Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Aug;25(8):4711-4719.
doi: 10.1007/s00784-021-03931-7. Epub 2021 Jun 9.

Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a systematic review and meta-analysis

S Bourouni  1 , K Dritsas  2 , D Kloukos  2 , R J Wierichs  3
Affiliations
Meta-Analysis

Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a systematic review and meta-analysis

S Bourouni et al. Clin Oral Investig. 2021 Aug.

Abstract

Objective: The present review systematically analyzed clinical studies investigating the efficacy of resin infiltration on post-orthodontic or non-post-orthodontic, white spot lesions (WSL), or fluorosis.

Materials: Five electronic databases (Central, PubMed, Ovid MEDLINE, Ovid EMBASE, LILACS) were screened. Article selection and data abstraction were done in duplicate. No language or time restrictions were applied. Outcomes were visual-tactile or DIAGNOdent measurements.

Results: Eleven studies with 1834 teeth being affected in 413 patients were included. Nine studies were randomized control trials, one a prospective cohort study, and one had an unclear study design. Meta-analysis could be performed for "resin infiltration vs. untreated control," "resin infiltration vs. fluoride varnish," and "resin infiltration without bleaching vs. resin infiltration with bleaching." WSL being treated with resin infiltration showed a significantly higher optical improvement than WSL without any treatment (standard mean difference (SMD) [95% CI] = 1.24 [0.59, 1.88], moderate level of evidence [visual-tactile assessment]) and with fluoride varnish application (mean difference (MD) [95% CI] = 4.76 [0.74, 8.78], moderate level of evidence [DIAGNOdent reading]). In patients with fluorosis, bleaching prior to resin infiltration showed no difference in the masking effect compared to infiltration alone (MD [95% CI] = - 0.30 [- 0.98, 0.39], moderate level of evidence).

Conclusion: Resin infiltration has a significantly higher masking effect than natural remineralization or regular application of fluoride varnishes. However, although the evidence was graded as moderate, this conclusion is based on only very few well-conducted RCTs.

Clinical relevance: Resin infiltration seems to be a viable option to esthetically mask enamel white spot lesions and fluorosis.

Keywords: Enamel microabrasion; Fixed orthodontic appliances; Fluoride varnish; Fluorosis; Meta-analysis; Post-orthodontic; Resin infiltration; Review; Tooth sealants; White spot lesions; White spots.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow
Fig. 2
Fig. 2
Quantitative meta-analyses for the comparison resin infiltration vs. untreated control. Standardized mean differences (SMD) (and 95% confidence intervals (95% CI)) were calculated since studies used the same construct but different scales. Forest plots, heterogeneity parameter (I2), as well as overall statistics (Z, P) are given
Fig. 3
Fig. 3
Quantitative meta-analyses for the comparison resin infiltration vs. fluoride control. Mean differences (SMD) (and 95% confidence intervals (95%CI)) were calculated since studies used the same construct and same scales. Forest plots, heterogeneity parameter (I2), as well as overall statistics (Z, P) are given
Fig. 4
Fig. 4
Risk of bias assessment. a For interventional, randomized controlled trials (RCTs) Risk of Bias 2.0 tool and b for interventional, non-randomized controlled trials the ROBINS-I tool was used
See this image and copyright information in PMC

Comment in

References

    1. Ekstrand KR, Martignon S. Visual–tactile detection and assessment. In: Meyer-Lueckel H, Paris S, Ekstrand KR, editors. Book title. Stuttgart: Thieme Verlag KG; 2013.
    1. Hadler-Olsen S, Sandvik K, El-Agroudi MA, Ogaard B. The incidence of caries and white spot lesions in orthodontically treated adolescents with a comprehensive caries prophylactic regimen: a prospective study. Eur J Orthod. 2012;34:633–639. doi: 10.1093/ejo/cjr068. - DOI - PubMed
    1. Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982;81:93–98. doi: 10.1016/0002-9416(82)90032-x. - DOI - PubMed
    1. Heymann GC, Grauer D. A contemporary review of white spot lesions in orthodontics. J Esthet Restor Dent. 2013;25:85–95. doi: 10.1111/jerd.12013. - DOI - PubMed
    1. Kidd EA, Fejerskov O. What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms. J Dent Res. 2004;83(Spec No C):C35–C38. doi: 10.1177/154405910408301s07. - DOI - PubMed