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Effectiveness and Clinical Indications of 2 × 4 Fixed Orthodontic Therapy in Regard to Mixed Dentition: A Systematic
Gianna Dipalma1, Grazia Marinelli1, Lucia Casamassima1
1Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Background/Objectives:
This systematic review examines the effectiveness and clinical indications of the 2 × 4 fixed orthodontic appliance for interceptive treatment in children with mixed dentition, aiming to simplify future orthodontic needs.
Methods:
Following the PRISMA guidelines, a search was conducted across PubMed, Web of Science, and Scopus (May 2000-May 2025). The inclusion criteria focused on open-access, in vivo/human studies, case-control studies, cohort studies, and RCTs in English. Risk of bias was assessed using Rob 2.0.
Results:
Out of 362 initial records, 7 studies were included. Most of the included studies showed a low risk of bias, with some moderate risk in terms of confounding variables and participant selection, but no high risk was identified.
Conclusions:
The 2 × 4 fixed orthodontic appliance is an effective interceptive therapy for mixed dentition. Clinicians can optimize outcomes by understanding its biomechanics and clinical applications. Further research is needed to understand long-term impacts and improve efficiency.
