Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis
Wang Jiangwei, Yang Yingying, Wang Yingxue, Zhang Lu, Ji Wei, Hong Zheng, Zhang Linkun,
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( Wang Jiangwei ) - Tianjin Medical University School of Clinical Stomatology
( Yang Yingying ) - Tianjin Medical University School of Clinical Stomatology
( Wang Yingxue ) - Tianjin Medical University School of Clinical Stomatology
( Zhang Lu ) - Nankai University School of Medicine Tianjin Stomatological Hospital Department of Orthodontic
( Ji Wei ) - Nankai University School of Medicine Tianjin Stomatological Hospital Department of Orthodontic
( Hong Zheng ) - Nankai University School of Medicine Tianjin Stomatological Hospital Department of Orthodontic
( Zhang Linkun ) - Nankai University School of Medicine Tianjin Stomatological Hospital Department of Orthodontic
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.
키워드
Class III treatment; Evidence-based orthodontics; Bone implant contact; Early treatment
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