Management of post-orthodontic white spot lesions: an updated systematic review

TY - JOUR

T1 - Management of post-orthodontic white spot lesions

T2 - an updated systematic review

AU - Sonesson, Mikael

AU - Bergstrand, Fredrik

AU - Gizani, Sotiria

AU - Twetman, Svante

N1 - © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: [email protected].

PY - 2017/4/1

Y1 - 2017/4/1

N2 - BACKGROUND/OBJECTIVES: The management of post-orthodontic white spot lesions is based on remineralization strategies or a minimal-invasive camouflage of the lesions.AIM: The aim of this systematic review was to identify and assess the quality of evidence for the various clinical technologies.SEARCH METHODS: Four databases were searched for relevant literature published in English between 2011 and 31 October 2015 according to a pre-determined PICO. Only controlled clinical studies were considered. Abstract lists and the selected full-text papers were independently examined by two reviewers and any differences were solved in consensus. The Cochrane handbook and the AMSTAR tool were used for grading the risk of bias. The quality of evidence was rated according to GRADE.RESULTS: Out of 280 identified publications, seven studies on remineralization, micro-abrasion and resin infiltration met the inclusion criteria. Two of them were assessed with low risk of bias. No pooling of results was possible due to study heterogeneity. The quality of evidence for all technologies was graded as very low.LIMITATIONS: Only papers published in English with more than 20 adolescents or young adults were considered. Furthermore, a follow-up period of at least 8 weeks was required. The publication bias could not be assessed due to the paucity of included trials.CONCLUSIONS/CLINICAL IMPLICATIONS: There is a lack of reliable scientific evidence to support re-mineralizing or camouflaging strategies to manage post-orthodontic white spot lesions. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.

AB - BACKGROUND/OBJECTIVES: The management of post-orthodontic white spot lesions is based on remineralization strategies or a minimal-invasive camouflage of the lesions.AIM: The aim of this systematic review was to identify and assess the quality of evidence for the various clinical technologies.SEARCH METHODS: Four databases were searched for relevant literature published in English between 2011 and 31 October 2015 according to a pre-determined PICO. Only controlled clinical studies were considered. Abstract lists and the selected full-text papers were independently examined by two reviewers and any differences were solved in consensus. The Cochrane handbook and the AMSTAR tool were used for grading the risk of bias. The quality of evidence was rated according to GRADE.RESULTS: Out of 280 identified publications, seven studies on remineralization, micro-abrasion and resin infiltration met the inclusion criteria. Two of them were assessed with low risk of bias. No pooling of results was possible due to study heterogeneity. The quality of evidence for all technologies was graded as very low.LIMITATIONS: Only papers published in English with more than 20 adolescents or young adults were considered. Furthermore, a follow-up period of at least 8 weeks was required. The publication bias could not be assessed due to the paucity of included trials.CONCLUSIONS/CLINICAL IMPLICATIONS: There is a lack of reliable scientific evidence to support re-mineralizing or camouflaging strategies to manage post-orthodontic white spot lesions. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.

U2 - 10.1093/ejo/cjw023

DO - 10.1093/ejo/cjw023

M3 - Review

C2 - 27030284

SN - 0141-5387

VL - 39

SP - 116

EP - 121

JO - European Journal of Orthodontics

JF - European Journal of Orthodontics

IS - 2

ER -