{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:24:51Z","timestamp":1791876291210,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dental fluorosis produces enamel opacities and discolorations that compromise esthetics and often require minimally invasive treatments. Although several modalities are available including microabrasion, bleaching, resin infiltration, and remineralization, their comparative performance remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate and rank the esthetic masking efficacy of minimally invasive treatments for dental fluorosis using a network meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and network meta\u2010analysis were conducted in accordance with PRISMA\u2010NMA. Seven controlled clinical studies (13 interventions; 555 participants) met eligibility criteria. Random\u2010effects network models were performed in R and independently replicated in MetaInsight. Treatment rankings were generated with SUCRA\/P\u2010scores, and certainty of evidence was assessed using CINeMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multimodal protocols combining microabrasion with in\u2010office bleaching achieved the highest esthetic performance across immediate, three\u2010month, and 6\u2010month evaluations. Microabrasion\u2009+\u2009in\u2010office bleaching (MAB\u2009+\u2009IOB) ranked first (highest SUCRA probability) and produced the largest \u0394\n                      <jats:italic>E<\/jats:italic>\n                      improvements, followed by MAB\u2009+\u2009IOB\u2009+\u2009CPP\u2010ACP and MAB\u2009+\u2009RI. Resin infiltration alone showed consistent, clinically meaningful effects and emerged as the most effective standalone technique. In contrast, microabrasion alone, CPP\u2010ACP, and sodium hypochlorite demonstrated modest or unstable changes. Cross\u2010platform triangulation between R and MetaInsight produced fully concordant effect estimates and identical treatment hierarchies. CINeMA indicated no major incoherence and moderate confidence for most comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined minimally invasive strategies, particularly MAB\u2009+\u2009IOB, with or without CPP\u2010ACP, provide the greatest and most durable esthetic masking of fluorosis\u2010related discoloration. Resin infiltration remains the strongest single\u2010modality option. Remineralization and oxidizing agents alone show limited effectiveness. These findings establish a clinically relevant hierarchy to guide conservative management of dental fluorosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>Sequential multimodal protocols integrating surface modification, bleaching, and resin\u2010based refractive adjustment maximize esthetic outcomes while preserving enamel, supporting their use as first\u2010line approaches for mild\u2010to\u2010moderate fluorosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO; registration number CRD420251234096<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70119","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:53:46Z","timestamp":1770026026000},"page":"1323-1337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Minimally Invasive Treatments for Dental Fluorosis: A Network Meta\u2010Analysis of Esthetic Masking Efficacy"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8571-4429","authenticated-orcid":false,"given":"Alain Manuel","family":"Chaple Gil","sequence":"first","affiliation":[{"name":"Universidad Aut\u00f3noma de Chile Facultad de Ciencias de la Salud  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8250-6931","authenticated-orcid":false,"given":"Laura","family":"Pereda V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Penn Dental Medicine University of Pennsylvania  Philadelphia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5935-9313","authenticated-orcid":false,"given":"Meylin","family":"Santiesteban Vel\u00e1zquez","sequence":"additional","affiliation":[{"name":"Universidad de Ciencias M\u00e9dicas de La Habana  La Habana Cuba"},{"name":"Universidad Aut\u00f3noma del Paraguay  Asunci\u00f3n Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7249-0541","authenticated-orcid":false,"given":"Jorge J.","family":"Menendez","sequence":"additional","affiliation":[{"name":"Nova Southeastern University College of Dental Medicine  Fort Lauderdale USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010024\u201004472\u20107"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.22592\/ode2024n43e334"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010021\u201003931\u20107"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2024.105276"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.70028"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20102385"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-0716-1566-9_12"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2023.02.016"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010022\u201001631\u20108"},{"key":"e_1_2_10_11_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions. 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