Efficacy of selective enamel etching in reducing white spot lesions during fixed orthodontic treatment: A systematic review
https://doi.org/10.36377/ET-0209
Abstract
AIM. This systematic review aims to systematically assess the efficacy of selective enamel etching compared to conventional etching methods in reducing the incidence and severity of white spot lesions during fixed orthodontic therapy.
MATERIALS AND METHODS. A systematic literature search was performed following the PRISMA 2020 statement and was registered on PROSPERO (CRD420251026790). The databases PubMed, Scopus, Embase, and Google Scholar were searched for randomized controlled trials, split-mouth studies, and prospective cohorts up to 15 July 2025 that compared selective and conventional enamel etching in patients undergoing fixed orthodontic treatment. The primary outcomes included incidence, severity, and timing of white spot lesions during orthodontic treatment. The study quality was assessed using the JBI checklist.
RESULTS. Four studies, including 131 patients, fulfilled the inclusion criteria. All the included studies showed that selective etching decreased the early development of white spot lesions or delayed it for a period, especially in the first 3–6 months of orthodontic treatment. The long-term differences, however, were less pronounced at the end of the treatment. No adverse effects or an increased bond failure rate related to selective etching was reported.
CONCLUSIONS. Selective enamel etching offers an initial protective effect because it delays the development of white spot lesions in the early stages of orthodontic treatment. However, it is not known with certainty if selective enamel etching has a long-term benefit due to the limitation of evidence. Therefore, it must be considered an adjunctive preventive measure until confirmation is obtained from larger, standardized clinical trials.
About the Authors
A. Kharche
Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth (Deemed to be University)
India
Competing Interests:
India
Asmita Kharche – Department of Orthodontics and Dentofacial Orthopedics
Pimpri, Pune 411018, India
Competing Interests:
The authors declare no conflict of interests.
R. Gautam
Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth (Deemed to be University)
India
Competing Interests:
India
Rajaganesh Gautam – Department of Orthodontics and Dentofacial Orthopedics
Pimpri, Pune 411018, India
Competing Interests:
The authors declare no conflict of interests.
S. R. Patil
Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth (Deemed to be University)
India
Competing Interests:
India
Santosh R. Patil – Department of Dental Research Cell
Pimpri, Pune 411018, India
Competing Interests:
The authors declare no conflict of interests.
A. Mathur
Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth (Deemed to be University)
India
Competing Interests:
India
Ankita Mathur – Department of Dental Research Cell
Pimpri, Pune 411018, India
Competing Interests:
The authors declare no conflict of interests.
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Review
For citations:
Kharche A., Gautam R., Patil S.R., Mathur A. Efficacy of selective enamel etching in reducing white spot lesions during fixed orthodontic treatment: A systematic review. Endodontics Today. https://doi.org/10.36377/ET-0209
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