Abstract
Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching. The criteria for eligibility were: patients who had undergone orthodontic treatment with skeletal anchorage (miniplates and miniscrews). Patients with syndromes or craniofacial deformities or who had undergone maxillofacial surgery were excluded. The following variables were recorded for each article: author, year of publication, type of study, sample size, dropouts, demographic variables, treatment carried out, radiographic study (2D or 3D), follow-up time, and quality of the articles on the Newcastle-Ottawa Scale. The means and confidence intervals of the following variables were employed: Wits, overjet, ANB, SNA and SNB. Initially, 239 articles were identified. After removing the duplicates and applying the selection criteria, 9 were included in the qualitative synthesis and 7 in the quantitative synthesis (meta-analysis). It may be concluded that skeletal anchorage is an effective treatment for improving skeletal Class III malocclusion, but when compared with other traditional treatments such as disjunction and face mask, there is no clear evidence that skeletal anchorage improves the results.
Highlights
The incidence of skeletal class III malocclusion varies in different population types
The treatment can be a combination of orthodontics and surgery, or just orthodontic camouflage
The following variables were recorded for each article reviewed: author, year published, type of study, sample size, dropouts, demographic variables, inclusion and exclusion criteria, treatment used, type of radiographic study used (2D or 3D), follow-up time, quantitative or qualitative variables expressing the study results, and quality of the articles accepted
Summary
The incidence of skeletal class III malocclusion varies in different population types. It is around 5% in patients of Caucasian origin but between 9% and 19% in those of Asian descent. Effectiveness of skeletal anchorage in class III patients [1]. It can be caused by a retrognathic or hypoplastic maxilla, a prognathic mandible, or a combination of the two [2,3]. Orthopaedic treatment aims to reduce future therapeutic needs in the permanent dentition [4]. A number of authors have carried out orthopaedic treatment using skeletal anchorage [8,9,10]. It would appear that using miniplates and miniscrews achieves greater skeletal effects with a smaller dentoalveolar component than is the case with conventional orthopaedic appliances [11,12,13]
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