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)

Incidence of successfully erupted PDC that were favourably positioned · 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

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

Overall treatment time wearing orthodontic appliances · 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

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

Canine 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 5-month retention period
    Ugolini 2015: deciduous 4.2 mm vs permanent 3.3 mm; P<0.01 (more stable anterior expansion with deciduous anchorage)
    1 study
    GRADE not reported

Self-ligating brackets (Damon System) vs Fixed tooth-borne expansion (Hyrax)

Crossbite correction · 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
  • Nam 2020: Damon 41/41 vs Hyrax 41/41; NS (no difference in crossbite correction; greater transverse molar/premolar expansion with Hyrax)
    1 study · 82 participants
    GRADE not reported

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

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

Fluoride-releasing resin-based sealant vs Non-fluoride resin-based sealant

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

For resin-based sealants, fluoride release did not significantly change WSL initiation (RR 0.71, wide CI); subgroup not separately GRADE-rated.

1 finding from 1 review

Extraction of lower deciduous canines vs No active treatment (control)

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 extraction of lower deciduous canines changes amount of crowding (lower incisor crowding, change) at 1-2 years compared with no active treatment (control) (very low certainty).

1 finding from 1 review

Bonded Minne appliance (slow maxillary expansion) vs Banded Minne appliance (slow maxillary expansion)

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

Fixed tooth-bone-borne expansion vs Fixed tooth-borne expansion (Hyrax)

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-bone-borne expansion showed no clear difference in crossbite correction compared with fixed tooth-borne expansion (Hyrax) (low certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Full-mouth bleeding score (FMBS) · Adolescents/teenagers undergoing orthodontic treatment

A single study reported a lower full-mouth bleeding score with aligners versus fixed appliances in adolescents at 12 months (MD -20.44, 95% CI -22.98 to -17.90; ungraded).

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)

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

The additional use of a sealant probably reduces the initiation of white spot lesions during fixed orthodontic treatment compared with no sealant (RR 0.70), but the certainty of evidence is very low.

1 finding from 1 review

Lower lip bumper vs No active treatment (control)

Lower molars to mandible (relationship of lower back teeth to the mandible) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Lower lip bumper led to lower lower molars to mandible at 6 months compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Vibrational appliance with fixed appliances vs Fixed appliances

Harms (orthodontically-induced inflammatory root resorption) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
1 finding from 1 review
  • Orthodontic treatment for crowded teeth in children 2021 · Cochrane All outcomes
    end of alignment
    Using a vibrational appliance did not affect amount of root resorption vs control (Woodhouse 2015; 72 participants analysed). Narrative; no pooled estimate.
    1 study · 72 participants
    GRADE not reported

Self-ligating brackets vs Conventional brackets

Time for ligation (seconds, to ligate six brackets) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Self-ligating brackets led to lower time for ligation (seconds, to ligate six brackets) compared with conventional brackets; GRADE not reported.

1 finding from 1 review

Bone-borne expansion vs Fixed tooth-borne expansion (Hyrax)

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

Bone-borne expansion showed no clear difference in molar expansion (inter-molar distance) compared with fixed tooth-borne expansion (Hyrax) (low certainty).

1 finding from 1 review

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

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 fluoride-vs-non-fluoride studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Fixed bonded Hyrax appliance followed by U-bow activator therapy vs no treatment

Molar 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 molar 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 5.1 mm vs untreated 0.8 mm; P<0.001 (no SD reported); significant in favour of treatment
    1 study · 66 participants
    GRADE not reported

Semi-rapid maxillary expansion vs Rapid maxillary expansion

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

Semi-rapid maxillary expansion showed no clear difference in canine expansion compared with rapid maxillary expansion; GRADE not reported.

1 finding from 1 review

Lacebacks with fixed appliances vs Fixed appliances

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 lacebacks with fixed appliances changes amount of crowding (change) at 6 months compared with fixed appliances only (control) (very low certainty).

1 finding from 1 review