Summary of findings for the main comparison. Surgical anchorage compared to conventional anchorage for patients undergoing orthodontic treatment.
| Surgical anchorage compared to conventional anchorage for patients undergoing orthodontic treatment | ||||||
| Patient or population: patients undergoing orthodontic treatment Settings: orthodontic clinics in university settings or specialist practice Intervention: surgical anchorage (mini‐screw or mid‐palatal implant) Comparison: conventional anchorage | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Conventional anchorage | Surgical anchorage | |||||
| Mesiodistal movement of the upper first permanent molar | The mean mesiodistal movement of the upper first permanent molar ranged across control groups from 1.47 to 3.22 mm | The mean mesiodistal movement of the upper first permanent molar in the intervention groups was 1.68 mm lower (2.27 to 1.09 lower) | 308 (7 studies) | ⊕⊕⊕⊝ moderate1, 2 | Lower scores indicates less movement (greater reinforcement of anchorage). A change of 1.5 mm or greater is clinically important | |
| Duration of overall treatment (months) | The mean duration of overall treatment was 2.23 years (SD 0.62) | The mean duration of overall treatment (months) in the intervention group was 0.15 years shorter (0.37 years shorter to 0.07 years longer) | 111 (3 studies) | ⊕⊕⊝⊝ low3,4 | Lower scores indicate a shorter duration of overall treatment Duration estimated using a standardised mean difference of –0.25 (‐0.62 to 0.12)5 |
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| Adverse events | This outcome was unreported in all included studies | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) CI: confidence interval; SD: standard deviation | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 7 studies at overall high (1), unclear (5) and low (1) risk of bias. Substantial heterogeneity I2 78% although mean difference (MD) of 6/7 studies in favour of surgical intervention
2 Outcome incompletely reported in 2 additional studies at overall high risk of bias (both studies reported in favour of surgical anchorage) and not reported in 1 study at overall high risk of bias
3 Small studies likely underpowered; imprecision of result
4 2 studies at unclear risk of bias, 1 study at high risk of bias
5 Representative study to re‐express standardised mean difference in years (Chesterfield 2007)