Abstract Background White spot lesions (WSLs) are a common clinical finding with implications for both individuals and society. Several treatment approaches have been proposed, among which resin infiltration (RI) has emerged as a promising option. Objective Investigate clinical and patient-reported outcomes of RI on WSLs at different time points. Search methods Unrestricted literature searches were conducted in six databases for human studies until September 2025. Selection criteria Randomized and non-randomized clinical studies on patients with WSLs on at least one anterior tooth treated with RI assessing different clinical- and patient-reported outcomes with a minimum patient follow-up of 3 months. Data collection and analysis Study selection, data extraction, and risk of bias assessment were performed in duplicate. Random-effects meta-analyses of pooled average changes between post-treatment and follow-up time points with their corresponding 95% confidence interval (CI) were performed, followed by sensitivity analyses. Results Thirty-four reports pertaining to 29 studies were included covering 544 patients (ages 7–40 years; 44% male on average) and 1495 teeth with WSLs. The risk of bias assessment revealed concerns mainly due to the small sample sizes, short follow-up periods, absence of blinded measurements, and lack of analysis of confounding factors or within-patient clustering. For most outcomes, RI showed inconsistent and heterogeneous effects. In the largest meta-analysis (six studies) comparing the standardized color difference (ΔE) between WSL and sound adjacent enamel from post-treatment to 6 months, the pooled average change was 0 (95% CI −0.42 to 0.41; P = .98), with high heterogeneity (I2 = 84%). A small meta-analysis showed significant improvements in patient satisfaction through a Visual Analogue Scale from post-treatment to 1 month (two studies; +11.9 mm; 95% CI +5.9 to +17.8 mm; P = .02), which diminished to non-significant levels at the 3 (P = .09), 6 (P = .20) and 12 months (P = .94). Twelve months post-treatment, no significant differences were seen for ΔΕ, fluorescence, patient satisfaction, or WSL area (P .05). Limitations Among the included studies, high between-study heterogeneity was observed for most outcome measures, while most studies featured small sample sizes and short follow-up times. Conclusions RI for WSLs shows highly inconsistent effects, compounded by limited follow-ups, highlighting the need for larger and standardized studies with extended follow-up to better evaluate treatment outcomes of resin-infiltrated WSLs. Registration PROSPERO CRD42024611702.
Ståhl et al. (Fri,) studied this question.