Comparison of therapies of white spot lesions: a systematic review and network meta-analysis

The difference between 4 groups
1. self-assembled peptide (SAP) - P11-4
2. P11-4 + Fluoride Varnish (FV)
3.Resin Infiltration (RI)
4.Casein phosphor peptides-amorphous calcium fluoride phosphate (CPP-ACFP)
5.Control group was found to be statistically significant.

Compared to the 'FV' and 'casein phosphor peptides-amorphous calcium phosphate (CPP-ACP)' groups, the 'P11-4 + FV" group and 'RI" group made a significant difference.

The hierarchy was evident in the SUCRA values of 7 therapies. P11-4 + FV and RI were considered effective therapies compared to the control or FV groups (gold standard group).

Conclusions: The available evidence suggests that resin infiltration and P11-4 in combination with fluoride varnish had advantages over gold standard (FV). The effect of tricalcium phosphate-based drugs and fluoride is not very noticeable. Overall, drugs based on P11-4 and resin infiltration will be better therapies. Using more than two drugs in combination also would increase efficacy.