Table 4. .

GRADE Evidence: Can the Condylar Position, Articular Disc, and Joint Space of TMJ Be Altered by RME in Growing Patients?

Certainty Assessment							Impact	Certainty	Importance
No. of Studies	Study Design	Risk of Bias	Inconsistency	Indirect Evidence	Inaccuracy	Other Considerations
CHANGES IN CONDYLAR POSITION (randomized)
1	randomized controlled trial	seriousa	not serious	not seriousb	very seriousc	none	RME does not alter the condylar position.	⊕○○○ VERY LOW	CRITICAL
CHANGES IN CONDYLAR POSITION (observational)
4	observational study	serious	not serious	not serious	not serious	none	RME alters the condylar position.	⊕○○○ VERY LOW	CRITICAL
SIGNS OF MANDIBULAR CONDYLE REMODELING
1	observational study	not serious	not serious	not serious	graved	none	RME promotes condylar remodeling.	⊕○○○ VERY LOW	IMPORTANT
CHANGES IN ARTICULAR JOINT SPACE
3	observational study	gravee	not serious	not serious	not serious	none	RME promotes joint space symmetry.	⊕○○○ VERY LOW	CRITICAL
CHANGES IN THE ARTICULAR DISK POSITION
2	observational study	not serious	not serious	not serious	not serious	none	RME does not modify the position of the articular disc.	⊕⊕○○ LOW	CRITICAL
CHANGES IN THE ARTICULAR DISK SHAPE
1	observational study	not serious	not serious	not serious	not serious	none	RME does not modify the shape of the articular disc.	⊕⊕○○ LOW	CRITICAL

^a Serious concern regarding an unclear risk of bias in one article and a high risk in another.

^b The age range of patients could include those who were no longer growing.

^c There was insufficient information about the process of random sequence generation, concealment of allocation, and blinding of outcome assessors.

^d The authors chose to use only one method of visual inspection, not using statistical analysis.

^e Serious concern regarding a high risk of bias in one article.