SynthesisBMC oral health2023
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis.
Synthesis in BMC oral health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06403371 (The Effect of Fluoride Varnish on White Spot Lesion in Clear Aligner Orthodontic Patients), which is not on this map. Cited by 26 papers, 1 of them a synthesis 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.
The Effect of Fluoride Varnish on White Spot Lesion in Clear Aligner Orthodontic Patients: Prospective Randomized Controlled Clinical Trial
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Changes in salivary biomarkers of pain, anxiety, stress, and inflammation related to tooth movement during orthodontic treatment: a systematic review.Dental press journal of orthodontics · 2024Pooled it
- Plaque removal efficacy of manual versus powered toothbrushes in patients with clear aligners: a single-brushing randomized controlled trial.BMC oral health · 2026Trial
- Effects of clear aligner cleaning agents on Streptococcus mutans biofilms and thermoplastic surface integrity: an in vitro study.Odontology · 2026Article
- Incidence and distribution of white spot lesions after clear aligner versus fixed appliance therapy : A retrospective digital photograph and intraoral scan analysis.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2026Article
- [Research advances in clear aligner].Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2026Review
- Review
- A prospective cohort study exploring salivary microbial predictors of white spot lesions during fixed orthodontic treatment.Journal of oral microbiology · 2026Article
- Prevalence of white spot lesions in children and adolescents across Northern, Central and Southern Italy: a multicenter cross-sectional study.Frontiers in oral health · 2026Article
- A 41-Month Case Report: Correction of Anterior Open Bite Using Clear Aligners Combined With Long-Arm Uprighting Springs.Case reports in dentistry · 2026Article
- The impact of clear aligners therapy on dental caries: a systematic review.Frontiers in dental medicine · 2026Review
- Influence of low viscosity resin infiltrant on the adhesion of orthodontic attachments.Dental press journal of orthodontics · 2026Article
- Evaluating the Impact of Clear Dental Aligners on Dental and Periodontal Conditions, Oral Microbial Patterns, and the Immune System.Advances in experimental medicine and biology · 2026Review
- Clear aligner therapy beyond esthetics: oral health, polymer materials, and the environmental cost of digital orthodontics.Frontiers in dental medicine · 2026Review
- Comparative effectiveness of remineralization agents on attachment-associated enamel demineralization in clear aligner patients: A 6-Month DIAGNOdent-Based controlled clinical trial.BMC oral health · 2025Article
- How AI-Driven Root and Bone Predictions Can Assist Clear Aligner Treatment Planning.Orthodontics & craniofacial research · 2025Review
- Duration-Dependent Caries Risk During Clear Aligner Therapy: A Retrospective Analysis.Biomimetics (Basel, Switzerland) · 2025Article
- Indications and limits of clear aligner therapy: an international modified Delphi consensus study.Progress in orthodontics · 2025Review
- Expert consensus on the clinical strategies for orthodontic treatment with clear aligners.International journal of oral science · 2025Review
- Expert consensus on the prevention and treatment of enamel demineralization in orthodontic treatment.International journal of oral science · 2025Article
- Novel antimicrobial and bioactive resin-based clear aligner attachment orthodontic materials.Frontiers in oral health · 2025Article
Corrections and comments
- Commented on by
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances.
methodsElectronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane's ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software.
resultsA total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD - 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances.
conclusionsA moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies. CLINICAL RELEVANCE: For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health. REGISTRATION: Open Science Framework (DOI: https://doi.org/10.17605/osf.io/kcpvb ).
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What OpenQuestion holds
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.