Effectiveness of prefabricated myofunctional appliances on Vertical Dimension in Children: A Systematic Review and Meta-Analysis

Authors

  • A Balian Dental and Stomatology Unit, Surgical Area Department, Cittadella Hospital, ULSS6 Euganea, Via Pilastroni 15, 35013 Cittadella
  • C Salerno Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy - Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland - Graduate School for Health Sciences, University of Bern, Bern
  • A Manti Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan
  • V Lanteri Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, Via del Pozzo 71, 41125 Modena
  • S Cirio Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan
  • MG Cagetti Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan

DOI:

https://doi.org/10.23804/ejpd.2025.2469

Keywords:

orthodontics, deep-bite, open-bite, elastodontic appliances, elastodontic devices, systematic review, meta-analysis

Abstract

AIM: Prefabricated myofunctional appliances (PMAs) are widely adopted for correcting the sagittal and vertical dimensions during mixed dentition. Despite the effectiveness of the antero-posterior relationship has been recently evaluated, the effectiveness in correcting the vertical dimension is still uncertain. This systematic review aimed to assess the effectiveness of PMAs treatment in children with mixed dentition on the vertical dimension, including sagittal and transverse parameters that may affect the vertical dimension. METHODS: PubMed, Scopus, Embase, Cochrane, Livivo, and Lilacs were searched from inception until November 5th, 2024. Selection criteria were: Randomized/non-randomized clinical studies (RCT/NRSI), prospective and retrospective cohort studies, before-and-after comparisons, and cross-sectional studies assessing PMAs treatment in mixed dentition children with deep-bite or open-bite malocclusion. The mean pre-treatment and post-treatment values of dental and/or skeletal variables and/or treatment changes as mean differences (MD)±SD, were extracted. Risk of bias was performed with Rob2 and the NHLBI quality assessment tools. Random-effect meta-analysis of MD and their 95% confidence intervals (ICs) were performed, followed by assessment of clinical relevance of significant results. CONCLUSION: The PMAs treatment seems to be associated with a reduction of overbite in deep-bite malocclusion, whereas the vertical skeletal pattern seems to be unaffected.