Correction of Anterior Open Bite Using Temporary Anchorage Devices: A Systematic Review and Meta-Analysis

使用临时支抗装置矫正前牙开颌:系统评价和荟萃分析

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Abstract

Background/Objectives: Anterior open bite (AOB) is a complex malocclusion characterized by the lack of vertical overlap between the upper and lower teeth during maximum intercuspation. It often results in functional impairments and aesthetic concerns. Traditional treatments for adult patients, including orthognathic surgery, are effective but invasive. Temporary anchorage devices (TADs) have emerged as a minimally invasive alternative. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of TADs for molar intrusion in the correction of AOB. Methods: A systematic review was conducted according to the PRISMA 2020 guidelines. An electronic search was performed in PubMed and Scopus until March 2025. The inclusion criteria comprised clinical studies in humans published in English or Spanish in the last 10 years. The risk of bias was assessed using RoB 2, ROBINS-I, and the Joanna Briggs Institute tools. A random-effects meta-analysis was carried out to estimate pooled intrusion values, and heterogeneity was evaluated using Cochran's Q test and the I(2) statistic. Results: Twelve studies were included. Molar intrusion using TADs achieved significant overbite improvements, with a pooled mean intrusion of 1.70 mm (95% CI: 0.53-2.87 mm). The heterogeneity among studies was high (I(2) = 88.5%). Despite variability in force magnitude and TAD type, lighter forces were generally associated with similar outcomes and fewer adverse effects. Conclusions: TADs offer a predictable and less invasive alternative to orthognathic surgery for AOB correction. When appropriately indicated and biomechanically managed, they provide effective vertical control and short- to medium-term stability in adult patients.

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