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%

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

Removable tooth-borne expansion (expansion plate) 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…

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

1 finding from 1 review

Extraction of third molars (wisdom teeth) vs No active treatment (control)

Size of the lower jaw (arch length, change) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Extraction of third molars (wisdom teeth) led to higher size of the lower jaw (arch length, change) compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Fixed tooth-borne expansion (Hyrax) vs Fixed fan-type expander

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
    post-treatment 3 weeks
    Gopalakrishnan 2017: Hyrax 8.00 (SD 2.19) mm vs fan-type 1.83 (SD 0.41) mm; P<0.001 (greater intermolar expansion with Hyrax)
    1 study · 12 participants
    GRADE not reported

Any orthodontic (non-surgical) treatment to correct posterior crossbite or expand the top teeth vs No treatment or another orthodontic treatment

Signs and symptoms of temporomandibular joint dysfunction · Children and adults with a posterior crossbite, without a Class III skeletal relationship, cleft lip or palate (or both), or other…

The review found no eligible studies for this question.

1 finding from 1 review

Lower lingual arch vs No active treatment (control)

Lower incisors to mandible (position, mm) at 9 months · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Lower lingual arch led to higher lower incisors to mandible at 1 year compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

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

Size of the lower jaw (arch length, change) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Extraction of lower deciduous canines led to lower size of the lower jaw (arch length, change) at 1 year compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

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

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

Fluoride-releasing coating materials do not appear to reduce WSL initiation more than non-fluoride coatings (RR 0.84, not significant); certainty of evidence is very low.

1 finding from 1 review

Schwarz appliance vs No active treatment (control)

Lower incisors to mandible (position, mm) at 9 months · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Schwarz appliance led to higher lower incisors to mandible (position, mm) at 9 months compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Copper nickel-titanium archwire vs Nickel-titanium archwire

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

Copper nickel-titanium archwire showed no clear difference in time to alignment (days) compared with nickel-titanium archwire; GRADE not reported.

1 finding from 1 review

Active self-ligating brackets vs Passive self-ligating brackets

Amount of crowding (upper anterior crowding) · 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
    baseline
    Only baseline upper anterior crowding reported (Pandis 2010a, n=70); evidence of baseline imbalance between groups (P=0.04); no post-treatment between-group crowding estimate reported.
    1 study
    GRADE not reported

Removable tooth-borne expansion (expansion plate) vs observation

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

Removable tooth-borne expansion (expansion plate) probably leads to higher canine expansion (inter-canine distance) compared with observation (no treatment) (moderate certainty).

1 finding from 1 review

Fixed tooth-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…

Fixed tooth-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