SynthesisPloS one2015
Treatment Effects of Removable Functional Appliances in Pre-Pubertal and Pubertal Class II Patients: A Systematic Review and Meta-Analysis of Controlled Studies.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 5 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- Coefficient of efficiency and effectiveness of functional appliances in class II malocclusion treatment : A systematic review.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2026Pooled it
- Precision wings treating skeletal class II in growing patients: a systematic review and meta-analysis.Progress in orthodontics · 2025Pooled it
- Stepwise versus single-step mandibular advancement with functional appliance in treating class II patients : A meta-analysis.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2020Pooled it
- Angle class II correction: stepwise mandibular advancement or bite jumping? : A systematic review and meta-analysis of skeletal, dental and condylar effects.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2020Pooled it
- Pooled it
- Dentoskeletal effects of aesthetic and conventional twin block appliances in the treatment of skeletal class II malocclusion: a randomized controlled trial.Scientific reports · 2025Trial
- Management of Skeletal Class II Malocclusion in a Growing Patient Using Clear Aligners and Class II Elastics: A Case Report.Dentistry journal · 2026Article
- Effects of Herbst and Pendex appliances treatment on the upper airway: A cone-beam computed tomography analysis.American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics · 2026Article
- Postpubertal Assessment of Treatment Timing in Class II Malocclusion Treated with Twin Block Followed by Fixed Appliances: A Retrospective Observational Study.Journal of clinical medicine · 2026Article
- "The pivotal role of proper nasolabial angle management in the functional treatment of skeletal Class II malocclusion: an opinion article".Frontiers in oral health · 2026Article
- MTH herbst appliance, class II elastics and Paolone-Kaitsas functional appliance in mixed dentition class II patients: a retrospective cohort study.Progress in orthodontics · 2025Article
- Effectiveness of Clear Aligner Therapy in Orthodontic Management for Children with Mixed Dentition: A Scoping Review.International journal of clinical pediatric dentistry · 2025Review
- Orthodontic Management of Class II Malocclusion with Clear Aligners: Mandibular Advancement vs. Class II Elastics.Children (Basel, Switzerland) · 2025Article
- Review
- TFRC Ablation Induces Insufficient Cartilage Development Through Mitochondrial p53 Translocation-Mediated Ferroptosis.International journal of molecular sciences · 2025Article
- Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review.Children (Basel, Switzerland) · 2025Review
- Soft tissue evaluation of functional therapy in growing patients with class II malocclusion: mandibular advancement vs. twin block-a retrospective study.Frontiers in dental medicine · 2025Article
- The Efficacy of the RME II System Compared with a Herbst Appliance in the Treatment of Class II Skeletal Malocclusion in Growing Patients: A Retrospective Study.Dentistry journal · 2024Article
- Artificial Intelligence in Orthodontics: Critical Review.Journal of dental research · 2024Review
- Long-term skeletodental changes with early and late treatment using modified C-palatal plates in hyperdivergent Class II adolescents.The Angle orthodontist · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment effects of removable functional appliances in Class II malocclusion patients according to the pre-pubertal or pubertal growth phase has yet to be clarified.
objectivesTo assess and compare skeletal and dentoalveolar effects of removable functional appliances in Class II malocclusion treatment between pre-pubertal and pubertal patients. SEARCH
methodsLiterature survey using the Medline, SCOPUS, LILACS and SciELO databases, the Cochrane Library from inception to May 31, 2015. A manual search was also performed. SELECTION CRITERIA: Randomised (RCTs) or controlled clinical trials with a matched untreated control group. No restrictions were set regarding the type of removable appliance whenever used alone. DATA COLLECTION AND ANALYSIS: For the meta-analysis, cephalometric parameters on the supplementary mandibular growth were the main outcomes, with other cephalometric parameters considered as secondary outcomes. Risk of bias in individual and across studies were evaluated along with sensitivity analysis for low quality studies. Mean differences and 95% confidence intervals for annualised changes were computed according to a random model. Differences between pre-pubertal and pubertal patients were assessed by subgroup analyses. GRADE assessment was performed for the main outcomes.
resultsTwelve articles (but only 3 RCTs) were included accounting for 8 pre-pubertal and 7 pubertal groups. Overall supplementary total mandibular length and mandibular ramus height were 0.95 mm (0.38, 1.51) and 0.00 mm (-0.52, 0.53) for pre-pubertal patients and 2.91 mm (2.04, 3.79) and 2.18 mm (1.51, 2.86) for pubertal patients, respectively. The subgroup difference was significant for both parameters (p<0.001). No maxillary growth restrain or increase in facial divergence was seen in either subgroup. The GRADE assessment was low for the pre-pubertal patients, and generally moderate for the pubertal patients.
conclusionsTaking into account the limited quality and heterogeneity of the included studies, functional treatment by removable appliances may be effective in treating Class II malocclusion with clinically relevant skeletal effects if performed during the pubertal growth phase.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.