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Effectiveness of aligners to correct vertical malocclusions in adult patients : Systematic review
Hajar Ben Mohimd1, Houda Neani2, Fatima Zaoui2
1Department of Dentofacial Orthopedics, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, Morocco. hajar_benmohimd@um5.ac.ma.
Introduction:
Aligners represent an important further development in orthodontic practice. The improvement of their biomechanical features has allowed treatment of more complex malocclusions. Vertical malocclusions are among the most difficult discrepancies to treat due to the complexity of the biomechanics of the movements involved. The aim of this systematic review was to assess the effectiveness of aligners in the treatment of open bite and deep bite malocclusions in adult patients.
Materials And Methods:
An electronic search was conducted on various databases: Medline via PubMed, ScienceDirect, The Cochrane Library, and Web of Science up to August 2024. The search was established on a well-defined research question using MeSH terms. Two investigators selected papers based on clear exclusion/inclusion criteria. In these papers, overbite change was assessed based on cephalometric measurements or intraoral scans. Search evaluation and the assessment of risk of bias were undertaken in each study following its type and design.
Results:
Of the 5511 references, 18 studies were included for qualitative analysis. Ten studies covered open bite treatment and eight studies treated deep bite. Since all the included papers were retrospective observational studies with heterogeneity of the protocols and a moderate risk of bias, the overall scientific evidence was identified to be at a low level.
Conclusion:
The results of individual studies suggest that aligners could be a viable technique for the correction of mild to moderate open bite with good vertical control in contrast to deep bite malocclusions where treatment efficacy is still limited. However, these results should be interpreted with caution since the overall quality of the evidence was rated as low according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Clinical Significance:
There is only low-certainty evidence suggesting that aligners could be a viable treatment option for open bite and deep bite malocclusions.
