Effectiveness and Clinical Indications of 2 × 4 Fixed Orthodontic Therapy in Regard to Mixed Dentition: A Systematic Review

Background/Objectives: This systematic review examines the effectiveness and clinical indications of the 2 × 4 fixed orthodontic appliance for interceptive treatment in children with mixed dentition, aiming to simplify future orthodontic needs. Methods: Following the PRISMA guidelines, a search was...

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Main Authors: Gianna Dipalma, Grazia Marinelli, Lucia Casamassima, Paola Nardelli, Danilo Ciccarese, Paolo De Sena, Francesco Inchingolo, Vito Crincoli, Andrea Palermo, Ioana Roxana Bordea, Andrea Carbonara, Angelo Michele Inchingolo, Alessio Danilo Inchingolo
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/7/897
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Summary:Background/Objectives: This systematic review examines the effectiveness and clinical indications of the 2 × 4 fixed orthodontic appliance for interceptive treatment in children with mixed dentition, aiming to simplify future orthodontic needs. Methods: Following the PRISMA guidelines, a search was conducted across PubMed, Web of Science, and Scopus (May 2000–May 2025). The inclusion criteria focused on open-access, in vivo/human studies, case–control studies, cohort studies, and RCTs in English. Risk of bias was assessed using Rob 2.0. Results: Out of 362 initial records, 7 studies were included. Most of the included studies showed a low risk of bias, with some moderate risk in terms of confounding variables and participant selection, but no high risk was identified. Conclusions: The 2 × 4 fixed orthodontic appliance is an effective interceptive therapy for mixed dentition. Clinicians can optimize outcomes by understanding its biomechanics and clinical applications. Further research is needed to understand long-term impacts and improve efficiency.
ISSN:2227-9067