Evaluation Of Dentoalveolar, Skeletal and Soft-Tissue Changes With FFA Including The Multibracket System: A Meta-analysis

Abstract

Objective: To assess skeletal, dentoalveolar, and soft-tissue effects of fixed functional appliances (FFAs), alone or in combination with multibracket appliances (comprehensive treatment), on Class II malocclusion in postpubertal patients. Data Sources: Literature survey was conducted using the Medline, SCOPUS, Latin American and Caribbean Health Sciences, and Scientific Electronic Library Online databases and the Cochrane Library, and through a manual search. No restrictions were set regarding the type of fixed appliance, treatment length, or to the cephalometric analysis used. Data extraction was mostly predefined at the protocol stage by 2 authors. Study Selection: Only double-blind randomized controlled trials (RCTs) of Class II skeletal cases treated by any FFA that had assessed specific skeletal, dental, or soft-tissue parameters were included. Data Synthesis: A total of 8 articles qualified for the final analysis. The studies were composed of late-adolescent or adult patients who were at the end of their postpubertal growth period. This meta-analysis included data from 271 subjects (142 Class II patients and 129 untreated individuals) and 8 RCTs, which assessed linear as well as angular cephalometric changes induced by Class II treatment with FFAs. Conclusions: Based on the data available on postpubertal patients, it was concluded that the fixed functional treatment is effective in Class II malocclusion and shows changes in skeletal, dental, as well as soft tissue.