Multiloop edgewise archwire for anterior open bite: A systematic review and meta-analysis of observational studies
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Published on: July 24, 2018
Erika Correa1, Dimitrios Michelogiannakis1, Abdul Basir Barmak2
1Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
Introduction:
The objective of this systematic review and meta-analysis was to assess the effectiveness of the multiloop edgewise archwire (MEAW) technique in the treatment of anterior open bite (AOB).
Methods:
The present study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research question was "In patients with AOB, what are the treatment effects of the MEAW technique on overbite correction and associated dental and skeletal outcomes?" Original clinical studies of patients in the permanent dentition diagnosed with AOB, with pre- and posttreatment cephalometric records, who were treated with the MEAW technique were included. Databases were searched without time and language barriers through November 2025. A risk of bias (RoB) assessment was performed using the Risk Of Bias In Non-randomized Studies of Interventions tool. Meta-analyses for mean differences (MD) were conducted using a random-effects model for changes in overbite and mandibular plane angle (MPA). Sensitivity subgroup analyses for MD were conducted using random- and fixed-effects models. The Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess the certainty of evidence. Publication bias was evaluated using Funnel plots.
Results:
Five observational retrospective studies were included. General characteristics included growing, nongrowing, extraction and nonextraction treatments, and a mean age ranging from 13-26 years. The RoB was moderate in all studies. The MEAW led to a significant increase in overbite (MD = -3.24 mm [95% confidence interval, -4.18 to -2.29 mm]) and no significant change in MPA. The certainty of evidence was low for changes in AOB and MPA. Sensitivity analysis showed relatively consistent MD of -2 to -4 mm.
Conclusions:
The effectiveness of the MEAW technique for the treatment of AOB remains inconclusive. Further high-quality, adequately powered randomized controlled trials with larger sample sizes are needed.