{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T03:08:19Z","timestamp":1774494499040,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Funds through FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["UID\/04279"],"award-info":[{"award-number":["UID\/04279"]}]},{"name":"National Funds through FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["CEECINST\/00137\/2018\/CP1520\/CT0022"],"award-info":[{"award-number":["CEECINST\/00137\/2018\/CP1520\/CT0022"]}]},{"name":"UCP and FCT as well for the CEEC institutional","award":["UID\/04279"],"award-info":[{"award-number":["UID\/04279"]}]},{"name":"UCP and FCT as well for the CEEC institutional","award":["CEECINST\/00137\/2018\/CP1520\/CT0022"],"award-info":[{"award-number":["CEECINST\/00137\/2018\/CP1520\/CT0022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gels"],"abstract":"<jats:p>White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability.<\/jats:p>","DOI":"10.3390\/gels11050371","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T06:31:29Z","timestamp":1747636289000},"page":"371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["White Spot Lesion Treatment Options: A Systematic Review of Different Techniques for Masking These Lesions"],"prefix":"10.3390","volume":"11","author":[{"given":"Michela","family":"Lamorgese","sequence":"first","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6288-0435","authenticated-orcid":false,"given":"N\u00e9lio","family":"Veiga","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"},{"name":"Center for Interdisciplinary Research in Health, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6141-9089","authenticated-orcid":false,"given":"Maria J.","family":"Correia","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"},{"name":"Center for Interdisciplinary Research in Health, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3201-0081","authenticated-orcid":false,"given":"Ana T. P. C.","family":"Gomes","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"},{"name":"Center for Interdisciplinary Research in Health, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]},{"given":"Sara","family":"Lopes","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5521-8168","authenticated-orcid":false,"given":"L\u00edgia","family":"Lopes-Rocha","sequence":"additional","affiliation":[{"name":"UNIPRO\u2014Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal"},{"name":"Department of Dental Sciences, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Polit\u00e9cnico e Universit\u00e1rio (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal"}]},{"given":"Rita","family":"Fidalgo-Pereira","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"},{"name":"Center for Interdisciplinary Research in Health, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-9216","authenticated-orcid":false,"given":"Pedro C.","family":"Lopes","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"},{"name":"Center for Interdisciplinary Research in Health, Universidade Cat\u00f3lica Portuguesa, 3504-505 Viseu, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Xie, Z., Yu, L., Li, S., Li, J., and Liu, Y. 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