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
Enamel remineralization / anti-demineralization extent · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, most bioactive glass-containing orthodontic adhesives (9 of 13 studies) showed significant enamel remineralization/anti-demineralization versus control, but the evidence is weak (predominantly high risk of bias, methodological heterogeneity, no meta-analysis; ungraded).
1 finding from 1 review
Out of 13 studies that evaluated bioactive glass particles/nanoparticles, 9 reported definitive statistically significant remineralization potential compared to control orthodontic adhesives [17, 21-24, 26-28, 31]; one…
13 studies
GRADE not reported
Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).
6 findings from 1 review
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White spot lesion incidence · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
Most studies reported a lower incidence of white spot lesions with clear aligners than fixed appliances, but heterogeneous assessment methods precluded meta-analysis (ungraded).
1 finding from 1 review
Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).
1 finding from 1 review
Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded).
1 finding from 1 review