon resin infiltration vs Baseline before resin infiltration
Lightness change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d 0.40 [0.11, 0.65]1 studyUngraded
Icon resin infiltration vs Baseline before resin infiltration
Color change · Patients with post-orthodontic white spot lesions and permanent dentition · 6 months
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… (2022)
Cohen's d 2.37 [1.91, 2.82]1 studyUngraded
Fluoride-releasing glass ionomer-based bonding agent vs Non-fluoride glass ionomer-based bonding agent
Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances · 1-24 months follow-up, Glass ionomer-based bonding agent
Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel… (2021)
RR 0.64 [0.41, 0.99]1 study · 144 participantsUngraded
Bonded Minne appliance (slow maxillary expansion) vs Banded Minne appliance (slow maxillary expansion)
Stability of crossbite correction (relapse of canine expansion) · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or… · 24 weeks after completion of expansion
Orthodontic treatment for posterior crossbites (2021) · Cochrane
Bonded Minne 1.6 mm (SD 0.5) vs Banded Minne 1.2 mm (SD 0.3); P=NS1 studyUngraded
Double primary (canine and first molar) tooth extraction vs Single primary (canine) tooth extraction
Root resorption of the impacted canine or adjacent incisors and first premolars · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)
Interventions for promoting the eruption of palatally displaced permanent canine teeth, without the need for… (2021) · Cochrane
The studies did not report adverse events.0 studiesNo studies
Fixed Hyrax maxillary expander vs Fixed fan-type maxillary expander
Canine expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or… · post-treatment 3 weeks
Orthodontic treatment for posterior crossbites (2021) · Cochrane
Gopalakrishnan 2017: Hyrax 6.00 (SD 0.63) mm vs fan-type 7.33 (SD 2.5) mm; P=0.235 (NS)1 study · 12 participantsUngraded
Lacebacks with fixed appliances vs Fixed appliances only (control)
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 · 6 months
Orthodontic treatment for crowded teeth in children (2021) · Cochrane
MD 0.83 [-6.41, 8.07]1 study · 62 participantsUngraded
Schwarz appliance vs No active treatment (control)
Size of the lower jaw (mandibular arch length, change) at 9 months · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth · 9 months
Orthodontic treatment for crowded teeth in children (2021) · Cochrane
MD 0.11 [-0.46, 0.68]1 study · 28 participantsUngraded
Double primary (canine and first molar) tooth extraction vs Single primary (canine) tooth extraction
Incidence of eruption of the PDC into the mouth · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC) · 48 months (maximum; mITT)
Interventions for promoting the eruption of palatally displaced permanent canine teeth, without the need for… (2021) · Cochrane
RR 1.28 [1.06, 1.54]2 studies · 96 participantsUngraded
Nitinol archwire vs Titinol archwire
Amount of crowding (change) up to 37 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth · up to 37 weeks
Orthodontic treatment for crowded teeth in children (2021) · Cochrane
MD -0.28 [-0.89, 0.33]1 study · 40 participantsVery low
Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances
Plaque index (PI) · Adults undergoing orthodontic treatment · 6 to 12 weeks, Adults
Impact of Aligners and Fixed Appliances on Oral Health during Orthodontic Treatment: A Systematic Review and… (2021)
MD -0.58 [-0.82, -0.34]4 studies · 202 participantsVery low
Active self-ligating brackets vs Passive self-ligating brackets
Time to alignment (days) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth · alignment
Orthodontic treatment for crowded teeth in children (2021) · Cochrane
MD -13.11 [-28.76, 2.53]2 studies · 144 participantsUngraded