Evidence map›Paper›PMID 38855038›Full record

ReviewJournal of oral biology and craniofacial research

Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis.

Sandhya Murali, Annapurna Kannan, Vignesh Kailasam

Abstract readReview
In one paragraph

Review in Journal of oral biology and craniofacial research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Functional appliances and airway in class II malocclusion : An umbrella review and re-analysis of three meta-analyses.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Sandhya MuraliDepartment of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, India.
Annapurna KannanDepartment of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, India.
Vignesh KailasamDepartment of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position brought about by functional appliance therapy. Therefore, this systematic review aimed to assess the changes in the cervical spine posture with functional appliance treatment in Skeletal Class II subjects. Methods: A search of studies in six electronic databases - Medline (via Pubmed), the Cochrane Library, OVID, LILACS, Scopus and Web of Science were performed until January 18, 2024 without any restriction in date or language of publication. Eligibility screening, study selection, and data extraction were performed by two reviewers independently. The risk of bias assessment of the included studies was performed with the Newcastle Ottawa scale and Cochrane RoB 2.0. Meta-analysis was performed using random effects model for assessment of changes in the cervical spine with removable and fixed functional appliances. Results: Twelve articles that satisfied the eligibility criteria were included for systematic review and nine articles for meta-analysis. Five studies showed a low risk of bias, one as moderate and six as high risk of bias. GRADE assessment revealed a low quality evidence. Meta-analysis revealed a decrease of the upper cervical inclination by 1.16° (95 % CI of -2.68 to 0.35, I Conclusions: Minimal uprighting of the cervical spine was noted with functional appliances. Fixed functional appliances exerted a greater effect than removable functional appliances. Cervical hyperlordosis was reduced with removable functional appliance treatment. Though these changes are minimal, the clinical orthodontist should be aware that functional therapy also influences cervical spine posture. Due to the heterogeneity and low quality of evidence, the results are to be considered critically.

Indexed as

Cervical spineLordosisOrthodontic appliancesPosture

Identifiers

PMID38855038
PMCPMC11157267

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.