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.

Background: Haptic simulation technologies are increasingly integrated into preclinical dental education to support procedural skill development. However, the extent to which haptic simulators improve performance compared to traditional phantom-head-based training remains unclear. Our goal is to systematically evaluate the effectiveness of haptic simulators in operative dentistry training, compared with conventional approaches. Methods: A systematic literature search was conducted in PubMed, Scopus, and Cochrane (2015–2025), complemented by manual searching, to identify studies evaluating virtual reality haptic simulators in preclinical operative dentistry education. The search strategy, structured according to the PICO framework, included preclinical undergraduate dental students, interventions with virtual reality haptic simulators, comparisons with conventional methods, and objective assessment of technical performance. Relevant data were extracted in a standardized manner, and the methodological quality of randomized controlled trials was assessed using RoB 2.0, while non-randomized studies were evaluated using ROBINS-I v2. Results: Of the 66 identified articles, 5 studies were included. The use of virtual reality simulators with haptic feedback in preclinical dental students was associated with increased efficiency in cavity preparation, reflected by reduced execution time and improved learning curves, as well as specific technical gains such as depth control. Overall cavity preparation quality was comparable to that achieved with conventional methods, with virtual reality being well accepted as an effective complementary tool in preclinical operative dentistry education. Conclusions: Haptic simulators appear effective for early preclinical skill development in operative dentistry and may complement traditional instruction. Evidence remains insufficient to confirm superiority over conventional methods or long-term clinical benefit. Higher-quality multicenter randomized trials with standardized performance measures are needed to strengthen the evidence base.

Background/Objectives: Oral health literacy (OHL) and oral health outcomes are socially patterned. This article proposes the Model of Stratified Oral Health Literacy (MELSO) to specify how educational resources and service conditions may shape the development and use of OHL. Methods: A narrative conceptual synthesis integrated health literacy theory, social determinants frameworks, and educational perspectives into five interrelated levels. No new participant data were collected or analysed. Results: MELSO links structural context, educational and cultural capital, functional, interactive, and critical OHL, self-management behaviours, and oral health outcomes. Its proposed added value is the joint specification of educational mediation, access-related moderation, and competency-specific associations within oral health. Five testable hypotheses and a staged strategy for measurement development and empirical evaluation are presented, including comparisons with simpler models. Conclusions: MELSO is a hypothesis-generating framework rather than a validated explanatory model or measurement instrument. Its utility depends on empirical evidence that the proposed relationships are distinguishable, reproducible, and informative beyond existing approaches.

White spot lesions (WSLs) are non-cavitated enamel lesions for which treatment success depends not only on initial lesion arrest or aesthetic improvement but also on long-term stability. This systematic review aimed to evaluate the long-term clinical, aesthetic, and remineralization outcomes of WSL treatments, with particular emphasis on treatment longevity and biomaterial-based approaches. A systematic search was conducted in PubMed, Scopus, and the Cochrane Library. Randomized controlled trials involving permanent teeth with ICDAS-assessed WSLs and a minimum follow-up of 12 months were eligible. Interventions included resin infiltration, fluoride-based therapies, remineralizing gels, casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) formulations, hydroxyapatite, self-assembling peptides, microabrasion, bleaching, and combined approaches. Risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool. Due to substantial clinical and methodological heterogeneity, a conventional pooled meta-analysis was not considered appropriate. Nine publications representing eight independent randomized controlled trials, with follow-up periods of 12–36 months, were included. Resin infiltration demonstrated the most consistent long-term aesthetic benefits and sustained reductions in visible WSL area. Non-invasive approaches, including fluoride-based therapies and remineralizing gels, generally improved outcomes from baseline; however, the additional benefits of specific formulations, including CPP-ACP/CPP-ACPF and fluoride-containing gels or varnishes, were inconsistent compared with conventional fluoride toothpaste. Limited quantitative comparisons favored resin infiltration over fluoride varnish, CPP-ACP, and fluoride toothpaste for lesion-area reduction. The certainty of evidence was low for aesthetic outcomes and very low to low for remineralization and lesion progression outcomes. Resin infiltration showed the most consistent long-term clinical and aesthetic benefits, maintained for up to 24 months. Non-invasive strategies may support lesion regression and remineralization, but their additional long-term benefits remain uncertain and appear dependent on formulation and treatment protocol. However, direct evidence of treatment durability was limited, as several trials assessed long-term effectiveness during continuous or repeated treatment rather than the maintenance of an initially achieved response. Recurrence and retreatment were inconsistently reported, and prevention of new WSLs represented a distinct clinical outcome. Further well-designed trials with standardized outcomes and longer follow-up are needed to establish the comparative effectiveness and longevity of biomaterial-based treatments for WSLs.