Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
ACP adhesive had lower demineralization scores at 1 month, with certainty not graded.
2 findings from 1 review
At T1, the control group had an average demineralization score of 3.39 (±1.29), whereas the ACP group had a notably lower average score of 2.58 (±1.11) (p-value of 0.000).
1 study · 26 participants
GRADE not reported
At T2, the control group had an average score of 4.32 (±2.32), while the ACP group continued to exhibit a lower average score of 3.41 (±1.11) (p-value of 0.000).
1 study · 26 participants
GRADE not reported
Enamel remineralization / anti-demineralization extent · Human teeth with early enamel lesions surrounding orthodontic brackets
No meta-analysis was conducted; most included in vitro studies reported significant remineralization with remineralizing orthodontic adhesives versus controls.
1 finding from 1 review
no estimate extracted
24 studies
GRADE not reported
Ion release · Human teeth with early enamel lesions surrounding orthodontic brackets
No meta-analysis was conducted; most studies reported increased ion release over time, but few reported peak values.
1 finding from 1 review
no estimate extracted
8 studies
GRADE not reported
Enamel demineralization (QLF ΔF) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Flash-free brackets showed no clinical WSL reduction, with certainty not graded.
1 finding from 1 review
White spot lesion rate and volume · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Opal Seal showed no significant difference in WSL rate or volume, with certainty not graded.
1 finding from 1 review
The WSL volume was lower in the Opal Seal group than in the Clearfil and Transbond XT groups, but there was no significant difference among the groups (p > 0.05).
1 study · 15 participants
GRADE not reported
Enamel demineralization (DIAGNOdent score) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
A single triple-blinded RCT found the ACP-containing adhesive reduced enamel demineralization versus a conventional adhesive over 6 months (ungraded).
1 finding from 1 review
White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
Two studies found adhesive flash-free brackets did not clinically reduce enamel demineralization or white spot lesions versus conventional brackets, though they reduced pathogenic bacteria (ungraded).
1 finding from 1 review
Enamel demineralization (DIAGNOdent score) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
Across three small non-randomized studies, fluoride-releasing primers (Opal Seal, Clearfil) showed no consistent clinical advantage over conventional primers in preventing white spot lesions (ungraded).
1 finding from 1 review
Fluoride ion release · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, the commercial RMGIC Fuji Ortho LC showed significant fluoride release up to 6 months in a single study (ungraded).
1 finding from 1 review
White spot lesion development (QLF: mineral loss, lesion area/depth, new lesions) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
A single RCT found the one-step adhesive without a primer (GC Ortho Connect) produced more and more severe white spot lesions than conventional multi-step systems (ungraded).
1 finding from 1 review
Calcium and phosphate ion release · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, an n-ACP-containing adhesive significantly increased calcium and phosphate ion release up to 42 days in a single study (ungraded).
1 finding from 1 review
Enamel remineralization / carious lesion development · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, an ammonium-based methacrylate-containing adhesive showed significant remineralization/anti-demineralization versus control in a single study (ungraded).
1 finding from 1 review
Enamel remineralization extent · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, a nano-CaF2-containing orthodontic cement showed significant enamel remineralization versus control in a single study (ungraded).
1 finding from 1 review
Enamel remineralization extent · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, n-ACP-containing orthodontic adhesives showed significant enamel remineralization versus control in both studies, but evidence is weak (only 2 studies; ungraded).
1 finding from 1 review
Enamel remineralization extent and color change · Human enamel specimens around orthodontic brackets (in vitro)
In vitro, an n-AFCP-containing orthodontic primer showed significant enamel remineralization and less color change versus control in a single study (ungraded).
1 finding from 1 review
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
Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Adhesive precoated flash-free brackets showed no demineralization difference, with certainty not graded.
1 finding from 1 review
Intergroup evaluation showed that there were no statistically significant differences in demineralization measurements between all sides of the conventional and flash-free brackets at all the time intervals (p >0.05).
1 study · 30 participants
GRADE not reported
White spot lesion incidence, area, and depth · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
GC Ortho Connect had more frequent, larger, and deeper WSLs, with certainty not graded.
1 finding from 1 review
Group 3 (GC Ortho Connect) showed a significantly higher incidence than both groups (p < 0.001). Group 3 (GC Ortho Connect) also had larger lesion areas and deeper lesions compared to other groups (p < 0.001).
1 study · 75 participants
GRADE not reported
White spot lesion formation (QLF: fluorescence loss, lesion area) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)
Indirect bonding with a flowable adhesive favored less QLF-measured demineralization, with certainty not graded.
1 finding from 1 review
The DB group exhibited significantly higher loss of fluorescence and degree of demineralization compared to the IB group between T0 and T1, with notable differences in specific quadrants (p <0.05 for ΔF and ΔF max).
1 study · 51 participants
GRADE not reported