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%

Facemask vs no intervention

Self-esteem (Piers-Harris self-concept scale) · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Facemask showed no clear difference in self-esteem (Piers-Harris self-concept scale) compared with untreated control (no treatment); GRADE not reported.

3 findings from 1 review

Facemask with rapid maxillary expansion (RME) vs Facemask with alternating rapid maxillary expansion and constriction (Alt-RAMEC)

ANB · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Facemask with rapid maxillary expansion (RME) showed no clear difference in ANB compared with facemask with alternating rapid maxillary expansion and constriction… (low certainty).

1 finding from 1 review

Antibacterial S. mutans reduction only in Farzanegan (chitosan+TiO2); Mollabashi (TiO2-only) showed no significant antibacterial effect - not attributable to TiO2 alone vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Streptococcus mutans count · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

The antibacterial (S. mutans) effect of TiO2 nanoparticles was conflicting across two RCTs (ungraded).

1 finding from 1 review

Light-cured resin-modified glass ionomer cement vs Resin adhesive

First-time bracket failure · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Resin-modified glass ionomer cement showed no difference in first-time bracket failure, with certainty not graded.

1 finding from 1 review

Chin cup (600 g force) vs Chin cup (300 g force)

Wits appraisal · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Chin cup (600 g force) showed no clear difference in wits appraisal compared with chin cup (300 g force); GRADE not reported.

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of tooth surfaces developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 15% of tooth surfaces developed new ICLs during fixed orthodontic treatment (pooled 0.15, 95% CI 0.08-0.26; very low certainty; extreme heterogeneity).

1 finding from 1 review

Hybrid Hyrax (RME) with miniscrews and Class III elastics vs Conventional Hyrax (RME) with miniscrews and Class III elastics

Overjet · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Hybrid Hyrax (RME) with miniscrews and Class III elastics showed no clear difference in overjet compared with conventional Hyrax (RME) with miniscrews and Class III elastics; GRADE not reported.

1 finding from 1 review

Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional ceramic brackets

Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Adhesive precoated flash-free brackets showed no demineralization difference, with certainty not graded.

1 finding from 1 review

Transbond XT with 1% chitosan and 1% TiO2 nanoparticles vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Chitosan and TiO2 adhesive reduced S. mutans counts, with certainty not graded.

1 finding from 1 review

Facemask with rapid maxillary expansion (RME) vs Mini maxillary protractor

Overjet · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Facemask with rapid maxillary expansion (RME) showed no clear difference in overjet compared with mini maxillary protractor; GRADE not reported.

1 finding from 1 review

Facemask (RME) or modified facemask vs Other non-surgical orthodontic treatments (mini maxillary protractor, Pushing Splints, modified tandem, Reverse Forsus, reverse Twin Block, reverse chin cup, tongue appliance, Frankel III)

ANB · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

It is very uncertain whether facemask (RME) or modified facemask changes ANB compared with other non-surgical orthodontic treatments (mini maxillary… (very low certainty).

1 finding from 1 review

TiO2-modified composite (1 wt.%) vs Control composite in contralateral quadrant

Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

TiO2-modified composite showed no S. mutans difference, with certainty not graded.

1 finding from 1 review

Facemask (RME) or modified facemask vs Surgically-anchored appliance (miniscrews or miniplates)

Overjet · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

It is very uncertain whether facemask (RME) or modified facemask changes overjet compared with surgically-anchored appliance (miniscrews or miniplates) (very low certainty).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs prevalence · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

ICLs prevalence increased with longer orthodontic treatment duration (meta-regression P=.01; ungraded).

1 finding from 1 review

Facemask with rapid maxillary expansion (RME) vs Facemask with alternating rapid maxillary expansion and constriction (Alt-RAMEC)

Overjet · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

The review found no eligible studies for this question.

1 finding from 1 review

Clearfil Protect Bond antibacterial fluoride-releasing primer vs Conventional Transbond XT primer

White spot lesion incidence · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Clearfil Protect Bond showed no difference in WSL incidence, with certainty not graded.

1 finding from 1 review