Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

371 questions · 390 findings · 17 reviews · Orthodontics

No studies found 88 · 22.6%GRADE not reported 203 · 52.1%Very low 38 · 9.7%Low 38 · 9.7%Moderate 20 · 5.1%High 3 · 0.8%

Eruption guidance appliance vs No active treatment (control)

Amount of crowding (number of children with crowding, mandible) after 1 year · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether eruption guidance appliance changes amount of crowding (number of children with crowding, mandible)… compared with no active treatment (control) (very low certainty).

1 finding from 1 review

Bone-borne expansion 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…
1 finding from 1 review
  • Orthodontic treatment for posterior crossbites 2021 · Cochrane All outcomes
    Adolescents
    Alberta 2010: bone-borne expansion corrected all posterior crossbites (21/21); no self-correction in the untreated group
    1 study
    GRADE not reported

Self-ligating brackets vs Conventional brackets

Lower incisor inclination (lingual tipping and retrusion) · 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 lower incisors to mandible (inclination, degrees) compared with conventional brackets; GRADE not reported.

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

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

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

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

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

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

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

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

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

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