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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Oral Health 1/2015

Influence of orthodontic treatment with fixed appliances on enamel color: a systematic review

BMC Oral Health > Ausgabe 1/2015
Qiushuo Chen, Xicong Zheng, Weiting Chen, Zhenyu Ni, Yu Zhou
Wichtige Hinweise
Qiushuo Chen, Xicong Zheng, Weiting Chen, Zhenyu Ni and Yu Zhou contributed equally to this work.

Competing interests

The authors declare that they have no competing interests. There was no external support or funding source associated with this review.

Authors’ contributions

ZY and CQS designed the study, gathered the information, performed the statistical analysis and wrote the first draft of the manuscript. ZXC, CWT and NZY designed the form for data gathering and supervised the statistical analysis. All authors read and approved the final manuscript.



The purposes of this systematic review were to identify and review the orthodontic literature with regard to enamel color alterations after orthodontic treatment with fixed appliances. The effects of clean-up procedures on the surface of enamel were also investigated.


We searched the following electronic databases: Medline (1950 to 6 July 2014), EMBASE via OVID (1980 to 6 July 2014), Google Scholar, Web of Science (1950 to 6 July 2014), CENTRAL (The Cochrane Library, 2014, Issue 7). We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two authors were responsible for study selection, validity assessment, and data extraction.


Five studies met the inclusion criteria, including 3 randomized controlled trials and 2 prospective studies. Four trials were assessed as being unclear with regard to risk of bias. One was assessed as being at high risk of bias. The studies reviewed suggested that orthodontic treatment alters the original color of enamel, and both adhesive systems and resin-removal methods can contribute to this change.


There is no strong evidence from this review that orthodontic treatment with fixed appliances alters the original color of enamel. Further well-designed and conducted randomized controlled trials are required, to facilitate comparisons of results.
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