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Table 3 Characteristics of studies included in systematic review

From: Effect of molar intrusion with temporary anchorage devices in patients with anterior open bite: a systematic review

Author and year of publication Sample size and age Comparison Study design Method measurement Study materials Treatment time Force applied Reduction of open bite Effect on mandibular autorotation Effect on facial morphology Outcomes assessed Side effects Author’s conclusion
Sugawara et al. (2002) [22] SAS (9) (13.3 to 28.9 yrs) Pre- and post-, one group only (miniplates) R, CS Lateral cephalometric analysis, panoramic analysis, dental cast analysis SAS miniplate (L shaped) in lower molars only SAS 14.9 mo (9 to 22 mo) follow-up 12 mo Not declared ↑ overbite by 4.9 mm ↓ overbite 0.9 mm after 1 yrs follow-up Counterclockwise rotation ↓ FH/MP by 1.3° ↑ FH/MP by 0.4° after 1 yrs follow-up ↓ALFH, ↓ interlabial gap and improve AP jaw relation. Stable profile after 1 yrs follow-up. Overbite MP/FH LAFH U6-PP L6-MP 27.2 % rate of relapse in the 1st molars and 30.3 % in the 2nd molars. SAS is effective for open bite treatment; overcorrection is necessary.
Deguchi et al. (2011) [23] G1: non-IA (15) 22.9 yrs; G2: IA (15) 25.7 yrs Two-group comparison (non-implant anterior elastics and HPHG with MEAW vs. implant group) R, L, CT Lateral cephalometric analysis, cast analysis PAR and DI scores G1: non-implant group (HPHG, MEAW, or accentuated COS with elastics); G2: implant group (sectional wire in upper and lower posterior segment) G1: non- IA 1–3 yrs; G2: IA 1–3 yrs 2 yrs follow-up Not declared G1: ↑ OB by 6.5 mm ↓ 0.5 mm after 2 yrs G2: ↑ OB by 6.2 mm ↓ 0.8 mm after 2 yrs G1: ↑ MP/SN by 2.7° clockwise rotation, ↑ 0.3 mm after 2 yrs G2: ↓ MP/SN by 3.6° counterclockwise rotation, ↑1.6° after 2 yrs G1: ↑ AFH and ↓facial convexity, and ↓lips protrusion G2: ↓ AFH, more ↓ in facial convexity, and ↓ lips protrusion Disappearance of incompetent lips. Overbite MeGo/SN LAFH U6-PP L6-MP Less molar torque control, extrusion of lower molars. 1 patient in G1 and 2 patients in G2 showed relapse after 2 yrs. G2 showed more relapse than G1, overcorrection and myofunctional therapy is recommended. Keep screws longer time or use retainer with occlusal stops in mandible.
Buschang et al. (2011) [24] MSIs (9) 13.2 yrs Pre- and post-, one group only (miniscrews) P, CS Lateral cephalometric analysis MSIs miniscrew implants in upper posterior segment (with RPE) + buccal miniscrews in lower molars 1.9 yrs (1.4 to 2.5 yrs) 150 g per side Not declared ↓ MPA by 3.9° counterclockwise rotation Chin moved forward by 2.4 mm ↑ SNB, and ↓ facial convexity MPA Lower molar eruption. No stability information. Using MSIs for intrusion is effective, not painful or uncomfortable.
Akan et al. (2013) [25] Miniplate (19) 17.7 yrs Pre- and post-, one group only (miniplate + acrylic plate) P, CS Lateral cephalometric analysis PA radiograph EMG and EVG recording Surgical miniplates in upper posterior segment only 6.8 mo 400 g per side ↑Overbite by 4.79 mm ↓ Go Gn/SN by 3.79° counterclockwise rotation ↑ SNB, ↓ LAFH, ↓ AFH, ↓ facial convexity, and ↑upper lip/ E plane Overbite MP/FH GoGn/SN LAFH U6-HL L6-MP Insignificance tipping molars buccally. No stability information. Miniplate is successful Tx and has no effect on TMJ and masticatory muscles activity.
Xun et al. 2007 [26] Miniscrews (12) 18.7 yrs Pre- and post-, one group only (miniscrews) R, CS Lateral cephalometric analysis Midpalatal miniscrew in upper arch + buccal miniscrews in lower molars 6.8 mo 150 g per side ↑ overbite by 4.2 mm ↓Me Go/ SN by 2.3° counterclockwise rotation ↓ AFH, ↓ LAFH, and ↓ Ns-Sn-Pos improvement of convex profile. Overbite MMA MeGo/SN LAFH U6-PP L6-MP No stability information. Miniscrew provide stable, simple, and less invasive anchorage.
Erverdi et al. (2004) [27] Miniplate (10) 17-23 yrs Pre- and post-, one group only (miniplate) P, CS Lateral cephalometric analysis PA radiograph analysis Miniplate (I shaped) sectional wire in upper posterior segment only, (ext of upper 1st premolar in 6 P) 5.1 mo Not declared ↑ overbite by 3.7 mm ↓ Go Gn / SN by 1.7° counterclockwise rotation ↓ AFH, ↑ glabella-SN-pogonion. Improve smile and profile. Overbite MMA GoGn/SN U6-PP L6-MP Upper molars tipped buccally slightly, tissue inflammation and irritation of cheeks. No stability information. Minimal invasive and simple technique for intrusion, long-term follow-up required.
Erverdi et al. (2007) [28] Miniplate (11) 19.5 yrs Pre- and post-, one group only (miniplate + acrylic plate) P, L, CS Lateral cephalometric analysis Miniplate (I shaped) In upper posterior segment only 9.6 mo 1 yrs follow-up 400 g per side ↑ overbite by 5.1 mm ↓ Go Gn / SN by 3.0° counterclockwise rotation ↓ LAFH, ↑ SNB Overbite GoGn/SN LAFH U6-PP Minor edema, pain, and extrusion of lower molars. No relapse regarding rotation at 1 yrs follow-up, few cases showed extrusion 1 mm of upper molars. Therapy is effective. Longer follow-up required with large number of patients.
Scheffler et al. (2014) [29] Miniplates & miniscrews (30) (12.7 to 48.1 yrs) 24.1 yrs Pre- and post-, one group only (miniplate &miniscrew + acrylic plate) R, L, CS Lateral cephalometric analysis Miniscrews (16 P) or miniplates (14 P) in upper posterior segment only 3.6–9.6 mo for intrusion 6–33 mo total tx time 150 g per side ↑ Overbite by 2.2 mm ↓ Go Gn/SN by 1.2° counterclockwise rotation ↑ 0.2 at debonding No change at 1 and 2 yrs follow-up ↓ LAFH decrease LAFH by a fraction of a millimeter at 1 and 2 yrs follow-up Overbite GoGn/SN LAFH U6-PP L6-GoGn Extrusion of lower molars, elongation of upper and lower incisors. 15 and 22 % of the patients showed relapse (>1 mm) in overbite at 1 and 2 yrs follow-up, respectively. Control vertical position of mandibular molars. Some intrusion of maxillary canine is needed.
Foot et al. (2014) [14] SIS (16) (12.2 to 14.3 yrs) 13.1 yrs Pre- and post-, one group only (miniscrews + acrylic plate) P, CS Conebeam + lateral cephalometric analysis Sydney intrusion spring (SIS) in upper posterior segment only 4.91 mo (2.5 to 7.7 mo) 500 g per side ↑ Overbite by 3 mm ↓ MP/SN by 1.2° counterclockwise rotation ↓ LAFH, ↓ G’SnPo’ Overbite MP/FH MMA GoGn/SN LAFH U6-PP L6-MP Tissue irritation, difficulty in adaptation and maintaining of appliance. No stability information. Effective appliance for posterior teeth intrusion with minimal reactivation, and well tolerated by patients.
Kuroda et al. (2007) [10] G1: miniplate or miniscrew (10) G2: orthogna-thic surgery (13) (16-46 yrs) 21.6 yrs Two-group comparison (miniplate or miniscrew group vs. orthognathic surgery group) P, CT Lateral cephalometric analysis G1: TADs sectional wire in upper and lower posterior segment G2: LeFort 1 osteotomy and intraoral vertical ramus osteotomy or sagittal split ramus osteotomy G1: 27.6 mo (19–36 mo) G2: 33.5 mo (20–44 mo) G1: 150 gm G2: not declared G1: ↑ overbite by 6.8 mm G2: ↑ overbite by 7 mm G1: counterclock-wise rotation ↓ FH/MP by 3.3° G2: counterclock-wise rotation ↓ FH/MP by 0.3° G1: ↓ TAFH & LAFH better morphologic improvement than surgery G2: ↓TAFH, no change in LAFH Overbite MP/FH LAFH U6-PP L6-MP Elongation of incisors in orthognathic surgery group. No stability information. Molar intrusion by skeletal anchorage is simpler and cause more rotation of mandible than surgery.
Hart et al. (2015) [32] Palatal miniscrews (31) (11.6 to 55.5 yrs) 20.7 yrs Pre- and post- one group only (palatal miniscrews) (21 adolescent vs. 10 adult patients) R, CS Lateral cephalometric analysis Bilateral perimolar palatal miniscrews (25 p) and midpalatal miniimplants (6 p) in upper arch only (uses TPA + QH to control intermolar width) 1.3 yrs Not declared ↑ Overbite by 3.8 mm ↓ FH/MP by 1.1° counterclockwise rotation ↓ LAFH, ↓ AFH ↓ PFH decrease in skeletal class II features Overbite MP/FH LAFH U6-PP U6-BaH L6-MP Extrusion of lower first and second molars, distal tipping of maxillary 1st molars. No stability information. Miniscrews provide adequate anchorage for molar intrusion. Adolescent patients showed more favorable mandibular autorotation than adults. mandibular molar positions could be controlled by occlusal coverage with retainer, or full fixed appliance.
Lee HA, and Park YC. (2008) [31] Miniscrews (11) (18.2 to 31.1 yrs) 23.3 yrs Pre- and post- one group only (buccal miniscrews) P, L, CS Lateral cephalometric analysis Miniscrews with palatal rigid splint to prevent molar tipping sectional wire in upper posterior segment only. 5.4 mo Not declared ↑ Overbite by 5.47 mm ↓ 0.99 mm after 17.4 mo retention period Counterclockwise rotation ↓ Me Go/SN by 2.0° ↑ Me Go/SN 0.18° after 17.4-mo retention period ↓ AFH, pogonion moved 2.17 mm forward. Improve esthetic with muscle adaptation. ↑ AFH by 0.38 mm after 17.4 mo retention period. Overbite MeGo/SN MP/FH AFH U6-PP 10.36 % relapse rate for molar intrusion, and 18.10 % relapse rate for overbite after 17.4-mo retention period. Intrusion of maxillary posterior teeth by using miniscrews in adult patients is an effective method for open bite correction with good stability.
  1. Abbreviation: P prospective, R retrospective, CT clinical trial, CS case series, L longitudinal, ↑ increase, ↓ decrease, ext extraction, SAS skeletal anchorage device, COS curve of Spee, tx treatment, RPE rapid palatal expansion, PA posterior-anterior, mo months, yrs years, P patients, Me Menton, Go Gonion, Gn gnathion, SN Sella-Nasion, MP mandibular plane, FH Frakfurt horizontal, MPA mandibular plane angle, MMA maxillary mandibular angle, U6 upper first molar, PP palatal plane, HL horizontal line, BaH basion horizontal plane parallel to FH, TPA transpalatal arch, QH quad helix