Effectiveness of Treating Vertical Maxillary Excess Among Non-growing Adult Patients With Skeletal Anchorage System: A Systematic Review and Meta-Analysis of Case Reports From 2008 to 2023.

Vertical maxillary excess presents a complex challenge in orthodontic treatment, necessitating effective anchorage systems for optimal correction. This research is useful to assess the skeletal anchorage system's (SAS) effectiveness in correcting the vertical maxillary excess among adult patients presenting with gummy smiles. This study includes case reports with English full text and examines the global general adult (18+) human population with vertical maxillary excess (VME). Publications from 2008 to 2023 were considered. The current systematic Review's framework follows patient, intervention, comparison, outcome and (sometimes) time (PICO(T)) criteria. Information sources were PubMed advanced search, Excerpta Medica database (EMBASE) (Elsevier), Web of Science, and Scopus (advanced search). On February 6th, 2024, the last search was carried out utilizing the same databases; the risk of bias was evaluated utilizing the National Institutes of Health (NIH) Quality Assessment Tool. Data synthesis was carried out on their own by the case and classical teams. The Meta XL (v.5.0) program (EpiGear International Pty Ltd., Queensland, Australia) Excel extension for meta-analysis was used. The inverse variance heterogeneity model was applied during the meta-analysis process. I2 and Cochrane's Q statistics were applied to gauge the degree of data heterogeneity. Two hundred fifty-two potential articles were found as a result of the search technique. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of 12 studies went through the analysis procedure. All 12 studies (case reports) and a total of 12 participants, including 11 females and one male, were studied from countries like India, the USA, Korea, Japan, China, and Mongolia. The age of patients is between 18 and 36 years. Out of 12 studies, in 11 studies, the orthodontic problem was Class II malocclusion with vertical maxillary excess. The pooled intrusion for the orthodontic treatment was seen, and almost 70% of the studies had a similar range. Only three studies were out of the 95% CI range of the other studies. The heterogeneity among the studies was 97.42%. Findings showed that p was statistically significant (p < 0.0001). The limitation of this study is that this is a systematic review and meta-analysis of case reports.