Non-Cochrane · intervention · PM35954634
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the Application of Infiltrative Resins: Systematic Review and Meta-Analysis.
Baptista-Sánchez Hugo, Antonio-Zancajo Laura, Albaladejo-Martínez Alberto, et al. · International journal of environmental research and public health · 2022 · PubMed · doi:10.3390/ijerph19159277
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
9
current version
GRADE rated
0
No studies
0
Included studies
4
linked below
No studies 0 · 0%Ungraded 9 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with permanent dentition and post-orthodontic white spot lesions after removal of conventional fixed orthodontic appliances (in vivo, humans) | Patients with post-orthodontic white spot lesions in permanent teeth across 4 RCTs (458 teeth; screening flow: 25 records identified, 13 eligible after title/abstract, 4 included; per-study patient counts 12 to 20) |
| Intervention | Resin infiltration (ICON, DMG America) | ICON resin infiltration (all 4 included studies) |
| Comparison | Not explicitly specified (efficacy and 6-month stability of resin infiltration assessed as pre/post change) | Baseline before infiltration (T0); within-arm pre/post change pooled (original trials' comparators were Clinpro XT varnish, control group, and microabrasion) |
| Outcomes | Change in color and brightness (lightness) of white spot lesions | Color change: 4 studies, 458 teeth, pooled SMD 1.36 (95% CI 1.14 to 1.59), statistically significant; Lightness/brightness change: 3 studies, 330 teeth, pooled SMD -0.001 (95% CI -0.23 to 0.23), not significant |
| Study designs | Clinical trials verifying effectiveness of resin infiltration with at least 6-month follow-up; in vivo human studies; reviews, case-control studies, monographs, in vitro and animal studies excluded; teeth with caries, fluorosis or tetracycline lesions excluded | 4 RCTs (published 2015 to 2019) |
| Timing | Minimum 6-month follow-up; articles published in the last 10 years | 6 months (T0 to T1) |
Search date: December 2021 to May 2022. Databases: PubMed; Embase; Google Scholar; Scopus; Medline; Web of Science
Questions and results
Icon resin infiltration vs Baseline before resin infiltration
Population: Patients with post-orthodontic white spot lesions and permanent dentition
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lightness change 6 months Knosel (2019) reported a statistically significant lightness-change effect. Source: Figure 4: Knosel (2019) · same question in other reviews | Cohen's d 0.71 [0.32, 1.09] | 1 study | Ungraded |
Color change 6 months Eckstein (2015) reported a statistically significant color-change effect. Source: Figure 3: Eckstein (2015) · same question in other reviews | Cohen's d 0.40 [0.11, 0.65] | 1 study | Ungraded |
Color change 6 months Knosel (2019) reported a statistically significant color-change effect. Source: Figure 3: Michael Knosel (2019) · same question in other reviews | Cohen's d 0.82 [0.43, 1.20] | 1 study | Ungraded |
Color change 6 months Kannan (2019) reported a statistically significant color-change effect. Source: Figure 3: Amarpurna Kannan (2019) · same question in other reviews | Cohen's d 6.80 [5.70, 7.82] | 1 study | Ungraded |
Lightness/brightness change of white spot lesion (luminosity L*, T0 to T1) 6 months Population: Patients with post-orthodontic white spot lesions (permanent dentition, after removal of fixed multibracket orthodontic appliances); in vivo human studies ICON resin infiltration showed no statistically significant change in lightness/brightness of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD -0.001, 95% CI -0.23 to 0.23; 3 studies, 330 teeth; I2=97%); not GRADE-rated. Source: Results 3.3.1 (Color and Lightness Evaluation); Figure 4 (lightness forest plot); Figure 6 (lightness funnel plot); Table 2 · same question in other reviews | SMD -0.001 [-0.23, 0.23] | 3 studies · 330 participants | Ungraded |
Lightness change 6 months Kannan (2019) reported a statistically significant lightness-change effect. Source: Figure 4: Kannan (2019) · same question in other reviews | Cohen's d -1.76 [-2.22, -1.30] | 1 study | Ungraded |
Color change of white spot lesion (color difference, T0 to T1) 6 months Population: Patients with post-orthodontic white spot lesions (permanent dentition, after removal of fixed multibracket orthodontic appliances); in vivo human studies ICON resin infiltration significantly improved the color of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD 1.36, 95% CI 1.14 to 1.59; 4 studies, 458 teeth), although heterogeneity was very high (I2=98%) with a heavy outlier (Kannan); not GRADE-rated. Source: Results 3.3.1 (Color and Lightness Evaluation); Figure 3 (color forest plot); Figure 5 (color funnel plot); Table 2 · same question in other reviews | SMD 1.36 [1.14, 1.59] | 4 studies · 458 participants | Ungraded |
Lightness change 6 months Eckstein (2015) reported a statistically significant lightness-change effect. Source: Figure 4: Eckstein (2015) · same question in other reviews | Cohen's d 0.40 [0.11, 0.65] | 1 study | Ungraded |
Color change 6 months Gu (2019) reported a statistically significant color-change effect. Source: Figure 3: Xi Gu (2019) · same question in other reviews | Cohen's d 2.37 [1.91, 2.82] | 1 study | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | No | no |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | Partial Yes | no |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Partial Yes | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | RCT: No · NRSI: N/A | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | No | no |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | No | no |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 4
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Kannan & Padmanabhan 2019 Comparative evaluation of Icon® resin infiltration and Clinpro™ XT varnish on colour and fluorescence changes of white spot lesions: a… PMID:31204437 | 2 other reviews | not stated | not extracted yet | not extracted yet |
| Gu et al. 2019 Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth, randomized… PMID:30719932 | 1 other review | Color change | not extracted yet | not extracted yet |
| Knosel et al. 2019 Long-term follow-up of camouflage effects following resin infiltration of post orthodontic white-spot lesions in vivo. PMID:30324799 | 1 other review | not stated | not extracted yet | not extracted yet |
| Eckstein et al. 2015 Camouflage effects following resin infiltration of postorthodontic white-spot lesions in vivo: One-year follow-up. PMID:25126675 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).