Assessment of short-term skeletal and dental effects of mandibular advancement with aligners in class II patients

Aim: This systematic review and meta-analysis aimed to assess the short term skeletal and dental effects of clear aligners with mandibular advancement feature (CAMA) in class II malocclusion due to mandibular retrognathism. Methods: An electronic data search was performed without any restriction in the year of publication in five search engines. Data were extracted and Newcastle–Ottawa Scale for observational studies was used to assess the risk of bias. As necessary, statistical heterogeneity was examined, random effects model was used in meta-analyses and parameters assessed by meta-analysis across studies were graded for quality of evidence. Results: Seven retrospective and five prospective studies were included. Five studies had low risk, two had moderate and five had high risk of bias. There was a significant increase in mandibular length following CAMA therapy. There was no significant difference in the skeletal changes brought about by twin block and CAMA. There was no significant change in maxillary and mandibular incisor inclination after twin block or CAMA therapy. Conclusion: It can be concluded that CAMA promoted mandibular growth, but it was not significantly greater than twin block. There was no difference in the maxillary and mandibular incisor inclination with twin block or CAMA therapy.