SynthesisClinical oral investigations2020
Effectiveness of remineralizing agents in the prevention and reversal of orthodontically induced white spot lesions: a systematic review and network meta-analysis.
Synthesis in Clinical oral investigations, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04992481 (Influence of Fluoride Varnish, Ozone and Octenidin on the Incidence of White Spot Lesions and Caries During Orthodontic Treatment - a Randomized Clinical Trial), which is not on this map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Influence of Fluoride Varnish, Ozone and Octenidin on the Incidence of White Spot Lesions and Caries During Orthodontic Treatment - a Randomized Clinical Trial
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Caries prevention in permanent teeth - basic recommendations of the German S 3 guideline.Clinical oral investigations · 2026Guideline
- Efficacy of various interventions for the management of white spot lesions associated with fixed orthodontic treatment: a systematic review and network meta-analysis of randomized controlled trials.BMC oral health · 2026Pooled it
- Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- A prospective, triple-blind, randomized controlled clinical trial evaluating the protective effect of P11-4 peptide on enamel demineralization during multibracket orthodontic treatment.BMC oral health · 2026Trial
- Evaluation of the remineralization potential of self-assembling peptide P11-4 with fluoride compared to fluoride varnish in the management of incipient carious lesions: a randomized controlled clinical trial.Clinical oral investigations · 2024Trial
- Comparative evaluation of four treatments for postorthodontic white spot lesions: a randomized controlled trial.Clinical oral investigations · 2023Trial
- Fluoride varnish, ozone and octenidine reduce the incidence of white spot lesions and caries during orthodontic treatment: randomized controlled trial.Scientific reports · 2022Trial
- A study on the treatment of enamel white spot lesions using chitosan-calcium phosphate microgels loaded with EGCG-NPs.Frontiers in pharmacology · 2026Article
- Dual-Mode Antibacterial Orthodontic Composite: Contact-Killing QACs and Sustained CHX Release via Large-Pore Mesoporous Silica Nanoparticles.International journal of molecular sciences · 2025Article
- White spot lesion management: Knowledge and practices during fixed orthodontic treatment among Saudi dentist -A cross-sectional study.Bioinformation · 2025Article
- Review
- Development of Tooth Brushing Recommendations Through Professional Consensus.International dental journal · 2024Article
- Effect of Dentifrice Ingredients on Volume and Vitality of a Simulated Periodontal Multispecies Biofilm.Dentistry journal · 2024Article
- In-vitro effect of a single application of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets.Dental press journal of orthodontics · 2024Article
- White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives.Journal of orthodontic science · 2024Review
- Recent advances in antibacterial coatings for orthodontic appliances.Frontiers in bioengineering and biotechnology · 2023Review
- Synergistic remineralization of enamel white spot lesions using mesoporous bioactive glasses loaded with amorphous calcium phosphate.Frontiers in bioengineering and biotechnology · 2023Article
- Resin Infiltration of Non-Cavitated Enamel Lesions in Paediatric Dentistry: A Narrative Review.Children (Basel, Switzerland) · 2022Review
- Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey.Clinical oral investigations · 2022Article
- Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
Abstract
objectivesTo compare the effectiveness of remineralizing agents in the prevention and reversal of white spot lesions (WSLs), which occur during fixed orthodontic treatment, through a systematic review and network meta-analysis. MATERIALS AND
methodsWe reviewed controlled randomized clinical trial (RCT) data querying nine databases combined with a manual search (last search date: March 10, 2020). Of 2273 identified studies, 36 RCTs were finally included. After study selection and data extraction, pair-wise and network meta-analyses were performed to analyze the effectiveness of remineralizing agents in the prevention and reversal of WSLs in the short term (≤ 3 months) and long term (> 3 months). The risk of bias was assessed based on the Cochrane guidelines. Statistical heterogeneity, inconsistencies, and cumulative ranking were also evaluated.
resultsIn terms of WSL prevention, sodium fluoride (NaF) varnish had the highest cumulative ranking for the short-term decalcification index (99.3%); acidulated phosphate fluoride (APF) foam ranked first for long-term incidence (96.9%), followed by difluorosilane (Dfs) varnish and high-concentration fluoride toothpaste (HFT) (79.4% and 77.4%, respectively). In the reversal of WSLs, no significant difference was found among different agents or their combinations for the two available outcomes (short-term integrated fluorescence loss and short-term percentage of fluorescence loss).
conclusionsIn the prevention of WSLs, APF foam showed the best remineralizing effectiveness in the long term (after debonding), followed by Dfs varnish and HFT. It is unclear whether remineralizing agents can effectively reverse WSLs based on the existing evidence. CLINICAL RELEVANCE: APF foam may be recommended as a remineralizing agent for preventing orthodontically induced WSLs. PROSPERO REGISTRATION NUMBER: CRD42019116852.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.