Table 2.

Certainty assessment (GRADE tool) for the evaluation of skeletal, soft facial features, and dental arched morphology outcomes.

Outcome; Number of Participants (Studies)	Relative Effect (95% CI)	Certainty	What Happens
Skeletal features; 315 (6 observational studies)	Not estimable	⊕⊕◯◯ LOWa	Three studies found differences in the cephalometric features of children with OSA compared to a control group. Two studies reported a class II skeletal pattern and a vertical craniofacial growth tendency in the OSA group. One study also reported an inferiorly positioned hyoid in the OSA group.
Soft facial features; 59 (1 observational study)	Not estimable	⊕⊕⊕◯ MODERATEb	OSA probably results in little to no difference in soft facial features.
Dental arches morphology; 109 (2 observational studies)	Not estimable	⊕⊕◯◯ LOWa	Children with OSA may present little to no difference in dental arches morphology.

^aOverlap among CIs was observed across studies. ^bOnly 1 study was included and presented a wide variation among CIs. CI = confidence interval, GRADE = Grading of Recommendations, Assessment, Development and Evaluations, OSA = obstructive sleep apnea. Very low = The true effect is probably markedly different from the estimated effect, Low = The true effect might be markedly different from the estimated effect, Moderate = The authors believe that the true effect is probably close to the estimated effect, High = The authors have a lot of confidence that the true effect is similar to the estimated effect.