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Maxillary Arch Intrusion With Temporary Anchorage Devices Versus Conventional Intrusion Arches: A Systematic Review
Aparna Khamatkar1, Aditi Sawtekar1, Karthick Shetty1
1Department of Orthodontics and Dentofacial Orthopedics, D. Y. Patil Deemed to be University, School of Dentistry, Navi Mumbai, IND.
Abstract:
Deep bite correction often requires maxillary incisor intrusion, and both temporary anchorage devices (TADs) and conventional intrusion arches are used for this purpose. This systematic review and meta-analysis aimed to compare the effectiveness of TAD-supported maxillary arch intrusion with conventional intrusion arches in patients with deep bite or Class II malocclusion undergoing maxillary incisor intrusion. A comprehensive electronic search was performed in PubMed, PMC/MEDLINE, Cochrane Library, and DOAJ for studies published up to December 31, 2025. Randomized controlled trials and non-randomized comparative clinical studies evaluating maxillary incisor intrusion with TADs versus conventional intrusion arches were included. Study selection, data extraction, risk of bias assessment, and quantitative synthesis were performed using predefined criteria. Nine studies met the eligibility criteria, including three randomized controlled trials and six non-randomized comparative studies. Both TAD-supported and conventional intrusion mechanics were effective in achieving maxillary incisor intrusion and reducing deep bite. However, the pooled analysis favored TAD-supported intrusion for the rate of intrusion, amount of incisor intrusion, and overbite correction. The pooled standardized mean difference was 1.18 for the rate of intrusion, -0.88 for incisor intrusion, and -0.48 for overbite correction, all favoring TADs. Treatment duration did not differ significantly between the two approaches. Qualitative findings also suggested better posterior anchorage preservation with TAD-supported mechanics, whereas conventional intrusion arches were more commonly associated with molar extrusion and incisor proclination. Within the limitations of the available evidence, TAD-supported intrusion tended to show favorable effects for some intrusion-related outcomes compared with conventional intrusion arches; however, treatment duration did not differ significantly, and adverse effects were also reported in some TAD protocols. The certainty of evidence was low to very low, and thus, further well-designed long-term studies are needed.