What do systematic reviews say?

Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment

• Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic treatment 2023 · Cochrane All outcomes
  Woodhouse 2015 (81 participants, 22 dropouts): PAR reduction intervention median 28.0 (IQR 21.0-38.0), control median 29.0 (IQR 24.0-31.0), placebo median 27.0 (IQR 20.0-35.0); percentage improvement medians 88.9 /…
  1 study · 59 participants
  GRADE not reported

Fluoride-releasing glass ionomer-based bonding agent vs Non-fluoride glass ionomer-based bonding agent

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

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Glass ionomer-based bonding agent
  RR 0.64 [0.41, 0.99]
  1 study · 144 participants
  GRADE not reported

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

Among fluoride-releasing sealants, the reduction in WSL initiation versus no sealant was not statistically significant (RR 0.69); subgroup not separately GRADE-rated.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  3-27 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Sealant with fluoride release
  RR 0.69 [0.46, 1.05]
  3 studies · 1467 participants
  GRADE not reported

Resin infiltration vs Untreated control (natural remineralization)

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).

• Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a… 2021 All outcomes

  4 weeks to 6 months
  SMD 1.24 [0.59, 1.88]
  3 studies · 949 participants
  Moderate
• Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a… 2021 All outcomes

  4 weeks to 6 months · Visual analog scale (Senestraro et al. 2013)
  SMD 2.34 [1.68, 3.01]
  1 study · 66 participants
  GRADE not reported
• Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a… 2021 All outcomes

  4 weeks to 6 months · Spectroscopy delta-E (Knosel et al. 2013)
  SMD 0.63 [0.26, 1.01]
  1 study · 115 participants
  GRADE not reported

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

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

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1 to 24 months · Fixed orthodontic treatment · Overall
  RR 0.84 [0.70, 1.01]
  10 studies · 4705 participants
  Very low

Glass ionomer cement vs Resin adhesive

Glass ionomer cement did not show a statistically significant difference in new white spot lesions versus resin adhesive (very low certainty).

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  12 to 24 months · Fixed orthodontic treatment · Overall
  RR 0.72 [0.34, 1.54]
  3 studies · 394 participants
  Very low

Glass ionomer cement (for bracket bonding) vs Resin adhesive

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.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  12-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level
  RR 0.72 [0.34, 1.54]
  3 studies · 394 participants
  Very low

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

Sealant use reduced the incidence of new white spot lesions versus no sealant (very low certainty).

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  3 to 27 months · Fixed orthodontic treatment · Overall
  RR 0.70 [0.53, 0.93]
  6 studies · 2314 participants
  Very low

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

For compomer-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.71); subgroup not separately GRADE-rated.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Compomer-based bonding agents
  RR 0.71 [0.46, 1.11]
  2 studies · 400 participants
  GRADE not reported

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

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

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  3-27 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Sealant without fluoride release
  RR 0.69 [0.49, 0.97]
  3 studies · 847 participants
  GRADE not reported

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

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).

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1 to 24 months · Fixed orthodontic treatment · Compomer-based bonding agents
  RR 0.71 [0.46, 1.11]
  2 studies · 400 participants
  GRADE not reported

Intervention not reported

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  Sensitivity (glass ionomer cement vs resin adhesive, excluding high risk-of-bias studies)
  RR 1.02 [0.82, 1.27]
  Studies not reported
  GRADE not reported

Intervention not reported

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  Sensitivity (coating with vs without fluoride release, excluding parallel-arm studies)
  RR 0.82 [0.66, 1.02]
  Studies not reported
  GRADE not reported

Intervention not reported

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  Sensitivity (sealant vs no sealant, excluding high risk-of-bias studies)
  RR 0.85 [0.66, 1.10]
  Studies not reported
  GRADE not reported

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

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

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Resin-based sealants
  RR 0.71 [0.35, 1.43]
  2 studies · 644 participants
  GRADE not reported

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

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.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  3-27 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level
  RR 0.70 [0.53, 0.93]
  6 studies · 2314 participants
  Very low

Intervention not reported

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  Sensitivity (coating with vs without fluoride release, excluding high risk-of-bias studies)
  RR 0.83 [0.67, 1.04]
  Studies not reported
  GRADE not reported

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

Fluoride-releasing coating materials do not appear to reduce WSL initiation more than non-fluoride coatings (RR 0.84, not significant); certainty of evidence is very low.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level
  RR 0.84 [0.70, 1.01]
  10 studies · 4705 participants
  Very low

Fluoride-releasing resin-based bonding agent vs Non-fluoride resin-based bonding agent

For resin-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.97); subgroup not separately GRADE-rated.

• Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a… 2021 All outcomes

  1-24 months follow-up · Patients undergoing fixed (multibracket) orthodontic appliance treatment; clinical/dental setting; analysis at tooth level · Resin-based bonding agents
  RR 0.97 [0.79, 1.19]
  5 studies · 3517 participants
  GRADE not reported

Fixed-appliance orthodontic treatment incorporating surgically assisted orthodontics (adjunctive surgical procedure: corticotomy, micro-osteoperforation or interseptal bone reduction) to increase the rate of tooth movement vs Conventional orthodontic appliance treatment

The review found no eligible studies for this question.

• Surgical adjunctive procedures for accelerating orthodontic treatment 2015 · Cochrane All outcomes
  Results: 'Our prespecified secondary outcomes of patient satisfaction, improvement in occlusion, and prolonged stability of treatment were not measured in the trials.'
  0 studies
  No studies found