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Extraction or non-extraction treatment for Class II division 2 malocclusion?
Benjamin J Goldstein1, Analia Veitz-Keenan1
1NYU College of Dentistry, New York, USA.
Evidence-Based Dentistry
|October 27, 2018
Summary
No clinical trials were found to support or refute orthodontic treatments for deep bite and retroclined teeth in children. Further research is challenging due to low prevalence and ethical considerations in designing randomized controlled trials.
Area of Science:
- Orthodontics
- Pediatric Dentistry
Background:
- Class II division 2 malocclusion, characterized by deep bite and retroclined upper incisors, is a common orthodontic concern in children.
- Evidence-based guidelines for managing this condition are lacking, impacting clinical decision-making.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) and controlled clinical trials (CCTs) evaluating orthodontic treatments for Class II division 2 malocclusion in children.
- To identify evidence comparing orthodontic treatment with tooth extraction versus non-extraction or no treatment.
Main Methods:
- Comprehensive search of multiple databases including Cochrane, Medline, and Embase, supplemented by trial registries.
- Inclusion criteria focused on RCTs and CCTs in participants aged 16 or younger, excluding those with craniofacial syndromes.
- Two independent reviewers screened studies, with efforts to obtain missing data from primary authors.
Main Results:
- A total of 1345 records were identified, with 857 unique records after duplicate removal.
- All identified records were rejected, and no eligible RCTs or CCTs were found.
- Consequently, no evidence-based recommendations can be made for treating Class II division 2 malocclusion in children.
Conclusions:
- There is a significant lack of clinical trial evidence to guide orthodontic treatment choices for Class II division 2 malocclusion in children.
- Conducting such trials is difficult due to the condition's low prevalence, recruitment challenges, and ethical issues surrounding randomization.
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