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The Angle Orthodontist Mar 2021To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion.
MATERIALS AND METHODS
Through a predefined search strategy, electronic searching was conducted in PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, and SIGLE with no language restrictions. Eligible study selection, data extraction, and evaluation of risk of bias (Cochrane Collaboration tool) were conducted by two authors independently and in duplicate. Any disagreement was solved by discussion or judged by a third reviewer. Statistical pooling, sensitivity analysis, subgroup analysis, and assessment of small-study effects were conducted by using Comprehensive Meta-Analysis and Stata 12.0. Heterogeneity was analyzed for different types of study designs, TADs, and radiographic examinations.
RESULTS
Electronic search yielded a total of 256 studies after removing duplicates. Among them, six studies were finally included. All articles were of high quality. The pooled mean differences were -0.27 (95% confidence interval [CI]: -0.59, 0.05) for SNA, 0.58 (95% CI: -0.07, 1.23) for SNB, -0.86 (95% CI: -1.74, -0.03) for ANB, 1.63 (95% CI: 0.46, 2.80) for Co-Po, 0.75 (95% CI: 0.28, 1.23) for SN-MP, -7.56 (95% CI: -11.37, -3.76) for L1-MP, 0.47 (95% CI: -0.98, 1.91) for overjet, 0.39 (95% CI: -0.57, 1.35) for overbite, -1.84 (95% CI: -5.15, 1.47) for SN-OP, and 4.97 (95% CI: -1.22, 11.17) for nasolabial angle.
CONCLUSIONS
TADs (especially miniplates) were able to eliminate dental adverse effects of Forsus appliances for correction of skeletal Class II malocclusion.
Topics: Humans; Malocclusion, Angle Class II; Mandible; Orthodontic Appliances, Functional; Orthodontics, Corrective; Overbite
PubMed: 33378419
DOI: 10.2319/051120-421.1 -
BMC Oral Health Jan 2024The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two pistons the patient cannot remove. The so-called bite-jumping keeps the mandible in a more anterior position for a variable period, usually at least 6 months. This appliance does not inhibit joint functions and movements, although there are scientific papers in the literature investigating whether this appliance can lead to temporomandibular disorders. This systematic review aims to evaluate whether Herbst's device can cause temporomandibular diseases by assessing the presence of TMD in patients before and after treatment.
METHODS
A literature search up to 3 May 2023 was carried out on three online databases: PubMed, Scopus and Web of Science. Only studies that evaluated patients with Helkimo scores and Manual functional analysis were considered, as studies that assessed the difference in TMD before and after Herbst therapy. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (pre and post-Herbst).
RESULTS
The included papers in this review were 60. Fifty-seven were excluded. In addition, a manual search was performed. After the search phase, four articles were considered in the study, one of which was found through a manual search. The overall effect showed that there was no difference in TMD prevalence between pre-Herbst and post-Herbst therapy (OR 0.74; 95% CI: 0.33-1.68).
CONCLUSION
Herbst appliance seems not to lead to an increase in the incidence of TMD in treated patients; on the contrary, it appears to decrease it. Further studies are needed to assess the possible influence of Herbst on TMDs.
Topics: Humans; Prevalence; Cephalometry; Orthodontic Appliances, Functional; Malocclusion, Angle Class II; Temporomandibular Joint Disorders
PubMed: 38281907
DOI: 10.1186/s12903-023-03738-w -
Journal of Orthodontics Dec 2019To assess the treatment efficacy/efficiency with prefabricated myofunctional appliances (PMA) for children with malocclusion. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the treatment efficacy/efficiency with prefabricated myofunctional appliances (PMA) for children with malocclusion.
DATA SOURCES
Nine databases searched without limitations till July 2019.
DATA SELECTION
Randomised trials comparing PMAs to functional appliance treatment or no treatment.
DATA EXTRACTION
Study selection, data extraction and risk of bias assessment were done in duplicate.
DATA SYNTHESIS
Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted on seven publications (three published and one unpublished trials; 232 patients; 53% male; mean age 10.2 years). Compared to no treatment, one trial indicated that PMAs were somewhat effective in reducing overjet (MD -2.4; 95% CI -3.3 to -1.5), reducing overbite (MD -2.5; 95% CI -3.2 to -1.8), reducing mandibular crowding (RR 0.4; 95% CI 0.2-0.8) and establishing Class I canine relationship (RR = 2.3; 95% CI 1.1-4.9). However, compared to custom-made functional appliances, three trials indicated that PMAs were less effective in reducing the ANB angle (MD 0.9; 95% CI 0.5-1.4), increasing mandibular ramus length (MD -2.2; 95% CI -2.9 to -1.51), reducing overjet (MD 1.5; 95% CI 0.9-2.1), establishing a solid Class I molar relationship (RR 0.3; 95% CI 0.2-0.7), reducing the nasolabial angle (MD 5.8; 95% CI 0.8-10.8) and reducing facial convexity (MD -2.6; 95% CI -4.3 to -0.9). Finally, the quality of evidence was moderate to low due to risk of bias.
CONCLUSIONS
PMAs are more effective in reducing overjet, overbite, mandibular crowding and establishing Class I canine relationship than no treatment. However, compared to custom-made functional appliances, PMAs are less effective in producing dental, skeletal or soft-tissue changes, even though they are less costly.
Topics: Child; Female; Humans; Male; Malocclusion, Angle Class II; Mandible; Myofunctional Therapy; Orthodontic Appliances, Fixed; Orthodontics, Corrective; Overbite; Randomized Controlled Trials as Topic
PubMed: 31597520
DOI: 10.1177/1465312519880558