Treatment effects of Carriere Motion Appliance on patients with class II malocclusion: A systematic review and meta-analysis.

OBJECTIVE

To investigate the treatment effects of Carriere Motion Appliance (CMA) on class II patients.

METHODS

A comprehensive electronic search was performed in PubMed, Scopus, Web of science, ScienceDirect, ProQuest (dissertation and thesis), Google Scholar and ClinicalTrials.gov. All types of clinical trials that contained at least pre- and post-treatment measures of patients treated by CMA were included in this systematic review and meta-analysis. The risk of bias was assessed for all included studies. The considered outcomes were the skeletal, dento-alveolar, soft tissues, temporomandibular joint and airway changes, electromyographic activity and stability.

RESULTS

Sixteen studies were included in this systematic review and meta-analysis. The absence of randomized controlled trials which could induce confounding and selection of participant bias is considered the main risk of bias affecting the available studies. Regarding the skeletal changes, no significant effects were appreciated (changes in SNB angle; SMD=-0.13; 95% CI (-0.57, 0.31); P=0.58. Changes in SN-MP; SMD=-0.11; 95% CI (-0.54, 0.33); P=0.64). With respect to the dento-alveolar changes, an increased lower incisor's proclination (L1-MP) was observed; SMD=-0.69; 95% CI (-1.14, -0.24); P=0.003. CMA caused an increase in the airway volume, an increase in the masseter and temporalis muscles activities and a minor relapse of malocclusion after 4-years of follow-up. The results should be taken with caution because only secondary level of evidence was found.

CONCLUSIONS

The CMA used for the treatment of class II malocclusion did not cause skeletal changes; however, largely dento-alveolar effects were noticed. Prospective randomized clinical trials are highly recommended.