Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,890 questions · 3,917 findings · 272 reviews · All outcomes

No studies found 429 · 11%GRADE not reported 2,657 · 67.8%Very low 512 · 13.1%Low 219 · 5.6%Moderate 80 · 2%High 20 · 0.5%

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

For a glass-ionomer-based bonding agent (single study), fluoride release significantly reduced WSL initiation (RR 0.64); subgroup not separately GRADE-rated.

1 finding from 1 review

Sealant/coating agent WITH fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

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

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

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

Glass ionomer cement vs Resin adhesive

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

Glass ionomer cement (for bracket bonding) vs Resin adhesive

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

Blood and saliva analysis (biomarker tests) vs Surgical or punch biopsy with histological assessment

Outcome not reported · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions

The review found no eligible studies for this question.

1 finding from 1 review

Light-based detection and/or oral spectroscopy (e.g. ViziLite, VELscope, Microlux DL, Identafi 3000) vs Surgical or punch biopsy with histological assessment

Specificity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Sealant (any type) vs No sealant (control/no treatment)

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

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

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

Sealant/coating agent WITHOUT fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

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 non-fluoride sealants, WSL initiation was significantly reduced versus no sealant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

Specificity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions
1 finding from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

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 sealant-vs-no-sealant studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Fluoride-releasing compomer bonding agent did not show a statistically significant reduction in new white spot lesions versus non-fluoride compomer bonding agent (very low certainty).

1 finding from 1 review

Fluoride-releasing resin-based sealant vs Non-fluoride resin-based sealant

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 sealants, fluoride release did not significantly change WSL initiation (RR 0.71, wide CI); subgroup not separately GRADE-rated.

1 finding from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

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

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

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