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Meta-Analysis
. 2014 Dec 2;15(1):62.
doi: 10.1186/s40510-014-0062-9.

Clinical effectiveness of chin cup treatment for the management of Class III malocclusion in pre-pubertal patients: a systematic review and meta-analysis

Maria I Chatzoudi, Ioulia Ioannidou-Marathiotou, Moschos A Papadopoulos
Meta-Analysis

Clinical effectiveness of chin cup treatment for the management of Class III malocclusion in pre-pubertal patients: a systematic review and meta-analysis

Maria I Chatzoudi et al. Prog Orthod. .

Abstract

Background: Chin cup is regarded as the oldest orthodontic appliance for the management of Class III malocclusion. To assess its clinical effectiveness in pre-pubertal patients, a meta-analysis on specific cephalometric values is attempted.

Methods: Detailed electronic and hand searches with no restrictions were performed up to July 2014. Only randomized controlled trials (RCTs) and cohort studies, i.e. prospective controlled trials (pCCTs) and (retrospective) observational studies (OS), were included. Analyses were performed by calculating the standard difference in means and the corresponding 95% confidence intervals, using the random effects model. Data heterogeneity and risk of bias assessment of the included studies were also performed. Study selection, data extraction and risk of bias assessment were performed twice. The level of significance was set at P ≤ 0.05 for all tests, except for heterogeneity (P ≤ 0.1).

Results: Seven treated groups from five studies (no RCTs, four pCCTs, one OS) were eligible for inclusion, assessing only the short-term occipital pull chin cup effects. In total, 120 treated patients (mean age: 8.5 to 11 years) compared with 64 untreated individuals (mean age: 7.3 to 9.89 years) were assessed by means of 13 cephalometric variables. The overall quality of these studies was low to medium. In comparison to untreated individuals, the SNB and gonial angles decreased significantly following chin cup use, whereas ANB, Wits appraisal, SN-ML, N-Me and overjet increased. For the rest of the variables, no statistically significant differences were detected.

Conclusions: Although the occipital chin cup affects significantly a number of skeletal and dentoalveolar cephalometric variables, indicating an overall positive effect for the treatment of Class III malocclusion, data heterogeneity and between-studies variance impose precaution in the interpretation of the results.

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Figures

Figure 1
Figure 1
Flow diagram of the retrieved studies through the selection process.
Figure 2
Figure 2
Cephalometric variables examined in current investigation.
Figure 3
Figure 3
Forest plot of the cephalometric variable SNA.
Figure 4
Figure 4
Forest plot of the cephalometric variable SNB.
Figure 5
Figure 5
Forest plot of the cephalometric variable ANB.
Figure 6
Figure 6
Forest plot of the cephalometric variable Wits appraisal.
Figure 7
Figure 7
Forest plot of the cephalometric variable Co-Gn.
Figure 8
Figure 8
Forest plot of the cephalometric variable Co-Go.
Figure 9
Figure 9
Forest plot of the cephalometric variable Gonial angle.
Figure 10
Figure 10
Forest plot of the cephalometric variable N-Me.
Figure 11
Figure 11
Forest plot of the cephalometric variable UFH.
Figure 12
Figure 12
Forest plot of the cephalometric variable LAFH.
Figure 13
Figure 13
Forest plot of the cephalometric variable SN-ML.
Figure 14
Figure 14
Forest plot of the cephalometric variable overjet.
Figure 15
Figure 15
Forest plot of the cephalometric variable overbite.
See this image and copyright information in PMC

References

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    1. Chang HP, Lin HC, Liu PH, Chang CH. Geometric morphometric assessment of treatment effects of maxillary protraction combined with chin cup appliance on the maxillofacial complex. J Oral Rehabil. 2005;32:720–28. doi: 10.1111/j.1365-2842.2005.01504.x. - DOI - PubMed
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