Prevalence of ICLs (mean number of lesions per subject) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances
Patients had on average about 2.24 ICLs per subject during/after fixed orthodontic treatment (95% CI 1.79-2.70; very low certainty; very high heterogeneity).
1 finding from 1 review
Association between orthodontic treatment duration and ICLs prevalence · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances
ICLs prevalence increased with longer orthodontic treatment duration (meta-regression P=.01; ungraded).
1 finding from 1 review
Prevalence of ICLs (proportion of tooth surfaces affected) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances
About 22% of tooth surfaces showed ICLs during/after fixed orthodontic treatment (pooled 0.22, 95% CI 0.14-0.33; very low certainty; extreme heterogeneity).
1 finding from 1 review
Prevalence of ICLs (proportion of subjects affected) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances
Around 57% of patients had ICLs during or after fixed orthodontic treatment (pooled prevalence 0.57, 95% CI 0.48-0.65; very low certainty; very high heterogeneity).
1 finding from 1 review
Prevalence of white spot lesions (WSL) at debonding, subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances
Fluoride varnish applied regularly during fixed orthodontic treatment may reduce the prevalence of white spot lesions at debonding (pooled RR 0.64, 95% CI 0.42 to 0.98), but the certainty of evidence is very low.
1 finding from 1 review
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 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 / white spot lesion prevention (DIAGNOdent, enamel mineral content) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)
Two small RCTs gave inconsistent results for TiO2-modified adhesives/composites on enamel demineralization (one favorable on DIAGNOdent, one no difference in mineral content); ungraded.
1 finding from 1 review
Lactobacilli presence (CFU > 10^5) · Adults undergoing orthodontic treatment
Aligners probably lower the risk of high lactobacilli counts versus fixed appliances in adults at 3 months (RR 0.09, 95% CI 0.02 to 0.47; low certainty).
2 findings from 1 review
S. mutans presence (CFU > 10^5) · Adults undergoing orthodontic treatment
Aligners probably lower the risk of high S. mutans counts versus fixed appliances in adults at 3 months (RR 0.07, 95% CI 0.01 to 0.49; low certainty).
2 findings from 1 review
S. mutans presence · Adolescents/teenagers undergoing orthodontic treatment
A single study found no significant difference in S. mutans presence between aligners and fixed appliances in adolescents at 1 month (RR 0.86, 95% CI 0.64 to 1.14; ungraded).
1 finding from 1 review
RR 0.86 [0.64, 1.14]
1 study
GRADE not reported
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
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
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
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
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
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
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
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
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