Evidence map›Paper›PMID 39607678›Full record

SynthesisEuropean journal of orthodontics2024

Occlusal outcome of orthodontic treatment: a systematic review with meta-analyses of randomized trials.

Spyridon N Papageorgiou, Theodora Giannakopoulou, Theodore Eliades, Vaska Vandevska-Radunovic

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European journal of orthodontics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
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

4 authors.

Spyridon N PapageorgiouClinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland.ORCID 0000-0003-1968-3326
Theodora GiannakopoulouDepartment of Paediatric Oral Heath and Orthodontics, University Centre for Dental Medicine UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland.ORCID 0009-0002-3170-5567
Theodore EliadesClinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland.ORCID 0000-0003-2313-4979
Vaska Vandevska-RadunovicDepartment of Orthodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, P.O. Box 1072 Blindern, N-0316 Oslo, Norway.ORCID 0000-0002-4098-5161

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral appliances or treatment protocols are marketed to either patients or orthodontists as being associated with improved orthodontic outcomes. However, clinical decision-making should be based on robust scientific evidence and not marketing claims or anecdotal evidence.

objectiveTo identify appliances/protocols being associated with improved outcomes of fixed appliance treatment. SEARCH

methodsUnrestricted literature searches in seven databases/registers for human studies until March 2024. SELECTION CRITERIA: Randomized or quasi-randomized clinical trials on human patients of any age, sex, or ethnicity receiving comprehensive orthodontic treatment with fixed appliances and assessing occlusal outcome with either the Peer Assessment Rating (PAR) or the American Board of Orthodontics-Objective Grading System (ABO-OGS) index. DATA COLLECTION AND ANALYSIS: Duplicate/independent study selection, data extraction, and risk of bias assessment with the Cochrane RoB 2 tool. Random-effects meta-analyses of averages or mean differences with their 95% Confidence Intervals (CI), followed by meta-regression/subgroup/sensitivity analyses and assessment of the quality of clinical recommendations with the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

resultsData from 20 small- to moderately-sized trials covering 1470 patients indicated that orthodontic treatment with fixed appliances is effective and results on average in a final PAR score of 6.0 points (95% CI 3.9-8.2 points), an absolute PAR reduction of 23.0 points (95% CI 15.6-30.4 points), a % PAR reduction of 82.6% (95% CI 70.8%-94.4%), and an absolute ABO-OGS score of 18.9 points (95% CI 11.7-26.2 points). However, very high between-study heterogeneity (I2 > 75%) was seen for both PAR and ABO-OGS. Extraction treatment was associated with significantly better occlusal outcome than non-extraction treatment with ABO-OGS (12.9 versus 16.6 points; P = .02). There was no statistically significant difference in occlusal outcome with (i) 0.018″-slot or 0.022″-slot brackets; (ii) customized or prefabricated brackets; (iii) anchorage reinforcement with temporary anchorage devices; (iv) use of vibrational adjuncts; and (v) aligners or fixed appliances (P > .05 in all instances), while small benefits were seen with indirectly bonded brackets.

conclusionsConsiderable between-study heterogeneity exists in the reported occlusal outcome of fixed appliance treatment, and different appliances or adjuncts have little effect on this. Standardization and/or automatization of the scoring procedures for PAR and ABO-OGS might help to improve consistency and reliability of outcome measurement in orthodontic trials. REGISTRATION: PROSPERO (CRD42024525088).

Indexed as

MalocclusionOrthodontics, CorrectiveDental OcclusionHumansOrthodontic AppliancesOrthodontic Appliances, FixedRandomized Controlled Trials as TopicTreatment Outcomeevidence-based medicinefixed applianceorthodontic treatmentrandomized clinical trialsystematic reviewtreatment effectiveness

Identifiers

PMID39607678
PMCPMC11602743

What OpenQuestion holds

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Registered trials

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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.