Effectiveness of prefabricated myofunctional appliances in the treatment of Class II division 1 malocclusion: a systematic review
Abstract
BACKGROUND
Prefabricated myofunctional appliances (PMAs) are widely advocated for correcting Class II division I malocclusion. However, their effectiveness is associated with a high amount of uncertainty within contemporary literature.
OBJECTIVES
The aim of this review was to systematically examine the available literature regarding the effectiveness of PMAs in treating Class II division 1 malocclusion in children and adolescents.
SEARCH METHODS
Comprehensive unrestricted electronic searches in multiple databases as well as manual searches were conducted up to August 2018.
SELECTION CRITERIA
Randomized controlled trials (RCTs) and non-randomized studies (NRS) matching the eligibility criteria.
DATA COLLECTION AND ANALYSIS
Two independent review authors were directly involved in study selection, data extraction, and bias assessment. The Cochrane risk of bias tool and the ROBINS-I tool were used for assessing the risk of bias. Quantitative pooling of the data was undertaken with a random-effects model with its 95% confidence interval (CI).
RESULTS
Three RCTs comparing PMAs to activators and three NRS comparing PMAs to untreated controls met the inclusion criteria. On a short-term basis, exploratory quantitative synthesis indicated that the activators were more effective than the PMAs in correcting overjet with a mean difference of (1.1 mm; 95% CI: 0.44 to 1.77). On a long-term basis, there were no significant differences between the two appliances. Qualitative synthesis…
How strong is the evidence?
Evidence Hub reads this as a systematic review, 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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