The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis

  • Wang, Jiangwei (School of Clinical Stomatology, Tianjin Medical University) ;
  • Yang, Yingying (School of Clinical Stomatology, Tianjin Medical University) ;
  • Wang, Yingxue (School of Clinical Stomatology, Tianjin Medical University) ;
  • Zhang, Lu (Department of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University) ;
  • Ji, Wei (Department of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University) ;
  • Hong, Zheng (Department of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University) ;
  • Zhang, Linkun (Department of Orthodontic, Tianjin Stomatological Hospital, School of Medicine, Nankai University)
  • Received : 2021.10.12
  • Accepted : 2022.03.11
  • Published : 2022.09.25
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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

Acknowledgement

This work was funded by Tianjin Key Medical Discipline (Specialty) Construction Project, and supported by the 13th Five Years Clinical Key Disciplines of Tianjin (grant number, ZDPY-12), and the Tianjin Health Science and Technology Project (grant number, ZC20146).

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