Findings

What do systematic reviews say?

4 questions · 4 findings · 3 reviews · Orthodontics · All outcomes

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No studies found 0 · 0%GRADE not reported 2 · 50%Very low 2 · 50%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Experimental orthodontic composite containing nano-hydroxyapatite (n-HAP) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel surface microhardness · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, a nano-hydroxyapatite-containing orthodontic composite showed significant enamel remineralization versus control in a single study (ungraded).

1 finding from 1 review

Remineralization and anti-demineralization effect of orthodontic adhesives on enamel surrounding orthodontic brackets:… 2024 All outcomes
pH cycling 28 days · In vitro (laboratory) · Overall
A study using an orthodontic composite containing nano-hydroxyapatite showed statistically significant remineralization compared with control orthodontic adhesives [34].
1 study
GRADE not reported

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of tooth surfaces developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 15% of tooth surfaces developed new ICLs during fixed orthodontic treatment (pooled 0.15, 95% CI 0.08-0.26; very low certainty; extreme heterogeneity).

1 finding from 1 review

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During fixed orthodontic treatment (development of new lesions) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
Proportion 0.15 [0.08, 0.26]
4 studies · 1890 participants
Very low

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

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

Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. 2024 All outcomes
During or after fixed orthodontic treatment (cross-sectional/at debonding) · International (16 countries; studies published 2005-2022); orthodontic clinical settings · Overall (random-effects model)
Proportion 0.22 [0.14, 0.33]
6 studies · 11583 participants
Very low

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

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

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
Baseline to end of treatment (varying) · University/hospital orthodontic clinics and private practice (multiple countries)
Not meta-analyzed. 2 RCTs assessed WSL severity by lesion surface area (Albhaisi 2020 [12]; Alshatti 2017 [31]) and 1 (Albhaisi 2020 [12]) also by lesion depth; reported narratively with differing methods, generally…
2 studies
GRADE not reported