Table 3 Characteristics of studies included in systematic review

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.