Cochrane · intervention · CD010572
Surgical adjunctive procedures for accelerating orthodontic treatment
Fleming, PS, Fedorowicz, Z, Johal, A, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
8
current version
GRADE rated
3
No studies
4
Included studies
4
as reported
No studies 4 · 50%Ungraded 1 · 12.5%Very low 1 · 12.5%Low 2 · 25%Moderate 0 · 0%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 | Individuals of any age receiving orthodontic treatment with fixed appliances (braces) (people requiring orthodontic tooth movement); participants treated with orthognathic surgery or with cleft lip or palate or other craniofacial deformity/syndrome excluded | A total of 57 (15 male and 42 female) participants aged 11 to 33 years across 4 trials; mean age 19.2 years in the extraction space-closure study (Aboul-Ela 2011); adults only in the canine-retraction studies (Alikhani 2013; Leethanakul 2014); age range 11.1 to 12.9 years in the ectopic-canine study (Fischer 2007) |
| Intervention | Any form of orthodontic treatment with fixed appliances, including extraction and non-extraction treatment with or without inter-proximal reduction (tooth size reduction), incorporating surgically assisted/accelerated orthodontics to increase the rate of tooth movement | Surgical adjuncts: corticotomy (n=2: space closure, Aboul-Ela 2011; ectopic-canine alignment, Fischer 2007); micro-osteoperforations, repeated (n=1: Alikhani 2013); interseptal bone reduction (n=1: Leethanakul 2014) |
| Comparison | Any form of orthodontic treatment with fixed appliances, including extraction and non-extraction treatment with or without inter-proximal reduction, without use of surgically assisted/accelerated orthodontics | Conventional fixed appliance-based orthodontic treatment without surgical assistance (n=4) |
| Outcomes | Primary: duration of orthodontic treatment, number of visits during active treatment (scheduled and unscheduled) and duration of visits; Secondary: harms arising during orthodontic treatment (gingival and periodontal problems, anchorage loss, iatrogenic damage to teeth e.g. caries/decalcification, root resorption); patient-reported/patient-centred outcomes (impact of fixed appliances on daily life, quality of life and pain experience); patient satisfaction (validated questionnaires or scales); improvement in occlusion (PAR or other validated scale); prolonged stability of treatment | Rate of tooth movement (n=4); periodontal health and inflammatory response (n=1); pain experience (n=1); duration of orthodontic treatment not reported (n=0) |
| Study designs | Randomised controlled trials | Randomised controlled trials (n=4; 2 split-mouth; all assessed at unclear risk of bias) |
| Timing | Not specified | Follow-up: one month (Alikhani 2013); three months of canine retraction (Leethanakul 2014); orthodontic space closure up to four months (Aboul-Ela 2011); until alignment of the ectopic canine tip (Fischer 2007) |
Search date: 2014-09. Databases: Cochrane Oral Health Group's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via OVID; EMBASE via OVID; LILACS via BIREME; metaRegister of Controlled Trials (mRCT); ClinicalTrials.gov (US NIH Register); WHO International Clinical Trials Registry Platform (ICTRP)
Questions and results
Show all 2 versionsFixed-appliance orthodontic treatment incorporating surgically assisted orthodontics (adjunctive surgical procedure: corticotomy, micro-osteoperforation or interseptal bone reduction) to increase the rate of tooth movement vs Conventional treatment: fixed-appliance orthodontic treatment without surgical assistance
Population: Individuals of any age receiving orthodontic treatment with fixed appliances (braces) (people requiring orthodontic tooth movement); participants treated with orthognathic surgery or with cleft lip or palate or other craniofacial deformity/syndrome excluded
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prolonged stability of treatment (adjudged using an accepted scale) | Results: 'Our prespecified secondary outcomes of patient satisfaction, improvement in occlusion, and prolonged stability of treatment were not measured in the trials.' | 0 studies | No studies |
Patient satisfaction (measured using validated questionnaires or scales) | Results: 'Our prespecified secondary outcomes of patient satisfaction, improvement in occlusion, and prolonged stability of treatment were not measured in the trials.' | 0 studies | No studies |
Rate of tooth movement (orthodontic tooth movement in mm at 3 months) 3 months | MD 2.03 [1.52, 2.54] The mean orthodontic movement in the control groups was 3.0 mm (median of the two control-group means, 2.54 and 3.4… | 2 studies · 31 participants | Low Downgraded: risk of bias, indirectness |
Duration of orthodontic treatment, number of visits during active treatment (scheduled and unscheduled) and duration of visits | SoF row: Illustrative comparative risks '‐' / '‐'; no relative effect; Comments: 'Not reported'. Results: 'Our prespecified primary outcome (the duration of orthodontic treatment, number of visits during active… | 0 studies | No studies |
Harms arising during orthodontic treatment (gingival and periodontal problems, anchorage loss and iatrogenic damage to teeth e.g. caries/decalcification, root resorption); only periodontal/gingival health assessed Up to 4 months | SoF: Assumed risk 'See comment'; Corresponding risk 'See comment'; 13 (1 study, split‐mouth); Quality ⊕⊖⊖⊖ very low. Comment: 'Gingival and periodonal problems only were assesed in 1 study (Aboul‐Ela 2011). No precise… See comment vs See comment | 1 study · 13 participants | Very low Downgraded: risk of bias, imprecision |
Patient-reported outcome: pain experience (discomfort) 24 hours to 28 days | Results: 'Pain experience was compared between surgical and non‐surgical cases in a single study (Alikhani 2013). Within 24 hours of appliance activation and canine retraction, both groups reported higher levels of… | 1 study | Ungraded |
Rate of tooth movement (orthodontic tooth movement in mm at 1 month) 1 month | MD 0.61 [0.49, 0.72] | 3 studies · 42 participants | Low Downgraded: risk of bias, indirectness |
Improvement in occlusion (Peer Assessment Rating (PAR) or other validated scale) | Results: 'Our prespecified secondary outcomes of patient satisfaction, improvement in occlusion, and prolonged stability of treatment were not measured in the trials.' | 0 studies | No studies |