An updated systematic review regarding early Class II malocclusion correction

Abstract

Abstract Background and aim Class II malocclusion is one of the most common malocclusions in young children and a great deal of research on this topic has been undertaken. Despite this, there are still knowledge gaps on whether it is effective to treat these malocclusions early or what type of treatment should be performed. The aim of this article was to systematically review and update the quality of evidence for various treatment modalities considering Class II malocclusion correction before 10\xa0years of age and with a focus on improvement of dental and skeletal relationships, soft tissue profile, relation to temporomandibular disorder (TMD), incidence on dental trauma, cost-effectiveness, and quality of life. Material and methods Four databases were searched, from January 1960 to April 2019. Inclusion criteria were randomized or controlled trials reporting short- or long-term effects on dental or basal relationships, soft tissue profile, associations to TMD, quality of life, incidence of trauma, or costs. The quality of evidence was scored according to Grading of Recommendations Assessment Development and Evaluation. Results A total of 300 publications were identified and 23 satisfied the inclusion criteria for full evaluation. The quality of evidence was high in 5 trials, moderate in 3, and low in\xa015. Conclusions From the short-term perspective, there is a high level of evidence that early treatment reduces overjet and improves the anterior-posterior skeletal relationship. There is insufficient evidence about whether early treatment can reduce the incidence of trauma, is cost-effective, provides improved soft tissue profile, improves oral health–related quality of life, or possesses a risk of developing TMD.