European journal of orthodontics最新文献

{"title":"Malocclusion traits and oral health-related quality of life in adolescents: a multicenter cross-sectional study.","authors":"Emma Göranson, Lillemor Dimberg, Aron Naimi-Akbar, Mikael Sonesson","doi":"10.1093/ejo/cjag032","DOIUrl":"10.1093/ejo/cjag032","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to examine associations between separate malocclusion traits and oral health-related quality of life (OHRQoL) among adolescents with malocclusion. It also aimed to assess sex differences in OHRQoL and whether sex modified the associations between malocclusion traits and OHRQoL.</p><p><strong>Methods: </strong>We conducted a multicenter cross-sectional study among adolescents aged 12-19 years. Two groups were recruited: a no malocclusion group from general dentistry clinics and a malocclusion group from specialist orthodontic clinics. The participants completed two OHRQoL instruments-the generic Child Perceptions Questionnaire (CPQ11-14 short form) and the orthodontic-specific Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Malocclusion was assessed based on intraoral photographs. Sociodemographic data were obtained from Statistics Sweden, and caries data from the national caries registry (SKaPa). Associations between malocclusion traits and OHRQoL were examined using linear regression models adjusted for confounders, with additional analyses of sex differences in OHRQoL and effect modification by sex.</p><p><strong>Results: </strong>The final sample included 103 without malocclusion and 541 with malocclusion. After adjustment, anterior crowding was associated with poorer OHRQoL compared with other malocclusion traits in both instruments. Among those with malocclusion, females reported poorer OHRQoL than males, whereas no sex differences were observed in the no malocclusion group. In the sex-stratified analyses, associations between separate malocclusion traits and OHRQoL were largely similar across sexes.</p><p><strong>Conclusions: </strong>Anterior crowding shows the strongest association with poorer OHRQoL. Females with malocclusion report poorer OHRQoL than males, but there is limited evidence of sex modifying associations between separate malocclusion traits and OHRQoL.</p><p><strong>Registration: </strong>ClinicalTrials.gov on 02 Sept 2021 (registration number: NCT05038865).</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clear aligners: between clinical inertia and dormant disruption.","authors":"Theodore Eliades","doi":"10.1093/ejo/cjag018","DOIUrl":"10.1093/ejo/cjag018","url":null,"abstract":"<p><p>Clear aligner therapy has expanded rapidly over the past two decades; yet clinical efficiency, biomechanical predictability, and long-term enamel preservation remain limited by the current generation of attachments, bonding protocols, and aligner materials. Despite increasing publications and the proliferation of aligner companies, fundamental innovations in force delivery, attachment debonding, and material design have lagged clinical demand. This review highlights potential advances in prepolymerized attachment materials, nonetch bonding strategies, debond-on-demand and biomimetic adhesives, and nondissipative energy polymers, providing a roadmap for translating biomedical innovations into clinical aligner practice. Emphasis is placed on strategies that preserve enamel, minimize stress relaxation, and enable reversible or on-demand adhesion, addressing gaps that have constrained aligner therapy performance and predictability.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worthwhile or wasteful? Assessing the impact of funding, author collaboration and article availability on article metrics.","authors":"Christos Livas, Nikolaos Pandis, Konstantina Delli","doi":"10.1093/ejo/cjag015","DOIUrl":"10.1093/ejo/cjag015","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the profile of funded orthodontic articles and compare the citation impact and online visibility of grant-supported versus unfunded publications.</p><p><strong>Methods: </strong>All orthodontic articles published in 2021 that included funding acknowledgments were retrieved through a systematic search of the Web of Science (WoS) Core Collection. Article, authorship collaboration and funding characteristics were analysed using negative binomial regression to evaluate their association with the number of WoS citations. Altmetric Attention Scores (AASs) and citations for a subsample of funded articles were compared with those of unfunded articles published in the same journals to assess the impact of funding.</p><p><strong>Results: </strong>A total of 484 publications were identified, with a median of 6 authors [interquartile range (IQR): 4], 3 institutions (IQR: 3), and 8 WoS citations (IQR: 10). More than half of the articles originated from Asia, and nearly one-fourth were published in journals issued by publishers once claimed as predatory. National collaboration, extramural funding, and national public funders accounted for the greatest proportion of publications. The number of collaborating countries and PubMed indexing were significantly associated with more citations (P < 0.05), while free article availability and author origin showed weaker associations (P = 0.05 and P = 0.06, respectively). Unfunded publications appeared to receive significantly higher citation counts and AASs compared with funded ones.</p><p><strong>Conclusions: </strong>The number of collaborating countries and PubMed indexing were significantly associated with a higher citation impact among grant-supported orthodontic articles. Funding did not appear to significantly influence citation numbers or online attention. The substantial involvement of formerly flagged predatory publishers in the publication of funded orthodontic studies could prompt ethical concerns.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of accuracy, reliability, readability, and semantic consistency of generative AI responses to rephrased orthodontic patient questions.","authors":"Panchali Batra, Eshwar Puttaswamy, JyothiKiran Hurkadle, Dipti Shastri, Vipul Sharma, Monis Raza, Muskan Jakhal","doi":"10.1093/ejo/cjag024","DOIUrl":"10.1093/ejo/cjag024","url":null,"abstract":"<p><strong>Background: </strong>Patients increasingly consult generative artificial intelligence (GenAI) chatbots for orthodontic information. However, as a single question may be phrased in multiple ways, the consistency of responses remains uncertain.</p><p><strong>Objective: </strong>To evaluate and compare the accuracy, quality, reliability, readability, and semantic stability of five GenAI Chabot models in answering common orthodontic patient questions and their rephrased variants.</p><p><strong>Materials and methods: </strong>13 frequently asked orthodontic questions were identified and rephrased once, yielding 26 prompts. Each prompt was submitted to five AI models under standardized conditions. All models were accessed via publicly available web-based chat interfaces, including ChatGPT-3.5, ChatGPT-4, Bing Copilot, Google Gemini 1.0 Pro, and LLaMA-3-70B-Instruct Five orthodontists independently rated responses using a 4-point accuracy Likert scale, Global Quality Scale, modified DISCERN checklist, and Flesch Reading Ease Score (FRES). Readability was additionally assessed by students in grades 5-8. Semantic stability was determined by comparing ratings for original versus rephrased prompts. Statistical analyses included ANOVA, chi-square tests, and intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>ChatGPT-4 ranked second but exhibited moderate consistency (54%). Gemini showed good stability (92%) but lower quality. Bing Copilot and ChatGPT-3.5 underperformed, especially in consistency (46% and 23%). All models produced responses with low readability (Flesch scores 45-49).</p><p><strong>Conclusions: </strong>GenAI chatbots provide generally accurate orthodontic information, but performance depends on question phrasing. Only LLaMa and Gemini show high consistency. Better consistency, readability, and evidence-based accuracy are needed before the use of LLMs in patient education.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of tooth discoloration and bleaching response in the presence of clear aligners and attachments.","authors":"Pervin Bilginer, Merve Kurnaz, Ece Basaran","doi":"10.1093/ejo/cjag023","DOIUrl":"10.1093/ejo/cjag023","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the influence of clear aligners with and without attachments on tooth discoloration after exposure to common staining beverages, and to assess the bleaching effect of %6 hydrogen peroxide (HP) agent applied through aligners.</p><p><strong>Methods: </strong>Forty extracted human premolars were allocated into four groups (n = 10): attachments only, no aligners or attachments, aligners with attachments, and aligners only. Specimens mounted on typodont models and fitted with Invisalign aligners. Typodont models were sequentially immersed in artificial saliva, tea, coffee, and red wine for 6 days each, simulating 6 months of consumption. Aligners were replaced every 12 hours, and staining solutions were renewed daily. Color measurements were recorded at baseline and after each experimental stage using standardized digital photography, and color differences were calculated using the CIEDE2000 (ΔE00) formula. Following the staining protocol, bleaching was performed for 6 days using a 6% HP based gel applied through aligners. Statistical analysis was performed using the Kruskal-Wallis H test (P < .05).</p><p><strong>Results: </strong>All groups demonstrated clinically perceptible discoloration after staining. The greatest mean color change was observed in the attachment only group (ΔE00 = 23.30), whereas the lowest discoloration occurred in the aligners only group (ΔE00 = 6.60). Red wine produced the greatest color change among staining agents, while tea and coffee produced comparable staining. Bleaching significantly reduced discoloration in all groups.</p><p><strong>Conclusion: </strong>Commonly consumed staining agents produced clinically perceptible tooth discoloration. Composite attachments increased susceptibility to tooth discoloration, whereas aligners showed a protective effect by limiting color change. Bleaching with 6% HP agent applied through aligners significantly reduced discoloration. Dietary habits and the presence of attachments should be considered when managing esthetic concerns during clear aligner therapy (CAT), and bleaching may be recommended without waiting for attachment removal.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of eruption guidance appliances on occlusal traits: a systematic review and meta-analysis.","authors":"Lotta Pelkonen, Auli Suominen, Anna-Liisa Svedström-Oristo","doi":"10.1093/ejo/cjag020","DOIUrl":"10.1093/ejo/cjag020","url":null,"abstract":"<p><strong>Background: </strong>Early treatment of malocclusion in primary and early mixed dentition is often carried out by dentists under the supervision of orthodontists. In these treatments, simple appliances are preferred.</p><p><strong>Objectives: </strong>To analyse which occlusal traits can be corrected with prefabricated eruption guidance appliances (EGAs) in mixed dentitions.</p><p><strong>Search methods: </strong>Articles written in English and published between January 1990 and March 2023 were searched from Cochrane Library, Clinicaltrials.gov, EMBASE, International Clinical Trials Registry Platform, LILAC, PubMed, and Scopus.</p><p><strong>Selection criteria: </strong>The inclusion criteria were formed according to the Patient, Intervention, Comparison, Outcomes, and Study design schema (PICOS).</p><p><strong>Data collection and analysis: </strong>Selection of the articles followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was evaluated using RoB 2 and ROBINS-I tools. The pooled estimates for the change in clinical and cephalometric measurements were calculated. The overall quality of the outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.</p><p><strong>Results: </strong>Seven articles with 277 patients and 219 controls were included. One was a randomized controlled trial, one was a retrospective study, and three were prospective treatment studies. Two follow-up studies analysed cephalometric data of already included studies. Four prefabricated appliances were used: Education Fonctionnelle, LM-Activator™, Nite-Guide®, and Occlus-o-Guide®. Treatment protocols varied from passive night-time use to combinations of active daytime and passive night-time use. Treatment periods varied from 10 months to 3.3 years. The main findings were reductions in overjet (range 1.1-2.3 mm) and overbite (range 0.6-2.0 mm). Other findings included improvement in crowding and molar relationship and better tooth-to-tooth contacts. Even though most of the changes were dental, significant increases in the length of the mandible were reported in two studies. Four studies were included in the meta-analyses. In these analyses, the changes in overjet, overbite, SNB, and ANB were found statistically significant.</p><p><strong>Conclusions: </strong>EGAs comprise a group of functional appliances suitable for reduction of excessive overjet and overbite in mixed dentition. However, more studies are needed to elucidate their effects on skeletal structures.</p><p><strong>Registration: </strong>The protocol for this review was registered at PROSPERO under the ID CRD42023441197.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal high-fat/high-sugar diet has single-generation dental effects and two-generation skeletal effects in adult offspring mice.","authors":"Mohamed G Hassan, Kyle H Koester, Natalia S Harasymowicz, Arin K Oestreich, Kelle H Moley, Farshid Guilak, Erica L Scheller","doi":"10.1093/ejo/cjag035","DOIUrl":"10.1093/ejo/cjag035","url":null,"abstract":"<p><strong>Background: </strong>Maternal nutrition is increasingly recognized as a modulator of offspring skeletal development. While genetics has long been considered the primary determinant of craniofacial morphology, emerging evidence suggests that prenatal and early postnatal dietary exposures also influence facial morphology. However, how maternal diet differentially affects male and female craniofacial structures remains unclear. This study aimed to examine the effects of a maternal high-fat, high-sugar (HFHS) diet on craniofacial and dental morphology in first- (F1) and second- (F2) generation adult mice.</p><p><strong>Materials and methods: </strong>Female mice were fed a HFHS diet for 6 weeks before mating and throughout pregnancy and lactation. F1 offspring were weaned to a standard chow diet, and a subset of female F1 offspring were bred to produce F2 offspring, also maintained on chow. Craniofacial skeletal and dental structures of adult F1 and F2 mice at 1-year of age were assessed using micro-computed tomography for linear and geometric morphometrics.</p><p><strong>Results: </strong>HFHS diet exposure significantly reduced midfacial and mandibular length in F1 females, and these effects persisted in F2 females. In males, cranial and mandibular morphology were not affected. Tooth size was reduced in both sexes of F1 offspring but not in F2.</p><p><strong>Conclusion: </strong>Maternal HFHS diet induces jaw-specific changes in offspring craniofacial morphology, with subtle skeletal differences observed in females across both generations. By contrast, dental effects did not persist beyond one generation. These findings highlight the potential for maternal dietary habits to exert both immediate and transgenerational influences on offspring facial form that may persist into adulthood.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13174945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal study of rapid maxillary expansion effects on electromyographic, skeletal, and dental changes in children with functional posterior crossbite.","authors":"Gustavo Hauber Gameiro, Annicele da Silva Andrade, Maria Beatriz Duarte Gavião","doi":"10.1093/ejo/cjag014","DOIUrl":"10.1093/ejo/cjag014","url":null,"abstract":"<p><strong>Background/objectives: </strong>Long-term neuromuscular effects of rapid maxillary expansion (RME) for functional posterior crossbite (FPCB) remain unclear. This prospective longitudinal study evaluated RME effects on masticatory muscle electromyographic (EMG) activity and transverse skeletal/dental dimensions in children with FPCB.</p><p><strong>Materials/methods: </strong>Seventeen FPCB patients (mean age 8.8 years) treated with Hyrax expanders and 15 age-matched controls with normal occlusion were evaluated. Surface EMG activity, dental casts, and posteroanterior cephalograms were recorded at baseline (T1) and at the final evaluation (T2), with a mean interval of 10.6 months between assessments, encompassing the active expansion phase followed by 6 months of removable retention.</p><p><strong>Results: </strong>EMG analysis showed significantly increased masseter and temporalis activity after RME, indicating improved neuromuscular function. Cephalometric measurements revealed significant increases in maxillary skeletal width and maxillo-mandibular skeletal ratio without mandibular changes. Skeletal expansion (2.97 mm) represented 51% of the total maxillary intermolar width increase (5.86 mm), demonstrating favorable skeletal contribution. The maxillary-to-mandibular intermolar ratio normalized compared with controls.</p><p><strong>Limitations: </strong>Small sample size, single-center design, and 10-month follow-up duration may limit generalizability and long-term stability assessment.</p><p><strong>Conclusions/implications: </strong>RME significantly improves maxillary transverse dimensions and masticatory muscle activity in young FPCB patients. Early treatment optimizes skeletal-to-dental expansion ratio and promotes favorable stomatognathic system development.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TMD burden, not malocclusion severity, is associated with impaired OHRQoL in orthodontic patients.","authors":"Adrian Ujin Yap, Abd Aziz Alias, Aziz Khakimov, Kathreena Kadir, Zamri Bin Radzi","doi":"10.1093/ejo/cjag031","DOIUrl":"10.1093/ejo/cjag031","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared the impact of malocclusion severity and temporomandibular disorder (TMD) burden on oral health-related quality of life (OHRQoL) in orthodontic patients. Age-stratified analyses examined the moderating and mediating roles of oral behaviors, somatic symptoms, and psychological distress.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted with 274 orthodontic patients, comprising 113 adolescents (10-19 years) and 161 adults (20-30 years). Validated instruments assessed oral behaviors (OBC), TMD severity/burden (SFAI/5Ts-B), somatic symptoms (SSS-8), psychological distress (PHQ-4), and OHRQoL (OHIP-14). Malocclusion severity was determined using the Index of Orthodontic Treatment Need (IOTN). Group differences were analyzed with Chi-square and Mann-Whitney U tests. Associations were examined using Spearman's correlations, and moderation/mediation analyses were performed with Hayes' PROCESS macro (α = 0.05).</p><p><strong>Results: </strong>Nearly all participants (94.9%) demonstrated definite orthodontic treatment need. TMDs were present in 49.6% of the cohort, with adults showing greater symptom severity and somatic burden. Malocclusion severity exhibited negligible correlations with OHRQoL, whereas TMD burden was moderately associated with impaired OHRQoL across age groups. Mediation analyses showed that oral behaviors, somatic symptoms, and psychological distress mediated the impact of TMD burden on OHRQoL, with age-specific moderation effects. In adolescents, mediation effects were consistently weakened by moderation. In adults, oral behaviors and somatic symptoms mediated without moderation, while psychological distress showed weakened mediation.</p><p><strong>Limitations: </strong>Cross-sectional design precluded causal inference, restricting interpretation to associations.</p><p><strong>Conclusions: </strong>Malocclusion severity did not directly impair OHRQoL in orthodontic patients. Instead, TMD burden affected OHRQoL primarily through psychosocial pathways, underscoring the need for integrated biopsychosocial screening in orthodontic care.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of resin infiltration for white spot lesions at different time points: a systematic review and meta-analysis.","authors":"Laura Ståhl, Spyridon N Papageorgiou, Anna Westerlund, Julia Naoumova","doi":"10.1093/ejo/cjag021","DOIUrl":"10.1093/ejo/cjag021","url":null,"abstract":"<p><strong>Background: </strong>White spot lesions (WSLs) are a common clinical finding with implications for both individuals and society. Several treatment approaches have been proposed, among which resin infiltration (RI) has emerged as a promising option.</p><p><strong>Objective: </strong>Investigate clinical and patient-reported outcomes of RI on WSLs at different time points.</p><p><strong>Search methods: </strong>Unrestricted literature searches were conducted in six databases for human studies until September 2025.</p><p><strong>Selection criteria: </strong>Randomized and non-randomized clinical studies on patients with WSLs on at least one anterior tooth treated with RI assessing different clinical- and patient-reported outcomes with a minimum patient follow-up of 3 months.</p><p><strong>Data collection and analysis: </strong>Study selection, data extraction, and risk of bias assessment were performed in duplicate. Random-effects meta-analyses of pooled average changes between post-treatment and follow-up time points with their corresponding 95% confidence interval (CI) were performed, followed by sensitivity analyses.</p><p><strong>Results: </strong>Thirty-four reports pertaining to 29 studies were included covering 544 patients (ages 7-40 years; 44% male on average) and 1495 teeth with WSLs. The risk of bias assessment revealed concerns mainly due to the small sample sizes, short follow-up periods, absence of blinded measurements, and lack of analysis of confounding factors or within-patient clustering. For most outcomes, RI showed inconsistent and heterogeneous effects. In the largest meta-analysis (six studies) comparing the standardized color difference (ΔE) between WSL and sound adjacent enamel from post-treatment to 6 months, the pooled average change was 0 (95% CI -0.42 to 0.41; P = .98), with high heterogeneity (I2 = 84%). A small meta-analysis showed significant improvements in patient satisfaction through a Visual Analogue Scale from post-treatment to 1 month (two studies; +11.9 mm; 95% CI +5.9 to +17.8 mm; P = .02), which diminished to non-significant levels at the 3 (P = .09), 6 (P = .20) and 12 months (P = .94). Twelve months post-treatment, no significant differences were seen for ΔΕ, fluorescence, patient satisfaction, or WSL area (P > .05).</p><p><strong>Limitations: </strong>Among the included studies, high between-study heterogeneity was observed for most outcome measures, while most studies featured small sample sizes and short follow-up times.</p><p><strong>Conclusions: </strong>RI for WSLs shows highly inconsistent effects, compounded by limited follow-ups, highlighting the need for larger and standardized studies with extended follow-up to better evaluate treatment outcomes of resin-infiltrated WSLs.</p><p><strong>Registration: </strong>PROSPERO CRD42024611702.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}