Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

762 questions · 830 findings · 43 reviews · Orthodontics

No studies found 186 · 22.4%GRADE not reported 410 · 49.4%Very low 122 · 14.7%Low 79 · 9.5%Moderate 30 · 3.6%High 3 · 0.4%

Copper nickel-titanium archwire vs Nickel-titanium archwire

Amount of crowding · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether copper nickel-titanium archwire changes amount of crowding (Little's Irregularity Index) at 12 weeks compared with nickel-titanium archwire (very low certainty).

1 finding from 1 review

Quad-helix plus multi-bracket appliance vs Expansion arch plus multi-bracket appliance

Canine expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Quad-helix plus multi-bracket appliance showed no clear difference in canine expansion compared with expansion arch plus multi-bracket appliance; GRADE not reported.

1 finding from 1 review

Fixed tooth-borne expansion (quad-helix) vs observation

Molar expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed tooth-borne expansion (quad-helix) probably leads to higher molar expansion (inter-molar distance) compared with observation (no treatment) (moderate certainty).

1 finding from 1 review

Schwarz appliance vs No active treatment (control)

Amount of crowding (change in mandibular crowding) at 8 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether schwarz appliance changes amount of crowding (lower arch crowding, change) at 9 months compared with no active treatment (control) (very low certainty).

1 finding from 1 review

Fixed tooth-borne expansion (Hyrax) vs Fixed tooth-tissue-borne expansion (Haas)

Molar expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed tooth-borne expansion (Hyrax) showed no clear difference in molar expansion (inter-molar distance) compared with fixed tooth-tissue-borne expansion (Haas) (moderate certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

White spot lesions (WSLs), tooth level · Adults undergoing orthodontic treatment

A single study reported a lower risk of white spot lesions (tooth level) with aligners versus fixed appliances in adults at 3 months (RR 0.72, 95% CI 0.60 to 0.86; ungraded).

1 finding from 1 review

Extraction of the primary (baby) canine (single primary tooth extraction) vs No extraction (non-intervention control)

Time taken for the canine to erupt into the mouth · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)

The review found no eligible studies for this question.

1 finding from 1 review

Fixed tooth-borne expansion (Hyrax) vs observation

Crossbite correction · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed tooth-borne expansion (Hyrax) probably leads to higher crossbite correction compared with observation (no treatment) (moderate certainty).

1 finding from 1 review

Fixed tooth-borne expansion (Hyrax) vs Bonded Hyrax (tooth/tissue-borne)

Molar expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…
1 finding from 1 review
  • Orthodontic treatment for posterior crossbites 2021 · Cochrane All outcomes
    3 months after completion of expansion
    Asanza 1997: banded 6 mm (min 4.3-max 7.2) vs bonded 5.9 mm (min 3.2-max 7.7); P=NS (no SD reported); no significant difference in tipping or symmetrical expansion
    1 study
    GRADE not reported

Double primary (canine and first molar) tooth extraction vs Single primary (canine) tooth extraction

Number of participants referred for surgical exposure of the PDC · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)

It is very uncertain whether double primary (canine and first molar) tooth extraction changes number of participants referred for surgical exposure of the PDC compared with single primary (canine) tooth extraction (very low certainty).

1 finding from 1 review

Nickel-titanium archwire vs Multistranded stainless steel archwire

Amount of crowding (change in mandibular crowding) at 8 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether nickel-titanium archwire changes amount of crowding (change in mandibular crowding) at 8 weeks compared with multistranded stainless steel archwire (very low certainty).

1 finding from 1 review

Fixed bonded acrylic splint expander vs no treatment

Canine expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed bonded acrylic splint expander showed no clear difference in canine expansion (maxillary intercanine width) compared with no treatment; GRADE not reported.

1 finding from 1 review

Fixed tooth-borne expansion (quad-helix) vs Removable tooth-borne expansion (expansion plate)

Molar expansion · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

Fixed tooth-borne expansion (quad-helix) leads to higher molar expansion (inter-molar distance) compared with removable tooth-borne expansion (expansion plate) (high certainty).

1 finding from 1 review

Extraction of the primary (baby) canine (single primary tooth extraction) vs No extraction (non-intervention control)

Incidence of eruption of the PDC into the mouth · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)

It is very uncertain whether extraction of the primary (baby) canine (single primary tooth… changes incidence of eruption of the PDC into the mouth compared with no extraction (non-intervention control) (very low certainty).

1 finding from 1 review

Self-ligating brackets vs Conventional brackets

Time to alignment · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Self-ligating brackets showed no clear difference in time to alignment (days) compared with conventional brackets; GRADE not reported.

1 finding from 1 review

Cervical pull headgear vs Minor interceptive procedures (control)

Position of the incisors (upper incisor inclination) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Cervical pull headgear led to higher upper incisors to maxilla at 2 years compared with minor interceptive procedures (control); GRADE not reported.

1 finding from 1 review

Resin infiltration vs Fluoride varnish

Optical/esthetic improvement (DIAGNOdent reading) · Patients (mainly children) with white spot lesions (WSL)

Resin infiltration produced significantly greater optical improvement than fluoride varnish (MD 4.76, 95% CI 0.74 to 8.78; moderate certainty).

3 findings from 1 review