Figure 1.
Figure 2.
Search strategies for electronic database_
| Step | PubMed | Embase, Scopus, WOS | CENTRAL, SIGLE, ProQuest |
|---|---|---|---|
| 1 | Fatigue Resistant Device* OR FRD OR Forsus | Fatigue Resistant Device* OR FRD OR Forsus | Forsus |
| 2 | Orthodontic Anchorage Procedures [MESH] OR miniscrew OR miniplate OR anchor* OR mini-implant* OR implant* OR TAD OR skeletal anchor* | Miniscrew OR miniplate OR anchor* OR mini-implant* OR implant* OR TAD OR skeletal anchor* | |
| 3 | 1 AND 2 | 1 AND 2 |
Risk of bias assessment for CCTs following Newcastle-Ottawa Scale_
| Selection (maximum 4 stars) | Comparability (maximum 2 stars) | Outcome (maximum 3 stars) | Total score (maximum 9 stars) | |
|---|---|---|---|---|
| Turkkahraman et al., 2016 (27) | 4 | 1 | 3 | 8 |
| Gandedkar et al., 2019 (28) | 3 | 1 | 2 | 6 |
General information about included studies_
| Study ID | Study design | Patients characteristics | Grouping | Intervention protocol | Sample loss | Measurement modality | Outcomes reported |
|---|---|---|---|---|---|---|---|
| Aslan et al., 2014 (23) | RCT | n=33, M15:F18 | E: n=16, M5:F11, age:13.68±1.09y | E: FFRD+Miniscrew | None | Lateral Cephalogram | Skeletal, dento-alveolar, soft tissue |
| Elkordy et al., 2016 (25) | RCT | n=31, M0:F31 | E: n=15, M0:F15, age:13.07±1.41y | E: FFRD+Mini-implant | None | CBCT | Skeletal, dento-alveolar |
| Turkkahraman et al., 2016 (27) | CCT | n=30, M20:F10 | E: n=15, M13:F2, age:12.77±1.24y | E: FFRD+Miniplate | None | Lateral Cephalogram | Skeletal, dento-alveolar, soft tissue |
| Eissa et al.,2017 (24) | RCT | n=30, M11:F19 | E: n=15, M5:F10, age:12.53±1.12y | E: FFRD+Miniscrew | 1 sample lost in the FFRD group | Lateral Cephalogram | Skeletal, dento-alveolar, soft tissue |
| Elkordy et al.,2019 (26) | RCT | n=32, M0:F32 (allocated, 30 analysed) | E: n=16, M0:F16, age:12.5±0.9y | E: FFRD+Miniplate | Both groups have 1 sample lost | CBCT | Skeletal, dento-alveolar |
| Gandedkar et al.,2019 (28) | CCT | n=16, M0:F16 | E: n=8, M0:F8, age: 12.96±0.38y | E: FFRD+Miniplate | None | CBCT | Skeletal, dento-alveola, TMJ |
GRADE assessment for quality of available evidence_
| Quality assessment | Patients(n) | Relative effect (95% CI) | Quality | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Studies | Risk of bias | Inconsistency | Indirectness | Imprecision | Other | C* | E* | ||
| Mandibular length | |||||||||
| 6 | Not Serious | Serious | Not serious | Not serious | None | 86 | 85 | Not pooled | ⨁⨁⨁◯ |
| Mandibular rotation | |||||||||
| 6 | Not Serious | Serious | Not serious | Not serious | None | 86 | 85 | Not pooled | ⨁⨁⨁◯ |
| Lower incisors inclination | |||||||||
| 6 | Not Serious | Serious | Not serious | Not serious | None | 86 | 85 | Not pooled | ⨁⨁⨁◯ |
| Soft tissue position change | |||||||||
| 3 | Serious | Serious | Not serious | Serious** | None | 47 | 46 | Not pooled | ⨁◯◯◯ |
Intervention details of included studies_
| Study ID | Brackets | Bonding protocol | TAD clinical protocol | Pushrod insertion site | Additional control |
|---|---|---|---|---|---|
| Aslan et al., 2014 (23) | Roth | E: Both arches (0.018*0.018-inch vertical slot brackets were bonded on lower canines) | Indirect anchorage | E: Mandibular archwires distal to canines | Not mentioned |
| Elkordy et al., 2016 (25) | MBT (3M) | E: Both arches | Indirect anchorage | E: Mandibular archwires distal to canines | TPA: Cemented to upper first molars |
| Turkkahraman et al., 2016 (27) | Roth | E: Maxilla only | Direct anchorage | E: The miniplate heads | Not mentioned |
| Eissa et al., 2017 (24) | MBT (Ormco) | E: Both arches (Damon 3MX brackets with 0.018*0.018-inch vertical slot were bonded on lower canines) | Indirect anchorage | E: Mandibular archwires distal to canines | TPA: Cemented to upper first molars |
| Elkordy et al., 2019 (26) | MBT (3M) | E: Maxilla only | Direct anchorage | E: The miniplate heads | TPA: Cemented to upper first molars |
| Gandedkar et al., 2019 (28) | Not specific*
| E: Both arches | Direct anchorage | E: The miniplate heads | TPA: Cemented to upper first molars |
Definition of cephalometric values_
| Cephalometric value | Definition |
|---|---|
| Mandibular skeletal measurement | |
| Co-Gn | The linear distance between Condylion point and Gnathion point |
| Ar-Pog | The linear distance between Articulare point and Pogonion point |
| Go-Pog | The linear distance between Gonion point and Pogonion point |
| MP/SN | The angle formed between mandibular plane and line S-N |
| GoMe/FH | The angle formed between line Go-Me and Frankfort plane |
| Lower incisors inclination | |
| L1/MP | The angle formed between the L1 long axis and the mandibular plane |
| L1/NB | The angle formed between the L1 long axis and line N-B |
| L1/FP | The angle formed between the L1 long axis and the frontal plane |
| Soft tissue position measurement | |
| Lbinf-VRL | The distance from lower lip to a self-defined vertical reference line |
| Li-E | The distance from lower lip to E line |
| Li-S | The distance from lower lip to S line |