Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis
Objective: Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position brought about by functional appliance therapy. Therefore, this systematic review aimed to assess the changes in the cervica...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-07-01
|
| Series: | Journal of Oral Biology and Craniofacial Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212426824000939 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589955110535168 |
|---|---|
| author | Sandhya Murali Annapurna Kannan Vignesh Kailasam |
| author_facet | Sandhya Murali Annapurna Kannan Vignesh Kailasam |
| author_sort | Sandhya Murali |
| collection | DOAJ |
| description | Objective: Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position brought about by functional appliance therapy. Therefore, this systematic review aimed to assess the changes in the cervical spine posture with functional appliance treatment in Skeletal Class II subjects. Methods: A search of studies in six electronic databases - Medline (via Pubmed), the Cochrane Library, OVID, LILACS, Scopus and Web of Science were performed until January 18, 2024 without any restriction in date or language of publication. Eligibility screening, study selection, and data extraction were performed by two reviewers independently. The risk of bias assessment of the included studies was performed with the Newcastle Ottawa scale and Cochrane RoB 2.0. Meta-analysis was performed using random effects model for assessment of changes in the cervical spine with removable and fixed functional appliances. Results: Twelve articles that satisfied the eligibility criteria were included for systematic review and nine articles for meta-analysis. Five studies showed a low risk of bias, one as moderate and six as high risk of bias. GRADE assessment revealed a low quality evidence. Meta-analysis revealed a decrease of the upper cervical inclination by 1.16° (95 % CI of −2.68 to 0.35, I2 = 6 %), an increase of the middle cervical inclination by 2.20° (95 % CI of 0.46–3.94, I2 = 49 %), an increase in cervical curvature angle by 1.60° (95 % CI of 0.12–3.09, I2 = 89 %) and a decrease in cervical lordosis angle by 1.54° (95 % CI of −4.16 to 1.08, I2 = 0 %). Conclusions: Minimal uprighting of the cervical spine was noted with functional appliances. Fixed functional appliances exerted a greater effect than removable functional appliances. Cervical hyperlordosis was reduced with removable functional appliance treatment. Though these changes are minimal, the clinical orthodontist should be aware that functional therapy also influences cervical spine posture. Due to the heterogeneity and low quality of evidence, the results are to be considered critically. |
| format | Article |
| id | doaj-art-06df911c38a34dd7ab315329a38b9067 |
| institution | Kabale University |
| issn | 2212-4268 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Oral Biology and Craniofacial Research |
| spelling | doaj-art-06df911c38a34dd7ab315329a38b90672025-01-24T04:45:06ZengElsevierJournal of Oral Biology and Craniofacial Research2212-42682024-07-01144446454Cervical spine changes with functional appliance treatment: A systematic review and meta-analysisSandhya Murali0Annapurna Kannan1Vignesh Kailasam2Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, IndiaCorresponding author.; Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, IndiaDepartment of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, IndiaObjective: Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position brought about by functional appliance therapy. Therefore, this systematic review aimed to assess the changes in the cervical spine posture with functional appliance treatment in Skeletal Class II subjects. Methods: A search of studies in six electronic databases - Medline (via Pubmed), the Cochrane Library, OVID, LILACS, Scopus and Web of Science were performed until January 18, 2024 without any restriction in date or language of publication. Eligibility screening, study selection, and data extraction were performed by two reviewers independently. The risk of bias assessment of the included studies was performed with the Newcastle Ottawa scale and Cochrane RoB 2.0. Meta-analysis was performed using random effects model for assessment of changes in the cervical spine with removable and fixed functional appliances. Results: Twelve articles that satisfied the eligibility criteria were included for systematic review and nine articles for meta-analysis. Five studies showed a low risk of bias, one as moderate and six as high risk of bias. GRADE assessment revealed a low quality evidence. Meta-analysis revealed a decrease of the upper cervical inclination by 1.16° (95 % CI of −2.68 to 0.35, I2 = 6 %), an increase of the middle cervical inclination by 2.20° (95 % CI of 0.46–3.94, I2 = 49 %), an increase in cervical curvature angle by 1.60° (95 % CI of 0.12–3.09, I2 = 89 %) and a decrease in cervical lordosis angle by 1.54° (95 % CI of −4.16 to 1.08, I2 = 0 %). Conclusions: Minimal uprighting of the cervical spine was noted with functional appliances. Fixed functional appliances exerted a greater effect than removable functional appliances. Cervical hyperlordosis was reduced with removable functional appliance treatment. Though these changes are minimal, the clinical orthodontist should be aware that functional therapy also influences cervical spine posture. Due to the heterogeneity and low quality of evidence, the results are to be considered critically.http://www.sciencedirect.com/science/article/pii/S2212426824000939Orthodontic appliancesCervical spinePostureLordosis |
| spellingShingle | Sandhya Murali Annapurna Kannan Vignesh Kailasam Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis Journal of Oral Biology and Craniofacial Research Orthodontic appliances Cervical spine Posture Lordosis |
| title | Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis |
| title_full | Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis |
| title_fullStr | Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis |
| title_full_unstemmed | Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis |
| title_short | Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis |
| title_sort | cervical spine changes with functional appliance treatment a systematic review and meta analysis |
| topic | Orthodontic appliances Cervical spine Posture Lordosis |
| url | http://www.sciencedirect.com/science/article/pii/S2212426824000939 |
| work_keys_str_mv | AT sandhyamurali cervicalspinechangeswithfunctionalappliancetreatmentasystematicreviewandmetaanalysis AT annapurnakannan cervicalspinechangeswithfunctionalappliancetreatmentasystematicreviewandmetaanalysis AT vigneshkailasam cervicalspinechangeswithfunctionalappliancetreatmentasystematicreviewandmetaanalysis |