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KJO Korean Journal of Orthodontics

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pISSN 2234-7518
eISSN 2005-372X
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Korean J Orthod

Published online November 18, 2021

Copyright © The Korean Association of Orthodontists.

Which anchorage device is the best during retraction of anterior teeth? An overview of systematic reviews

Yassir A. Yassira, Sarah A. Nabbatb, Grant T. McIntyrec, David R. Bearnd

a Assistant Professor, Orthodontic Department, College of Dentistry, University of Baghdad, Iraq. School of Dentistry, University of Dundee, UK
b Orthodontist, Ministry of Health, Baghdad, Iraq.
c Honorary Professor of Orthodontics. School of Dentistry, University of Dundee, UK
d Professor of Orthodontics. School of Dentistry, University of Dundee, UK

Correspondence to:Yassir A. Yassir, Orthodontic Department, College of Dentistry, University of Baghdad, Iraq.
E-mail: yassirkyassir@gmail.com
Phone number: +964 7703919599

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives: Toevaluate the available evidence regarding clinical effectiveness of different types of anchorage devices.
Methods: A comprehensive literature search was conducted for systematic reviews investigating different anchorage methods published up to 15th April, 2021. This was accomplished using different electronic databases. Any ongoing systematic reviews were searched using Prospero and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews.
Results: Fourteen systematic reviews were included (11 were of moderate/high-quality). Skeletal anchorage with miniscrews was found to be associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage is more effective in retracting anterior teeth and intruding incisors and molars resulting in minor vertical skeletal changes and improving the soft tissue profile. There was insufficient evidence for the preference of any anchorage methods in terms of duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when directly-loaded, when used in the mandible, buccally rather than palatally when used in the maxilla, when using dual rather than single miniscrews, for en-masse retraction, and for adults.
Conclusions: The level of evidence regarding anchorage effectiveness is moderate. Skeletal anchorage can be used with more anchorage preservation compared to conventional anchorage. Further high-quality randomized clinical trials are required to confirm these findings.

Keywords: Orthodontic Anchorage Procedures, Anchorage loss, Orthodontic mini-implant

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Korean J Orthod

Published online November 18, 2021

Copyright © The Korean Association of Orthodontists.

Which anchorage device is the best during retraction of anterior teeth? An overview of systematic reviews

Yassir A. Yassira, Sarah A. Nabbatb, Grant T. McIntyrec, David R. Bearnd

a Assistant Professor, Orthodontic Department, College of Dentistry, University of Baghdad, Iraq. School of Dentistry, University of Dundee, UK
b Orthodontist, Ministry of Health, Baghdad, Iraq.
c Honorary Professor of Orthodontics. School of Dentistry, University of Dundee, UK
d Professor of Orthodontics. School of Dentistry, University of Dundee, UK

Correspondence to:Yassir A. Yassir, Orthodontic Department, College of Dentistry, University of Baghdad, Iraq.
E-mail: yassirkyassir@gmail.com
Phone number: +964 7703919599

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives: Toevaluate the available evidence regarding clinical effectiveness of different types of anchorage devices.
Methods: A comprehensive literature search was conducted for systematic reviews investigating different anchorage methods published up to 15th April, 2021. This was accomplished using different electronic databases. Any ongoing systematic reviews were searched using Prospero and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews.
Results: Fourteen systematic reviews were included (11 were of moderate/high-quality). Skeletal anchorage with miniscrews was found to be associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage is more effective in retracting anterior teeth and intruding incisors and molars resulting in minor vertical skeletal changes and improving the soft tissue profile. There was insufficient evidence for the preference of any anchorage methods in terms of duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when directly-loaded, when used in the mandible, buccally rather than palatally when used in the maxilla, when using dual rather than single miniscrews, for en-masse retraction, and for adults.
Conclusions: The level of evidence regarding anchorage effectiveness is moderate. Skeletal anchorage can be used with more anchorage preservation compared to conventional anchorage. Further high-quality randomized clinical trials are required to confirm these findings.

Keywords: Orthodontic Anchorage Procedures, Anchorage loss, Orthodontic mini-implant