Airway dimensional changes following bone anchored maxillary protraction: a systematic review

Area of Science:

• Orthodontics and Dental Research
• Maxillofacial Surgery
• Respiratory Physiology

Background:

• Class III malocclusions often require interventions for maxillary hypoplasia.
• Skeletal anchorage for maxillary protraction aims for orthopedic changes with minimal dental effects.
• Evaluating airway dimensional changes is crucial for understanding the comprehensive impact of this treatment.

Approach:

• A systematic review was conducted evaluating randomized and prospective clinical trials.
• Databases searched included PubMed, Cochrane Library, Web of Science, Scopus, Google Scholar, and Open Grey.
• Risk of bias and study quality were assessed using established tools (RoB 2, ROBINS-I, modified Jadad score).

Key Points:

• Four clinical trials met the inclusion criteria, assessing airway changes post-bone-anchored maxillary protraction.
• All included studies indicated an improvement in airway dimensions with bone-anchored maxillary protraction devices.
• Evidence quality was low to moderate, with three of four studies having guarded evidence.

Conclusions:

• Bone-anchored maxillary protraction appears to improve airway dimensions.
• The current evidence is insufficient to strongly support significant airway dimension increases due to limited studies and methodological quality.
• Further high-quality randomized controlled trials are required for definitive conclusions on airway dimensional changes.