Division of Orthodontics, University of Connecticut Health, Farmington, USA.
Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan.
Eur J Orthod. 2022 May 24;44(3):311-324. doi: 10.1093/ejo/cjab058.
Treatment outcomes for Class III orthopaedic treatment are highly unpredictable and dependent on the timing of interception, age, and biological sex.
This systematic review aimed to assess the effects of sex dimorphism on outcomes and duration of orthopaedic treatment for Class III malocclusion in young children.
Unrestricted search in six electronic databases until May 2021 was conducted. Supplemented by search in resources for published, unpublished literature, and ongoing trials.
Randomized and non-randomized controlled trials reporting the use of Class III growth modification appliances, with baseline and outcome data for both sexes, were included.
Study selection and data extraction were performed blindly and in duplicate by two reviewers. ROBINS-I, Cochrane Risk of Bias, and GRADE tools were used for certainty assessment.
A total of 2429 records were screened. Four trials fulfilled the inclusion criteria, one was a randomized clinical trial (RCT) comparing facemask and facemask with mini-screw. Two clinical trials evaluated the effects of facemask appliance, one had a control group, another was prospective non-controlled. One compared the effects of the maxillary protraction bow appliance to a no treatment control. Two of the clinical trials were appraised as low and one was appraised as high risk of bias. The overall certainty of the available evidence was assessed as moderate. There was significant clinical heterogeneity in terms of methodology, type of intervention, and the measured outcomes, precluding a meta-analysis.
Minimal variations in sagittal, vertical, and dentoalveolar post-treatment cephalometric changes were reported between sexes. The available evidence is unclear to support these variations. Long-term-powered RCTs assessing cephalometric outcomes between sexes until the end of growth spurt and without pooling are not available, therefore, much needed.
PROSPERO database number CRD42020185797.
III 类错颌畸形的治疗效果高度不可预测，取决于干预时机、年龄和生物学性别。
本系统评价旨在评估性别二态性对儿童早期 III 类错颌畸形矫形治疗效果和持续时间的影响。
对 6 个电子数据库进行无限制检索，检索截至 2021 年 5 月。并补充对已发表和未发表文献资源以及正在进行的试验的检索。
纳入报告使用 III 类生长矫正器的随机和非随机对照试验，且有基线和两性数据。
研究选择和数据提取由两名评审员独立盲法进行。采用 ROBINS-I、Cochrane 偏倚风险和 GRADE 工具评估确定性。
共筛选出 2429 条记录。4 项试验符合纳入标准，其中 1 项为比较面具和面具联合微型螺钉的随机临床试验 (RCT)。2 项临床试验评估了面具矫正器的效果，1 项有对照组，另 1 项为前瞻性非对照。1 项比较了上颌前牵引弓矫正器与不治疗对照的效果。2 项临床研究被评价为低风险，1 项被评价为高风险。可用证据的总体确定性被评估为中等。由于方法、干预类型和测量结果方面存在显著的临床异质性，因此无法进行荟萃分析。
在矢状、垂直和牙牙槽后治疗头影测量变化方面，两性之间报道的差异极小。目前的证据尚不清楚是否支持这些差异。目前没有评估两性之间头影测量结果直到生长突增结束且不进行合并的长期、有影响力的 RCT，因此非常需要此类研究。
PROSPERO 数据库编号 CRD42020185797。
