Resin Infiltration for Masking Post-Orthodontic White Spot Lesions: A Systematic Review and Meta-Analysis

BackgroundWhite spot lesions (WSLs) affect up to 95% of patients after fixed orthodontic treatment. These demineralized areas harm aesthetics and may become more visible after tooth bleaching. Resin infiltration offers a micro-invasive masking technique. ObjectiveTo systematically review and meta-analyze the efficacy of resin infiltration for masking post-orthodontic white spot lesions compared with no treatment, placebo, or alternative remineralizing agents. MethodsWe followed PRISMA 2020 guidelines. We searched electronic databases (PubMed Central, Google Scholar, CORE, Epistemonikos, DOAJ) from inception to April 24, 2026, using database-specific search strings. We included randomized controlled trials (RCTs) and prospective clinical studies that evaluated resin infiltration for post-orthodontic WSLs in human participants. The primary outcome was change in lesion visibility. Two authors assessed risk of bias using Cochrane ROB-2 (RCTs) and ROBINS-I (non-randomized studies). We performed a random-effects meta-analysis using R (version 4.3.1; meta package) and estimated between-study variance ({tau}2) with the DerSimonian-Laird method. ResultsTen studies (6 RCTs, 4 prospective cohorts) with 1,204 patients and 3,847 WSLs met the inclusion criteria. Resin infiltration significantly reduced lesion visibility compared with no treatment (standardized mean difference [SMD] = -1.78; 95% CI: -2.24 to -1.32; p < 0.001; I2 = 65%) and compared with fluoride varnish (SMD = -1.42; 95% CI: -1.82 to -1.02; p < 0.001; I2 = 48%). The effect remained stable at 12-24 months. Patient satisfaction ranged from 84% to 94%. Mild transient sensitivity (11%) was the only reported adverse event. Funnel plot inspection showed no obvious small-study effects. ConclusionsResin infiltration shows high efficacy and durability for masking post-orthodontic white spot lesions, with a very large effect size. Clinicians should consider it the first-line minimally invasive aesthetic treatment before any tooth whitening procedure.