Precision wings treating skeletal class II in growing patients: a systematic review and meta-analysis

Area of Science:

• Orthodontics
• Dentofacial Orthopedics

Background:

• Skeletal Class II malocclusion, frequently linked to mandibular deficiency, is commonly managed with functional appliances.
• Precision Wings represent an alternative functional appliance, integrating mandibular advancement with dental alignment.

Purpose of the Study:

• To systematically review the efficacy of Precision Wings in treating skeletal Class II malocclusion in growing individuals.

Main Methods:

• A systematic review following PRISMA guidelines, selecting studies based on the PICOS strategy.
• Unrestricted electronic searches across seven databases were conducted up to February 2025.
• Risk of bias was assessed using ROBINS-I, and evidence certainty was evaluated using the GRADE approach.

Main Results:

• Seven studies were included, indicating Precision Wings may effectively treat skeletal Class II malocclusion through dental and skeletal changes.
• Skeletal effects were primarily observed as small sagittal mandibular changes, reducing ANB° (MD = -0.81) due to increased SNB° (MD = 0.55), with no significant SNA° changes.
• No significant vertical effects were reported, and meta-analyses comparing Precision Wings with other appliances were not feasible due to heterogeneity.

Conclusions:

• Current evidence suggests Precision Wings provide minimal clinical improvement in mandibular growth for skeletal Class II malocclusion.
• Future research should focus on well-designed randomized clinical trials with standardized protocols and extended follow-ups for more definitive conclusions.