Of all the treatments for incipient caries lesions during orthodontic treatment, agents with fluoride including varnish have the highest level of evidence. Multiple laboratory and clinical studies have demonstrated its efficacy. Highly-filled resin sealers like Pro-seal are relatively new, although the results from a few in vitro studies have demonstrated impressive results. On the other hand, a clinical study on its demineralization prevention has not yet surfaced. At this juncture, the evidence level for ACP products like CPP-ACP paste or ACP resin bonding cement is low. There is a clear need for more independent research of casein derivatives like CPP-ACP to make conclusions about its efficacy in caries prevention.
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