Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review
Abstract Aims To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-11-01
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| Series: | Progress in Orthodontics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40510-023-00490-3 |
| _version_ | 1797451368101838848 |
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| author | Sarah Abu Arqub Dalya Al-Moghrabi Marissa G. Iverson Philippe Farha Hala Abdullah Alsalman Flavio Uribe |
| author_facet | Sarah Abu Arqub Dalya Al-Moghrabi Marissa G. Iverson Philippe Farha Hala Abdullah Alsalman Flavio Uribe |
| author_sort | Sarah Abu Arqub |
| collection | DOAJ |
| description | Abstract Aims To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events. Methods A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal. Results A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low. Conclusions Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed. |
| first_indexed | 2024-03-09T14:52:43Z |
| format | Article |
| id | doaj.art-e2b089ff68404866bb43bf3d83bacdca |
| institution | Directory Open Access Journal |
| issn | 2196-1042 |
| language | English |
| last_indexed | 2024-03-09T14:52:43Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Progress in Orthodontics |
| spelling | doaj.art-e2b089ff68404866bb43bf3d83bacdca2023-11-26T14:22:37ZengSpringerOpenProgress in Orthodontics2196-10422023-11-0124111710.1186/s40510-023-00490-3Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic reviewSarah Abu Arqub0Dalya Al-Moghrabi1Marissa G. Iverson2Philippe Farha3Hala Abdullah Alsalman4Flavio Uribe5Division of Orthodontics, University of FloridaDepartment of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman UniversityL.M. Stowe Library, University of Connecticut HealthBoston University Henry M. Goldman School of Dental MedicineDepartment of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman UniversityDivision of Orthodontics, Department of Craniofacial Sciences, University of Connecticut HealthAbstract Aims To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events. Methods A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal. Results A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low. Conclusions Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.https://doi.org/10.1186/s40510-023-00490-3Maxillary molar intrusionTemporary anchorage devicesPosterior bite blocksOpen bite bionatorRapid molar intruder |
| spellingShingle | Sarah Abu Arqub Dalya Al-Moghrabi Marissa G. Iverson Philippe Farha Hala Abdullah Alsalman Flavio Uribe Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review Progress in Orthodontics Maxillary molar intrusion Temporary anchorage devices Posterior bite blocks Open bite bionator Rapid molar intruder |
| title | Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review |
| title_full | Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review |
| title_fullStr | Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review |
| title_full_unstemmed | Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review |
| title_short | Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review |
| title_sort | assessment of the efficacy of various maxillary molar intrusion therapies a systematic review |
| topic | Maxillary molar intrusion Temporary anchorage devices Posterior bite blocks Open bite bionator Rapid molar intruder |
| url | https://doi.org/10.1186/s40510-023-00490-3 |
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