BACKGROUND/OBJECTIVES: Orthodontic miniscrews serve as critical temporary anchorage devices (TADs), but their clinical success is often limited by biomechanical instability. This research was done to evaluate the biomechanical impact of different miniscrew insertion angles on stress distribution and micromotion using finite element analysis (FEA). METHODOLOGY: FEA was performed on a total of 225 mandibular models derived from cone beam computed tomography scans of Indian adults. Titanium alloy (Ti-6Al-4V) miniscrews with Sandblasted, Large-grit, Acidsurface modification was inserted at angles of 30°, 45°, 60°, and 90°. Each setup was subjected to vertical and oblique orthodontic loads of 2 N and 5 N. Stress, displacement, and micromotion were analyzed, and the obtained data were statistically evaluated. RESULTS: Miniscrew insertion at 45° demonstrated the most favorable biomechanical profile, with the lowest von Mises stress (61.2 MPa), minimal micromotion (0.033 mm), and optimal stress distribution. Insertion angle had a significant effect on stress (P < 0.001), and regression analysis identified insertion angle and bone density as significant predictors of stress and micromotion (adjusted R² = 0.89). The odds of failure due to high stress and micromotion were highest at insertion angles of 90° and 30°, respectively.Multivariate regression revealed that both insertion angle and bone density significantly influenced miniscrew stress and micromotion, with optimal 45° angulation and higher bone density minimizing failure risk (adjusted R² = 0.89). CONCLUSION: A 45° insertion angle offers biomechanical superiority for miniscrew placement, reducing stress concentrations and the risk of micromotion. These findings provide evidence-based guidance for clinical orthodontic practice, particularly in Indian populations.
OBJECTIVES: To compare cervical vertebral dimensions in individuals with different growth patterns. MATERIALS AND METHODS: 45 individuals were taken and equally divided into three groups. Age of participants were above 18 years. Routine lateral cephalometric radiographs were collected and subjects was divided using parameters FHP- MP, SN-MP, Tweeds FMA, Y- Axis and facial axis. To measure vertical height and length of c3 and c4 cervical vertebrae the reference points were marked on acetate paper using a soft lead pencil and measured with a digital micrometer caliper. The reference points used are Cv3sa, Cv4sa, Cv3ia, Cv4ia, Cv3sp, Cv4sp, Cv3ip, Cv4ip. RESULTS: No significant difference observed between three growth patterns for C3 length superior (p—0.12) and C3 vertical posterior (p-0.14). A significant difference observed in C3 vertical anterior (p-0.02) and C3 length inferior (p-0.04). A significant difference observed in length superior (p-0.02) and length inferior (p-0.01) for C4. CONCLUSIONS: Individuals with average growth pattern tend to have larger inferior length for c3 and c4 and superior length for C4 than vertical growth patterns. whereas c3 vertical anterior value of horizontal is significantly higher than vertical growth patterns. Overall vertical growers presented smaller dimensions of cervical vertebrae 3 and 4.
BACKGROUND:The Malocclusion Impact Questionnaire (MIQ) is a validated tool used to assess how malocclusion affects oral health-related quality of life (OHRQoL). This research focused on translating and culturally adapting the MIQ, then validating it in a group of Arab adolescents with malocclusion. MATERIALS AND METHODS:Following translation per current guidelines, a pilot study with 20 adolescent native Arabic-speakers confirmed the comprehensiveness of the Arabic MIQ (MIQ-AR). The main study included 233 native Arabic-speaking children aged 10-16, who sought initial orthodontic advice. Construct validity was assessed by correlating the total MIQ-AR scale score with responses to global questions. Convergent validity was measured using the Child Perceptions Questionnaire (CPQ11-14 - ISF: 16). Internal consistency and reliability were evaluated using Cronbach's alpha. Forty adolescents completed both questionnaires again after 3 weeks to assess measurement stability, using Spearman's correlation coefficient and the intraclass correlation coefficient. Additionally, principal component analysis (PCA) was conducted. RESULTS:The MIQ-AR demonstrated high internal consistency with Cronbach's α above 0.90 and exhibited a strong Discrimination Index. A positive, strong, significant correlation between the global questions and the total MIQ-AR score supported the construct validity of the MIQ-AR. Convergent validity was confirmed through positive, strong, and statistically significant correlation between the MIQ-AR total scores and the CPQ11-14 scale. The test-retest reliability assessment confirmed the measure's stability over time, and the PCA yielded a two-component solution that accounted for 52.3% of the total variance. CONCLUSION:The current version of MIQ-AR demonstrates strong psychometric properties in terms of validity and reliability, and appears to be a reliable instrument for assessing the impact of malocclusion on OHRQoL among Arab adolescents. However, these findings should be interpreted with caution, as they may be limited to populations like the study sample. Further testing of the measure is required across a variety of settings and further work should evaluate measurement invariance and responsiveness across countries and more representative community samples.
OBJECTIVES:The study's aim was determining incidence of the overjet that increased, as well as evaluating the connection between it and other measurements sagittal in patients with malocclusion and not receiving treatment. MATERIALS AND METHODS:A conduction of a cross-sectional study was conducted on 585 orthodontic patients whose Cephalometric X-rays were obtained from orthodontic centers in Karbala city, Iraq. The iRYS software was used in cephalometric analysis to detect the anatomical landmarks and angles and to measure the overjet and determine the skeletal classes according to the amount of Sella-Nasion-A point (SNA), Sella-Nasion-B point (SNB), and A point-Nasion-B point (ANB) angles. Statistical analyses included Chi-square tests and binary logistic regression to assess associations. RESULTS:Increased overjet was observed in 56.4% of the subjects, decreased overjet in 21.7%, and normal overjet in 21.9%. Chi-square analysis revealed that 74.8% of the increased overjet cases were associated with Class II skeletal pattern (P < 0.001), while only 13.6% were associated with Class III, showing no significant correlation. Logistic regression confirmed that Class II malocclusion significantly increased the likelihood of the increased overjet (B = 0.867, OR = 2.379, 95% CI: 1.58-3.56, P < 0.001), whereas Class III malocclusion decreased this likelihood (B = -2.072, OR = 0.126, 95% CI: 0.069-0.229, P < 0.001). CONCLUSION:The increased overjet was the most prevalent condition in the study population. The increased overjet is highly prevalent and strongly associated with Class II skeletal pattern, whereas Class III is protective. Early skeletal assessment is essential for diagnosis and treatment planning.
PURPOSE: The aim of the study was to compare the anterior parameters and the palatal height index (PHI) in obstructive sleep apnea (OSA) patients and control subjects, using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The CBCT data of 30 male OSA patient diagnosed with polysomnography and 30 male control subjects with no sleeping disorders were analyzed using the software 3D Slicer. The head position during the scan was similar in both groups. The anterior parameters (overjet and overbite) and the PHI were calculated. Independent samples T-test was used to identify statistically significant differences between the means of two independent groups. Chi-square test was used to assess relationship between categorical variables. A P value of less than 0.05 was considered statistically significant. RESULTS: The mean value of PHI was lower in the OSA group (P = 0.010). No statistically significant difference between the means of overbite and overjet was found between the two groups. CONCLUSION: The anterior parameters did not show significant differences between the groups. However, the OSA group have a significantly lower mean PHI than the control group.
OBJECTIVE:To evaluate and compare the effects of two alcohol-free mouthrinses, Listerine® Zero, and Pepsodent Daun Sirih®, on the force decay of orthodontic elastomeric chains commonly used in orthodontic treatment. MATERIALS AND METHODS:Sixty elastomeric chain segments were randomly allocated into three groups (n = 20 per group): control (artificial saliva), Listerine® Zero, and Pepsodent Daun Sirih®. Samples were immersed twice daily for 30 sec in their respective solutions and stored in artificial saliva at 37°C between immersions for 21 days. Force measurements were recorded at baseline (Day 0) and on Days 1, 7, 14, and 21 using a digital force gauge. Data normality was assessed using the Shapiro-Wilk test. As the data were not normally distributed, the Kruskal-Wallis test followed by the Mann-Whitney U test was applied, with statistical significance set at P < 0.05. RESULTS:Both mouthrinses produced a progressive reduction in force over time, with the greatest force decay occurring within the first 24 hours, followed by a more gradual decline up to 21 days. However, elastomeric chains immersed in Pepsodent Daun Sirih® consistently retained higher residual force than those immersed in Listerine® Zero at all observation periods, indicating a slower rate of force degradation. CONCLUSION:Pepsodent Daun Sirih® demonstrated a lower degree of force decay and maintained significantly higher residual force compared with Listerine® Zero throughout the observation period. These findings suggest that Pepsodent Daun Sirih® may be a more suitable alcohol-free mouthrinse for preserving orthodontic force during treatment.
OBJECTIVE: This review systematically evaluated the evidence on clear aligner therapy, focusing on its dentoskeletal, periodontal, and patient-related advantages over traditional appliances. MATERIALS AND METHODS: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science for relevant studies published between January 2015 and March 2025. The two authors independently assessed the titles and abstracts of conceivably eligible papers. Disputes between the two examiners were settled by discussion, and a third party was consulted for a conclusive decision. The review question was formulated using the population, intervention, comparison, and outcome (PICO) framework. The risk of bias instrument RoB-2 was used to assess the risk of bias in randomized controlled trials (RCTs). The Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) method was used in assessing non-randomized studies. RESULTS: The search identified 196 studies, of which 55 underwent full-text review, and 15 met the inclusion criteria. Thirteen were non-randomized studies and two randomized. Six examined long-term aligner outcomes without comparison, three compared aligners with twin block appliances, one with an untreated group, and six with fixed appliances. According to the ROBINS-I tool, three studies showed low, three moderate, and seven high risk of bias (RoB), while both RCTs had low risk according to RoB-2. CONCLUSION: Clear aligners enhance dental aesthetics and periodontal health relative to conventional fixed appliances, offering potential benefits in treatment length and patient comfort.
OBJECTIVE:To correlate McNamara's User's Guide for Cervical Vertebral Maturation, Fishman's Hand Wrist Maturation, Chronological Age, and Dental Age for the assessment of Skeletal Maturation in growing orthodontic patients of different ethnic groups. MATERIALS AND METHODS:A total of 253 patients (127 males and 126 females) from different ethnic groups with lateral cephalograms, orthopantomograms, and hand-wrist radiographs were analyzed. Statistical analysis was performed, including Pearson's correlation coefficient, ANOVA, and Tukey post hoc analysis. RESULTS:Strong correlations were observed between CA, Demirjian's DA, CVM, and HWM (r = 0.732-0.872, P < 0.001). Significant differences among age assessment methods were identified using ANOVA, with Tukey post hoc analysis highlighting differences between CA and DA (P = 0.006) and CVM and SMI (P < 0.001). No significant differences were found between CA and CVM (P = 0.979) or DA and SMI (P = 0.774). CONCLUSION:This study demonstrated a significant correlation between CVM, HWM, CA, and DA in assessing skeletal maturation across different ethnic groups.
OBJECTIVE: This study aimed to evaluate the potential for root resorption and periodontal complications in patients with Class II malocclusion undergoing piezocision-assisted orthodontic treatment over a 2-year follow-up period. MATERIALS AND METHODS: Twenty patients (11 females, 9 males; mean age: 16.1 ± 2.8 years) requiring bilateral canine distalization and maxillary first premolar extraction were included in this split-mouth study. One quadrant was randomly assigned to undergo piezocision, while the contralateral quadrant served as the control. Panoramic radiographs were utilized to assess root resorption at baseline (T1), and 2 years post-treatment (T2). Additionally, gingival health and tooth mobility scores were evaluated. Statistical analyses were performed using the Wilcoxon signed-rank test. RESULTS: No clinically significant root resorption was observed in either group. Mild resorption was noted on the upper canine of one patient in the piezocision group, while another patient in the control group exhibited resorption on the upper lateral incisor. Gingival health, and mobility scores decreased from T1 to T2 in both groups, with no statistically significant differences found between the piezocision and control sides. Scar formation on the attached gingiva was observed in one patient following piezocision; however, this was not associated with bone loss or increased periodontal pocket depth. CONCLUSION: Piezocision-assisted orthodontic treatment did not result in clinically significant root resorption or adverse periodontal outcomes in patients with Class II malocclusion over a 2-year period. These findings support the safety of piezocision as a method for accelerating tooth movement without compromising periodontal health. Further research with larger sample sizes and histological assessments is recommended to validate these results.
INTRODUCTION: Cephalometrics is the most frequently utilized clinical tool for assessing sagittal jaw relationships. There have been numerous linear and angular measures employed to diagnose these anteroposterior discrepancies. Each of the methods demonstrates its intrinsic characteristics based on the variation of variables besides the jaw relationship itself. The objective of this study is to make a comparative evaluation of 23 parameters, which includes linear and angular measurements of sagittal discrepancy in detail. MATERIALS AND METHODS: About 150 lateral cephalograms were gathered from subjects obtained in natural head position. This comparative study evaluated the mean and standard deviation, the reliability, and the correlation between various parameters and their sensitivity and specificity were calculated. RESULTS AND CONCLUSION: All the measurements are statistically highly significant in determining the sagittal skeletal discrepancy. Recent angles like Beta angle, Yen angle, and Pi analysis have lots of accuracy and consistency associated with them. However, the human population exhibits significant variability, making it impossible for a single cephalometric examination to reliably determine true skeletal relationships in every circumstance. Therefore, the spectrum of cephalometric analysis must be understood by clinicians so that it can be used appropriately according to the patient’s needs.
Theoretical and anatomical pathways suggest a connection between the stomatognathic and visual systems. However, the evidence for associations between dental occlusion, temporomandibular disorders (TMD), and visual function is fragmented and of uncertain quality. This study aimed to systematically review and critically appraise the evidence regarding associations between occlusal factors, TMD, and visual parameters. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE (via PubMed) from 1946 to March 2025 for English-language studies investigating occlusion/TMD and visual outcomes. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Joanna Briggs Institute (JBI) critical appraisal tools. A narrative synthesis was performed due to clinical heterogeneity. Ten studies (*n* = 7 cross-sectional, *n* = 2 case reports, *n* = 1 experimental) met the inclusion criteria. Evidence suggested associations between Class II malocclusion and myopia, altered masticatory muscle activity in myopia, abnormal pupillary responses in TMD, and vergence disorders in TMD patients. However, the overall body of evidence was rated as very low certainty due to pervasive methodological limitations: All studies had a high risk of bias, small sample sizes (20--150), and a cross-sectional design. Most studies originated from a single research group. While some associations between occlusal factors, TMD, and visual function are reported, the current evidence is insufficient to establish causality or clinical significance. The high risk of bias, small sample sizes, and lack of independent replication preclude definitive conclusions. Future high-quality, prospective, and adequately powered studies are required.
OBJECTIVE: This study aims to demonstrate the correlation between anterior tooth retraction and changes in the dimensions of the pharyngeal airway in cases of bimaxillary protrusion. MATERIALS AND METHODS: Changes in dental parameters and the width of the upper and lower pharyngeal airways from 46 lateral cephalometric radiographs that met the inclusion criteria were measured. Changes were tested for significance using the paired t-test, and correlations were tested using the Pearson correlation test. RESULTS: Significant changes were observed in dental parameters and in the width of the upper pharyngeal airway following orthodontic treatment (P < 0.05). However, no significant change was found in the width of the lower pharyngeal airway (P = 0.166). There was no significant correlation between changes in the upper incisor parameters and upper pharyngeal airway width (P = 0.130 and P = 0.738), nor between changes in the lower incisor parameters and lower pharyngeal airway width (P = 0.911 and P = 0.614). CONCLUSION: Anterior tooth retraction does not significantly correlate with changes in the width of the pharyngeal airway. Therefore, premolar extraction for anterior tooth retraction can be considered a safe orthodontic approach in cases of bimaxillary protrusion.
OBJECTIVE: To evaluate and compare the expression levels of Receptor Activator of Nuclear Factor Kappa B Ligand (RANKL) and Osteoprotegerin (OPG) in canine periodontal tissues subjected to periodontal distraction versus conventional retraction at different treatment time points. MATERIALS AND METHODS: The study involved 40 cuspids from 20 patients (9 males, 11 females) randomly allocated to either the periodontal distraction (PD) group or the conventional retraction group. Appliances were applied by a single practitioner in a split-mouth design. In Group 1 (PD), a trans-palatal arch and Hyrax expanders were used following premolar extraction with osteotomies performed to facilitate distraction. Group 2 (conventional retraction) used MBT brackets with sectional archwires and elastic chains. Gingival crevicular fluid samples were collected on the first day (D0), after 1 week (W1), and 6 weeks (W6) and OPG and RANKL levels were analyzed using ELISA test. RESULTS: There was a significant difference in canine retraction duration between methods (P < 0.001), with periodontal distraction taking 24.1 ± 2.08 days versus 110.5 ± 4.84 days for conventional retraction. RANKL levels showed no baseline difference, but were significantly higher in the periodontal distraction group at weeks 1 and 6 (P = 0.010 and P = 0.001, respectively). OPG levels were initially similar, but by weeks 1 and 6, they were significantly lower in the periodontal distraction group (P = 0.001). CONCLUSION: The periodontal distraction method significantly reduces the duration of canine retraction and enhances osteoclastic activity, as evidenced by increased RANKL and decreased OPG levels, facilitating accelerated tooth movement through efficient bone resorption and remodeling.
OBJECTIVE: Assessment of total root volume, root length, labial bone height, and amount of intrusion for three different intrusive mechanics; orthodontic miniscrews, utility arch, and the nitinol reverse curve archwire (RCA). PATIENTS AND METHODS: Twenty-one deep bite orthodontic patients (male and female, age range 12–16 years old), were involved in the current study. According to the method of intrusion for lower incisors, the patients were randomly subdivided into three groups; Group (A): patients received an intrusive force delivered by elastics from two mini-screws between mandibular lateral incisor and mandibular canine. Group (B): patients received an intrusive force delivered by intrusive utility arch. Group (C): patients received an intrusive force delivered by RCA. Cone beam computed tomography (CBCT) was taken just before and after completion of intrusion of the lower anterior segment. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) version 18; Bonferroni’s post hoc test was used for pair-wise comparisons when the ANOVA test is significant. The significance level was set at P ≤ 0.05. RESULTS: A statistically significant difference in root length reduction was found among the three groups. Post hoc analysis revealed no significant difference between group A and group B with mean difference (−0.97 mm, −0.93 mm). However, root length reduction in group A and group B was significantly greater than that of group C, which showed the least mean difference (−0.81 mm) in root length reduction. CONCLUSIONS: The nitinol RCA produce adverse effects as a root resorption and reduction of labial bone height during intrusion of the lower anterior segment more than that produced by the orthodontic miniscrews with elastics and utility arch as intrusive mechanics.
OBJECTIVE:To evaluate the effects of Lactobacillus paracasei probiotic toothpaste, cetylpyridinium chloride (CPC) toothpaste, and amyloglucosidase-glucose oxidase toothpaste on the levels of Porphyromonas. gingivalis, Aggregatibacter actinomycetemcomitans, and plaque index in individuals undergoing fixed orthodontic treatment. MATERIALS AND METHODS:A double-blind randomized controlled clinical trial was conducted using purposive sampling. Participants were randomly assigned to use one of the toothpaste types. Saliva samples were collected at baseline and one month after using the toothpaste. Bacterial levels were quantified using quantitative polymerase chain reaction, and plaque accumulation was assessed using the Orthodontic Plaque Index. RESULTS:All groups showed a reduction of P. gingivalis and A. actinomycetemcomitans following the intervention; however, no significant changes were observed in the plaque index. Statistical analysis using two-way repeated measures analysis of variance with sphericity assumed revealed no significant differences between the groups (p < 0.05). CONCLUSION:Toothpastes containing L. paracasei, CPC, and amyloglucosidase-glucose oxidase enzyme show potential for reducing periodontal pathogens, suggesting a preventive benefit against periodontal complications in patients with fixed orthodontic appliances.
OBJECTIVE: To assess the diagnostic accuracy of artificial intelligence-based models in the determination of tooth extraction in orthodontic treatment planning. MATERIALS AND METHODS: A comprehensive literature search was conducted in multiple databases (PubMed, LILACS, Web of Science, Scopus, EBSCO, and Google Scholar) up to June, 2024. Studies that met the inclusion criteria based on the PIRD (Participants, Index test, Reference test, Diagnostic) framework were selected. The risk of bias of included studies was assessed using the QUADAS-2 tool, and their methodological quality was evaluated as well using a standardized checklist. RESULTS: Out of 361 retrieved records, eleven studies were included in this review. Nine of these studies achieved a score of over 50% on the AI quality checklist, indicating acceptable methodological quality. However, a comprehensive assessment using the QUADAS-2 tool revealed that all studies had some level of risk of bias, particularly in patient selection, the conduct of AI-based predictions, and the reference standard used. CONCLUSION: Neural networks and classifier models demonstrated the high level of accuracy ranging from 82% to 94% in determining the optimal tooth extraction protocol. However, to ensure reliable predictions, artificial intelligence-based models should be rigorously trained, incorporating a comprehensive range of factors.
OBJECTIVE: This scoping review aims to evaluate the efficacy and limitations of clear aligner therapy (CAT), particularly Invisalign, in the transverse development of the maxillary arch. With increasing demand for esthetic, removable orthodontic alternatives, clear aligners are used beyond mild crowding to manage arch expansion and crossbites. MATERIALS AND METHODS: A comprehensive search of PubMed, Scopus, Web of Science, Google Scholar, Elsevier, and National Center for Biotechnology Information was conducted to identify English-language studies published between 2020 and 2024. Keywords used included “maxillary arch development,” “CAT,” and “Invisalign.” After applying inclusion and exclusion criteria, eight studies were included from an initial 3,190 identified records. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework guided the selection process. RESULTS: The included studies demonstrated that clear aligners can achieve maxillary expansion primarily through buccal tipping of posterior teeth. However, bodily movement remains limited. The predictability of expansion outcomes varied, with cusp width changes being more reliable than root or gingival-level movements. One study found an expansion efficiency of over 90% at the first premolar cusp, while others noted discrepancies between planned and achieved outcomes. CONCLUSION: Clear aligners demonstrate moderate effectiveness for maxillary arch expansion through dental tipping, especially in mild to moderate cases. However, they are less predictable for bodily movement or large-scale skeletal changes. Further high-quality, controlled trials are required to validate these outcomes and optimize treatment protocols.
BACKGROUND: Maxillary midline diastema (MMD) is a gap between the maxillary central incisors, posing cosmetic and psychosocial concerns for most patients. MMD results from multifactorial causes, including labial frenum, microdontia, genetics, and various oral habits. The purpose of this article was to review MMD, analyze its prevalence, describe a new shape-based classification, and identify potential causes with a focus on evidence-based practice. MATERIALS AND METHODS: This cross-sectional descriptive study utilized orthodontic clinical records of Saudi adults aged 18–30 years who had not sought orthodontic treatment. MMD presence was confirmed by examining dental models. Diastema size was measured at gingival, middle, and incisal levels using a Mitutoyo calliper with 0.1 mm accuracy. Pairs of Angle Class I models were used to ensure equivalent tooth size for specimens. Patient records were reviewed to determine etiologies, and Bolton’s tooth size ratio was calculated for analysis. Statistical analyses included Z-test, Shapiro–Wilk test, paired/independent t-tests, and post-hoc Bonferroni tests, conducted using SPSS version 26. RESULTS: The overall prevalence of MMD was 25% (n = 96), with 67% occurring in males. Among malocclusions, MMD prevalence was 42% in Class I, 32% in Class II, and 26% in Class III. MMD size distribution was 0.5–1 mm (18%), 1–2 mm (38%), and >2 mm (44%). A new shape-based classification identified trapezoidal (44%), triangular (40%), rectangular (12%), inverted triangular (2%), and biconcave (2%) forms. Major contributors included labial frenum elongation (25%), microdontia (19%), and midline shifting (72%). No significant differences in tooth sizes were found between MMD cases and Angle Class I controls (P > 0.05). Differences at the three measurement levels were negligible (P > 0.05) for both gender and malocclusion. CONCLUSION: This study highlights the polygenic nature of MMD and introduces a new shape-based classification. Key predisposing factors, such as midline shift and microdontia, were identified. These findings will guide clinicians in treating patients diagnosed with MMD.
Class III malocclusion in mixed dentition often involves maxillary retrusion. Conventional orthopedic treatments, such as facemask or chin cup therapy, aim to redirect craniofacial growth but frequently cause dentoalveolar compensation and unfavorable vertical changes. Bone-anchored maxillary protraction (BAMP) provides skeletal traction to enhance maxillary advancement while limiting vertical side effects. This review compares the skeletal, dentoalveolar, and soft-tissue outcomes of BAMP versus conventional orthopedic treatment or natural growth in children under 12 years. The protocol was prospectively registered in PROSPERO (CRD420251042103). A systematic search of PubMed, Scopus, Embase, Web of Science, and the Cochrane Library was conducted up to April 2025 following PRISMA 2020 guidelines. Studies evaluating BAMP against conventional Class III therapies or untreated controls in children younger than 12 years were included. Four quantitative and four qualitative studies were synthesized. Risk of bias was assessed using RoB 2.0 and ROBINS-I. Across 116 patients in the quantitative studies, BAMP consistently improved SNA (+1.9° to +6.17°) and ANB (+1.4° to +6.83°), enhanced Wits appraisal, and demonstrated minimal increases in SN-MP angles, indicating superior vertical control. Overjet gains (+5.97 mm) and stable upper incisor inclination suggested reduced dental compensation. Soft-tissue improvements included enhanced midface projection. The qualitative studies supported these trends. Current evidence indicates that BAMP achieves greater skeletal correction and vertical control with fewer dentoalveolar side effects compared with conventional Class III therapies or observation. Further long-term studies are required.
