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KJO Korean Journal of Orthodontics

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Korean J Orthod   

First Published Date July 18, 2022

Copyright © The Korean Association of Orthodontists.

Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis

Jiangwei Wanga,b,c , Yingying Yanga,b,c, Yingxue Wanga,b,c, Lu Zhangb,c,d, Wei Jib,c,d, Zheng Hongb,c,d, Linkun Zhangb

aSchool of Clinical Stomatology, Tianjin Medical University, Tianjin, China
bDepartment of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
cTianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
dSchool of Medicine, Nankai University, Tianjin, China

Correspondence to:Linkun Zhang.
Professor, Department of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75 Dagu Road, Tianjin 300041, China.
Tel +86-022-59080683 e-mail linkunzhang@nankai.edu.cn

How to cite this article: Wang J, Yang Y, Wang Y, Zhang L, Ji W, Hong Z, Zhang L. Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis. Korean J Orthod. First published date July 18, 2022. https://doi.org/10.4041/kjod21.264

Received: October 12, 2021; Revised: February 14, 2022; Accepted: March 11, 2022

Abstract

Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

Keywords: Class III treatment, Evidence-based orthodontics, Bone implant contact, Early treatment

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Korean J Orthod   

First Published Date July 18, 2022

Copyright © The Korean Association of Orthodontists.

Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis

Jiangwei Wanga,b,c , Yingying Yanga,b,c, Yingxue Wanga,b,c, Lu Zhangb,c,d, Wei Jib,c,d, Zheng Hongb,c,d, Linkun Zhangb

aSchool of Clinical Stomatology, Tianjin Medical University, Tianjin, China
bDepartment of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
cTianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
dSchool of Medicine, Nankai University, Tianjin, China

Correspondence to:Linkun Zhang.
Professor, Department of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75 Dagu Road, Tianjin 300041, China.
Tel +86-022-59080683 e-mail linkunzhang@nankai.edu.cn

How to cite this article: Wang J, Yang Y, Wang Y, Zhang L, Ji W, Hong Z, Zhang L. Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis. Korean J Orthod. First published date July 18, 2022. https://doi.org/10.4041/kjod21.264

Received: October 12, 2021; Revised: February 14, 2022; Accepted: March 11, 2022

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

Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

Keywords: Class III treatment, Evidence-based orthodontics, Bone implant contact, Early treatment