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Background <p>While mandibular advancement aligners (MAAs) have emerged as a treatment option for skeletal Class II malocclusions, their comparative efficacy versus conventional functional appliances remains to be fully established.</p> Methods <p>This systematic review followed PRISMA guidelines, searching PubMed and Cochrane Library databases using the PICO framework. Included studies were evaluated for quality and risk of bias according to their respective designs.</p> Results <p>Analysis of 13 eligible studies revealed: Comparable effectiveness in mandibular advancement (mean difference: 0.8&#xa0;mm, p = 0.12). Similar improvements in ANB angle (mean reduction: 1.5° ± 0.3). Equivalent oropharyngeal space gains (+ 3.2&#xa0;mm average). Notable differences included: Greater vertical dimension changes with conventional appliances (p &lt; 0.05). Significantly higher patient preference (78%) and compliance rates with MAAs. However, the current evidence is limited by the retrospective design of most studies, small sample sizes, and variability in outcome measures. These methodological heterogeneities prevented the performance of a meta-analysis and restrict the generalizability of the findings.</p> Conclusion <p>MAAs demonstrate clinically similar dentoalveolar effects and airway improvements compared to conventional functional appliances, while offering superior patient comfort. Although their skeletal impact may be slightly less pronounced, MAAs represent an effective and patient-friendly alternative for managing growing Class II malocclusions.</p> <p><i>Clinical trial number</i> PROSPERO registration number: CRD42024622119.</p>

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Comparative efficacy of mandibular advancement aligners and conventional orthopedic appliances in treating class II malocclusion: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月13日

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  • Fatima Salek,
  • Hicham Benyahia,
  • Fatima Zaoui

摘要

Background

While mandibular advancement aligners (MAAs) have emerged as a treatment option for skeletal Class II malocclusions, their comparative efficacy versus conventional functional appliances remains to be fully established.

Methods

This systematic review followed PRISMA guidelines, searching PubMed and Cochrane Library databases using the PICO framework. Included studies were evaluated for quality and risk of bias according to their respective designs.

Results

Analysis of 13 eligible studies revealed: Comparable effectiveness in mandibular advancement (mean difference: 0.8 mm, p = 0.12). Similar improvements in ANB angle (mean reduction: 1.5° ± 0.3). Equivalent oropharyngeal space gains (+ 3.2 mm average). Notable differences included: Greater vertical dimension changes with conventional appliances (p < 0.05). Significantly higher patient preference (78%) and compliance rates with MAAs. However, the current evidence is limited by the retrospective design of most studies, small sample sizes, and variability in outcome measures. These methodological heterogeneities prevented the performance of a meta-analysis and restrict the generalizability of the findings.

Conclusion

MAAs demonstrate clinically similar dentoalveolar effects and airway improvements compared to conventional functional appliances, while offering superior patient comfort. Although their skeletal impact may be slightly less pronounced, MAAs represent an effective and patient-friendly alternative for managing growing Class II malocclusions.

Clinical trial number PROSPERO registration number: CRD42024622119.