ArticleBMC oral health2025
Comparative effectiveness of remineralization agents on attachment-associated enamel demineralization in clear aligner patients: A 6-Month DIAGNOdent-Based controlled clinical trial.
Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07229105 (Comparative Effectiveness of Remineralization Agents on Attachment-Associated Demineralization in Clear Aligner Patients), which is not on this map. Not yet cited in PubMed.
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.
Comparative Effectiveness of Remineralization Agents on Attachment-Associated Demineralization in Clear Aligner Patients: A 6-Month DIAGNOdent-Based Observational Study
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesClear aligner attachments increase the risk of white spot lesions (WSL), with a 35.5% incidence in adolescents. The number of anterior attachments is an independent risk factor (OR = 2.192). Despite 17 million patients treated worldwide, no study has quantitatively assessed demineralization around attachment margins. To compare the effectiveness of CPP-ACP, nano-hydroxyapatite (nHAp), and fluoride varnish versus a control for attachment-associated demineralization using DIAGNOdent monitoring.
methodsThis prospective controlled clinical trial evaluated 52 patients; 45 were enrolled, and 40 completed after five pre-baseline withdrawals. Participants were allocated to four groups (n = 10 each): Group A (control, fluoride toothpaste), Group B (CPP-ACP daily), Group C (nHAp professional + home gel), and Group D (fluoride varnish quarterly). DIAGNOdent measurements were taken around attachments at baseline, 1, 3, and 6 months. Linear mixed-effects models analyzed group differences (p < 0.05).
resultsAll 40 participants completed the 6-month study (100% retention). Baseline values were comparable (p = 0.48). Mean DIAGNOdent changes at 6 months were: Control + 4.35 [95%CI: 3.77–4.93], CPP-ACP − 4.02 [− 4.47 to − 3.56], nHAp − 5.36 [− 5.99 to − 4.72], Fluoride − 4.45 [− 4.78 to − 4.11]. The main group effect was significant (p < 0.001; η²p = 0.974). All treatments outperformed the control (p < 0.001). nHAp showed the greatest reduction, superior to CPP-ACP (p < 0.001) and fluoride (p = 0.019). Fluoride exhibited a biphasic pattern.
conclusionsAll remineralization protocols significantly reduced demineralization versus control, with nHAp demonstrating the highest efficacy. Early preventive intervention and regular monitoring are recommended in attachment-bearing patients. Larger randomized trials are warranted.
trial registrationClinicalTrials.gov NCT07229105. Registered 13 November 2025. Retrospectively registered.
Indexed as
Identifiers
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.