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%

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

Any other adverse effects of the interventions, such as gingival disease and demineralisation · 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

Coaxial nickel-titanium archwire vs Nickel-titanium archwire

Amount of tooth movement / reduction in crowding at 12 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether coaxial nickel-titanium archwire changes amount of tooth movement / reduction in crowding at 12 weeks compared with nickel-titanium archwire (very low certainty).

1 finding from 1 review

Sealant/coating agent WITHOUT fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Among non-fluoride sealants, WSL initiation was significantly reduced versus no sealant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Fixed bonded Hyrax appliance followed by U-bow activator therapy 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 Hyrax appliance followed by U-bow activator therapy showed no clear difference in canine expansion compared with no treatment; GRADE not reported.

1 finding from 1 review
  • Orthodontic treatment for posterior crossbites 2021 · Cochrane All outcomes
    12 months after start of treatment
    U-bow activator 3.6 mm vs untreated 1 mm; P<0.001 (no SD reported); significant in favour of treatment
    1 study · 66 participants
    GRADE not reported

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

Canine 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) may leads to higher canine expansion (inter-canine distance) compared with removable tooth-borne expansion (expansion plate) (low certainty).

1 finding from 1 review

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

Molar 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 molar expansion compared with expansion arch plus multi-bracket appliance; GRADE not reported.

1 finding from 1 review

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

Length of treatment · 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 lower length of treatment compared with removable tooth-borne expansion (expansion plate) (moderate certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Probing pocket depth (PPD/PD) · Adults undergoing orthodontic treatment

Aligners may reduce pocket depth compared with fixed appliances in adults at 6-12 weeks (MD -0.42 mm, 95% CI -0.71 to -0.12; very low certainty).

1 finding from 1 review

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

Stability of crossbite correction (relapse of 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
    12 months after correction
    Relapse occurred in 9.1% of both quad-helix and expansion plate groups after one year of follow-up (Godoy 2011)
    1 study · 66 participants
    GRADE not reported

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

White spot lesions (WSLs), patient level · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in white spot lesion formation (patient level) between aligners and fixed appliances in adolescents at 9 months (RR 0.33, 95% CI 0.10 to 1.04; ungraded).

1 finding from 1 review

Vibrational appliance with fixed appliances vs Fixed appliances

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

Vibrational appliance with fixed appliances showed no clear difference in time to alignment (days) compared with fixed appliances only / no vibrational appliance (control); GRADE not reported.

1 finding from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

White spot lesions were also measured by laser fluorescence in 3 sealant-vs-no-sealant studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Fluoride-releasing compomer bonding agent did not show a statistically significant reduction in new white spot lesions versus non-fluoride compomer bonding agent (very low certainty).

1 finding from 1 review

Haas expander anchored on deciduous second molars vs Haas expander anchored on permanent first molars

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

Hyrax with conventional expansion screw vs Hyrax with NiTi memory expansion screw

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
    after 6-month retention period
    Halicioglu 2014: conventional Hyrax 8.41 (SD 2.09) mm vs NiTi Hyrax 8.94 (SD 1.73) mm; no statistically significant differences for any outcome
    1 study
    GRADE not reported

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

S. mutans presence · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in S. mutans presence between aligners and fixed appliances in adolescents at 1 month (RR 0.86, 95% CI 0.64 to 1.14; ungraded).

1 finding from 1 review

Self-ligating brackets vs Conventional brackets

Amount of crowding (lower incisor crowding) at 10 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether self-ligating brackets changes amount of crowding (lower incisor crowding) at 10 weeks compared with conventional brackets (very low certainty).

1 finding from 1 review

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review