Distalization of maxillary molars using temporary skeletal anchorage devices: A Systematic review and meta-analysis
Abstract
OBJECTIVES
The aim of this systematic review is to assess the treatment effects (amount of distalization, distal tipping, and vertical movement) of buccally versus palatally placed temporary skeletal anchorage devices (TSADs) on maxillary first molars during distalization.
MATERIALS AND METHODS
Medline and Scopus databases were searched up to September 2020 for randomized controlled trials (RCTs) and non-randomized prospective cohort studies on maxillary molar distalization using TSADs in patients with Class II malocclusion. After study selection, data extraction, and risk of bias assessment, meta-analyses were performed for the amount of distalization, distal tipping and intrusion of first molars.
RESULTS
Nine studies (2 RCTs and 7 prospective studies) were included. The risk of bias of the RCTs was low to unclear. The non-randomized studies were of moderate quality. In five studies, the TSADs were placed in the infrazygomatic process while in two studies, they were placed in the buccal interradicular spaces, and in two studies, they were placed in the midpalatal region. The first molar distalization was 2.75 mm when buccal interradicular TSADs were used, but 4.07 and 4.17 mm with palatal and infrazgomatic TSADs. The palatal appliances were associated with 11.17° of distal tipping of the first molar while infrazygomatic and buccal inter-radicular TSADs resulted in 3.99° and 1.70° of tipping, respectively.
CONCLUSIONS
Inter-radicular TSADs resulted in less distal tipping but…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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