Quad-helix compared with expansion plate for treatment of functional posterior cross bite | |
---|---|
Patient or population: patients in mixed dentition had functional posterior crossbite Intervention: quad-helix Comparison: expansion plate |
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
---|---|---|---|---|---|---|
Risk with expansion plate | Risk with quad-helix | |||||
Maxillary intermolar width—RCTs | MD 1.25 higher (0.75 higher to 1.75 higher) | – | 241 (4 RCTs) | ⨁⨁⨁◯ MODERATEa | The treatment by quad-helix increased the maxillary intermolar width by 1.25 mm with a statistically significant difference compared with expansion plate | |
Maxillary intermolar width—CCTs | MD 0.23 higher (0.99 lower to 1.45 higher) | – | 72 (2 CCTs) | ⨁◯◯◯ VERY LOWb,c,d | Quad-helix may increase/have little to no effect on maxillary intermolar width but the evidence is very uncertain | |
Maxillary intercanine width—RCTs | MD 0.42 higher (0.55 lower to 1.39 higher) | – | 241 (4 RCTs) | ⨁◯◯◯ VERY LOWa,c,e | The evidence suggests that quad-helix may increase the maxillary intercanine width slightly compared with expansion plate and the difference between both groups is non-significant | |
Maxillary intercanine width—CCTs | MD 0.45 higher (1.87 lower to 2.77 higher) | – | 72 (2 CCTs) | ⨁◯◯◯ VERY LOWb,c,e | The evidence suggests that quad-helix may increase/decrease the maxillary intercanine width slightly compared with expansion plate and the difference between both groups is non-significant | |
Mandibular intermolar width—RCTs | MD 0.3 lower (1.06 lower to 0.47 higher) | – | 131 (3 RCTs) | ⨁◯◯◯ VERY LOWa,c,f | Quad-helix may reduce/have little to no effect on mandibular intermolar width compared with expansion plate but the evidence is very uncertain | |
mandibular intermolar width—CCTs | MD 0.01 lower (0.28 lower to 0.25 higher) | – | 72 (2 CCTs) | ⨁◯◯◯ VERY LOWb,d,g | Quad-helix may reduce/have little to no effect on mandibular intermolar width compared with expansion plate but the evidence is very uncertain | |
Mandibular intercanine width—RCTs | MD 0.39 lower (0.86 lower to 0.09 higher) | – | 131 (3 RCTs) | ⨁◯◯◯ VERY LOWa,d,h | Quad-helix may have little to no effect on mandibular intercanine width compared with expansion plate but the evidence is very uncertain | |
Mandibular intercanine width—CCTs | MD 0.19 higher (0.13 lower to 0.5 higher) | – | 72 (2 CCTs) | ⨁◯◯◯ VERY LOWb,d,g | Quad-helix may have little to no effect on mandibular intercanine width but the evidence is very uncertain | |
Success rate—RCTs | 757 per 1,000 | 977 per 1000 (757 to 1000) | RR 1.29 (1.00 to 1.66) | 206 (3 RCTs) | ⨁⨁⨁◯ MODERATEh | The evidence suggests that quad-helix likely results in an increase in success rate compared with expansion plate and the difference between both groups is significant |
Success rate—CCTs | 1000 per 1000 | 1000 per 1000 (910 to 1000) | RR 1.00 (0.91 to 1.10) | 38 (1 CCT) | ⨁◯◯◯ VERY LOWb,i | The evidence is very uncertain about the effect of quad-helix compared with expansion plate on success rate |
Relapse at 1 year post-treatment | 91 per 1000 | 91 per 1000 (20 to 418) | RR 1.00 (0.22 to 4.60) | 66 (1 RCT) | ⨁⨁◯◯ LOWi | The evidence suggests that quad-helix results in no difference in relapse at 1 year post-treatment compared with expansion plate |
Relapse at 3 years post-treatment | 0 per 1000 | 0 per 1000 (0 to 0) | RR 2.29 (0.10 to 52.48) | 35 (1 RCT) | ⨁◯◯◯ VERY LOWa,j | The evidence is very uncertain about the effect of quad-helix and expansion plate on relapse at 3 years post-treatment |
Relapse at 5.6 years | 53 per 1000 | 158 per 1000 (18 to 1,000) | RR 3.00 (0.34 to 26.33) | 38 (1 CCT) | ⨁◯◯◯ VERY LOWb,j | Quad-helix may have little effect on relapse at 5.6 years compared with expansion plate but the evidence is very uncertain |
Treatment duration—RCTs | MD 3.36 lower (4.97 lower to 1.75 lower) | – | 206 (3 RCTs) | ⨁⨁⨁◯ MODERATEh | The evidence suggests that quad-helix probably results in a reduction in treatment duration compared with expansion plate | |
Treatment duration—CCTs | MD 4.8 lower (7.07 lower to 2.53 lower) | – | 38 (1 CCT) | ⨁◯◯◯ VERY LOWb,g | Quad-helix may reduce the treatment duration compared with expansion plate but the evidence is very uncertain | |
Mandibular midline correction | 644 per 1000 | 760 per 1000 (618 to 940) | RR 1.18 (0.96 to 1.46) | 122 (2 RCTs) | ⨁⨁⨁◯ MODERATEk | The evidence suggests that quad-helix may increase the midline correction rate compared with expansion plate but the difference between both groups is statistically non-significant |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) CI: Confidence interval; MD: Mean difference; RR: Risk ratio | ||||||
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |