Cochrane · intervention · CD003451

Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children

Owens, D, Watkinson, S, Harrison, JE, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library

Oral Health Orthodontics3 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 4 · 5.1%Ungraded 58 · 74.4%Very low 3 · 3.8%Low 9 · 11.5%Moderate 4 · 5.1%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion). Excluded: cleft lip or palate or other craniofacial deformities/syndromes; studies with less than 80% participants aged 16 years or younger; children who previously received surgical treatment.	Children aged five to 13 years at start of treatment, from different ethnic backgrounds (mostly not stated); 20 to 73 children per study (average 38); approximately equal boys and girls
Intervention	Non-surgical orthodontic interventions (removable, fixed and/or functional; e.g. facemask, chin cup, mandibular headgear, reverse Twin Block); surgically-anchored orthodontic interventions (e.g. miniscrews, miniplates, bone-anchored intermaxillary traction); any other intra- or extra-oral intervention	Facemask (n=179); Chin cup (n=90); Tandem traction bow appliance (n=30); Mandibular headgear (n=60); Orthodontic removable traction appliance (n=40); Reverse Twin Block with lip pads and RME (n=26); Reverse Forsus (n=22); Mini maxillary protractor (n=32); Pushing Splints (n=42); Modified tandem appliance (n=32); Reverse chin cup (n=42); Tongue plate appliance (n=47); Frankel III functional appliance (n=34); Miniscrews (n=43); Surgical miniplates (n=30); Bone-anchored intermaxillary traction (n=38)
Comparison	No treatment / delayed treatment / another active intervention	Untreated control (n=431)
Outcomes	Primary: prominence of the lower front teeth (overjet, mm or index of malocclusion). Secondary: relationship between upper and lower jaw (ANB angle or Wits appraisal); psychosocial measures; patient satisfaction; surgery in adulthood; adverse effects (including jaw joint problems, health of the gums, damage to the teeth).	Overjet (n=184); ANB (n=345); Wits appraisal (n=175); Piers-Harris children's self-concept scale (n=69); Oral Aesthetic Subjective Impact Score (n=69); Perceived need for surgery in adulthood (n=65); Temporomandibular joint signs and symptoms (n=69)
Study designs	Randomised controlled trials (RCTs)	29 RCTs (1169 participants; 1102 analysed); six three-arm trials
Timing	Clinically important outcomes recorded at the most commonly reported time points; most studies measured at beginning and end of treatment (average treatment time four to 13 months)	Most studies reported outcomes immediately post-treatment or up to 15 months after start of treatment; one study reported longer-term outcomes at three and six years

Search date: 2023-01. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; US NIH Ongoing Trials Register ClinicalTrials.gov; WHO International Clinical Trials Registry Platform (ICTRP)