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Long-term effects of functional appliances in treated versus untreated patients with Class II malocclusion: A systematic review and meta-analysis

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  • Giorgio Cacciatore
  • Alessandro Ugolini
  • Chiarella Sforza
  • Oghenekome Gbinigie
  • Annette Plüddemann

Abstract

Objective: To assess the cephalometric skeletal and soft-tissue of functional appliances in treated versus untreated Class II subjects in the long-term (primarily at the end of growth, secondarily at least 3 years after retention). Search methods: Unrestricted electronic search of 24 databases and additional manual searches up to March 2018. Selection criteria: Randomised and non-randomised controlled trials reporting on cephalometric skeletal and soft-tissue measurements of Class II patients (aged 16 years or under) treated with functional appliances, worn alone or in combination with multi-bracket therapy, compared to untreated Class II subjects. Data collection and analysis: Mean differences (MDs) and 95% confidence intervals (95% CIs) were calculated with the random-effects model. Data were analysed at 2 primary time points (above 18 years of age, at the end of growth according to the Cervical Vertebral Maturation method) and a secondary time point (at least 3 years after retention). The risk of bias and quality of evidence were assessed according to the ROBINS tool and GRADE system, respectively. Results: Eight non-randomised studies published in 12 papers were included. Functional appliances produced a significant improvement of the maxillo-mandibular relationship, at almost all time points (Wits appraisal at the end of growth, MD -3.52 mm, 95% CI -5.11 to -1.93, P

Suggested Citation

  • Giorgio Cacciatore & Alessandro Ugolini & Chiarella Sforza & Oghenekome Gbinigie & Annette Plüddemann, 2019. "Long-term effects of functional appliances in treated versus untreated patients with Class II malocclusion: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-26, September.
    • Handle: RePEc:plo:pone00:0221624
    DOI: 10.1371/journal.pone.0221624
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Giuseppe Perinetti & Jasmina Primožič & Lorenzo Franchi & Luca Contardo, 2015. "Treatment Effects of Removable Functional Appliances in Pre-Pubertal and Pubertal Class II Patients: A Systematic Review and Meta-Analysis of Controlled Studies," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-35, October.
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