Dentoalveolar changes caused by extraoral traction and bionator in class ii division 1. Systematic review

Abstract

Objective: The purpose of this systematic review was to evaluate the existing evidence in relation to superior dentoalveolar changes, ANB angle, SNA and overjet on individuals with a Class II division 1 malocclusion in mixed dentition treated with headgear or Bionator. Materials and methods: A comprehensive literature search was performed by using 4 electronic databases, restricting to 10 years (2010-2020). Prospective randomized clinical trials (RCTs) and non-randomized (CCTs) were selected, excluding gray literature, theses and conference proceedings. Reference lists of eligible articles for inclusion were also manually checked. For the selection, the found articles were entered by two evaluators in the Rayyan QCRI software. Results: Three studies were included: two non-randomized controlled clinical trials (CCT) and one randomized clinical trial (RCT) for qualitative synthesis. Using the Revman 5.4.1 program, the risk of bias of the studies was assessed, resulting in only one study with a low risk of bias. The ANB variable decreased significantly for both groups. The A position with both appliances decreased significantly, this was measured differently with each approach: SNA was evaluated for the Bionator (°) and for traction, A-S´ (mm). Conclusion: Both approaches, Bionator and extra-oral traction could be used for Class II division 1 treatment, however, there is insufficient quality and up-to-date evidence in order to determine superior dentoalveolar changes between these two appliances.