Fluoride-containing orthodontic adhesives and decalcification in patients with fixed appliances: a systematic review

Abstract

Introduction: Our objectives were to (1) systematically review the literature on the effectiveness of fluoride-containing adhesives in controlling decalcification in fixed orthodontic patients, (2) determine which fluoride-containing adhesives provide protection against decalcification, and (3) make recommendations on the usage of fluoride-containing adhesives in patients with fixed orthodontic appliances.

Methods: In this systematic review, we searched published and unpublished material in any language using general and specialist databases; key orthodontic journals were searched by hand. Predefined inclusion criteria based on objective outcome measures for decalcification, presence of a comparison group, and the study design were applied to select the studies. Included studies were double extracted onto predesigned data extraction sheets.

Results: A qualitative analysis of 5 randomized controlled trials and 5 clinical trials is presented.

Conclusions: It is impossible to make recommendations on the use of fluoride-containing orthodontic adhesives during fixed orthodontic treatment. However, there is evidence to suggest that (1) glass ionomer cement is more effective than composite resin in preventing white spot formation, but the evidence is weak; (2) further research is required to determine the effectiveness of the various fluoride-containing orthodontic adhesives; and (3) common outcome measures and reporting standards would assist future researchers.