ReviewJournal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie2026
Functional appliances and airway in class II malocclusion : An umbrella review and re-analysis of three meta-analyses.
Review in Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
8 authors.
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Abstract
purposeThe potential influence of functional appliances on respiratory health has recently gained attention, though evidence remains inconsistent. This umbrella review and meta-analysis evaluated the impact of functional appliances on the upper airway area and volume as primary aims, and any patient-centered reported outcomes in the literature as a secondary aim.
methodsThe protocol was registered in PROSPERO (CRD42024540778). Systematic reviews and meta-analysis including patients as individuals in the prepubertal or circumpubertal growth phases. Specifically, this refers to growing patients in the mixed to early permanent dentition, cervical vertebral maturation (CVM) stages II-IV, with class II malocclusion treated with removable or fixed functional appliances were selected. Studies involving noninterventional designs, craniofacial syndromes, major comorbidities, or diagnosed obstructive sleep apnea were excluded. A comprehensive search was performed across MEDLINE, Cochrane, Scopus, Web of Science, LILACS, and Ovid up to October 2024, following PRISMA guidelines. Grey literature was screened via OpenGrey. Risk of bias was assessed using ROBIS. Study overlap was evaluated through corrected covered area (CCA) and GROOVE indices. Quantitative re-analysis of three CBCT-based meta-analyses was conducted using random effects models.
resultsNine reviews met the inclusion criteria, eight with low risk of bias and moderate-to-high overlap (CCA = 10.97%). Functional appliances significantly increased oropharyngeal airway volume, especially the Herbst (up to 7759 mm
conclusionFunctional appliances demonstrated consistent effects in increasing the volume of the oropharyngeal region. However, variability among studies highlights the need for standardized protocols using volumetric assessments and adequate follow-up periods to determine treatment stability in a multidisciplinary approach for young patients.
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