Mecenas Paulo, Bastos Renata Travassos da Rosa Moreira, Fagundes Nathalia Carolina Fernandes, Normando David
Federal University of Pará (UFPA), Belém, Brazil.
Pará State University Center, Belém, Brazil.
Prog Orthod. 2025 May 26;26(1):16. doi: 10.1186/s40510-025-00564-4.
Skeletal Class II malocclusion, often associated with mandibular deficiency, is commonly treated with functional appliances. Precision Wings are a functional appliance that provides an alternative approach by combining mandibular advancement with dental alignment.
This systematic review aimed to evaluate the effectiveness of Precision Wings in treating skeletal Class II malocclusion in growing patients.
Studies assessing the correction of skeletal Class II malocclusion in growing patients treated with Precision Wings were selected according to the PICOS strategy. The PRISMA guidelines were followed.
Unrestricted electronic searches were conducted across seven databases up to February 2025.
The ROBINS-I tool was used to assess the risk of bias (RoB) in non-randomized studies. A random-effects meta-analysis was performed, and the certainty of the evidence was evaluated using the GRADE approach.
Seven studies were included, and data were extracted. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects meta-analysis. The findings suggest that Precision Wings may be effective in treating skeletal Class II malocclusion in growing patients through both dental and skeletal changes. Regarding skeletal effects, sagittal changes were limited to the mandible and were of small magnitude, with a reduction in ANB° (MD = -0.81; 95% CI: -1.04 to -0.58; p < 0.001) occurring exclusively due to an increase in SNB° (MD = 0.55; 95% CI: 0.11 to 0.98; p = 0.01), while no significant changes were observed in SNA° (MD = -0.02; 95% CI: -0.42 to 0.38; p = 0.91). The included studies did not report significant vertical effects. Meta-analyses comparing Precision Wings with other functional appliances were not feasible due to the small number of studies evaluating each comparison and the substantial clinical and methodological heterogeneity across the included studies.
Although the available scientific evidence on this topic is limited, treatment with Precision Wings appears to offer minimal clinical improvement in mandibular growth for the correction of skeletal Class II malocclusion. To obtain more conclusive findings, future research should prioritize well-structured randomized clinical trials with standardized treatment protocols, extended follow-ups, and consistent cephalometric assessment methods.
骨性II类错牙合通常与下颌骨发育不足有关，常用功能性矫治器进行治疗。精密翼矫治器是一种功能性矫治器，通过结合下颌前伸与牙齿排齐提供了一种替代方法。
本系统评价旨在评估精密翼矫治器在治疗生长发育期患者骨性II类错牙合中的有效性。
根据PICOS策略选择评估使用精密翼矫治器治疗生长发育期患者骨性II类错牙合矫治效果的研究。遵循PRISMA指南。
截至2025年2月，在七个数据库中进行了无限制的电子检索。
使用ROBINS-I工具评估非随机研究中的偏倚风险（RoB）。进行随机效应荟萃分析，并使用GRADE方法评估证据的确定性。
纳入七项研究并提取数据。使用随机效应荟萃分析计算95%置信区间（CI）的平均差（MD）。结果表明，精密翼矫治器可能通过牙齿和骨骼变化有效治疗生长发育期患者的骨性II类错牙合。关于骨骼效应，矢状面变化仅限于下颌骨，且幅度较小，仅由于SNB°增加（MD = 0.55；95% CI：0.11至0.98；p = 0.01）导致ANB°减小（MD = -0.81；95% CI：-1.04至-0.58；p < 0.001），而SNA°未观察到显著变化（MD = -0.02；95% CI：-0.42至0.38；p = 0.91）。纳入研究未报告显著的垂直效应。由于评估每种比较的研究数量较少且纳入研究之间存在大量临床和方法学异质性，因此比较精密翼矫治器与其他功能性矫治器的荟萃分析不可行。
尽管关于该主题的现有科学证据有限，但使用精密翼矫治器治疗在矫正骨性II类错牙合时对下颌骨生长的临床改善似乎最小。为获得更确凿的结果，未来研究应优先进行结构良好的随机临床试验，采用标准化治疗方案、延长随访时间并采用一致的头影测量评估方法。
