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Quantum of dentoalveolar compensation in class III malocclusion : Systematic review and meta-analysis
Keerthana Ramesh1, Venkateswaran Ananthanarayanan2, Vignesh Kailasam1
1Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), No. 1 Ramachandra Nagar, Porur, 600116, Chennai, Tamil Nadu, India.
Aim:
This systematic review aimed to assess and quantify the dentoalveolar compensation in skeletal class III malocclusion subjects.
Materials And Methods:
Untreated class III subjects whose dentoalveolar compensations were radiologically evaluated were included. Predetermined inclusion and exclusion criteria were applied across PubMed, Scopus, LILACS, Ovid, and Web of Science electronic databases up to 27 January 2025, with no restriction on the year of publication. A total of 1007 articles were obtained, of which 10 studies met the eligibility criteria and were included in the systematic review, while 7 were included for the meta-analysis.
Results:
Risk of bias assessment was performed using the Newcastle Ottawa scale. Four studies scored 8 points, four studies scored 7 points, and two studies scored 6 points. The qualitative evaluation indicated that the dentoalveolar compensation in class III malocclusion was a result of proclined maxillary and retroclined mandibular incisors. Quantitative evaluation showed that when compared to class I subjects, maxillary incisors in class III subjects were proclined by 4.75° (95% confidence interval [CI] 0.72-8.77). Mandibular incisors were retroclined with a mean change in inclination of -8.40° (95% CI -11.21 to -5.60), thus, indicating a greater contribution of mandibular incisors to the compensatory mechanism.
Conclusion:
The present systematic review and meta-analysis conclusively proved that maxillary incisor proclination and mandibular incisor retroclination contributed to dentoalveolar compensation in class III subjects. Quantitative analysis provided evidence that mandibular incisor retroclination contributed more to dentoalveolar compensation. The findings of this systematic review and meta-analysis would be of importance to the clinician while planning treatment, since respecting the anatomical limits of the underlying structures is essential.
