Burgos-Lancero Patricia, Ibor-Miguel Marta, Marqués-Martínez Laura, Boo-Gordillo Paula, García-Miralles Esther, Guinot-Barona Clara
Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain.
J Clin Med. 2025 Jul 13;14(14):4958. doi: 10.3390/jcm14144958.
Anterior open bite (AOB) is a complex malocclusion characterized by the lack of vertical overlap between the upper and lower teeth during maximum intercuspation. It often results in functional impairments and aesthetic concerns. Traditional treatments for adult patients, including orthognathic surgery, are effective but invasive. Temporary anchorage devices (TADs) have emerged as a minimally invasive alternative. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of TADs for molar intrusion in the correction of AOB. A systematic review was conducted according to the PRISMA 2020 guidelines. An electronic search was performed in PubMed and Scopus until March 2025. The inclusion criteria comprised clinical studies in humans published in English or Spanish in the last 10 years. The risk of bias was assessed using RoB 2, ROBINS-I, and the Joanna Briggs Institute tools. A random-effects meta-analysis was carried out to estimate pooled intrusion values, and heterogeneity was evaluated using Cochran's Q test and the I statistic. Twelve studies were included. Molar intrusion using TADs achieved significant overbite improvements, with a pooled mean intrusion of 1.70 mm (95% CI: 0.53-2.87 mm). The heterogeneity among studies was high (I = 88.5%). Despite variability in force magnitude and TAD type, lighter forces were generally associated with similar outcomes and fewer adverse effects. TADs offer a predictable and less invasive alternative to orthognathic surgery for AOB correction. When appropriately indicated and biomechanically managed, they provide effective vertical control and short- to medium-term stability in adult patients.
前牙开颌（AOB）是一种复杂的错牙合畸形，其特征是在最大牙尖交错位时上下牙齿缺乏垂直重叠。它常导致功能障碍和美观问题。针对成年患者的传统治疗方法，包括正颌手术，虽有效但具有侵入性。临时锚固装置（TADs）已成为一种微创替代方法。本系统评价和荟萃分析的目的是评估TADs在矫正AOB中用于磨牙压低的有效性。根据PRISMA 2020指南进行了系统评价。截至2025年3月，在PubMed和Scopus中进行了电子检索。纳入标准包括过去10年以英文或西班牙文发表的关于人类的临床研究。使用RoB 2、ROBINS-I和乔安娜·布里格斯研究所工具评估偏倚风险。进行随机效应荟萃分析以估计汇总压低值，并使用Cochran's Q检验和I统计量评估异质性。纳入了12项研究。使用TADs进行磨牙压低显著改善了覆牙合，汇总平均压低为1.70毫米（95%置信区间：0.53 - 2.87毫米）。研究间的异质性较高（I = 88.5%）。尽管力的大小和TAD类型存在差异，但较轻的力通常与相似的结果和较少的不良反应相关。对于AOB矫正，TADs为正颌手术提供了一种可预测且侵入性较小的替代方法。当适当地应用并进行生物力学管理时，它们可为成年患者提供有效的垂直控制以及短期至中期的稳定性。
